[A case of pleomorphic xanthoastrocytoma].

A case of pleomorphic xanthoastrocytoma (Kepes) is reported. This patient was a 12-year-old boy with a history of convulsive seizure. Neurological examination on admission showed no abnormality. Plain CT scan revealed a well defined low density area with calcification in the right frontal lobe. A part of peripheral portion of low density area were well enhanced with contrast media. At operation, there was a cyst containing xanthochromic fluid in the right frontal lobe. A part of cyst well near the cerebral surface was reddish hard. Total removal of nodular tumor and subtotal removal of the cyst wall were performed. He has been doing well for these 3 years following craniotomy and has no deficit without CT evidence of recurrent tumor. Histologically the tumor cells displayed marked pleomorohism. However either necrosis or mitosis were not seen. Frequently these cells had vacuolated or foamy cytoplasm. There were many of the giant cells and multinucleated cells. In some area, these tumor cells were surrounded by a fine network of reticulin fibers. Electron microscopically the tumor cells were occasionally filled with glial filament and lipid granules were seen. Immunoperoxidase technique revealed GFAP in the cytoplasm of the tumor cells. This case was considered to be pleomorphic xanthoastrocytoma first proposed by Kepes.