Takita Hirotaka, Shimono Taro, Nakajo Kosuke, Ichinose Tsutomu, Tanaka Sayaka, Hirato Junko, Ikota Hayato, Pas Maciej, Sakamoto Haruna, Hiramatsu Shodai, Miki Yukio
Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan.
Department of Neurosurgery, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan.
Radiol Case Rep. 2025 May 6;20(7):3565-3569. doi: 10.1016/j.radcr.2025.04.036. eCollection 2025 Jul.
Pleomorphic xanthoastrocytoma (PXA) is a rare astrocytic tumor. According to the 2021 World Health Organization (WHO) classification of central nervous system (CNS) tumors, PXAs with 5 or more mitoses per 10 high-power fields are classified as CNS WHO grade 3. Imaging findings of PXA CNS WHO grade 3 have rarely been reported, and thalamic cases are particularly uncommon. We present a case of thalamic PXA CNS WHO grade 3. A 71-year-old male presented with progressive right hemiparesis over three months. Magnetic resonance imaging (MRI) revealed a mass lesion in the left thalamus. Due to rapid tumor growth causing obstructive hydrocephalus, he underwent urgent craniotomy for tumor resection. Histopathology confirmed a PXA CNS WHO grade 3. Postoperatively, the patient received 54 Gy of radiation therapy in 27 fractions. His right hemiparesis persisted. He was subsequently transferred to a rehabilitation hospital.
多形性黄色星形细胞瘤（PXA）是一种罕见的星形细胞肿瘤。根据2021年世界卫生组织（WHO）中枢神经系统（CNS）肿瘤分类，每10个高倍视野中有5个或更多有丝分裂的PXA被分类为CNS WHO 3级。CNS WHO 3级PXA的影像学表现鲜有报道，丘脑病例尤为罕见。我们报告一例丘脑CNS WHO 3级PXA病例。一名71岁男性在三个月内出现进行性右半身轻瘫。磁共振成像（MRI）显示左丘脑有一肿块病变。由于肿瘤快速生长导致梗阻性脑积水，他接受了紧急开颅肿瘤切除术。组织病理学证实为CNS WHO 3级PXA。术后，患者接受了27次分割的54 Gy放射治疗。他的右半身轻瘫持续存在。随后他被转至康复医院。
