title: Pleomorphic xanthoastrocytoma: report of six cases with special consideration of diagnostic and therapeutic pitfalls.
abstract: BACKGROUND
  Pleomorphic xanthoastrocytoma (PXA) is a rare clinicopathologic entity that occurs typically in young patients. Improved neuroradiologic techniques, especially gadolinium-enhanced magnetic resonance imaging (MRI), reveal a characteristic tumor appearance.
  
  
  METHODS
  We present six cases of PXA operated on with unusual clinical course, elucidating different clinical implications.
  
  
  RESULTS
  Two patients showed subsequent progression into a malignant glioma, one case was a primary anaplastic PXA. The latter case had not previously been reported in the literature. Increased mitotic activity seems to indicate a worse clinical course; whereas focal infiltration of the brain does not necessarily lead to malignant transformation.
  
  
  CONCLUSIONS
  Surgical removal is the treatment of choice. A consequent follow-up is mandatory in order to detect a potentially malignant recurrence as early as possible and to select patients who need additional therapy.
authors.affiliation: Department of Neurosurgery, University of Würzburg, Germany.
authors.forename: J C
authors.initials: JC
authors.lastname: Tonn
authors.forename: W
authors.initials: W
authors.lastname: Paulus
authors.forename: M
authors.initials: M
authors.lastname: Warmuth-Metz
authors.forename: W
authors.initials: W
authors.lastname: Schachenmayr
authors.forename: N
authors.initials: N
authors.lastname: Sörensen
authors.forename: K
authors.initials: K
authors.lastname: Roosen
mesh_terms: D000293:Adolescent; D000328:Adult; D001254:Astrocytoma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D014057:Tomography, X-Ray Computed