title: Late sequelae of treated pleomorphic xanthoastrocytoma: malignant brain stem astrocytoma occurring 15 years after radiation therapy.
abstract: The pleomorphic xanthoastrocytoma (PXA) is a unique astrocytic neoplasm with an unexpectedly favorable prognosis despite striking pleomorphism of the cellular constituents. Although a majority of patients experience extended survival, these tumors may recur and some cases progress to high-grade astrocytoma. Recurrence inevitably involves the anatomic vicinity of the primary tumor. In this report, we describe a malignant brain stem astrocytoma that occurred 15 years after surgery and radiation treatment of a 16-year-old patient who had a temporal lobe PXA. To our knowledge, this is the first reported case of a malignant astrocytoma arising outside the primary anatomic site of a previously treated PXA and likely represents a radiation-induced secondary neoplasm.
authors.affiliation: Section of Neuropathology, University of Texas M.D. Anderson Cancer Center, Houston, USA.
authors.forename: G N
authors.initials: GN
authors.lastname: Fuller
authors.forename: S E
authors.initials: SE
authors.lastname: Kaba
authors.forename: L E
authors.initials: LE
authors.lastname: Ginsberg
authors.forename: I E
authors.initials: IE
authors.lastname: McCutcheon
authors.forename: L A
authors.initials: LA
authors.lastname: Langford
mesh_terms: D000293:Adolescent; D000927:Anticonvulsants / Q000627:therapeutic use; D001254:Astrocytoma / Q000000981:diagnostic imaging / Q000473:pathology* / Q000532:radiotherapy*; D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000532:radiotherapy*; D001933:Brain Stem / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D008297:Male; D009460:Neurologic Examination; D010672:Phenytoin / Q000627:therapeutic use; D011859:Radiography; D012640:Seizures / Q000150:complications / Q000188:drug therapy; D013702:Temporal Lobe / Q000000981:diagnostic imaging / Q000473:pathology
chemical_list: D000927:Anticonvulsants; D010672:Phenytoin