title: Pleomorphic xanthoastrocytoma of childhood: MR imaging and diffusion MR imaging features.
abstract: OBJECTIVE
  Pleomorphic xanthoastrocytomas are rare astrocytic neoplasms of childhood and young adulthood. The purpose of this retrospective review was to evaluate MR imaging features of pediatric pleomorphic xanthoastrocytomas with an emphasis on diffusion MR imaging.
  
  
  METHODS
  Review of the neuro-oncology data base revealed 11 pediatric patients (range, 4.7-16.1 years) with pleomorphic xanthoastroacytomas with 9 of these patients having preoperative MR imaging available. Six patients had preoperative diffusion MR imaging. Demographics, histopathology slides, conventional imaging characteristics (location, cystic component, hemorrhage, enhancement, vasogenic edema, inner table scalloping), and ADC metrics (mean tumor ADC and tumor to normal brain ADC ratio) were evaluated.
  
  
  RESULTS
  Three pleomorphic xanthoastrocytomas had anaplastic features. Ten tumors were supratentorial. Two-thirds (6 of 9) of all tumors were either predominantly cystic or had cystic components, and three-fourths (6 of 8) of the supratentorial tumors had associated inner table scalloping. Seven of the 9 tumors had marked vasogenic edema (>10 mm). Mean tumoral ADC (n = 7) was 912 ± 219 × 10(-6) mm(2)/s (min-max: 617-1189). The tumor to normal brain ADC ratio was 1.14 ± 0.26 (min-max: 0.75-1.47).
  
  
  CONCLUSIONS
  Pleomorphic xanthoastrocytoma should be entertained in the differential diagnosis of peripheral supratentorial tumors that appear during childhood. Cysts, inner table scalloping, and marked vasogenic edema are relatively frequent features. Relatively low ADC values and ADC ratios are not uncommon in pleomorphic xanthoastrocytoma.
authors.affiliation: From the Departments of Radiology (W.M., K.K.).
authors.forename: W
authors.initials: W
authors.lastname: Moore
authors.affiliation: Pathology (D.M., L.M.).
authors.forename: D
authors.initials: D
authors.lastname: Mathis
authors.affiliation: Neuro-Oncology (L.G.), Children's Medical Center, Dallas, Texas.
authors.forename: L
authors.initials: L
authors.lastname: Gargan
authors.affiliation: Pediatrics (D.C.B., L.J.K.), University of Texas Southwestern Medical Center, Dallas, Texas Pediatrics (D.C.B., L.J.K.).
authors.forename: D C
authors.initials: DC
authors.lastname: Bowers
authors.affiliation: Pediatrics (D.C.B., L.J.K.), University of Texas Southwestern Medical Center, Dallas, Texas Pediatrics (D.C.B., L.J.K.).
authors.forename: L J
authors.initials: LJ
authors.lastname: Klesse
authors.affiliation: Pathology (D.M., L.M.) Pathology (L.M.).
authors.forename: L
authors.initials: L
authors.lastname: Margraf
authors.affiliation: From the Departments of Radiology (W.M., K.K.) Departments of Radiology (K.K.) korgun.koral@utsouthwestern.edu.
authors.forename: K
authors.initials: K
authors.lastname: Koral
mesh_terms: D000293:Adolescent; D001254:Astrocytoma / Q000473:pathology*; D001921:Brain / Q000473:pathology; D001932:Brain Neoplasms / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D059906:Neuroimaging; D012189:Retrospective Studies; D015173:Supratentorial Neoplasms / Q000473:pathology*