title: Spontaneous intratumoural and intraventricular haemorrhage associated with a pilomyxoid astrocytoma in the hypothalamic/chiasmatic region.
abstract: Pilomyxoid astrocytoma (PMA) is a rare, low-grade glioma that is recognised as a variant of pilocytic astrocytoma. There have been few reports on this pathologic entity presenting with spontaneous haemorrhage. In this study, we report a rare case of PMA in the hypothalamic/chiasmatic region presenting with intratumoural and intraventricular haemorrhage. An external ventricular drain was urgently inserted. A ventriculo-peritoneal shunt (VP) was undergone 4weeks thereafter. The patient received fractionated Gamma Knife radiosurgery in another hospital 3weeks after the VP shunt. Three months later, subtotal resection of the tumour was performed in our hospital via a pterional approach. The pathological diagnosis was PMA. Postoperatively, no adjuvant therapy was given, and the neurologic deficits were improved. However, the presentation of endocrine deficits remained. Notably, PMAs in the hypothalamic/chiasmatic region presenting with massive intratumoural and intraventricular haemorrhage may result in a severe condition and long-term impairment of endocrine function. Long-term follow-up is required to monitor the recurrence of the tumour and endocrinopathy.
authors.affiliation: Department of Neurosurgery, Wei Fang People's Hospital, 151 Guangwen Street, Weifang 261041, China.
authors.forename: Zhe
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Neurosurgery, Wei Fang People's Hospital, 151 Guangwen Street, Weifang 261041, China. Electronic address: golf0705@163.com.
authors.forename: Hong-Mei
authors.initials: HM
authors.lastname: Yan
authors.affiliation: Department of Neurosurgery, Wei Fang People's Hospital, 151 Guangwen Street, Weifang 261041, China.
authors.forename: Xiu-Rong
authors.initials: XR
authors.lastname: Zhou
authors.affiliation: Department of Neurosurgery, Wei Fang People's Hospital, 151 Guangwen Street, Weifang 261041, China.
authors.forename: Jin-Kai
authors.initials: JK
authors.lastname: Liu
authors.affiliation: Department of Neurosurgery, Wei Fang People's Hospital, 151 Guangwen Street, Weifang 261041, China.
authors.forename: Jian-Yong
authors.initials: JY
authors.lastname: Chang
authors.affiliation: Department of Neurosurgery, Wei Fang People's Hospital, 151 Guangwen Street, Weifang 261041, China.
authors.forename: Yu-Ting
authors.initials: YT
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D001254:Astrocytoma / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D002552:Cerebral Ventricles / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D004322:Drainage; D006801:Humans; D007029:Hypothalamic Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D020300:Intracranial Hemorrhages / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D016634:Radiosurgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D017287:Ventriculoperitoneal Shunt
keywords: Haemorrhage; Hypothalamic/chiasmatic region; Pilomyxoid astrocytoma; Treatment