Primary Cerebellar Pilocytic Astrocytoma With Anaplastic Features in a Patient With Neurofibromatosis Type 1 -Case Report-

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  • TSUDA Kyoji
    Department of Neurosurgery, Graduate School of Comprehensive Human Sciences, University of Tsukuba
  • ISHIKAWA Eiichi
    Department of Neurosurgery, Graduate School of Comprehensive Human Sciences, University of Tsukuba
  • SAITO Atsushi
    Department of Neurosurgery, Graduate School of Comprehensive Human Sciences, University of Tsukuba Department of Neurosurgery, Mito Saiseikai General Hospital
  • SATOMI Kaishi
    Department of Diagnostic Pathology, Graduate School of Comprehensive Human Sciences, University of Tsukuba
  • SAKATA Akiko
    Department of Diagnostic Pathology, Graduate School of Comprehensive Human Sciences, University of Tsukuba
  • TAKANO Shingo
    Department of Neurosurgery, Graduate School of Comprehensive Human Sciences, University of Tsukuba
  • MORISHITA Yukio
    Department of Diagnostic Pathology, Graduate School of Comprehensive Human Sciences, University of Tsukuba
  • NOGUCHI Masayuki
    Department of Diagnostic Pathology, Graduate School of Comprehensive Human Sciences, University of Tsukuba
  • MATSUMURA Akira
    Department of Neurosurgery, Graduate School of Comprehensive Human Sciences, University of Tsukuba

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  • —Case Report—

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A 70-year-old woman with neurofibromatosis type 1 (NF-1) presented with a primary cerebellar pilocytic astrocytoma (PA) with anaplastic features manifesting as worsening headache and ataxia. Magnetic resonance (MR) imaging on admission showed a diffusely enhanced solid mass in the left cerebellar hemisphere, although MR imaging showed no abnormalities 2 years before admission. Histological examination after gross total removal of the tumor exhibited a biphasic pattern with marked Rosenthal fibers, together with some malignant features including frequent mitoses and invasive growth pattern. The final diagnosis was PA with anaplastic features. Previous PA cases with mitotic activity and endothelial proliferation, and/or palisading necrosis have been classified as anaplastic PA (or PA with anaplastic features). In the present case, the tumor histology corresponded to this designation. The present case indicates that PAs with anaplastic features can occur in patients with NF-1.<br>

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