Learning objectives
Our purpose is to illustrate and describe the radiological appearance of hypothalamic/chiasmatic pilocytic astrocytoma in adult population,
describing typical and atypical imaging findings with computed tomography (CT) and magnetic resonance imaging (MRI).
Background
We report 3 cases of adult cerebral pilocytic astrocytomas,
two of them young adults,
presenting with severe headache,
nausea and vomitting.
Non-contrast computed tomography (CT) and magnetic resonance imaging (MRI) with gadolinium were performed,
revealing acute intratumoral hemorrhage.
Findings and procedure details
Case 1
A 28-year-old woman with no past medical history presented to the emergency department with 10 days of headache accompanied with blurred vision.
Firstly,
a non-contrast CT was performed,
revealing a hyperdense nodular lesion in the supraselar/chiasmatic region.
Secondly,
computed tomographic angiography did not show any vascular abnormality or enhancement.
The patient was transferred to neurosurgery service with a suspected supraselar tumor.
Magnetic resonance imaging (MRI) of the head demostrated a well-defined supraselar mass with involvement of the optic chiasm,
spreading along the right...
Conclusion
Although often being highly vascular tumors,
the presentation of cerebral pilocytic astrocytomas with intracranial hemorrhage is extremely rare,
nevertheless,
it should be considered during differential diagnosis of intracerebral hemorrhages in that location.
References
1.
Kim SM,
Kim SW,
Chang CH,
Kim OL.
Cerebellar pilocytic astrocytomas with spontaneous intratumoral hemorrhage in adult.
J Korean Neurosurg Soc.
2011;49:363-6.
2.
Lones MA,
Verity MA.
Fatal hemorrhage in a cerebral pilocytic astrocytoma-adult type.
Acta Neuropathol.
1991;81:688-90
3.
Koeller KK,
Rushing EJ.
From the archives of the AFIP: pilocytic astrocytoma: radiologic-pathologic correlation.
Radiographics.
2004;24:1693-708
4.
Galgano MA,
Padalino DJ,
Fullmer J,
Krishnamurthy S.
Hemorrhagic pilocytic astrocytomas in Adults: a case report and literature review.
2016;8:510