Pilocytic Astrocytoma with Massive Microcalcification in a Child: A Tumor with Excellent Prognosis

Mazaher  Ramezani; Masoud  Sadeghi

doi:10.18502/ijpho.v16i3.21756

Mazaher Ramezani Molecular Pathology Research Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
Masoud Sadeghi Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran

DOI: https://doi.org/10.18502/ijpho.v16i3.21756

Keywords: Child, Calcification; Pilocytic astrocytoma

Abstract

Background: Pilocytic astrocytoma (PA) is the most common primary astroglial neoplasm in children and adolescents. Massive calcification is a rare feature of PA and may complicate radiologic and pathologic diagnosis. Herein, we report a case of PA with extensive microcalcification in western Iran.

Case Presentation: A 12-year-old boy presented with a two-year history of headache and vomiting that had worsened during the previous 15 days. Physical examination revealed a conscious and hemodynamically stable patient with no focal neurologic deficits. Histopathologic examination demonstrated a fascicular and microcystic tumor composed of cells with oval to spindle-shaped nuclei and bipolar cytoplasmic processes within a fibrillary matrix. Hyalinized arborizing ectatic vessels, Rosenthal fibers, and extensive areas of microcalcification were also identified.

Conclusion: Calcification is an uncommon feature of PAs and may create diagnostic challenges for radiologists and pathologists. Calcified PAs may occur at any age, with an approximately equal male-to-female ratio. Headache, vomiting, seizures, and visual disturbances are among the most common presenting symptoms in patients with calcified PA.