Massive Calcified Cerebellar Pilocytic Astrocytoma with Rapid Recurrence : A Rare Case

Abstract

Pilocytic astrocytomas (PAs) are World Heath Organization Grade I tumors and are most common in children. PA calcification is not a common finding and has been reported more frequently in the optic nerve, hypothalamic/thalamus and superficially located cerebral tumors. We present a cerebellar PA in a 3-year-old male patient with cystic components and massive calcification areas. The residual tumor grew rapidly after the first operation, and the patient was operated on again. A histopathological examination revealed polar spongioblastoma-like cells. Massive calcification is not a common feature in PAs and can lead to difficulties in radiological and pathological differential diagnoses.

An elderly case of malignant small cell glioma with hemorrhage coexistent with a calcified pilocytic astrocytoma component in the cerebellar hemisphere

“…Generally, calcification is observed in slowly growing gliomas and is recognized as a sign of degenerative status. Conversely, the aggressive clinical course of calcified cerebellar PA has been reported previously . Thus, our extremely rare case is instructive to show that careful follow‐up is necessary even for calcified PAs.…”

Calcified Pilocytic Astrocytomas and Calcifying Pseudoneoplasms of the Neuraxis: A Diagnostic Challenge

“…Calcium deposits take a long time to form, which explains why calcifications appear more frequently in slow-growing glial tumors. The rate of calcification in glial tumors ranges from 9.3% to 19%, and up to 25% of PAs have calcification, though only four cases of extensive massive calcification associated with PA have been reported [ 1 , 10 ]. Eosinophilic granular bodies (EGBs) from globular aggregates with astrocyte processes and the granular material that calcifies and mineralizes can be found within these tumors.…”

“…While calcification is more commonly regarded as a feature of benign or slow-growing tumors, the detailed original mechanism remains unclear [5]. A few cases of calcified pilocytic astrocytoma (CPA) have been published as case reports [10][11][12]. Although calcification is not common, it has been reported more frequently in the optic nerve, hypothalamus, and thalamus, as well as in superficially located cerebellar tumors.…”