PT  - JOURNAL ARTICLE
AU  - Cortez, Gustavo M
AU  - Monteiro, Andre
AU  - Ludwig, Benjamin
AU  - Hanel, Ricardo
TI  - Reappraisal of haemorrhagic suprasellar pilocytic astrocytoma during adulthood
AID  - 10.1136/bcr-2020-235662
DP  - 2020 Oct 01
TA  - BMJ Case Reports
PG  - e235662
VI  - 13
IP  - 10
4099  - http://casereports.bmj.com/content/13/10/e235662.short
4100  - http://casereports.bmj.com/content/13/10/e235662.full
SO  - BMJ Case Reports2020 Oct 01; 13
AB  - Pilocytic astrocytomas comprise the most common central nervous system tumour during childhood and have an excellent response to surgical treatment in this population. The tumour incidence decreases with age, whereas more aggressive behaviour tends to increase. Haemorrhage as a presenting feature of pilocytic astrocytomas is a rare phenomenon, especially in the adult population. We present a case of a 55-year-old patient with progressive headaches and dizziness. MRI confirmed a sellar and predominantly retrochiasmal suprasellar lesion with heterogeneous signal, enhancement and blood products. Management via transsphenoidal approach was performed, and histopathology revealed the unexpected diagnosis of haemorrhagic pilocytic astrocytoma. Haemorrhagic pilocytic astrocytoma is an infrequent entity in the adult population and it is essential to recognise the peculiarities regarding diagnostic evaluation and management, which differ from the paediatric population. During adulthood, this tumour carries an overall unfavourable prognosis, with higher rates of progression and recurrence.