RT Journal Article
SR Electronic
T1 Reappraisal of haemorrhagic suprasellar pilocytic astrocytoma during adulthood
JF BMJ Case Reports
JO BMJ Case Reports
FD BMJ Publishing Group Ltd
SP e235662
DO 10.1136/bcr-2020-235662
VO 13
IS 10
A1 Cortez, Gustavo M
A1 Monteiro, Andre
A1 Ludwig, Benjamin
A1 Hanel, Ricardo
YR 2020
UL http://casereports.bmj.com/content/13/10/e235662.abstract
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.