Anaplastic pilocytic astrocytoma (APA) is an exceptionally rare type of high-grade glioma in adults. Establishing histopathological diagnosis is challenging and its clinical and radiological appearance insidious. By this case series and first literature review we investigated the various clinical, neuroradiological, and histopathological features of APA in adults. 3 new cases with APA in adults diagnosed at our institution over the last decade and provide a first review of the current clinical, histopathological, and neuroradiological literature to update the reader’s knowledge about APA.

A screening of our in hospital database from the institute of Pathology was performed to identify adult patients with APA. The need for ethical approval was waived by the institutional review board due to sole case reporting setting of the study.  An in hospital screening of the database from the Institute of Pathology was conducted to identify cases of APA. Further, we performed a literature review in PubMed using the keywords “anaplastic/malignant/atypical AND pilocytic astrocytoma” and “anaplastic astrocytoma/glioblastoma AND Rosenthal fibers” and summarized the current knowledge about APA in adults.

Over the last decade we were able to identify 3 adult patients with APA in our hospital. According to the pertinent literature, the prognosis of APA in adults (documented survival of up to 10 years) appears to be better than in other high-grade gliomas. Few cases were associated with neurofibromatosis type 1, which seems to predispose for development of APA. Although molecular genetics is still of limited value for differentiation of APA from other high-grade glioma, advanced neuroimaging techniques such as magnetic resonance perfusion imaging and spectroscopy allow improved differential work-up. In particular, APA in adults has the ability to mimic various neurological diseases such as tumefactive demyelinating lesions, low-, or high-grade gliomas.

Although currently not explicitly recognized as a distinct clinico-pathologic entity it seems that adult APA behaves differently from conventional high-grade glioma and should be included in differential diagnostics to enable adequate patient care. However, further studies are needed to better understand this extremely rare disease.

You can submit your research work through online at https://bit.ly/3k7QUiv

Media contact:

Christina

Editorial Assistant

Mail Id: cellsignaling@emedicalsci.com

Journal of Cell Signaling.