Astrocytoma with pilomyxoid features presenting in an adult

Pilomyxoid histology is presently considered to occur in pediatric brain tumors. We report an astrocytoma with pilomyxoid features presenting in an adult and discuss its relationship to both the established childhood pilomyxoid astrocytoma (PMA) and recently reported tanycytoma. A 28-year-old man with medically intractable seizures presented for surgical evaluation. MRI revealed a discrete lesion in the right amygdala/uncus region. The patient elected for craniotomy with stereotactic temporal lobe resection and excision of the lesion. Postoperatively, the patient has done well. At 30-month follow up, he is seizure free and without evidence of tumor recurrence. We report an astrocytoma with pilomyxoid features presenting in an adult, illustrating that while this histological pattern is most commonly seen in children, it may also affect older individuals. Recognition of this enigmatic pattern in adult gliomas expands the currently accepted epidemiology for this lesion.