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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 24:1906-1908, October 2003
© 2003 American Society of Neuroradiology

PEDIATRICS

MR Imaging Characteristics of Pilomyxoid Astrocytomas

Atilla Arslanoglu^a, Bayram Cirak^b, Alena Horska^a, James Okoh^e, Tarik Tihan^f, Leslie Aronson^c, Anthony M. Avellino^g, Peter C. Burger^d and David M. Yousem^a

^a Department of Radiology, Johns Hopkins University, Baltimore, MD
^b Department of Neurosurgery, Johns Hopkins University, Baltimore, MD
^c Department of Pediatric Oncology, Johns Hopkins University, Baltimore, MD
^d Department of Pathology, Johns Hopkins University, Baltimore, MD
^e Department of Radiology, Manatee Memorial Hospital, Miami, FL
^f Department of Pathology, University of California, San Francisco, San Francisco, CA
^g Department of Neurosurgery, University of Washington, Seattle, WA

Address correspondence to Atilla Arslanoglu, MD, The Russell H. Morgan Department of Radiology and Radiologic Sciences, Johns Hopkins Medical Institution, 600 N. Wolfe Street, Phipps B-112, Baltimore, MD 21287

BACKGROUND AND PURPOSE: Pilomyxoid astrocytoma (PMA) is a recently described tumor that typically occurs in the chiasmatic-hypothalamic region in young children and has unique histopathologic and clinical characteristics. These tumors have been previously diagnosed as pilocytic astrocytoma (PA). PMA appears to have a higher rate of recurrence and CSF dissemination than typical PA.

METHODS: We analyzed MR findings in four patients with PMA and compared them with those of typical chiasmatic-hypothalamic PA.

RESULTS: MR findings of PMA were chiasmatic or hypothalamic enhancing solid tumor with hydrocephalus, highly homogeneous T2 signal intensity that extended into the deep white and gray matter, and CSF dissemination.

CONCLUSION: Larger series are needed before the MR imaging findings of chiasmatic or hypothalamic enhancing solid tumor with hydrocephalus, highly homogeneous T2 signal intensity extending into the deep white and gray matter, and CSF dissemination can be used in the differential diagnosis of such tumors.