Anaplastic Pleomorphic Xanthoastrocytoma With Long-term Survival: An Autopsy Case Report

Abstract Background: The survival rate of anaplastic pleomorphic xanthoastrocytoma (APXA) is not well established due to the limited number of cases, but a few reports have suggested that the 5-year overall survival rate for APXA patients isaround 50%. We herein report an autopsy case of an APXA patient who survived 30 years after her rst surgery.Case presentation: A 37-year-old woman initially underwent total resection of a right temporal lobe tumor. The primary diagnosis at that time was grade II-III astrocytoma. Postoperative radio-chemotherapy was completed and follow-up was stopped after 22 years of no recurrence. However, 30 years after the initial treatment, the patient returned presenting with deterioration in consciousness. Magnetic resonance imaging revealed multiple heterogeneously enhanced tumors. A diagnosis of APXA was reached after a reevaluation of the initial resected specimens. She died four months after the recurrence. An autopsy revealed that the recurrence was glioblastoma multiforme.Conclusion: To our knowledge, this patient is the longest APXA survival case. Autopsy specimens did not indicate local recurrences, which suggested primary lesion control could be associated with survival.