Intraventricular WHO Grade 3 Pleomorphic Xanthoastrocytoma: A Rare Case Report and Review of the Literature
Bibliographic record
Abstract
Background: Cerebral pleomorphic xanthoastrocytoma (PXA) in patients with Neurofibromatosis Type 1 (NF1) is truly a rare entity. Intraventricular anaplastic PXA (APXA) is an even more uncommon presentation, with only three cases reported in the literature. Case Description: We present the case of a 30‐year‐old female with known NF1 who developed an intraventricular WHO Grade 3 PXA. The tumor was initially resected but recurred aggressively, requiring further surgery and adjuvant therapy with radiation, lomustine, and bevacizumab. Despite treatment, the tumor continued to progress, and the patient’s clinical course deteriorated. Discussion: Distinguishing Grade 3 PXA from epithelioid glioblastoma can be diagnostically challenging and often requires further molecular testing. Aggressive multimodal therapy including maximal safe resection, radiation, and chemotherapy may be warranted, but outcomes remain poor. The challenging location of this patient’s tumor in the ventricular system added to the complexity of overall treatment. Furthermore, the association of WHO Grade 3 PXA with NF1 is exceedingly rare, and the optimal management and prognosis of this rare tumor in the setting of NF1 are not well established. Conclusions: This case report highlights the unique challenges in diagnosing and managing intraventricular WHO Grade 3 PXA, particularly in the context of NF1. Additional research is necessary to enhance the understanding and effective management of these rare and aggressive tumors.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.007 | 0.005 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".