A Rare Presentation Of Giant Pediatric Pilomyxoid Astrocytoma Involved In The Sellar Region: Case Report And Literature Review

Pilomyxoid astrocytoma (PMA) is a rare malignant tumor with a poor prognosis and a high incidence of dissemination in children. We present a case of an unusual giant pediatric PMA with unique clinical imaging. A 13-month-old female presented with three months of nystagmus and developmental retardation. Magnetic resonance imaging (MRI) showed the size of the tumor was approximately 4.5x4.2x4.0 cm(3), and there was significant enhancement with an abundant blood supply. Three-dimensional printing (3D-P) of the tumor demonstrated that the bilateral anterior cerebral arteries and the anterior communicating artery were completely wrapped by this giant tumor. Subsequently, the patient underwent total resection with good recovery with the assistance of 3D-P. The presumed diagnosis of the lesion was suprasellar germinoma or craniopharyngioma, however, postoperative histopathological examination identified it as being a rare PMA. Uncommon PMA with unique clinical features should be emphasized as differential diagnosis in the sellar region. 3D-P is a safe and effective tool for successful treatment of a rare hypervascular PMA.