Hemorrhagic astroblastoma: atypical presentation of a rare tumor. Illustrative case

Zumaeta J.; Martinez R.; Rea N.S.; Anicama-Lima W.E.; Casavilca-Zambrano S.; Valerio J. · Journal of Neurosurgery: Case Lessons (2025) · DOI: 10.3171/case24486

Resumen

BACKGROUND Astroblastoma is an extremely rare tumor of the central nervous system, and its origin and validity as a different entity are still being debated. Because of its rarity and similarities to other glial neoplasms, it is often misdiagnosed, impacting treatment and outcomes. OBSERVATIONS Astroblastoma is very rare and mainly affects children and young adults. It does not have a definitive World Health Organization grade and is divided into low-and high-grade categories. The clinical presentation is consistent with signs of intracranial hypertension. Radiographic imaging shows a bubbly, solid-cystic supratentorial mass with irregular contrast enhancement. The case reported herein is unusual because the intratumoral hemorrhage caused compression and midline shift, requiring urgent surgery. LESSONS Astroblastoma with intratumoral hemorrhage is atypical and is associated with high-grade tumors. Managing severe intracranial hypertension requires emergency surgery to prevent fatalities. Treatment can include adjunctive chemotherapy and radiation therapy based on the extent of tumor resection.