Composite pleomorphic xanthoastrocytoma and ganglioglioma: Report of four cases and review of the literature

Arie Perry, Caterina Giannini, Bernd W. Scheithauer, Amyn Mohammed Rojiani, Anthony T. Yachnis, In S. Seo, Peter C. Johnson, Jennie Kho, Scot Shapiro

Research output: Contribution to journalArticlepeer-review

89 Scopus citations


Composite pleomorphic xanthoastrocytoma (PXA)-ganglioglioma (GG) is a rare recently described entity. Only three examples have been documented, one of which showed evidence of malignant transformation. We report an additional four cases and update the literature. With the exception of an 82-year-old man, all patients have been under 30 years of age. The temporal lobe was involved in three cases and cerebellum in another three. Radiologic features were those common to PXA and GG. Histologically, all were 'collision tumors' composed of abutting, although spatially distinct, PXA and GG components. In two cases, the second element was only recognized at reexcision or recurrence. Histologic anaplasia, always in the PXA component, was evident as brisk mitotic activity and/or necrosis in five cases. Of the seven patients, one died of disease 17 years after the onset of seizures and after multiple recurrences, the last of which largely resembled glioblastoma. We conclude that the composite PXA-GG is a rare neoplasm that shares many features of its individual components. In addition to its temporal lobe predilection, the cerebellum is frequently affected. As when it occurs in isolation, the PXA component of composite PXA-GG possesses the potential for malignant transformation.

Original languageEnglish (US)
Pages (from-to)763-771
Number of pages9
JournalAmerican Journal of Surgical Pathology
Issue number7
StatePublished - Oct 7 1997
Externally publishedYes


  • Anaplasia Immunohistochemistry
  • Collision tumor
  • Ganglioglioma
  • Glioneuronal neoplasm
  • Pleomorphic xanthoastrocytoma

ASJC Scopus subject areas

  • Anatomy
  • Pathology and Forensic Medicine


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