Abstract
BACKGROUND: Pleomorphic xanthoastrocytoma (PXA) is a rare central nervous system (CNS) tumor. Clinical manifestations often start with seizures, and the lesions are often located in the superficial parts of the cerebral hemisphere, especially in the temporal lobe. Patients with PXA can be cured via surgical treatment, but whether the seizure can be controlled by simply removing the tumor through surgery still needs to be determined. CASE DESCRIPTION: The patient was a 10-year-old boy with clinical manifestations of recurrent epileptic seizures. Preoperative standardized antiepileptic drug treatment failed to control seizures. The patient's electroencephalogram (EEG) showed was the right temporal lobe is the main slow wave and spike slow wave emitting area, and magnetic resonance imaging (MRI) showed was structural abnormalities in the right anterior temporal cortex. After multidisciplinary preoperative evaluation at the epilepsy center of Tianjin Children's Hospital, lesion enlargement resection was performed with the assistance of multimodal imaging and electrocorticography (ECoG) monitoring. There were no epileptic seizures during the 6-month follow-up after surgery. CONCLUSIONS: For this patient with PXA accompanied by epilepsy, surgical resection can be the first line of treatment. Meanwhile, a comprehensive multidisciplinary preoperative evaluation should be conducted rather than solely relying on neurosurgery to determine surgical treatment. Additionally, imaging and intraoperative ECoG are crucial for the success of surgery and appropriate enlargement and resection can effectively eliminate epileptic seizures.