Juvenile pilocytic astrocytoma in association with arteriovenous malformation

Soltanolkotabi, M.; Schoeneman, S. E.; Dipatri, A. J.; Hurley, M. C.; Ansari, S. A.; Rajaram, V.; Tomita, T.; Shaibani, A.

Interv Neuroradiol. 2012 Jun 12; 18(2):140-7


Pilocytic astrocytomas are highly vascular, relatively common primary brain tumors in the pediatric population, but their association with a true arteriovenous malformation (AVM) is extremely rare. We describe an eight-year-old girl with a right supratentorial juvenile pilocytic astrocytoma (WHO grade I) with an angiographically documented AVM entangled in the tumor mass who presented with intracranial hemorrhage due to a ruptured anterior choroidal artery pseudoaneurysm encased in the lesion. The AVM nidus as well as the hemorrhage site was embolized with Onyx. A literature review revealed only one previous report of a true intermixture of these two lesions. We hypothesize whether the association of vascular malformations and primary brain tumors are merely coincidental or if they point to the existence of a distinct entity and/or a common etiologic factor.

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