Granular cell astrocytoma: report of a case and review of the literature.

A 54-year-old man with no remarkable past medical history was referred to our hospital for the appearance of generalized tonic clonic seizures with loss of consciousness, preceded by phosphenes at the right eye. On magnetic resonance imaging, a contrast-enhanced tumor in the left occipital lobe with peripheral edema was noted. He underwent craniotomy, and the entire mass was removed. Microscopic examination revealed infiltrative atypical astrocytes (glial fibrillary acidic protein, GFAP, positive) with discrete borders and granular cytoplasm. Ki-67 labeling index was 40%. The tumor was diagnosed as a high-grade granular cell astrocytoma (GCA). Postoperative radiotherapy combined with temozolomide was administered. GCAs are aggressive lesions and should not to be confused with localized, benign granular cell tumors or with other non neoplastic granular cell changes in the central nervous system (CNS). GCAs are rare tumors. At this time, only 63 supratentorial/ hemispheric cases, including our case, have been reported in literature.