{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T17:51:34Z","timestamp":1791222694644,"version":"4.1.0"},"reference-count":18,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"18","license":[{"start":{"date-parts":[[2024,10,28]],"date-time":"2024-10-28T00:00:00Z","timestamp":1730073600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Cosmet Laser Ther"],"published-print":{"date-parts":[[2024,10,28]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Neuroepithelial tumors with histological features of pilocytic astrocytoma (PA), increased mitotic activity with high-grade features of microvascular proliferation, and palisading necrosis have often been designated as anaplastic PAs. High-grade astrocytoma with piloid features (HGAP) was recently classified as its own entity by the World Health Organization (WHO) in 2021, after being grouped under anaplastic PA. This rare tumor typically arises in the cerebellum. The authors present the case of a patient with HGAP in the conus medullaris, a rare occurrence, with only 17 reported HGAP cases in other parts of the spinal cord.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>An 83-year-old female patient presented with progressive lower-extremity weakness over 2 weeks. Subsequent imaging revealed an intramedullary spinal cord mass near the conus. Histopathological analysis confirmed a neuroepithelial tumor. Chromosomal microarray revealed the diagnosis of HGAP, an exceedingly unusual tumor to be found near the conus. The tumor characteristics showed uniformly low cellularity and low proliferation of medium-sized ovoid cells with elongated nuclei, embedded in a loose pilocytic matrix.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>This report presents the case of a patient with HGAP in the conus medullaris, a new WHO diagnosis that needs to be included in the differential diagnosis for conus masses.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE24390\">https:\/\/thejns.org\/doi\/10.3171\/CASE24390<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case24390","type":"journal-article","created":{"date-parts":[[2024,10,28]],"date-time":"2024-10-28T02:44:14Z","timestamp":1730083454000},"source":"Crossref","is-referenced-by-count":5,"title":["High-grade astrocytoma with piloid features in the conus medullaris: a rare presentation of a new World Health Organization diagnosis. Illustrative case"],"prefix":"10.3171","volume":"8","author":[{"given":"Brandy","family":"Ndirangu","sequence":"first","affiliation":[{"name":"Emory University School of Medicine, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stewart","family":"Neill","sequence":"additional","affiliation":[{"name":"Department of Pathology, Emory University School of Medicine, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Cory Adamson","sequence":"additional","affiliation":[{"name":"Georgia Neurosurgical Institute, Macon, Georgia"},{"name":"Mercer University School of Medicine, Macon, Georgia"},{"name":"Neurosurgery Section, Atlanta VA Healthcare System, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"1","key":"bib1","series-title":"J Spine Surg","first-page":"19","article-title":"Adult intradural intramedullary astrocytomas: a multicenter analysis","volume":"5","author":"Khalid","year":"2019","unstructured":"Khalid SKelly RCarlton A, et al. Adult intradural intramedullary astrocytomas: a multicenter analysis. J Spine Surg. 2019;5(1):19-30."},{"issue":"9","key":"bib2","series-title":"Acta Neurochir (Wien)","first-page":"2453","article-title":"The WHO 2021 classification of central nervous system tumours: a practical update on what neurosurgeons need to know\u2014a minireview","volume":"164","author":"Torp","year":"2022","unstructured":"Torp SHSolheim OSkjulsvik AJ. The WHO 2021 classification of central nervous system tumours: a practical update on what neurosurgeons need to know\u2014a minireview. Acta Neurochir (Wien). 2022;164(9):2453-2464."},{"key":"bib3","series-title":"World Neurosurg X","first-page":"100016","article-title":"Case report of spinal cord astrocytoma presenting with extensive spinal vertebral body destruction","volume":"2","author":"Tadele","year":"2019","unstructured":"Tadele AWoodraw SJohnson MD. Case report of spinal cord astrocytoma presenting with extensive spinal vertebral body destruction. World Neurosurg X. 2019;2:100016."},{"issue":"2","key":"bib4","series-title":"Acta Neuropathol","first-page":"273","article-title":"Anaplastic astrocytoma with piloid features, a novel molecular class of IDH wildtype glioma with recurrent MAPK pathway, CDKN2A\/B and ATRX alterations","volume":"136","author":"Reinhardt","year":"2018","unstructured":"Reinhardt AStichel DSchrimpf D, et al. Anaplastic astrocytoma with piloid features, a novel molecular class of IDH wildtype glioma with recurrent MAPK pathway, CDKN2A\/B and ATRX alterations. Acta Neuropathol. 2018;136(2):273-291."},{"issue":"1","key":"bib5","series-title":"Acta Neuropathol","first-page":"71","article-title":"Expanded analysis of high-grade astrocytoma with piloid features identifies an epigenetically and clinically distinct subtype associated with neurofibromatosis type 1","volume":"145","author":"Cimino","year":"2023","unstructured":"Cimino PJKetchum CTurakulov R, et al. Expanded analysis of high-grade astrocytoma with piloid features identifies an epigenetically and clinically distinct subtype associated with neurofibromatosis type 1. Acta Neuropathol. 2023;145(1):71-82."},{"issue":"2","key":"bib6","series-title":"Radiol Oncol","first-page":"97","article-title":"Diffusion differences between pilocytic astrocytomas and grade II ependymomas","volume":"45","author":"Pavlisa","year":"2011","unstructured":"Pavlisa GPavlisa GRados M. Diffusion differences between pilocytic astrocytomas and grade II ependymomas. Radiol Oncol. 2011;45(2):97-101."},{"issue":"1","key":"bib7","series-title":"J Neurooncol","first-page":"109","article-title":"High-grade astrocytoma with piloid features (HGAP): the Charit\u00e9 experience with a new central nervous system tumor entity","volume":"153","author":"Bender","year":"2021","unstructured":"Bender KPerez EChirica M, et al. High-grade astrocytoma with piloid features (HGAP): the Charit\u00e9 experience with a new central nervous system tumor entity. J Neurooncol. 2021;153(1):109-120."},{"issue":"4","key":"bib8","series-title":"AJNR Am J Neuroradiol","first-page":"468","article-title":"High-grade astrocytoma with piloid features: a dual institutional review of imaging findings of a novel entity","volume":"45","author":"Soni","year":"2024","unstructured":"Soni NAgarwal AAjmera P, et al. High-grade astrocytoma with piloid features: a dual institutional review of imaging findings of a novel entity. AJNR Am J Neuroradiol. 2024;45(4):468-474."},{"issue":"suppl","key":"bib9","series-title":"Neuro-Oncology","first-page":"v244","article-title":"QLTI-01. High-grade astrocytoma with piloid features response to treatment with carboplatin and vincristine","volume":"25","author":"Cielo","year":"2023","unstructured":"Cielo B. QLTI-01. High-grade astrocytoma with piloid features response to treatment with carboplatin and vincristine. Neuro-Oncology. 2023;25(suppl 5):v244-v245."},{"issue":"1","key":"bib1","series-title":"J Spine Surg","first-page":"19","article-title":"Adult intradural intramedullary astrocytomas: a multicenter analysis","volume":"5","author":"Khalid","year":"2019","unstructured":"Khalid SKelly RCarlton A, et al. Adult intradural intramedullary astrocytomas: a multicenter analysis. J Spine Surg. 2019;5(1):19-30."},{"issue":"9","key":"bib2","series-title":"Acta Neurochir (Wien)","first-page":"2453","article-title":"The WHO 2021 classification of central nervous system tumours: a practical update on what neurosurgeons need to know\u2014a minireview","volume":"164","author":"Torp","year":"2022","unstructured":"Torp SHSolheim OSkjulsvik AJ. The WHO 2021 classification of central nervous system tumours: a practical update on what neurosurgeons need to know\u2014a minireview. Acta Neurochir (Wien). 2022;164(9):2453-2464."},{"key":"bib3","series-title":"World Neurosurg X","first-page":"100016","article-title":"Case report of spinal cord astrocytoma presenting with extensive spinal vertebral body destruction","volume":"2","author":"Tadele","year":"2019","unstructured":"Tadele AWoodraw SJohnson MD. Case report of spinal cord astrocytoma presenting with extensive spinal vertebral body destruction. World Neurosurg X. 2019;2:100016."},{"issue":"2","key":"bib4","series-title":"Acta Neuropathol","first-page":"273","article-title":"Anaplastic astrocytoma with piloid features, a novel molecular class of IDH wildtype glioma with recurrent MAPK pathway, CDKN2A\/B and ATRX alterations","volume":"136","author":"Reinhardt","year":"2018","unstructured":"Reinhardt AStichel DSchrimpf D, et al. Anaplastic astrocytoma with piloid features, a novel molecular class of IDH wildtype glioma with recurrent MAPK pathway, CDKN2A\/B and ATRX alterations. 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AJNR Am J Neuroradiol. 2024;45(4):468-474."},{"issue":"suppl","key":"bib9","series-title":"Neuro-Oncology","first-page":"v244","article-title":"QLTI-01. High-grade astrocytoma with piloid features response to treatment with carboplatin and vincristine","volume":"25","author":"Cielo","year":"2023","unstructured":"Cielo B. QLTI-01. High-grade astrocytoma with piloid features response to treatment with carboplatin and vincristine. 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