Introduction: To report the unusal case of an 83-year-old male patient diagnosed with a left frontal angiocentric glioma. Description of our rare clinical case. Furthermore, a thorough review of the literature was performed with the purpose of updating and summarizing the main clinical, radiological and pathological features of this rare tumor.

Case report: An 83-year-old male patient presented at our institution complaining of a 1-month history of progressive weakness of his right-hand and difficulty performing fine movements. Brain MRI revealed a T2-hyperintense diffuse cortico-subcortical lesion was reported. We performed a neuronavigation-guided frontal craniotomy, with motor cortex mapping and subtotal resection. Pathology report described astrocitary neoplastic cells affecting mainly the cortex and piamater with the classic finding of subpial palisading, with no endothelial invasion or atypia. Neoplastic cells were positive for GFAP, EMA, WT-1, P16 and P53. Low proliferative activity was seen (Ki-67 < 2%). Some gliovascular structures were also reported. Considering the morphologic and immunohistochemical data, final pathologic diagnosis was angiocentric glioma. Literature review yielded only one previous case of a 70-year-old patient diagnosed with angiocentric glioma, among a total of 15 cases.

Discussion: We present a unique case of an elderly patient with a left frontal lobe tumor that displayed histopathologic features consistent with angiocentric glioma, a rare entity, described for the first time in 2005. Even though this tumor is commonly seen in children and young patients, elderly patients may present with this tumor, but may show slight differences in their clinical course in comparison with their pediatric counterparts.