星形母细胞瘤是一种罕见的肿瘤，其特征是局限性神经胶质肿瘤，最常见于年龄较大儿童的额顶叶大脑半球。我们报告了一个有趣的病例，即在全切除和放射治疗 21 年后星形母细胞瘤复发。一名 32 岁的右利手女性因全身强直阵挛性癫痫发作到急诊室就诊。她有双相情感障碍、顽固性偏头痛病史，之前曾因星形母细胞瘤切除过 3 次而癫痫发作。本次就诊的磁共振成像显示复发病灶最大直径增长至 3.8 厘米。使用语音映射和 5-氨基乙酰丙酸 (5-ALA) 进行左侧清醒开颅手术以切除肿瘤。肿瘤的下一代靶向测序揭示了框内 MN1::BEND2 融合转录本。我们发现 5-ALA 可用于星形母细胞瘤患者，以协助全切除，这对于长期生存很重要。我们的星形母细胞瘤病例表现出经典的星形母细胞瘤形态，具有典型的血管周围星形母细胞玫瑰花结，并且在给予 5-ALA 后发出明亮的荧光。

Astroblastoma is a rare neoplasm characterized as a circumscribed glial neoplasm most often arising in the frontoparietal cerebral hemispheres in older children.We report an intriguing case of an astroblastoma recurrence 21 years after gross-total resection and radiation. A 32-year-old right-handed female presented to the emergency department for a generalized tonic-clonic seizure. She had a history of bipolar disorder, intractable migraines, and prior seizures linked to an astroblastoma previously resected three times. Magnetic resonance imaging on the current visit showed growth of the recurrent lesion to a 3.8-cm maximal diameter. Left-sided awake craniotomy was performed to remove the tumor while using speech mapping and 5-aminolevulinic acid (5-ALA). Targeted next-generation sequencing of the tumor revealed in-frame MN1::BEND2 fusion transcripts.We found that 5-ALA can be used in astroblastoma patients to assist in gross-total resection, which is important for long-term survival. Our astroblastoma case demonstrated classic astroblastoma morphology, with typical perivascular astroblastic rosettes, and was brightly fluorescent after 5-ALA administration.