A right occipital lobe Grade II PXA in a 25-year-old male with a predominantly solid mass without cystic changes. (A,B) Contrast-enhanced axial and coronal T1WI showing marked enhancement of the solid component. (C) Photomicrography of the tumor showing marked cellular pleomorphism with spindle cells, multinucleated giant cells containing bizarre nuclei, and lipid-filled xanthomatous cells. Mitotic activity and necrosis were not present (H&E, ×400). (D,E) Molecular detection showing the IDH1/2 mutations not detected.