[Muscle atrophy of hand as an initial sign in a patient with protoplasmic astrocytoma: a case report and literature review].

We reported a rare case of protoplasmic astrocytoma presenting small muscle atrophy of the right hand as an initial sign. A 39-year-old male was admitted to hospital complaining of chronic muscle atrophy and subtle headache. Electromyography (EMG) showed brief small denervation and no signs of sensory-motor conduction impairment. CT and MRI revealed multiply expansive intracranial lesion in left hemisphere, which was highly suspected of cerebral echinococcus or Balo disease. The patient underwent surgical excision and pathological report was protoplasmic astrocytoma, with glial fibrillary acidic protein (GFAP, +++) of immunohistochemical method. We reviewed clinical features, radiological manifestations and pathology of protoplasmic astrocytoma with medical literature documents.