Unusual early recurrence of a cerebellar pilocytic astrocytoma following complete surgical resection

Sioutos, Panayiotis J.; Hamilton, Allan J.; Narotam, Pradeep K; Weinand, Martin E.

doi:10.1007/bf00177442

Cited by 8 publications

(2 citation statements)

References 29 publications

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“…No statistical difference in survival has been noted in patients who have undergone resection of the cyst wall compared with those in which the cyst is left alone (53). Direct neurosurgical evaluation of the extent of resection is surprisingly unreliable, and postoperative contrast-enhanced cross-sectional imaging, preferably MR imaging, is essential for definitive assessment (4,68,73,74).…”

Section: Therapymentioning

confidence: 99%

From the Archives of the AFIP

Koeller¹,

Rushing²

2004

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Pilocytic astrocytoma is the most common pediatric central nervous system glial neoplasm and the most common pediatric cerebellar tumor. This tumor has a noteworthy benign biologic behavior that translates into an extremely high survival rate-94% at 10 years-that is by far the best of any glial tumor. Most patients present in the first 2 decades, and clinical symptoms and signs are usually of several months duration and directly related to the specific location of the tumor. The cerebellum, optic nerve and chiasm, and hypothalamic region are the most common locations, but the tumor can also be found in the cerebral hemisphere, ventricles, and spinal cord. Surgical resection is the treatment of choice for all tumors, except for those involving the optic pathway and hypothalamic region, which may be treated with radiation therapy and chemotherapy. Cross-sectional imaging often demonstrates a classic appearance: a cystic mass with an enhancing mural nodule. Less common appearances are quite nonspecific. Surrounding vasogenic edema is rarely present, and this feature provides a valuable clue to the correct diagnosis. Accurate interpretation of imaging studies plays an essential role in directing treatment of these tumors, particularly when they arise in the optic pathway of patients with neurofibromatosis type 1. Disseminated disease and recurrence are extremely rare.

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Section: Therapymentioning

confidence: 99%

From the Archives of the AFIP

Koeller¹,

Rushing²

2004

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“…Studies showed that direct neurosurgical evaluation of the extent of resection was surprisingly unreliable, and postoperative, contrast-enhanced, cross-sectional imaging, preferably MRI, was essential for definitive assessment. [142022] Complete resection led to a better outcome, with most of the patients showing clinical improvement, and there was no Inpatient or late mortality. This showed the curative potential of resection, with no identifiable tumor left behind, as shown by other studies.…”

Section: Discussionmentioning

confidence: 99%

Clinical review of pediatric pilocytic astrocytomas treated at a tertiary care hospital in Pakistan

Khan¹,

Godil²,

Tabani³

et al. 2012

Surg Neurol Int

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Background:Pilocytic Astrocytoma (PA) is a common type of brain tumor in the pediatric population. They have a fairly good prognosis. This study describes PAs in detail, with a focus on the demographic factors, presenting features, management and prognosis, and aims, to identify the negative outcome predictors in our population, which can affect the course of the disease. This article will add to the understanding of PAs from a third world perspective.Methods:The Aga Khan University medical records (1995 – 2007) were reviewed, to study the clinical features, management, and outcome of patients (0 – 15 years) with Pilocytic Astrocytomas (PAs) in our population. After a thorough review of the medical records, all the PAs diagnosed on the basis of histopathology at our Pathology Laboratory, during this period, were included in the study.Results:Twenty-two patients were included with a mean age of 9.25 years. Male-to-female ratio was 1 : 1. The most common presenting feature was a sign of increased intracranial pressure. The most common location was the cerebellum followed by the cerebrum. Fifteen patients underwent maximum surgical resection. Three had recurrence, despite no residual tumor. There were 10 Intensive Care Unit (ICU) admissions and one inpatient mortality. Fifteen patients followed up in the clinic: Eight had recurrence and four underwent repeat surgery (three showed clinical improvement). Hydrocephalus was a predictor of ICU admission. Solid consistency was found to be a marker of recurrence.Conclusion:Pilocytic Astrocytomas are the most common pediatric brain tumors in our population, commonly located in the cerebellum. Complete resection is the best treatment option, but some tumors are aggressive and recurrence is not uncommon. The possible negative outcome predictors are age, source of admission, extent of resection, hydrocephalus, and solid consistency.

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Malignant pilocytic astrocytoma in the medulla oblongata: case report

1999

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A 27-year-old woman visited our hospital with chief complaints of abducens nerve palsy and cerebellar symptoms. On computerized tomographic scanning and magnetic resonance imaging, a tumor with strong enhancement was found on the dorsal side of the medulla oblongata. A tumor was excised by suboccipital craniotomy and C1 laminectomy. Histologically, many Rosenthal fibers together with pilocytic tumor cells were found in some regions, but a very high Ki-67 labeling rate accompanied by cells with nuclei of irregular size and giant cells was observed in other regions. The tumor was diagnosed as malignant pilocytic astrocytoma originating from pilocytic astrocytoma by transformation. The biological behavior of pilocytic astrocytoma is obscure in several respects. We report our experience of a case of malignant pilocytic astrocytoma that developed in the brain stem and progressed extremely rapidly.

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Unusual early recurrence of a cerebellar pilocytic astrocytoma following complete surgical resection

Cited by 8 publications

References 29 publications

From the Archives of the AFIP

From the Archives of the AFIP

Clinical review of pediatric pilocytic astrocytomas treated at a tertiary care hospital in Pakistan

Malignant pilocytic astrocytoma in the medulla oblongata: case report

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