Summary
The authors reviewed 5 cases of histopathologically verified malignant cerebellar astrocytic tumours (2 anaplastic astrocytomas and 3 glioblastomas) in children admitted to our department. All cases exhibited symptoms and signs of increased intracranial pressure and of a cerebellar lesion. Brain stem symptoms were present in 4 cases. All of the tumours were located in or near the midline of the cerebellum with no large cyst. Surgical removal (70 to 90% removal) of the tumour was performed in 4 cases. In one case only a biopsy was done. Even with subsequent follow-up treatment including radiotherapy, chemotherapy, and/or immunotherapy, the course of the disease could not be reversed, and all of the children died 3 to 13 months (mean 7 months) after admission due to tumour re-growth or recurrence. Tumour dissemination along the walls of the ventricular system was seen in 2 cases, and was considered to be a peculiar, fatal form of tumour recurrence in patients with this type of tumour. Malignant cerebellar astrocytic tumours in children have an extremely poor prognosis. Until, improved therapy is available to counteract this tragic consequence, it will remain so.
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References
Alpers CE, Davis RL, Wilson CB (1982) Persistence and late malignant transformation of childhood cerebellar astrocytoma. Case report. J Neurosurg 57: 548–551
Auer RN, Rice GPA, Hinton GG, Amacher AL, Gilbert JJ (1981) Cerebellar astrocytoma with benign histology and malignant clinical course. J Neurosurg 54: 128–132
Bernell WR, Kepes JJ, Seitz ER (1972) Late malignant recurrence of childhood cerebellar astrocytoma. Report of two cases. J Neurosurg 37: 470–474
Bloom HJG (1986) Treatment of brain gliomas in children. In: Bleehen NM (ed) Tumours of the brain. Springer, Berlin Heidelberg New York Tokyo, pp 121–140
Bruno L, Schut L, Bruce DA (1982) Cerebellar astrocytoma. In: Section of Pediatric Neurosurgery of the American Association of Neurological Surgeons (eds) Pediatric neurosurgery. Surgery of the developing nervous system. Grune & Stratton, New York, pp 367–374
Budka H (1975) Partially resected and irradiated cerebellar astrocytoma of childhood: malignant evolution after 28 years. Acta Neurochir (Wien) 32: 139–146
Chin HW, Maruyama Y, Tibbs P, Markesbery W, Young B (1984) Cerebellar glioblastoma in childhood. J Neuro-Oncol 2: 79–84
The Committee of Brain Tumor Registry in Japan (1987) Brain Tumor Registry in Japan, Vol 6. National Cancer Center, Tokyo, p 49
Cushing H (1931) Experiences with the cerebellar astrocytomas. Surg Gynec Obstet 52: 129–204
Georges PM, Noterman J, Flament-Durand J (1983) Glioblastoma of the cerebellum in children and adolescents. J NeuroOncol 1: 275–278
Ilgren EB, Stiller CA (1986) Cerebellar astrocytomas: Therapeutic management. Acta Neurochir (Wien) 81: 11–26
Ilgren EB, Stiller CA (1987) Cerebellar astrocytomas. Clinical characteristics and prognostic indices. J Neuro-Oncol 4: 293–308
Jacobi G, Kornhuber B (1987) Malignant brain tumors in children. In: Jellinger K (ed) Therapy of malignant brain tumors. Springer, Wien New York, pp 396–493
Kitaoka K, Tashiro K, Abe H, Tsuru M (1980) A clinical survey of cerebellar astrocytoma—Comparison between childhood and adult cases. No Shinkei Geka 8: 55–64
Klein DM, McCullough DC (1985) Surgical staging of cerebellar astrocytomas in childhood. Cancer 56: 1810–1811
Kleinman GM, Scoene WC, Walshe TM III, Richardson EP Jr (1978) Malignant transformation in benign cerebellar astrocytoma. Case report. J Neurosurg 49: 111–118
Lapras C, Patet JD, Lapras Jr Ch, Mottolese C (1986) Cerebellar astrocytomas in childhood. Child's Nerv Syst 2: 55–59
Laws Jr ER, Bergstrahl EJ, Taylor WF (1987) Cerebellar astrocytoma in children. Prog Exp Tumor Res 30: 122–127
Levin SA, McKeever PE, Greenberg HS (1987) Primary cerebellar glioblastoma multiforme. J Neuro-Oncol 5: 231–236
Matson DD (1969) Neurosurgery of infancy and childhood, ed 2. Springfield, CC Thomas, pp 410–479
Oi S, Raimondi AJ (1983) Brain tumors in infants and childrenFactors affecting prognosis—(Part 2) Location and prognosis of astrocytoma. No Shinkei Geka 11: 1049–1057
Rubinstein LJ (1972) Tumors of the central nervous system, Fasc 6: In: Atlas of tumor pathology. Washington DC, Armed Forces Institute of Pathology, pp 19–50
Russell DS, Rubinstein LJ (1977) Pathology of tumours of the nervous system, ed 4. Edward Arnold, London, pp 183–190
Steinberg GK, Shuer LM, Conley FK, Hanbery JW (1985) Evolution and outcome in malignant astroglial neoplasms of the cerebellum. J Neurosurg 62: 9–17
Tsuchida T, Fukuda M, Tanaka R (1982) Long term results of cerebellar astrocytoma with special reference to operative procedure and radiotherapy. Neurol Med Chir (Tokyo) 22: 117–124
Yamada S, Aiba T, Hara M (1986) Primary glioblastoma multiforme of the cerebellum. Report of two cases and review of the literature. Neurol Med Chir (Tokyo) 26: 233–239
Yoshioka S, Matsukado Y, Uemura S, Nagahiro N, Kuratsu J, Kajiwara H, Ohtsuka T (1985) Does the cerebellar astrocytoma always show good outcome? Clinicopathological analysis of 13 cases. Shoni no Noshinkei [Proceeding of the 13rd Congress of the Japanese Society for Pediatric Neurosurgery in Tsukuba ]: pp 82–83
Zito JL, Siva A, Smith TW, Leeds M, Davidson R (1983) Glioblastoma of the cerebellum. Computed tomographic and pathologic considerations. Surg Neurol 19: 373–378
Zülch KJ (1986) Brain tumors. Their biology and pathology, ed 3. Springer, Berlin Heidelberg New York Tokyo, pp 221–232
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Shinoda, J., Yamada, H., Sakai, N. et al. Malignant cerebellar astrocytic tumours in children. Acta neurochir 98, 1–8 (1989). https://doi.org/10.1007/BF01407169
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DOI: https://doi.org/10.1007/BF01407169