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

Case report and review of the literature

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Summary

Pilocytic cerebellar astrocytomas are usually benign tumors with generally an excellent prognosis following complete surgical resection. The goal of surgery is total resection to minimize the risk of recurrence. In this case report, a 5-year old boy who had undergone total resection of a posterior fossa pilocytic cerebellar astrocytoma (as documented by a contrast-enhanced computed tomography (CT) scan within 24 hours following surgery), developed a massive recurrence of the tumor within four months. Both the initial histology and the sections examined after the second resection revealed features typical for a pilocytic astrocytoma with no suspicion of malignancy. This case is unusual in that it is contrary to other reports suggesting that CT-documented complete surgical resection of pilocytic astrocytomas is without recurrence, and suggests the need for vigilant radiographic and clinical follow-up of these patients even if apparent complete resection of the tumor has been achieved.

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References

  1. Winston K, Gilles FH, Leviton A, Fulchiero A: Cerebellar gliomas in children. J Natl Cancer Inst 58: 833–838,1977

    Google Scholar 

  2. Hayostek CJ, Shaw EG, Scheithauer B, O'Fallon JR, Weiland TL, Schomberg PJ, Kelly PJ, Hu TC: Astrocytomas of the cerebellum. A comparative clinicopathologic study of pilocytic and diffuse astrocytomas. Cancer 72: 856–869,1993

    Google Scholar 

  3. Geissinger JD, Bucy PC: Astrocytomas of the cerebellum in children. Long-term study. Arch Neurol 24:125–135,1971

    Google Scholar 

  4. Gol A, Mokissock W: The cerebellar astrocytoma. A report of 98 verified cases. J Neurosurg 16: 287–296,1959

    Google Scholar 

  5. Zimmerman RA, Bilaniuk CT, Bruno LO, Rosenstock J: Computed tomography of cerebellar astrocytoma. Am J Roentgenol 130: 929–933,1978

    Google Scholar 

  6. Austin EJ, Alvord EC Jr.: Recurrences of cerebellar astrocytomas: a violation of Collins' Law. J Neurosurg 68: 41–47, 1988

    Google Scholar 

  7. Cushing H: Experiences with the cerebellar astrocytomas. A critical review of seventy-six cases. Surg Gynecol Obstet 52:129–204,1931

    Google Scholar 

  8. Davis CH, Joglekar VM: Cerebellar astrocytomas in children and young adults. J Neurol Neurosurg Psychiatry 44: 820–828,1981

    Google Scholar 

  9. Schneider JH Jr., Raffel C, McComb JG: Benign cerebellar astrocytomas of childhood. Neurosurgery 30: 58–63,1992

    Google Scholar 

  10. Shapiro K, Katz M: The recurrent cerebellar astrocytoma. Childs Brain 10:168–176,1983

    Google Scholar 

  11. Tsuchida T, Fukuda M, Tanaka R: Long term results of Cerebellar astrocytoma with special reference to operative procedure and radiotherapy. Neurol Med Chir 22:117–124,1982 (Jpn)

    Google Scholar 

  12. Palma L. Guidetti B: Cystic pilocytic astrocytomas of the cerebral hemispheres. Surgical experience with 51 cases and long-term results. J Neurosurg 62: 811–815,1985

    Google Scholar 

  13. Wallner KE, Gonzales MF, Edwards MSB, Wara WM, Sheline GE: Treatment results of juvenile pilocytic astrocytoma. J Neurosurg 69: 171–176, 1988

    Google Scholar 

  14. Casadei GP, Arrigoni GL, D'Angelo V, Bizzozero L: Late malignant recurrence of childhood cerebellar astrocytoma. Clin Neuropathol 9: 295–298,1990

    Google Scholar 

  15. Favre J, Deruaz JP, de Tribolet N: Pilocytic cerebellar astrocytoma in adults. Case report. Surg Neurol 39:360–364,1993

    Google Scholar 

  16. Kaluza J, Sider B, Danielewicz A, Lesz A, Gruska E: Local and diffuse spread of juvenile cerebellar astrocytoma in subarachnoid space. Light and electron microscopic study. Patologia Polska 42: 27–32,1991

    Google Scholar 

  17. Mishima K, Nakamura M, Nakamura H, Nakamura O, Funata N, Shitara N: Leptomeningeal dissemination of Cerebellar pilocytic astrocytoma. Case report. J Neurosurg 77: 788–291,1992

    Google Scholar 

  18. Pagni CA, Giordana MT, Canavero S: Benign recurrence of a pilocytic astrocytoma 36 years after radical removal. Case report. Neurosurgery 28: 606–609,1991

    Google Scholar 

  19. Schwartz AM, Ghatak NR: Malignant transformation of benign cerebellar astrocytoma. Cancer 65: 333–336,1990

    Google Scholar 

  20. Mamelak AN, Prados MD, Obana WG, Cogen PH, Edwards MSB: Treatment options and prognosis for multicentric juvenile pilocytic astrocytoma. J Neurosurg 81: 24–30, 1994

    Google Scholar 

  21. Akyol FH, Atahan IL, Zorlu F, Gurkaynak M, Alanyali H, Ozyar E: Results of post-operative or exclusive radiotherapy in grade 1 and grade 2 cerebellar astrocytoma patients. Radiother Oncol 23: 245–248,1992

    Google Scholar 

  22. Rostotskaia VI, Vikhert TM, Khukhlaeva EA, Panina T, Namsaraeva GT: The prognostic significance of the histological characteristics of cerebellar astrocytomas in children. Zhurnal Voprosy Neiroknirurgil Imeni N-N- Burdenko: 6–8,1990

  23. Montine TJ, Vandersteenhoven JJ, Aguzzi A, Boyko OB, Dodge RK, Kerns BJ, Burger PC: Prognostic significance of Ki-67 proliferation index in supratentorial fibrillary astrocytoma neoplasms. Neurosurgery 34: 674–679,1994

    Google Scholar 

  24. Sallinen PK, Haapasalo HK, Visakorpi T, Helen PT, Rantala IS, Isola JJ, Helen HJ: Prognostication of astrocytoma patient survival by Ki-67 (MIB-1), PCNA, and S-phase fraction using archival paraffin-embedded samples. J Pathol 174: 275–282,1994

    Google Scholar 

  25. Sutton LN, Molloy PT, Sernyak H, Goldwein J, Phillips PL, Rorke LB, Moshang T Jr., Lange B, Packer RJ: Long-term outcome to hypothalamic/chiasmatic astrocytomas in children treated with conservative surgery. J Neurosurg 83:583–589, 1995

    Google Scholar 

  26. Petronio J, Edwards MSB, Prados M, Freyberger S, Rabbitt J, Silver P, Levin VA: Management of chiasmal and hypothalamic gliomas of infancy and childhood with chemotherapy. J Neurosurg 74:701–708,1991

    Google Scholar 

  27. Rosenstock JG, Evans AE, Schut L: Response to vincristine of recurrent brain tumors in children. J Neurosurg 45: 135–140, 1976

    Google Scholar 

  28. Sutton LN: Current management of low-grade astrocytomas of childhood. Pediatr Neurosci 13: 98–107,1987

    Google Scholar 

  29. Lefkowitz IB, Packer RJ, Sutton LN, Siegel KR, Bruce DA, Evans AE, Shut L: Results of the treatment of children with recurrent gliomas with lomustine and vincristine. Cancer 61: 896–902,1988

    Google Scholar 

  30. Babu R, Huang P, Epstein F, Budzilovich GN: Late radiation necrosis of the brain. Case report. J Neuro-Onco1 17: 37–42,1993

    Google Scholar 

  31. Gjerris F, Klinken L: Long-term prognosis in children with benign cerebellar astrocytoma. J Neurosurg 49: 179–184, 1978

    Google Scholar 

  32. Marsa GW, Probert JC, Rubinstein LJ, Bagshaw MA: Radiation therapy in the treatment of childhood astrocytic gliomas. Cancer 32: 646–655,1973

    Google Scholar 

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Sioutos, P.J., Hamilton, A.J., Narotam, P.K. et al. Unusual early recurrence of a cerebellar pilocytic astrocytoma following complete surgical resection. J Neuro-Oncol 30, 47–54 (1996). https://doi.org/10.1007/BF00177442

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