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Child's Nervous System

, Volume 30, Issue 7, pp 1243–1248 | Cite as

Suprasellar pilocytic astrocytoma: one national centre’s experience

  • Tafadzwa Mandiwanza
  • Chandrasekaran Kaliaperumal
  • Ayman Khalil
  • Muhammad Sattar
  • Darach Crimmins
  • John Caird
Original Paper

Abstract

Introduction

Pilocytic astrocytomas in the supratentorial compartment make up 20 % of all brain tumours in children with only 5 % of these arising in the suprasellar region. Optic pathway gliomas or suprasellar gliomas are often seen in neurofibromatosis type 1 (NF1) patients. Given their location, suprasellar pilocytic astrocytomas are challenging to manage surgically with high morbidity rates from surgical resection. We assess our cohort of patients with suprasellar pilocytic astrocytoma and document our experience.

Method

A retrospective review of patients diagnosed with suprasellar glioma between 2000–October 2012. We included patients diagnosed with optic pathway glioma based on radiological features (with or without biopsy) and those who had a biopsy confirming pilocytic astrocytoma.

Results

Fifty-three patients included (sporadic tumours 24 and NF1 related 29). Fifteen sporadic and four NF1 patients were biopsied. Twelve sporadic and 13 NF1 patients were initially treated with chemotherapy while only 1 patient had radiotherapy initially. Progression was noted in 58 % of the sporadic group and 24 % of the NF1 group. The only significant factor for progression was NF1 status (p = 0.026).

Conclusion

Management should be guided by individual patient circumstance. In our cohort, chemotherapy did not significantly improve progression free survival; however, NF1 status significantly correlated with the decreased progression.

Keywords

Pilocytic astrocytoma Suprasellar Optic pathway glioma Neurofibromatosis type 1 

Notes

Acknowledgment

The first author is in receipt of an Educational grant from DePuy Synthes.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Tafadzwa Mandiwanza
    • 1
  • Chandrasekaran Kaliaperumal
    • 1
  • Ayman Khalil
    • 2
  • Muhammad Sattar
    • 1
  • Darach Crimmins
    • 1
  • John Caird
    • 1
  1. 1.Department of Paediatric NeurosurgeryChildren’s University HospitalDublin 1Ireland
  2. 2.Department of NeurosurgeryBeaumont HospitalDublin 9Ireland

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