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Child's Nervous System

, Volume 31, Issue 11, pp 2063–2069 | Cite as

Differences in the clinical courses of pediatric and adult pilocytic astrocytomas with progression: a single-institution study

  • Hyang-Hwa Ryu
  • Tae-Young Jung
  • Gwang-Jun Lee
  • Kyung-Hwa Lee
  • Seung-Hoon Jung
  • Shin Jung
  • Hee-Jo Baek
Original Paper

Abstract

Purpose

Pilocytic astrocytoma (PA) is a World Health Organization grade I neoplasm that generally follows a benign course. However, in some patients, PA exhibits an aggressive clinical course. Here, we examined the clinical course of pediatric and adult PAs with progression at a single institution.

Methods

Between 1995 and 2013, 39 patients with PA were treated. Nineteen were pediatric patients (mean age, 12 years; range, 1–17 years) with a male-to-female patient ratio of 10:9, while 20 were adults (mean age, 36.4 years; range, 19–65 years) with a male-to-female ratio of 9:11. We analyzed and compared tumor location, extent of tumor resection, adjuvant treatment, and clinical course in all patients.

Results

In the 19 pediatric patients, tumors were located in the cerebellar vermis, cerebellar hemisphere, optic pathways plus hypothalamus, hypothalamus, brainstem, and the temporal lobe in 6 (31.6 %), 5 (26.3 %), 3 (15.8 %), 2 (10.5 %), and 2 (10.5 %) patients and 1 (5.3 %) patient, respectively. The mass was totally, subtotally, or partially resected in 11 (57.9 %), 2 (10.5 %), and 4 (21.1 %) patients, respectively; biopsies were performed in 2 (10.5 %) patients. Immediate postoperative adjuvant treatment was carried out in 6 patients. Tumor progression was detected in 3 patients at 3.0, 4.6, and 5.2 years after treatment, respectively, without significant symptoms. In the 20 adult patients, tumors were located in the cerebellar hemisphere, cerebellar vermis, hypothalamus, brainstem, cerebral hemisphere, and lateral ventricle in 5 (25 %), 4 (20 %), 3 (15 %), 3 (15 %), 3 (15 %), and 2 (10 %) patients, respectively. The mass was totally, subtotally, or partially resected in 11 (55 %) and 6 (30 %) patients and 1 (5 %) patient, respectively; biopsies were performed in 2 patients. Immediate adjuvant treatment was carried out in 2 patients. Progression was detected in 3 patients at 0.3, 0.9, and 2.5 years after treatment, respectively, with progressive neurologic symptoms. There was one case of disease-related mortality during follow-up among the adult patients.

Conclusion

Most of the PA cases evaluated in this study were benign. However, tumor progression in adult PAs followed a more aggressive clinical course than those in pediatric PAs.

Keywords

Adult Clinical Pediatric Pilocytic astrocytoma Radiology Progression 

Notes

Acknowledgments

This study was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF), funded by the Ministry of Science, ICT and Future Planning (2014R1A1A1004469).

Conflict of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Hyang-Hwa Ryu
    • 1
  • Tae-Young Jung
    • 2
  • Gwang-Jun Lee
    • 2
  • Kyung-Hwa Lee
    • 3
  • Seung-Hoon Jung
    • 2
  • Shin Jung
    • 2
  • Hee-Jo Baek
    • 4
  1. 1.Brain Tumor Research LaboratoryChonnam National University Hwasun HospitalHwasun-eupRepublic of Korea
  2. 2.Department of NeurosurgeryChonnam National University Medical School, Chonnam National University Hwasun HospitalHwasun-eupRepublic of Korea
  3. 3.Department of PathologyChonnam National University Medical School, Chonnam National University Hwasun HospitalGwangjuSouth Korea
  4. 4.Department of PediatricsChonnam National University Medical School, Chonnam National University Hwasun HospitalGwangjuSouth Korea

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