[Pilocytic astrocytoma in childhood: presentation of six cases]
L F Torres1, G V Jacob, L de Noronha
1Serviço de Anatomia Patológica do Hospital de Clínicas, UFPR.
Insights
Pilocytic astrocytomas predominantly affect midline brain structures in young patients, often presenting with visual disturbances. Complete surgical resection is the recommended primary treatment for these low-grade tumors.
Area of Science:
- Neuro-oncology
- Pediatric Pathology
- Neurosurgery
Context:
- Pilocytic astrocytomas are the most common primary brain tumors in children.
- Understanding their clinicopathological features is crucial for effective management.
Purpose:
- To analyze the clinical, epidemiological, and histopathological characteristics of six pilocytic astrocytoma cases.
- To correlate tumor location with presenting symptoms and outcomes.
Summary:
- This study reviewed six pilocytic astrocytoma cases (1990-1994), focusing on age, sex, and lesion site.
- Tumors occurred in the optic chiasm, cerebral hemispheres, and third ventricle, with symptoms reflecting location.
- Treatment involved surgical resection and chemotherapy, with a 50% survival rate at the study's conclusion.
Impact:
- Highlights the predilection of juvenile pilocytic astrocytomas for midline brain structures.
- Emphasizes the importance of surgical resection for low-grade astrocytomas.
- Provides insights into the clinical presentation and prognosis of pilocytic astrocytomas in a pediatric cohort.
Objective:
To present 6 cases of pilocytic astrocytomas whose clinic, epidemiological and histopathological aspects were studied.
Methods:
Between 1990 and 1994 the records of the laboratories of pathology of the main hospitals in Curitiba were analysed and all cases of pilocytic astrocytomas were studied with special attention to age of onset, sex and site of the lesions. The biopsies, which were reviewed, have been processed according to conventional techniques and in a few cases electron microscopy and immunohistochemistry was further done.
Results:
Five patients were females and 1 was male. Medium age was 4,5 years (range 1-8). The pilocytic astrocytomas affected optic chiasm (n=3), midline of cerebral hemisfere (n=2) and third ventricle (n=1). The symptoms reflected the location and extension of the tumour. The commonest signs and symptoms were those of intracranial hypertension, visual disturbances, hydrocephalus, among others. The patients were treated with surgical ressection and chemotherapy. Three patients died after a medium survival of 45 days, and three remain alive.
Conclusions:
The authors emphasize that pilocytic astrocytoma, mainly the juvenile variant, affect mostly the midline brain structures of infants through signs of visual disturbance. These lesions are low grade astrocytomas and should be treated predominantly by total surgical ressection.
