Benign cerebellar pilocytic astrocytomas in children

Cerebellar astrocytomas are benign tumors of the central nervous system. They represent 10% of all pediatric intracranial brain tumors and 30% of all pediatric posterior fossa tumors especially in the first two decades of life.

We reviewed the medical records of patients; age at the time of surgery, pre- and post operative magnetic resonance imaging (MRI), localisation of the tumor, hydrocephalus, surgical approach, pre- and post operative neurological status, post operative adjuvant therapy and outcome were documented.

The male to female ratio was 20/11. Age at the time of evaluation ranged from 3 to 23 years. Age at the time of surgery ranged from 1 to 18 years. Follow-up duration after surgery was 1-12 years. 55% of these tumors were located at the cerebellar vermis and 45% were at the cerebellar hemispheres. Complete surgical resection was done in 74% of these patients. 5 patients had a second operation because of residual tumor. Ventriculoperitoneal shunt insertion was performed in 3 of 31 patients because of symptomatic hydrocephalus and 1 patient had an endoscopic third ventriculostomy pre-operatively. 90% of these patients had no neurological sequelae at follow-up evaluation.

Cerebellar astrocytomas are benign tumors where total resection is possible in the majority of cases with an excellent outcome.