Clinicopathological study of cerebellar astrocytoma in children

Abstract

Introduction: The first successful treatment of a pediatric brain tumor was in 1879 when Sir William Macewen successfully removed a meningioma from a 14-year-old girl. Brain tumors are the most common form of solid tumors and the leading cause of death from solid tumors in children (SEER program 1975–1999). Materials and Methods: Study area: This study was conducted at Bangur Institute of Neuroscience (BIN) and S.S.K.M Hospital. Study Population: Patients attending BIN OPD and admitting in BIN and S.S.K.M Hospital wards were selected. Inclusion Criteria: The following criteria were included in the study: (a) Patients with the diagnosis of cerebellar astrocytomas after magnetic resonance imaging investigation, (b) patients giving consent to be included in the study, and (c) patient willing to come for follow up. Study Period: The study period was 2 years (from September 1, 2010, to December 31, 2012). Sample Size: All diagnosed cases of cerebellar astrocytoma during the stated period. Exclusion Criteria: Patients not willing for the study were excluded from the study. Study Design: This was a non-randomized prospective clinical study. Pilocytic astrocytomas are the most common pediatric brain tumors in our population and are most commonly located in the cerebellum. Results: Most of the patients, 20 (90.9%), had neurological improvement on discharge. 1 patient (4.5%) died during the hospital course. The follow-up time period ranged from 3 months to 2 years, with a mean follow-up period of 1.5 years. Recurrence was observed in 5 patients (22.72%), but reoperation was done in 3 patients (13.63%). Of them, 1 patient (4.5%) received radiotherapy in spite of that recurrence was developed in 1.5 years. 2 patients (9.09%) have been kept under observation because these are asymptomatic. The solid consistency of tumors led to a poor prognosis, as it was associated with a greater number of ICU admissions, recurrence of tumors, and repeat surgeries (13.63%). The follow-up time period ranged from 3 months to 2 years, with a mean follow-up period of 1.5 years. Conclusion: A “wait and see” strategy is justified in patients with non-progressive recurrent or residual cerebellar LGG after primary tumor resection (23.30) radiotherapy can be considered.