Excision of Juvenile Pilocytic Astrocytoma of the Midbrain after Radiotherapy

Vol. 42, No. 5, 2006

Free Abstract Article (Fulltext) Article (PDF 498 KB)

Case Report

Excision of Juvenile Pilocytic Astrocytoma of the Midbrain after Radiotherapy
Koji Tsuboi, Wakoto Matsuda, Kazuhiro Nakamura, Shingo Takano, Akira Matsumura

Department of Neurosurgery, Doctoral Program in Functional and Regulatory Medical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan

Address of Corresponding Author

Pediatric Neurosurgery 2006;42:311-315 (DOI: 10.1159/000094069)

Key Words

Midbrain
Pilocytic astrocytoma
Radiation
Brain stem
Glioma

Abstract

A 13-year-old girl presented with consciousness disturbance, right hemiparesis, and impairment of hearing, swallowing, and ocular movements. A magnetic resonance image demonstrated marked hydrocephalus due to a large cystic tumor (40 × 40 × 30 mm) in the midbrain. Emergency ventricular drainage and stereotactic cyst puncture dramatically improved her condition. Since her family did not agree to surgery on the brain stem, radiotherapy was performed after ventriculoperitoneal shunting. Conventional radiotherapy of 50.4 Gy was temporarily effective, and the growth of the tumor was stabilized until approximately 8 months later when regrowth was noticed. At this stage, with the consent of her family, the tumor was removed via an infratentorial supracerebellar approach. The pathological diagnosis was juvenile pilocytic astrocytoma. The postoperative course was uneventful. No recurrence has been observed during the follow-up period of more than 6 years. This case study shows that initial excision may be appropriate for some low-grade focal lesions in the midbrain when the histological diagnosis and consent have been obtained.

Author Contacts

Koji Tsuboi, MD, PhD, Department of Neurosurgery
Doctoral Program in Functional and Regulatory Medical Sciences
Graduate School of Comprehensive Human Sciences, University of Tsukuba
1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575 (Japan)
Tel. +81 29 853 7589, Fax +81 29 853 3214, E-Mail tsuboi-k@md.tsukuba.ac.jp

Article Information

Received: June 10, 2005
Accepted after revision: November 9, 2005
Number of Print Pages : 5
Number of Figures : 3, Number of Tables : 0, Number of References : 20

Medline Abstract (ID 16902345)

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