A monocenter retrospective study of the surgical outcomes of adult pilocytic astrocytoma: a small case series and review of the literature

Abstract

Introduction: The peak age for the development of pilocytic astrocytoma (PA), a type of benign cerebellar tumor, is between 10 and 20 years. Adult PA is extremely rare, and consequently, very little is understood about its characteristics. Methods: We retrospectively reviewed the records of patients older than 18 years with pathologically proven PA who had surgery to remove the tumor between January 2010 and January 2020 and were followed until January 2022. Results: Although 32 cases were initially flagged as PA, we included 4 patients (2 male and 2 female) with adult PA. The average age of a male patient at diagnosis was 26.75 years old, and there was no mortality or recurrence. The mean age of female patients at diagnosis was 25 years old. One female was still living after the follow-up period ended. The cause of death in one female patient was unrelated to tumor. Women had a median follow-up of 36 months, and their mean overall survival was 42 months. Conclusion: PA in adults acts differently than in children. The extent of surgical resection and the location of the tumor influenced the prognosis. When possible, total resection should be the primary treatment, as it promotes good survival rates and low recurrence risk.