OBJECTIVE: This study described a 23-year experience in the treatment of children with pilocytic astrocytomas (piloA) with the aim of identifying putative clinical, histopathological, and/or immunohistochemical features that could be related to the outcome of these patients. METHODS: Clinical data of 31 patients under 18 years of age with piloA were obtained from 1984 to 2006. RESULTS: The mean age at the time of surgery was 7.8 +/- 4.2 years (1 to 17 years), and the mean follow-up was 5.7 +/- 5.4 years (1 to 20 years). The most common site of tumor formation was the cerebellum (17), followed by brainstem (4), optic chiasmatic hypothalamic region (4), cerebral hemisphere (3), cervical spinal cord (2), and optic nerve (1). Gross total resection (GTR) was achieved in 23 (74.1%), mainly in those with tumors located in the cerebellum and cerebral hemispheres (P = 0.02). The global mortality rate was 6.4%. Nine patients were reoperated. Rosenthal fibers, eosinophilic granular bodies, microvascular proliferation, and lymphocytic infiltration were observed in most cases. The mean Ki-67LI was 4.4 +/- 4.5%. In all cases, Gal-3 expression in tumor cells was observed with variable staining pattern. CONCLUSIONS: Aside from GTR, no other clinical, histopathological, or immunohistochemical features were found to be related to the prognosis. We postulate that strict follow-up is recommended if piloA is associated with high mitotic activity/Ki67-LI, or if GTR cannot be achieved at surgery. Tumor recurrence or progression of the residual lesion should be strictly observed. In some aspects, childhood piloA remains an enigmatic tumor.
OBJECTIVE: This study described a 23-year experience in the treatment of children with pilocytic astrocytomas (piloA) with the aim of identifying putative clinical, histopathological, and/or immunohistochemical features that could be related to the outcome of these patients. METHODS: Clinical data of 31 patients under 18 years of age with piloA were obtained from 1984 to 2006. RESULTS: The mean age at the time of surgery was 7.8 +/- 4.2 years (1 to 17 years), and the mean follow-up was 5.7 +/- 5.4 years (1 to 20 years). The most common site of tumor formation was the cerebellum (17), followed by brainstem (4), optic chiasmatic hypothalamic region (4), cerebral hemisphere (3), cervical spinal cord (2), and optic nerve (1). Gross total resection (GTR) was achieved in 23 (74.1%), mainly in those with tumors located in the cerebellum and cerebral hemispheres (P = 0.02). The global mortality rate was 6.4%. Nine patients were reoperated. Rosenthal fibers, eosinophilic granular bodies, microvascular proliferation, and lymphocytic infiltration were observed in most cases. The mean Ki-67LI was 4.4 +/- 4.5%. In all cases, Gal-3 expression in tumor cells was observed with variable staining pattern. CONCLUSIONS: Aside from GTR, no other clinical, histopathological, or immunohistochemical features were found to be related to the prognosis. We postulate that strict follow-up is recommended if piloA is associated with high mitotic activity/Ki67-LI, or if GTR cannot be achieved at surgery. Tumor recurrence or progression of the residual lesion should be strictly observed. In some aspects, childhood piloA remains an enigmatic tumor.
Authors: Mário H G Faria; Bronner P A Gonçalves; Régia M do S V do Patrocínio; Manoel O de Moraes-Filho; Silvia H B Rabenhorst Journal: Neuropathology Date: 2006-12 Impact factor: 1.906
Authors: E L Sobel; F H Gilles; A Leviton; C J Tavaré; E T Hedley-Whyte; L B Rorke; L S Adelman Journal: Neurosurgery Date: 1996-07 Impact factor: 4.654
Authors: P Pencalet; W Maixner; C Sainte-Rose; A Lellouch-Tubiana; G Cinalli; M Zerah; A Pierre-Kahn; E Hoppe-Hirsch; M Bourgeois; D Renier Journal: J Neurosurg Date: 1999-02 Impact factor: 5.115
Authors: Murat Şakir Ekşi; Baran Yılmaz; Akın Akakın; Zafer Orkun Toktaş; Ahmet Cemil Kaur; Mustafa Kemal Demir; Türker Kılıç Journal: Childs Nerv Syst Date: 2015-07-15 Impact factor: 1.475
Authors: Luis Eduardo Machado; Arthur William Alvarenga; Fernanda Ferreira da Silva; Martín Roffé; Maria Dirlei Begnami; Luís Fernando Bleggi Torres; Isabela Werneck da Cunha; Vilma Regina Martins; Glaucia Noeli Maroso Hajj Journal: J Histochem Cytochem Date: 2018-01-12 Impact factor: 2.479
Authors: Guillaume Bergthold; Pratiti Bandopadhayay; Wenya Linda Bi; Lori Ramkissoon; Charles Stiles; Rosalind A Segal; Rameen Beroukhim; Keith L Ligon; Jacques Grill; Mark W Kieran Journal: Biochim Biophys Acta Date: 2014-02-28