Malignant cerebellar astrocytic tumours in children.

The authors reviewed 5 cases of histopathologically verified malignant cerebellar astrocytic tumours (2 anaplastic astrocytomas and 3 glioblastomas) in children admitted to our department. All cases exhibited symptoms and signs of increased intracranial pressure and of a cerebellar lesion. Brain stem symptoms were present in 4 cases. All of the tumours were located in or near the midline of the cerebellum with no large cyst. Surgical removal (70 to 90% removal) of the tumour was performed in 4 cases. In one case only a biopsy was done. Even with subsequent follow-up treatment including radiotherapy, chemotherapy, and/or immunotherapy, the course of the disease could not be reversed, and all of the children died 3 to 13 months (mean 7 months) after admission due to tumour re-growth or recurrence. Tumour dissemination along the walls of the ventricular system was seen in 2 cases, and was considered to be a peculiar, fatal form of tumour recurrence in patients with this type of tumour. Malignant cerebellar astrocytic tumours in children have an extremely poor prognosis. Until, improved therapy is available to counteract this tragic consequence, it will remain so.