• Cerebellar Pilocytic Astrocytoma in Children

    Cerebellar pilocytic astrocytomas are brain tumors that arise from glial cells in the brain called astrocytomas, which make up the supportive network of the brain, providing structural support and other functions.

    These tumors, which are the most common type of low-grade glioma, grow in the cerebellum, the part of the brain that controls balance and coordination. Grade I tumors remain in one small focal area of the brain, while grade II tumors tend to spread out into surrounding areas. A chromosomal abnormality involving the BRAF gene is implicated in a large percentage of these tumors.

    Cerebellar Pilocytic Astrocytoma Treatment at Dana-Farber/Boston Children's

    Children with cerebellar pilocytic astrocytoma are treated at Dana-Farber/Boston Children's Cancer and Blood Disorders Center through our Glioma Program. Continue reading to learn more about Cerebellar Pilocytic Astrocytomas or visit the Glioma Program homepage to learn about our expertise and treatment options for this condition.

    Symptoms & Diagnosis

    Due to the relatively slow growth of cerebellar pilocytic astrocytomas, children may have symptoms for many months before seeing a doctor. Some children have more sudden onset of symptoms due to blockage of cerebrospinal fluid.

    The most common symptoms are related to increased pressure within the brain, including:

    • Headache (generally upon awakening in the morning)
    • Vomiting
    • Fatigue
    • Balance and coordination difficulties
    • Vision problems such as seeing double

    In addition to a complete physical examination, doctors diagnose cerebellar pilocytic astrocytoma with diagnostic imaging, including a magnetic resonance imaging (MRI) or a computerized tomography (CT or CAT) scan  if there is evidence of cerebrospinal fluid blockage. In some cases a biopsy is required. 

    After all tests are completed, doctors will be able to outline the best treatment options.

    Treatment & Care Options

    The most common treatments for cerebellar pilocytic astrocytoma are:

    • Surgery – the most common and often the only treatment required, with high success rates
    • Chemotherapy – either before surgery to shrink the tumor or to kill cancer cells
    • Radiation therapy – since cure rates with surgery and chemotherapy are so high, most children don’t need radiation therapy

    Progressive or Recurrent Disease

    Grade I tumors are not associated with recurrence after complete surgical removal. Grade II tumors are more likely to recur, requiring a second attempt at surgical removal, as well as chemotherapy and/or radiation therapy.

    Long-term Outlook

    Innovative treatments have led to very high cure rates of 90 percent to 95 percent. Children cured of cerebellar pilocytic astrocytoma enjoy a quality of life better than most other children with cancer. Balance, strength and coordination may be compromised, but fertility and life expectancy are not.
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