Lengthy-term outcomes of primarily metastatic juvenile pilocytic astrocytoma in kids.
J Neurosurg Pediatr. 2018 01;21(1):49-53
Authors: Yecies D, Fisher PG, Cheshier S, Edwards M, Grant G
OBJECTIVE Primarily metastatic juvenile pilocytic astrocytoma (JPA) is uncommon, doubtless representing 2%-Three% of all instances of JPA. As a result of rarity of primarily metastatic JPA, there’s at the moment no normal remedy paradigm and the long-term outcomes usually are not absolutely identified. The purpose of this case sequence was so as to add to the present understanding of this illness course of. METHODS The authors searched a complete database of pediatric sufferers with mind and spinal wire tumors handled at Lucile Packard Youngsters’s Hospital from 1997 to 2016 and recognized 5 sufferers with primarily metastatic JPA. A retrospective chart assessment was carried out and particulars of the sufferers’ remedy and medical course had been recorded for additional evaluation. RESULTS For the 5 sufferers with primarily metastatic JPA, the imply follow-up interval was 12.Three years. All sufferers in our sequence had biopsies or subtotal resections and upfront remedy. Three sufferers had been handled with chemotherapy alone, one was handled with chemotherapy and radiotherapy, and one was handled with radiotherapy alone. 4 sufferers had steady illness after preliminary remedy, and one affected person had a number of episodes of progressive illness however underwent profitable salvage remedy and has had steady illness for 19 years. One affected person died of an intracerebral hemorrhage 10 years following preliminary radiation remedy believed to be secondary to radiation vasculopathy. CONCLUSIONS Analysis of the whole neuraxis ought to be carried out in all situations of preliminary JPA prognosis to correctly assess for primarily metastatic illness. Many sufferers with primarily metastatic JPA could have steady illness after upfront remedy, though the upper price of steady illness discovered on this sequence relative to different reviews is probably going secondary to the small pattern dimension.
PMID: 29125440 [PubMed – indexed for MEDLINE]