Aim: Adult pilocytic astrocytoma is a rare tumor. We aim to contribute to understanding its clinical course and prognosis. Patients & methods: We searched our database for patients older than 18 years with pathology-proven pilocytic astrocytoma. Patients' clinical data were analyzed. Results: Fifteen patients were identified. The median age at diagnosis was 25 years (range: 18-56). Tumors were supratentorial in 47%. Gross-total and near-total resections were achieved in 40%, and sub-total resection in 47%. One (7%) recurrence and no mortality were encountered during a median follow-up of 11 months (range: 1-76). Conclusion: Pilocytic astrocytoma behaves differently in adults compared with pediatrics. It tends to arise in surgically challenging areas where the extent of resection may be limited. Total resection should be the main therapy whenever feasible. The survival rates are good, and recurrence is low.
Keywords: APA; PCA; adult pilocytic astrocytoma; grade I glioma; low-grade glioma; pilocytic astrocytoma.
Pilocytic astrocytoma is a benign brain tumor that most commonly arises in children. Rarely, this tumor may also arise in adults. Surgical removal of the tumor is the main treatment. In children, the tumor most commonly arises in the cerebellum, a part of the brain where surgical accessibility is good, and complete removal of the tumor significantly decreases the possibility of it recurring. In adults, the tumor is more likely to arise in critical areas of the brain or in areas of limited surgical accessibility, thus, making surgery especially challenging, and preventing complete removal. Moreover, studies found that the probability of the tumor recurring in adults is higher than in children. Studies discussing the properties of pilocytic astrocytoma in adults reported varying results. This is mainly due to the small number of patients studied. The rarity of this tumor makes it hard for large primary studies to be conducted. In this article, we report the characteristics and outcomes of 15 adult patients treated in a single center in Jordan. In our patients, the mean age was 25 years (range: 18–56), and the tumor was located above the tentorium in 47%. Complete and near-complete removal was possible in 40%. The mean duration of follow-up after surgery was 11 months (range: 1–76). The tumor recurred in only one patient. We aim to provide more data on this rare disease and contribute further to understanding its properties.