Juvenile Pilocytic Astrocytoma

FACTS

  • WHO Grade 1 glioma
  • BRAF in up to 70% patients
  • pilocytic astrocytomas encompass optic gliomas, hypothalamic gliomas, cerebellar piloycytic astrocytomas

HPI

universal ROS
  • focus on gait instability
  • vision if in opto-chiasmatic location

PHYSICAL EXAM

universal ROS
  • emphasis on cerebellar / bulbar exam

IMAGING

MRI: large cyst with enhancing mural nodule
A/P
  • Surgery: can be cured with GTR
  • adjuvant radiotherapy limited efficacy, + neuro-cognitive deficits
  • Counsel
    • prognosis related to EOR
 

Pathology

Figure 1: Pathology features: Rosenthal fibers (brightly eosinophilic masses intermixed with tumor cells) 
Figure 1: Pathology features: Rosenthal fibers (brightly eosinophilic masses intermixed with tumor cells)