An Elderly Patient with Pilocytic Astrocytoma Operated on 14 Years after Initial Detection:A Case Study

• Published in: Nō shinkei geka Vol. 45; no. 8; p. 707
• Main Authors: Isobe, Naoyuki, Nishimoto, Takeshi, Ueda, Takeshi
• Format: Journal Article
• Language: Japanese
• Published: Japan 01.08.2017
• Subjects: Aged, 80 and over; Astrocytoma - diagnostic imaging; Astrocytoma - surgery; Brain Neoplasms - diagnostic imaging; Brain Neoplasms - surgery; Female; Humans; Magnetic Resonance Imaging; Multimodal Imaging; Tomography, X-Ray Computed
• ISSN: 0301-2603
• DOI: 10.11477/mf.1436203579

Pilocytic astrocytomas are found predominantly in the pediatric population and are extremely rare in elderly patients. We describe a case of pilocytic astrocytoma in an elderly patient who presented with the symptoms of an enlarged tumoral cyst. A 70-year-old woman was found to have an asymptomatic small solid tumor with a cystic component in the right frontal lobe at "Ningen Dock(medical checkup)of the Brain". She was hospitalized and underwent further examinations including cerebral angiography. At that time, she was opposed to undergoing an operation for tumor removal owing to lack of symptoms. Approximately fourteen years later, she presented with dizziness upon posture conversion and recent memory disturbance. Computed tomography scanning revealed an enlarged cyst in the frontal lobe and perifocal edematous changes. Gadolinium-enhanced magnetic resonance imaging partially revealed the solid tumor and cystic capsule. The solid tumor had not enlarged substantially. The cystic fluid was aspirated and the solid tumor was resected via a frontal transcortical approach. The histological diagnosis was pilocytic astrocytoma without malignant features. After surgery, the patient's symptoms improved and additional therapy was not provided. After a year of postoperative follow-up, the size of the cystic lesion has reduced, and no recurrence of the solid tumor has been observed.