Journal of Neurology Research Reviews & Reports

ABSTRACT

Background: Pilocytic astrocytoma (PA) is a common tumor of the central nervous system and is considered a benign condition. However, in some cases PA can demonstrate aggressive clinical behavior.

Aim: To analyze and correlate factors leading to an aggressive course of disease in patients with PA.

Methods: As part of a retrospective study, medical records of adult patients (over 18 years of age) with a histological diagnosis of pilocytic astrocytoma were examined. The clinical course of the disease was analyzed for the 5-year follow-up period of patients operated on in 2018. A comparison was made of the anatomical location of the tumor, demographic data and proliferative activity index between the group of “normal” and “aggressive” course of the disease.

Results: 19 patients with signs of an aggressive course of the disease were identified. It was found that the age of the patients did not differ significantly between the groups. The most common location of the tumor was the cerebellum. The proliferative activity index (Ki-67) was slightly higher in the aggressive group (7.4% ± 4.3 to 4.12% ± 1.6). It was found that high Ki-67 was more common among young patients (under 30 years of age). In a number of cases, the histological data indicated anaplastic morphology in the presence of signs of PA, and therefore the presence of malignant astrocytoma with piloid features (HGAP) can be assumed.

Conclusion: A small percentage of PA are prone to an aggressive clinical course. One should be more wary of patients with a “benign” diagnosis. It is advisable to conduct large studies aimed at identifying factors characterizing the malignant course of PA. The introduction of molecular genetic diagnostic methods will make it possible to reliably distinguish PA from HGAP.