title: Significance of radical resection for pilomyxoid astrocytoma of the cerebellum: a case report and review of the literature.
abstract: BACKGROUND
  Pilomyxoid astrocytoma (PMA) was recently classified as a variant of pilocytic astrocytoma (PA) with significantly more aggressive clinical features than those of PA. Like PAs, PMAs frequently arise in the chiasmatic/hypothalamic regions. The cerebellum is also a common site of occurrence for PAs but not for PMAs.
  
  
  METHODS
  We present the case of a 31-month-old boy with cerebellar PMA that showed rapid regrowth during the 3 months following the first subtotal resection. Gross total resection was achieved in the second surgery, followed by radiation to the tumor bed.
  
  
  RESULTS
  During follow-up over the next 12 years, there has been no evidence of recurrence on magnetic resonance imaging.
  
  
  CONCLUSIONS
  Although the prognosis of cerebellar PMAs remains unknown because of the paucity of cases, the relevant literature reports a more favorable outcome for cerebellar PMAs than for PMAs occurring at other locations. The results of this case study and a review of the relevant literature advocate radical resection, sometimes involving multiple surgeries, for cerebellar PMAs because gross total or near total resection is more feasible in the cerebellum than in other locations.
authors.affiliation: Department of Neurosurgery, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama 350-8550, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Okano
authors.forename: Soichi
authors.initials: S
authors.lastname: Oya
authors.forename: Naoaki
authors.initials: N
authors.lastname: Fujisawa
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Tsuchiya
authors.forename: Masahiro
authors.initials: M
authors.lastname: Indo
authors.forename: Takumi
authors.initials: T
authors.lastname: Nakamura
authors.forename: Han Soo
authors.initials: HS
authors.lastname: Chang
authors.forename: Toru
authors.initials: T
authors.lastname: Matsui
mesh_terms: D001254:Astrocytoma / Q000601:surgery*; D001932:Brain Neoplasms / Q000601:surgery*; D002675:Child, Preschool; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D019635:Neurosurgical Procedures / Q000379:methods*; D014057:Tomography, X-Ray Computed