title: Midbrain Gliofibroma Presenting in Adulthood following "Cure" of a Childhood Intraventricular Pilocytic Astrocytoma.
abstract: BACKGROUND
  Gliofibromas are rare biphasic tumours with a good prognosis that usually occur in childhood. Rare adult spinal cases have been treated with radiotherapy. This report describes the case of a gliofibroma occurring in a young adult 10 years after treatment for a childhood pilocytic astrocytoma.
  
  
  METHODS
  A 14-year-old female underwent complete resection of a right lateral ventricle pilocytic astrocytoma confirmed on postoperative magnetic resonance imaging (MRI). At the age of 17, the tumour recurred, and a second complete resection was performed. Due to the early recurrence, she was placed on long-term MRI surveillance. At the age of 23, an enhancing left midbrain tumour was identified that was suspected to be a recurrent pilocytic astrocytoma. Following surgical resection the histopathology revealed a gliofibroma. Due to the growth of further tumour nodules she was treated with fractionated radiotherapy. There is no disease recurrence after 36 months of follow-up, and the patient remains well.
  
  
  CONCLUSIONS
  Gliofibromas are tumours which usually occur in childhood; this case report identifies a rare occurrence in an adult. The childhood intraventricular pilocytic astrocytoma was in an anatomically distinct location to the midbrain gliofibroma. Radiotherapy can control these tumours, and follow-up is required to understand the long-term outcome and prognosis.
authors.affiliation: School of Medicine, University of Liverpool, Liverpool, UK.
authors.forename: Mohammad U
authors.initials: MU
authors.lastname: Ahmad
authors.forename: Atik
authors.initials: A
authors.lastname: Barborie
authors.forename: Barry
authors.initials: B
authors.lastname: Pizer
authors.forename: David
authors.initials: D
authors.lastname: Husband
authors.forename: Conor
authors.initials: C
authors.lastname: Mallucci
authors.forename: Michael D
authors.initials: MD
authors.lastname: Jenkinson
mesh_terms: D000293:Adolescent; D001254:Astrocytoma / Q000000981:diagnostic imaging / Q000601:surgery*; D020295:Brain Stem Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery*; D005260:Female; D006801:Humans; D020547:Lateral Ventricles / Q000601:surgery; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D055815:Young Adult
keywords: Gliofibroma; Pilocytic astrocytoma; Radiotherapy; Surgery