Cerebellar Astrocytomas
The most common cerebellar tumor in children is the World Health Organization (WHO) grade I pilocytic astrocytoma (PA). Surgery can be curative in many cases, and recurrence is uncommon following gross total resection. Postoperative complications include cerebellar mutism, hydrocephalus requiring CSF diversion, aseptic meningitis, and long-term neuropsychological challenges. Adjuvant therapy is often unnecessary, but it is now evolving from traditional chemotherapy and radiation toward targeting components of the mitogen-activated protein kinase signaling pathway in select cases. Because the majority of patients survive, treatment paradigms have shifted toward preserving function and maintaining quality of life. The focus of this chapter is to review the clinical, pathologic, and molecular features of cerebellar astrocytomas and their current treatment paradigms.
