Pilocytic Astrocytoma

A pilocytic astrocytoma is a brain tumor that originates from star-shaped cells called astrocytes — a kind of glial cell, which support and nourish neurons in the brain. An astrocytoma is a type of glioma. Pilocytic astrocytomas are low-grade gliomas — a family of slow-growing tumors that arise from glial cells. They are the most benign and most treatable of the gliomas, with a cure rate of more than 90 percent.

As a pilocytic astrocytoma grows, it presses on surrounding healthy parts of the brain, affecting their function. As such, the symptoms of a pediatric pilocytic astrocytoma depend on the tumor's size and where in the brain it is located. Some of the most common symptoms of a pediatric pilocytic astrocytoma include:

• Headache
• Severe or frequent vomiting
• Vision problems
• Difficulty walking or balancing
• Seizures
• Weight gain or loss
• Premature puberty
• Clumsiness
• Confusion
• Sleepiness
• Changes in behavior

Because these tumors grow so slowly, children may experience symptoms for months before seeing a doctor. However, in some children, symptoms come on very quickly because the tumor blocks the flow of cerebrospinal fluid — a liquid that cushions the brain and spinal cord — within the brain.

It’s important to understand that these and other brain tumors most often occur with no known cause. There’s nothing that could have been done or avoided that would have prevented the tumor from developing.

To diagnose a pediatric pilocytic astrocytoma, your doctor will take your child's medical history and carry out both physical and neurological exams. Your doctor may also order a variety of tests, including:

• Magnetic resonance imaging (MRI)
• Biopsy or tissue sample
• Electroencephalogram (EEG)
• Lumbar puncture

After all tests are completed, doctors will be able to outline the best treatment options.

Our treatment approach for pediatric gliomas is personalized for each patient depending on several factors, including the tumor's type, stage, and location. Some therapies will treat the tumor while others are intended to address complications of the disease or side effects of the treatment.

In addition, our clinicians may offer access to targeted treatments based on the molecular profile of your child's tumor.

Some of the options your doctor may discuss include:

• Surgery to remove as much of the tumor as possible
• Chemotherapy
• Radiation therapy

For pilocytic astrocytomas, often surgery is the only treatment required. We also offer brain tumor clinical trials for children with pilocytic astrocytomas.

Children and adolescents with glioma are treated at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center through the Brain Tumor Center's Glioma Program, one of the largest and most experienced pediatric glioma programs in the world.

Our glioma specialists — a team of neuro-oncologists, surgeons, pathologists, and radiation oncologists — focus solely on the care of children diagnosed with gliomas. The Glioma Program also offers families the chance to have their child's tumor molecularly profiled (as long as a biopsy can be taken), which may help identify opportunities for targeted treatment.

The Glioma Program's research enterprise mirrors its clinical efforts in its multidisciplinary nature. Basic, translational and clinical scientists in the program work together and with colleagues at institutions like the Broad Institute to uncover new knowledge about the biology of gliomas and translate that understanding into new therapies or ways of overcoming resistance to existing ones.

Dana-Farber/Boston Children's houses the Pediatric Low-Grade Astrocytoma (PLGA) Program, the world's only multidisciplinary clinical and research program dedicated to pediatric low-grade gliomas. Established in 2007 with support from the PLGA Foundation, the program takes a multifaceted approach to finding more effective, less toxic treatments and a cure for children battling brain tumors, and has become the standard bearer for the research and care of pediatric brain tumors. Our pediatric neuro-oncologists, including Pratiti (Mimi) Bandopadhayay, MBBS, PhD, are actively contributing to these efforts.

Our program has contributed to international research efforts that have identified genomic drivers that contribute to growth of pilocytic astrocytoma. Specifically, we have identified genes that are commonly mutated in pilocytic astrocytoma. These findings are guiding clinical trials examining the activity of new drugs specifically for children with pilocytic astrocytoma.