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Twenty-three years follow-up after low-dose Gamma Knife surgery of a brainstem juvenile pilocytic astrocytoma: a case report and review of the literature

  • J. Sherry Liu
  • Denise Foo
  • Tseng Tsai Yeo
  • Kee Hang Ho
  • Vincent Diong Weng NgaEmail author
  • Bengt Karlsson
Case Report

Abstract

Juvenile pilocytic astrocytoma (JPA) is a World Health Organization (WHO) grade I tumor that is the commonest to occur in the 0–19 age group, with an excellent prognosis of 96% 10-year survival in pediatric patients. Complete resection is the treatment of choice for JPAs. However, this is not always feasible due to the location of certain tumors, and the management following subtotal resection is controversial. Fractionated radiotherapy, chemotherapy, radiosurgery, and observation have all been used to treat tumor remnants. We report a young patient with good tumor control 23 years following low-dose Gamma Knife surgery (GKS) of a subtotally resected brainstem JPA and recommend that GKS may be a feasible treatment option to achieve long-term tumor control when subtotal resection cannot be achieved, even if the GKS prescription dose must be significantly reduced due to large tumor volume or proximity to critical structures sensitive to radiation.

Keywords

Gamma Knife surgery Pilocytic astrocytoma Low-grade glioma Tumor control 

Notes

Compliance with ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Yong Loo Lin School of MedicineSingaporeSingapore
  2. 2.Division of NeurosurgeryNational University HospitalSingaporeSingapore

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