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Juvenile Pilocytic Astrocytomas

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Diagnosing and Treating a Juvenile Pilocytic Astrocytoma

A child who exhibits any neurological symptoms should have a complete physical exam done by his or her pediatrician, who will perform a basic neurological exam. If there is any reason to suspect an abnormality, the pediatrician will likely send the child to a neurologist for further examination, including imaging studies.

Magnetic resonance imaging (MRI) and computed tomography (CT) scans produce detailed images of the brain and allow doctors to detect the presence of a tumor. Sometimes the child is also given a contrast agent (a special dye) before the scan, so the tumor stands out against normal brain tissue and is easier to view.  Both MRI and CT scans are noninvasive, but they require the patient to remain motionless to capture high-quality images. Small children usually need to be sedated to keep them still enough to get good images.

Once the images are done, the child should be referred to a specialized pediatric neurosurgical team for evaluation. An experienced pediatric neurosurgeon with expertise in juvenile pilocytic astrocytomas can make the best recommendation for treatment.

Treatment Options
Some juvenile pilocytic astrocytomas (JPAs) do not require treatment at all. If they are not causing symptoms, then ongoing observation and regular MRI scans may be all that’s needed to make sure the tumor is not growing.

If the juvenile pilocytic astrocytoma is causing symptoms, or if a scan shows the tumor to be changing or growing, the pediatric neurosurgeon may recommend taking action. Treatment options include:

Surgery. If the tumor is located in an area that can be reached surgically, the best choice is usually to remove it. Total resection, or removal, usually provides a complete cure. (See more about Surgery for Juvenile Pilocytic Astrocytomas.)

Radiation. Radiation therapy is sometimes recommended as a followup to surgery if the neurosurgeon wasn’t able to remove the entire tumor. Since radiation can have long-term effects on development, it’s not usually recommended for young children.

Chemotherapy.  Chemotherapy is included in some treatment plans to stop the growth and spread of cancer cells and also to allow for smaller radiation doses. Chemotherapy can be given in pill form or as an IV drip. The chemotherapy goes on for several months and usually does not require hospitalization.

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Reviewed by: Jeffrey Greenfield, Ph.D., M.D.
Last reviewed/last updated: August 2018