Journal
NEUROSURGICAL REVIEW
Volume 44, Issue 2, Pages 1083-1091Publisher
SPRINGER
DOI: 10.1007/s10143-020-01293-4
Keywords
Cerebellopontine angle; CPA; Pilocytic astrocytoma; Glioma; Brainstem; Facial nerve
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Funding
- Projekt DEAL
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Glial tumors in the cerebellopontine angle (CPA) are rare, with less than 1% being pilocytic astrocytoma (PA-CPA). This study presented four cases of PA-CPA treated surgically, with good long-term facial nerve function and low recurrence rate postoperatively.
Glial tumors in the cerebellopontine angle (CPA) are uncommon and comprise less than 1% of CPA tumors. We present four cases of pilocytic astrocytoma of the CPA (PA-CPA) that were treated in our department. Patients who received surgical treatment for PA-CPA from January 2004 to December 2019 were identified by a computer search of their files from the Department of Neurosurgery, Tubingen. Patients were evaluated for initial symptoms, pre- and postoperative facial nerve function and cochlear function, complications, and recurrence rate by reviewing surgical reports, patient documents, neuroradiological data, and follow-up data. We identified four patients with PA-CPA out of about 1500 CPA lesions (similar to 0.2%), which were surgically treated in our department in the last 16 years. Of the four patients, three were male, and one was a female patient. Two were adults, and two were children (mean age 35 years). A gross total resection was achieved in three cases, and a subtotal resection was attained in one case. Two patients experienced a moderate facial palsy immediately after surgery (House-Brackmann grade III). In all cases, the facial function was intact or good (House-Brackmann grades I-II) at the long-term follow-up (mean follow-up 4.5 years). No mortality occurred during follow-up. Three of the patients had no recurrence at the latest follow-up (mean latest follow-up 4.5 years), while one patient had a slight recurrence. PA-CPA can be safely removed, and most complications immediately after surgery resolve in the long-term follow-up.
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