Anaplastic Pilocytic Astrocytoma in adults: A comprehensive literature review based on 2 clinical cases

Anaplastic Pilocytic Astrocytoma (APA) is a subtype of Pilocytic Astrocytoma (PA) that appears when the tumor shows signs of anaplasia and follow an aggressive clinical course. It is a very rarely tumor, especially in older than 18 years. We made a screening of our data base to find patients who was discharged with the diagnostic of APA and we made a search in PubMed to find articles that represents this kind of tumors and realize a literature review. We present 2 cases of patients with APA diagnostic: a progression from a Pilocytic Astrocytoma in a 38 years-old woman and a 36 years-old woman with a cerebellar APA. Both patients were operated without complications and persist asymptomatic in a five- and seven-years follow-up. On the literature review we found 18 articles with a total of 84 patients and described demographic, clinical, radiological, histopathological and genetic features. To our knowledge, the pathological presentation behavior of our clinical cases is very rare and can contribute important data to the published literature. APA is more aggressive than classical PA. It is important to identify this variant for stablish the best and faster treatment options, adjuvant therapies, appropriate prognosis and active follow-up.

Automated summary

Anaplastic Pilocytic Astrocytoma (APA) is a rare subtype of Pilocytic Astrocytoma (PA) with aggressive clinical course, especially in patients over 18 years old. This study presented two cases of APA patients who underwent successful surgery without complications and remained asymptomatic during follow-up. Literature review revealed APA to be more aggressive than classical PA, emphasizing the importance of early identification for optimal treatment and prognosis.