Clinical Analysis Of 8 Cases Of Intramedullary Pilocytic Astrocytoma And Literatures Review

ObjectiveReport 8 cases of intramedullary pilocytic astrocytoma about the clinical manifestation, imaging features, treatment and prognosis. Discuss about the disease’s clinical features combined with domestic and foreign literatures.MethodsThe clinical data of 8 patients with intramedullary PA confirmed by pathology in our hospital from 2005 till now were reviewed retrospectively. Discuss their clinical manifestation, imaging features, pathology characteristics and treatment.Results8 patients all underwent Magnetic Resonance enhancing scanning before the operation. The lesions were all intramedullary, including 2 in cervical cord,1 in cervical-thoracic cord and 5 in thoracic cord.5 cases occurred with motor dysfunction as the first symptoms, the other manifested with sense dysfunction. There is no distinctive signs in imaging exams including Computed Tomography and Magnetic Resonance Imaging. The confirmed diagnosis of this disease is mainly according to the pathology.5 cases underwent total laminectomy resection and reconstruct,2 cases only underwent laminectomy without reconstruction, the other had surgery of spinal cord decompression with biopsy and radiotherapy.5 cases tumors were totally resected,3 cases tumor was partially resected, their postoperation pathology confirmed the disease of pilocytic astrocytoma, with 1 anaplasia.2 cases was treated radiotherapy, others were not.5 cases had different degrees of aggravation in signs,2 case with no obvious difference, and the other one improved.ConclusionThe first symptom of intramedullary pilocytic astrocytoma was mainly motor dysfunction. MR has special advantages in diagnosis and location of this tumor. It should be differentially diagnosised with other intramedullary tumors. The pathological examination is the only method to make a definite diagnosis. Intramedullary pilocytic astrocytoma used to appear cervicothoracic junction of spine, with obscure boundary. Totally surgical resection is the first treatment for this disease. Radiotherapy is not necessary generally except in special case as local anaplasia.