MALIGNANT ASTROCYTOMAS OF THE CEREBELLUM - REPORT OF 10 CASES - REVIEW OF THE LITERATURE

While reviewing a series of 138 cerebellar tumors operated upon betwee n 1978 and 1991, the authors could only find 2 glioblastomas and 8 ana plastic astrocytomas, occuring in 4 children (3 to 14 years old) and 6 adults (23 to 48 years old). The 10 cases represent 2 % of the all ma lignant gliomas population observed during the same period of time. Cl inically speaking, nothing makes these tumors different from other cer ebellar ones. However, with an heterogenous image and an irregular con trast enhancement, the CT (scan) appearance can lead to the diagnosis. 7 lesions develop within the cerebellar vermis (vermis cerebelli) and 3 develop within the cerebellar hemisphere. Total surgical resection is performed in 9 cases and subtotal resection in 1 case (because of t he extension to the floor of the fourth ventricle). Adjunctive radioth erapy on the posterior cranial fossa is achieved in 8 cases. The 2 pat ients with a glioblastoma present with a recurrence of their tumor at 15 months and 6 years respectively, and eventually died. Out of the pa tients with an anaplastic astrocytoma, 4 are still alive without recur rence and with a median follow-up of 7 years. The pathogenesis of such lesions is discussed. An aggressive therapeutic management is suggest ed because of the possible prolonged survival rate.