• Shuo Sun, Hui Zhou, Zhao-Zheng Ding, and Hui Shi.
• Department of Neurosurgery, Xuzhou Medical University Affiliated Hospital of Lianyungang, Lianyungang, China.
• Medicine (Baltimore). 2018 Aug 1; 97 (31): e11329.

RationalePilocytic astrocytoma (PA) is the most common pediatric central nervous system glial tumor. Adult occurrence is rare, especially in elderly adults. How to manage the pilocytic astrocytoma with spontaneous intratumoral hemorrhage in the elderly is still unfamiliar with clinician.Patient ConcernsReports of tumors with intratumoral hemorrhage in elderly adults are extremely rare. We report a case of a 62-year-old male diagnosed with cerebellar pilocytic astrocytomas with spontaneous intratumoral hemorrhage. Informed consent was obtained from the patient.DiagnosesHistological examination of the specimens revealed pilocytic astrocytomas, including a hemorrhagic portion.InterventionsThe patient underwent the radical resections of tumour and was given the regular follow-up.Outcomes12 months later, he recovered without evidence of disease.LessonsCerebellar pilocytic astrocytomas associated with hemorrhages occur over the age of 60 is extremely rare. Removing the tumor and hematoma completely is the best treatment options. Long term follow-up is very necessary for this tumor.

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