• Timothy Woodiwiss, Juan Vivanco-Suarez, Tyson Matern, Kathryn L Eschbacher, and GreenleeJeremy D WJDWDepartment of Neurosurgery, University of Iowa Hospitals & Clinics, Iowa City, Iowa, USA. Electronic address: jeremy-greenlee@uiowa.edu..
• Department of Neurosurgery, University of Iowa Hospitals & Clinics, Iowa City, Iowa, USA.
• World Neurosurg. 2024 Jun 1; 186: e413e431e413-e431.

BackgroundPilocytic astrocytomas (PA) are the most common gliomas in children/adolescents but are less common and poorly studied in adults. Here, we describe the clinical presentation, surgical management, and outcomes of surgically treated adult patients with intraventricular (IV) PA and review the literature.MethodsConsecutive adult patients treated for IV brain tumors at a tertiary academic center over 25 years (1997-2023) were identified. Clinical data were reviewed retrospectively for adult IV PA patients. A systematic literature review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines.ResultsEight patients with IV PA were included. Median age was 25 years (range, 18-69 years), and 4 (50%) were female. The most common tumor location was the lateral ventricle (5, 63%), followed by the fourth ventricle (3, 37%). Subtotal and near total resection were the most common surgical outcomes (6 patients, 75%), followed by gross total resection in 2 (25%). Progression or recurrence occurred in 3 patients (37%), requiring repeat resection in 2 patients. The 5-year overall survival and progression-free survival were 67% and 40%, respectively. In addition, 42 cases were identified in the literature.ConclusionsPAs in adults are rare and an IV location is even more uncommon. The findings demonstrate the challenges in caring for these patients, with overall- and progression-free survival outcomes being poorer than the general adult PA population. Findings support the employment of surgical techniques and approaches that favor gross total resection when possible. Further studies are needed to better characterize this unique presentation.Copyright © 2024. Published by Elsevier Inc.

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