Partially resected and irradiated cerebellar astrocytoma of childhood: malignant evolution after 28 years.

Partial resection of a cystic cerebellar astrocytoma with well-differentiated histomorphology in a 13 year old girl was followed by a course of X-ray therapy. After a period of 27 years symptoms recurred. The patient died 2 days after a second operation, and autopsy showed a large partly cystic cerebellar astrocytoma with distinct morphological evidence of malignancy in some areas. The role of the X-ray therapy in the formation of peculiar bizarre giant cells in our case is discussed. Radio-induction of malignant tumour evolution after long latency has to be considered, but the possibility seems remote. However, the value of radiotherapy for cystic cerebellar astrocytomas needs some reconsideration. More caution in the long term prognosis of cystic cerebellar astrocytomas of childhood might be appropriate.