Mibrain cystic pilocytic astrocytoma.
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BACKGROUND: Pilocytic astrocytoma is a well-circumscribed tumor of the central nervous system (CNS WHO grade I), commonly affecting children. Pilocytic astrocytoma frequently arises from the cerebellum or cerebrum. Pilocytic astrocytoma arising from the brainstem is rare, accounting for 10 % of the cases. We hereby report a patient with midbrain cystic pilocytic astrocytoma. CASE DESCRIPTION: An 8-year-old girl presented with left-sided upper and lower limbs weakness, facial deviation, and multiple episodes of headache and vomiting for one week. The neurological examination revealed a left-sided hemiparesis (Power: 3/5) and facial weakness (House-Brackman II). Brain MRI showed an expansile cystic lesion with a mural nodule in the right side of the midbrain. The patient underwent stereotactic biopsy of the solid lesion and aspiration of the cystic component. The histopathological sections were compatible with pilocytic astrocytoma; CNS WHO grade 1. Post-operatively, the patient's hemiparesis and facial asymmetry improved immediately. She was commenced on chemotherapy and discharged with periodic clinicoradiological follow-up. CONCLUSION: Midbrain cystic pilocytic astrocytoma is rare and is considered a surgical challenge. The present article describes the clinical and radiological appearance of a patient with midbrain cystic pilocytic astrocytoma.