Symptoms of Pilocytic Astrocytoma

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Pilocytic astrocytoma (PA) is a slow-growing central nervous system tumor that originates from star-shaped cells in the brain and spinal cord called astrocytes. It is the most common pediatric tumor. It mainly develops in young people under the age of 19, although more aggressive forms may develop in adults.

The most common initial symptoms in children include headache, nausea and vomiting, difficulty with balance and coordination, and seizure. Adults tend to have more aggressive cases, which may lead to vision changes, memory issues, and clumsiness as a result of larger tumors that may cause hydrocephalus (fluid buildup in the brain).

This article discusses the symptoms of PA.

HCP speaking with child

Adie Bush / Getty Images

Frequent Symptoms 

PA may be benign and cause few, if any, symptoms. When they do appear, symptoms can vary based on the size, location, and extent of damage by the tumor. PA symptoms include:

  • Headache (particularly in the morning or made better by vomiting)
  • Unexplained vomiting 
  • Vision problems, such as double vision, blurry vision, or loss of vision
  • Difficulty walking or balancing
  • Seizures
  • Weight gain or loss
  • Premature puberty
  • Clumsiness
  • Memory issues
  • Confusion
  • Fatigue 
  • Changes in mood, personality, or behavior

Rare Symptoms 

Pilocytic astrocytomas are rarely life-threatening, but if they grow big enough in size they can cause hydrocephalus, a buildup of fluid in the cavities (ventricles) deep within the brain. Hydrocephalus is a medical emergency and can be life-threatening if left untreated.

If your child experiences a rapid increase in head size, irritability, headache, vision changes, or nausea and vomiting, seek immediate medical attention as they may be developing dangerously high levels of cerebral spinal fluid in the brain.

The location of PA also plays a role in the development of symptoms. For example, a pilocytic astrocytoma located near the optic nerve can cause blurry and double vision or nystagmus (when the eyes rapidly shift movement involuntarily), and a tumor in the cerebellum may cause difficulty with walking, balance, and coordination.

In rare cases, pilocytic astrocytomas that press on the hypothalamus or pituitary gland may cause delays in puberty and sexual maturation. 

Subgroup Indications

Subgroup indications are outlined below.

Juvenile Pilocytic Astrocytoma (JPA)

Most cases of JPA occur during adolescence. JPAs are commonly grade 1 tumors, small localized tumors that are rarely malignant in nature. Therefore, they are highly curable with complete removal of the tumor (surgical resection). 

Adult Pilocytic Astrocytoma

The majority of PA cases occur in people younger than 20 years old. It’s unclear whether adult PAs develop in adulthood or arise early in life but are not detected because they are asymptomatic. They may only be discovered when they begin producing symptoms or are found under unrelated circumstances.

Unlike the low-grade astrocytomas of JVA, adult cases are more likely to undergo genetic mutations and become malignant. Generally, the prognosis for adult pilocytic astrocytoma is not as good as for juvenile PA. The five-year survival rate for those age 5–19 is 96.5% compared to 52.9% in adults 60 years old or older.

When to See a Healthcare Provider

If your child experiences unexplained headaches (especially while waking up), nausea and vomiting, weight loss, difficulty with balance or walking, vision problems it may be a sign of increased pressure in the brain.

Hydrocephalus is a serious medical complication of pilocytic astrocytomas and must be addressed immediately to avoid life-altering damage. 

Summary

The most common initial symptoms of PA include headache, nausea and vomiting, difficulty with balance and coordination, and seizure. Adults tend to have more aggressive cases than children, which may manifest in vision changes, memory issues, and clumsiness as a result of larger tumors that may cause hydrocephalus, which is fluid buildup in the brain.

A Word From Verywell

The symptoms of PA are subtle and mimic many other conditions, so knowing these signs can help you to identify this condition early when it is most manageable. PA is rarely malignant and most of the symptoms evolve over time due to a growth in tumor size.

PA is treated by a team of healthcare professionals who will help formulate a treatment plan. In children, this medical team may include a pediatrician, specialized doctors such as a pediatric oncologist or pediatric neurologist, nurses, and support staff. The team will go over treatment options, which may include surgical resection.

5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Collins VP, Jones DT, Giannini C. Pilocytic astrocytoma: pathology, molecular mechanisms and markers. Acta Neuropathol. 2015 Jun;129(6):775-88. doi:10.1007/s00401-015-1410-7

  2. Ostrom, Q.T., et al. CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the United States in 2010-2014Neuro Oncol, 2017. 19(suppl_5): p. v1-v88. doi:10.1093/neuonc/nox158

  3. NIH. Hydrocephalus Fact Sheet. 

  4. Voronina, N., Aichmüller, C., Kolb, T. et al. The age of adult pilocytic astrocytoma cells. Oncogene 40, 2830–2841 (2021). doi:10.1038/s41388-021-01738-0

  5. Johnson DR, Brown PD, Galanis E, Hammack JE. Pilocytic astrocytoma survival in adults: analysis of the Surveillance, Epidemiology, and End Results Program of the National Cancer Institute. J Neurooncol. 2012;108(1):187-193. doi:10.1007/s11060-012-0829-0

By Shamard Charles, MD, MPH
Shamard Charles, MD, MPH is a public health physician and journalist. He has held positions with major news networks like NBC reporting on health policy, public health initiatives, diversity in medicine, and new developments in health care research and medical treatments.