BackgroundAstrocytomas are the most common primary adult brain tumors.ObjectivesIn this study, we investigated the impact of some potential prognostic factors on survival in patients with low and high grade astrocytomas.Patients and MethodsThis retrospective cohort study was performed on patients with brain astrocytoma who were referred to oncology departments, Omid and Ghaem hospitals, Mashhad University of Medical Sciences (2000 - 2011).Results415 patients with a median age of 43 and a male to female ratio of 252:163 (1.54) were recorded. Grade I to IV astrocytoma were found in 40 (9.6%), 88 (21.2%), 71 (17.1%) and 216 (52%) patients. With a median follow up time of 37 months for low grade and 13 months for high grade astrocytoma, the 5-year survival in grades I to IV was 92.1%, 69.1%, 49.2% and 9.6% respectively. In low grade astrocytomas, patients with grade I tumors, being ambulatory (5-year survival: 88% vs. 60.3%, P < 0.001) and performing optimal surgery (5-year survival 86% vs. 59.3%, P < 0.001) were associated with more favorable survival. In high grade astrocytomas, patients with grade III tumors, age < 50 (5-year survival 29.6% vs. 14.6%, P < 0.001), being ambulatory (5-year survival 39.4% vs. 10.5, P < 0.001), performing optimal surgery (5-year survival 46.1% vs. 4.3%, P < 0.001) and receiving chemotherapy (5-year survival 23.7% vs. 18.7%, P = 0.02) were associated with significantly higher overall survival.ConclusionsPerforming optimal surgery and good performance status were associated with more favorable survival in both low and high grade astrocytomas. In high grade a strocytomas, patients younger than 43 and those who received chemotherapy had better overall survival.

Introduction: Medulloblastoma is one of the most common malignancies in children. Common clinical symptoms of patients are related to the symptoms due to tumor in the posterior cranial fossa. Presentation of patients with symptoms related to metastatic tumors in the spinal canal are unusual. Case Presentation: We present a 6-year-old child with symptoms of lower back pain and Paraplegia as early symptoms of medulloblastom. The Magnetic Resonance Image (MRI) of spinal cord revealed multiple tumors in the spinal canal (initially diagnosed). A biopsy of the tumor was also performed. Then, whole CNS (Central Nervous System) imaging revealed tumor in the posterior cranial fossa. He had a dramatic improvement after treatment and returned to normal in all clinical signs. Four years have passed from his treatment and he is symptom free. Conclusions: Presentation of Medulloblastoma with widespread spinal canal drop metastases is rare. However, spinal drop metastasis should be considered to prevent a suboptimal management in child. These patients did not consider in aspect of the treatment outcome as hopeless.

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