Meningiomas are the most common non-glial intracranial tumors in adults, which account for 14 - 19 % of all primary intracranial tumors and occur most commonly in females. They are the most common tumors of the sphenoid wing, and constitute 15 - 20 % of all intracranial meningiomas, representing the third most common group of intracranial meningiomas. Most sphenoid wing meningiomas are relatively easy to remove; however, they are sometimes a challenge, due to their invasion of the cavernous sinus, the bone and, especially, to their close relationship to main arteries and cranial nerves. In these cases, total excision is extremely difficult, resulting in high morbidity and a high rate of re-growth or recurrence. Here, we review current concepts of diagnosis, treatment, and follow-up with clinical decision-making informed by multimodal imaging and molecular biology.

The peak age for the development of pilocytic astrocytomas (PA), a type of benign cerebellar tumor, is between the ages of 10 and 20. The tumor known as adult pilocytic astrocytoma is extremely rare. Consequently, very little is understood about the characteristics of these tumors. We retrospectively reviewed the records of patients older than 18 years with pathologically proven pilocytic astrocytoma who had surgery to remove the tumor between January 2010 and January 2020 and were followed until January 2022. Although 32 cases were initially recognized as PA, we only ended up including 4 patients (2 male and 2 female) with adult pilocytic astrocytoma, their mean age was 26,75 years. The mean age of male patients at diagnosis was 28 years, and there were no mortality or recurrences. The mean age of female patients at diagnosis was 25,5 years. One female was still living after the follow-up period ended. The cause of death of another female patient was unrelated to tumor. Women had a median follow-up of 36 months, and their mean overall survival was 42 months. Pilocytic astrocytoma in adults acts differently than in children. The extent of surgical resection and the location of the tumor were shown to influence the prognosis. When possible, total resection should be the primary treatment. Good survival rates and little recurrence are seen.