Malignant transformation of benign cerebellar astrocytoma

A patient who had a well-differentiated cerebellar astrocytoma resected at 4 years of age, had glioblastoma multiforme of the cerebellum after a symptom-free interval of 28 years. Late malignant transformation of a cerebellar astrocytoma of childhood is rare and previous cases are reviewed. Cerebellar astrocytomas are typically among the most benign of primary brain malignancies with excellent long-term survival rates, sometimes with incomplete resection. This patient indicates that follow-up needs to be long-term because biologic behavior cannot be predicted fully in all cases.