Pilocytic astrocytomas (PAs) account for 25% of all pediatric brain tumors and commonly occur in the first two decades of life. Recurrence and/or regrowth of residual tumors are not common and mostly occur within 4–5 years of the first surgery. Herein, we reported a 16-year-old male adolescent with neurological symptoms and signs that pathologic specimens confirmed the diagnosis of PA. The patient underwent 27 sessions of radiotherapy without surgery. After 5 years, at the age of 21, the patient readmitted with anxiety and headache and the recurrence of the same tumor with the same grade. We suggest follow-up of the patient after initial treatment for at least 5 years with considering any neurological symptoms including behavioral changes.
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