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[Third ventricle tumors in children]
1Service de Neurochirurgie Pédiatrique, Clinique Neurochirurgicale, Hôpital Roger-Salengro, CHRU, 59037 Lille Cedex.
Insights
Pediatric third ventricle tumors present unique challenges in diagnosis and treatment. Multidisciplinary care and tailored approaches are crucial for improving outcomes in children with these rare brain tumors.
Area of Science:
- Pediatric neuro-oncology
- Neurosurgery
- Pediatric oncology
Context:
- Third ventricle tumors in children present unique diagnostic and therapeutic challenges.
- Clinical presentation can be nonspecific, including macrocrania or developmental delays.
- Specific pediatric tumor types include pilocytic astrocytoma and hypothalamic hamartoma.
Purpose:
- To outline the specific problems associated with pediatric third ventricle tumors.
- To discuss the diagnostic and treatment complexities.
- To emphasize the need for a tailored, multidisciplinary approach.
Summary:
- Pediatric third ventricle tumors exhibit distinct clinical presentations, pathologies, and treatment considerations compared to adult tumors.
- Surgical risks are elevated in young children due to potential blood loss and hydrocephalus.
- Chemotherapy offers an alternative to irradiation, reducing complications like intellectual delay and endocrine disorders.
Impact:
- Highlights the importance of specialized pediatric neuro-oncology care.
- Informs treatment strategies, balancing surgical risks with the benefits of neoadjuvant chemotherapy.
- Stresses the necessity of long-term, multidisciplinary follow-up into adulthood for optimal patient outcomes.
Abstract:
Tumors of the third ventricle in children raise specific problems, owing to their clinical presentation, pathology, treatment, and outcome. The clinical presentation is often unspecific at that age, many cases presenting with isolated macrocrania or delayed milestones. Some histological types are specific of the pediatric group, such as the pilocytic astrocytoma or hypothalamic hamartoma, and others types which are exceptional in adults are relatively common in children, such as choroid plexus tumors. Surgery is especially dangerous in young children, because of the blood loss, and the hemispheric collapse associated with the large hydrocephalus which is the rule in these patients. External irradiation is associated with a high rate of complications, above all a progressive intellectual delay, and endocrine disorders. Chemotherapy has reduced the indication of irradiation, and, in some cases, can be performed preoperatively to reduce tumor volume and intraoperative blood loss. The therapeutic approach to these patients is thus pluridisciplinar, and should be tailored for each case, with a follow-up protracted well into the adult age.