The present and future of cerebral tumor surgery in children

Cerebral hemisphere tumors are less common than posterior fossa tumors in children, but are still important among childhood tumors. At the present time, many are low grade and can be treated satisfactorily with modern surgical techniques. These techniques include image-guided surgery in the conventional operating room, brain mapping, and surgery in the intraoperative MRI. Technical sophistication is the chief characteristic of present approaches to cerebral cortical tumors. In the future, surgery for these tumors will require both technical and biological sophistication. Malignant cerebral tumors are invasive and heterogeneous and require new understandings of biology to develop effective treatments. These biological understandings will be added to sophisticated surgical techniques for surgical resection, perhaps with local delivery methods.