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Pediatric brain tumors diagnosed in infancy require early intervention. Surgical removal outcomes varied, necessitating adjuvant radiotherapy and chemotherapy for non-radical resections in young children.
Area of Science:
- Pediatric Neurosurgery
- Pediatric Oncology
- Neuropathology
Background:
- This study reviews ten pediatric brain tumor cases diagnosed within the first year of life.
- Cases were operated on between 2 months and 4 years of age, spanning a 40-year period (1933-1973).
- These rare tumors represented 0.4% of all brain tumors and 1.9% of pediatric brain tumors in the studied period.
Purpose of the Study:
- To analyze the clinical experience and outcomes of brain tumors presenting in early infancy.
- To highlight the challenges and necessity of timely treatment for these rare pediatric neoplasms.
- To evaluate the efficacy of surgical interventions and the role of adjuvant therapies.
Main Methods:
- Retrospective case series analysis of ten pediatric patients with brain tumors.
- Review of surgical approaches, including partial removal, biopsy, and radical resection.
- Documentation of patient survival rates, operative complications, and late mortality.
Main Results:
- The series included various tumor types: 5 gliomas, 2 teratomas, 1 choroid plexus papilloma, 1 sarcoma, and 1 craniopharyngioma.
- Nine patients survived surgery, with three alive at 3, 4, and 7 years postoperatively.
- Mortality occurred in one patient during radical resection of a teratoma, and two late deaths were recorded.
Conclusions:
- Early diagnosis and treatment are crucial for brain tumors presenting in infancy.
- Adjuvant radiotherapy and chemotherapy are essential when radical surgical removal is not achieved.
- Aggressive management strategies are needed for improving outcomes in this challenging pediatric population.
Abstract:
The authors describe their experience with ten cases of brain tumors in children in whom the onset of symptoms occurred within the first year of life, but who were operated on when they were 2 months to 4 years of age. The series includes 5 gliomas (4 supratentorial, 1 cerebellar; 3 astrocytomas, 1 spongioblastoma, 1 ependymoblastoma), 2 teratomas of the lateral ventricle, and 3 single cases of third ventricle choroid plexus papilloma, temporal lobe sarcoma, and a parasellar craniopharyngioma. Six cases were partially removed, one of them was shunted. Only biopsy was carried out in two, one of which was shunted. The only case of radical removal was a lateral ventricle teratoma; this patient died at operation. Nine patients survived at surgery, three of whom are alive on the 3rd, 4th, and 7th postoperative year. There were two late deaths: one at 2 years (lateral ventricle astrocytoma, which was only biopsied) and one at 7 years and 3 months (spongioblastoma) following surgery. This series from a 40-year period (1933-1973) represents 0.4% of 2,832 brain tumors and 1.9% of 528 brain tumors in the pediatric age. The authors emphasize the need to treat brain tumors in early infancy and insist on the use of radiotherapy and chemotherapy when the lesions are not radically removed at surgery.