II. Perinatal brain tumors: a review of 250 cases

Central nervous system tumors occur considerably less often in the fetus and neonate than in the older child. They are not entirely the same as those present later in life. Their location, biologic behavior, response to therapy, and histologic types are different. Fetal and neonatal brain tumors (n = 250) were collected from the literature and studied for this review. The overall survival rate was 28%. The entire cranial cavity may be filled with tumor, and stillbirth is not uncommon. Macrocephaly was the most frequent presentation regardless of histology. Outcome is related to the size and location of the tumor, the histologic type, surgical resectability, and the condition of the infant at the time of diagnosis. Neonates with choroid plexus papillomas, gangliogliomas, and low-grade astrocytomas have the best prognosis, whereas those with teratomas and primitive neuroectodermal tumors have the worst prognosis.