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Morphological pattern and frequency of intracranial tumours in children
Ghazala Hanif1, Shahzad Shafqat
1Department of Pathology, King Edward Medical College, Lahore. koool@brain.net.pk
Insights
Pediatric brain tumors are most common in the infratentorial region, with astrocytomas being the most frequent type. Males are more affected than females, and supratentorial astrocytomas tend to be higher grade.
Area of Science:
- Pediatric neuro-oncology
- Neuropathology
- Cancer epidemiology
Background:
- Intracranial tumors represent a significant health concern in pediatric populations.
- Understanding the histopathological patterns and frequency of these tumors is crucial for diagnosis and treatment.
Purpose of the Study:
- To analyze the histopathological characteristics of intracranial tumors in children under 16 years old.
- To determine the frequency and common locations of these pediatric brain tumors.
- To correlate tumor site with histological diagnosis.
Main Methods:
- A descriptive study was conducted using histopathological data from 116 pediatric brain tumors.
- Tumor evaluation involved H&E staining, with special stains and immunohistochemistry used as needed.
- Data was collected over three years (1999-2002) from two major hospitals in Lahore.
Main Results:
- Glial tumors were the most common (75.8%), with astrocytomas being the most frequent subtype (44.8%).
- Medulloblastoma (15.5%) and ependymoma (10.3%) were the next most common pediatric brain tumors.
- Infratentorial tumors (56%) were more common than supratentorial tumors (44%), particularly in children aged 3-11 years.
Conclusions:
- Astrocytomas are the most prevalent intracranial tumors in children, frequently located in the infratentorial region.
- Supratentorial astrocytomas exhibit a higher grade of malignancy compared to their infratentorial counterparts.
- Pediatric brain tumors show a higher incidence in males.
Objective:
The objective of the present study was to observe the histopathological pattern of intracranial tumours and to provide a comprehensive data about its frequency in children less than 16 years and to correlate the site of lesion with the histological diagnosis.
Design:
A descriptive study.
Place And Duration Of Study:
The study was carried out at the Department of Histopathology, Children's Hospital and Institute of Child Health, Lahore and King Edward Medical College, Lahore over a period of three years. (January 1999 - December 2002).
Subjects And Methods:
The histopathological data of 116 brain tumours of all the patients less than 16 years was collected and compared with the findings reported from centres in other parts of the country. The initial histopathological evaluation of these lesions was performed on H&E stained sections of paraffin embedded tissues. Special stains and immunohistochemistry were performed whenever indicated. Autolyzed biopsies and previously reported biopsies were not included.
Results:
The ages ranged from 5 days to 16 years with male to female ratio of 3:1. Glial tumours comprised the largest category 75.8% and among all the glial tumours astrocytomas were the commonest comprising 44.8% of all intracranial neoplasms. Medulloblastoma 15.5% ranked the second most common brain tumour followed by ependymoma, 10.3%. Out of 116 cases, 51 (44%) were supratentorial and 65 (56%) infratentorial in location. In infratentorial region 38 % of the tumours were in the cerebellum, 9.5 % in the brain stem and 8.5 % in the fourth ventricle. The majority of these tumours were astrocytomas 32 cases (49.2%), WHO I/II, medulloblastoma 18 cases (27.6 %) and ependymoma 6 cases (9.2%). In supratentorial region out of 51 cases the most common tumour was astrocytoma, 20 cases (39.2%), high grade WHO III/IV, ependymoma, mixed glial tumours and PNET 5.1% each. The less common tumours included craniopharyngiomas, choroid plexus papilloma and ganglioneuroblastoma 3.4% each. Choroid plexus carcinoma, haemangioma, non Hodgkin's lymphoma, oligodendroglioma and ganglioneuroma 1.7% each. Infratentorial location was more common between the age of 3-11 years (58.2%), by contrast in the under 3 years old a supratentorial location was more frequent.
Conclusion:
Paediatric brain tumours are more common in infratentorial region and astrocytomas are the most common tumours. Supratentorial astrocytomas are more likely to be high grade than infratentorial. Males are affected more than females.
