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[Central nervous system metastases in children with solid tumours]
Joanna Nurzyńska-Flak1, Joanna Zawitkowska-Klaczyńska, Krzysztof Katski
1Department of Peadiatric Haematology and Oncology, Medical University, Chodzki 2 St., Lublin, Poland. info@prolab.lublin.pl
Insights
Central nervous system (CNS) metastases are rare in children with solid tumors, occurring in only 2.3% of cases. The prognosis for pediatric patients with CNS metastases is generally poor, highlighting the need for early detection and effective treatment strategies.
Area of Science:
- Pediatric Oncology
- Neuro-oncology
- Cancer Metastasis
Context:
- Central nervous system (CNS) metastases are common in adult cancers but rare in pediatric solid tumors.
- Understanding the clinical and prognostic factors of CNS recurrence in children is crucial for improving outcomes.
Purpose:
- To analyze the clinical and prognostic characteristics of central nervous system (CNS) recurrence in children treated for solid tumors.
- To determine the incidence and outcomes of CNS metastases in a pediatric cohort.
Summary:
- A retrospective study of 218 children with solid tumors found CNS metastases in 2.3% (5 children).
- Wilms' tumor, neuroblastoma, teratoma malignum, and leiomyosarcoma were associated with CNS metastases; bone tumors were not.
- The median time to CNS metastasis detection was 14 months, and the prognosis was grave, with only one survivor achieving complete remission after multimodal treatment.
Impact:
- This study highlights the rare but serious occurrence of CNS metastases in pediatric solid tumors.
- The findings underscore the poor prognosis associated with CNS metastases in children and the potential benefit of aggressive treatment for select cases.
- Early diagnosis and timely intervention are critical for improving survival rates in pediatric patients with CNS metastases.
Background:
Central nervous system (CNS) metastases occur in 20-30% of adult patients with systemic cancers. but they rarely occur in children with solid tumours.
Aim:
clinical and prognostic characteristics of CNS recurrence in children treated for solid tumours were analysed.
Patients And Methods:
The retrospective study enrolled 218 children treated for solid tumours in the Department of Paediatric Haematology and Oncology, Lublin Medical Academy, from January 1992 to December 2002. The diagnosis in this group was as follow: soft tissue sarcomas -- 51 patients, bone tumours -- 50. Wilms' tumour -- 48, neuroblastoma (NBL) -- 36, germ cell tumours -- 33: Children with primary CNS tumours, retinoblastoma, lymphoma and rare tumours were not analysed.
Results:
CNS metastases were diagnosed in five children (2.3%) - (2 boys. 3 girls; aged 2,5 to 17 years). Two of them were treated due to Wilms' tumour, one -- NBL, one -- teratoma malignum, one -- leiomyosarcoma. None of the children with bone tumours had CNS metastases. Diagnosis of CNS metastases was confirmed by imaging studies (CT, MRI). The median time from initial diagnosis to the detection of CNS metastases was 14 months. Two children underwent surgical resection of solitary metastases. One of them was also irradiated and received chemotherapy and only this child is alive and achieved complete remission. Other children died, with median period of 32 days.
Conclusions:
CNS metastases may occur in children with the recurrence of primary neoplastic disease. The prognosis is grave.
