[Pediatric neuro-oncology]

Pediatric neuro-oncology is getting more important for various reasons, brain tumours are the most frequent solid tumours in children below fifteen year of age, besides due to the recent advances in neuro-image techniques that make possible an early diagnosis and the fact that the children are usually treated in pediatric oncology units, with protocols that are internationally based allow a better survival with a better degree of evidence.

Actually the brain tumours should be classified according to their biological, genetic and molecular risk factors and their treatment should consider also the familial predisposition for developing a brain tumour, and the molecular markers expressed by the tumour. The objective of this work is to review the special characteristics of the brain tumours in the pediatric population and the differences with the brain tumours in adults, also to give the incidence and survival data of brain tumours in pediatric population from Spain based in the data from the National Registry of Pediatric Tumours. Also the clinical signs and symptoms of presentation that should alert for diagnosis in children, and how to make a diagnostic strategy based on the clinical manifestations, the image modalities for diagnosis, and the treatment strategy to be used based in multinational protocols, and stratified by histological, biological and genetic markers of risk are emphasized. Finally we describe the characteristics of the three more common histological subtypes because their prevalence in pediatric population; gliomas, medulloblastomas/primitive neuroectodermal tumours and ependymomas.

Improving prognosis of brain tumors in childhood has to be achieved by early despistage throughout image and biological techniques, following multicentric protocols in specialized units and stratified treatments regarding the biological risk in order to diminish morbility and sequels.