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Benign intrinsic tectal "tumors" in children
P L May1, S I Blaser, H J Hoffman
1Division of Neurosurgery, Hospital for Sick Children, Toronto, Ontario, Canada.
Journal of Neurosurgery
|June 1, 1991
Summary
This study identifies a specific group of benign dorsal midbrain tumors in children. These tumors cause hydrocephalus but show no progression, suggesting conservative management with CSF diversion is effective.
Area of Science:
- Pediatric neuro-oncology
- Neuroradiology
- Neurosurgery
Background:
- Intrinsic dorsal midbrain tumors are rare in children.
- Hydrocephalus secondary to aqueductal obstruction is a common presentation.
- Distinguishing benign from malignant tectal tumors is clinically important.
Purpose of the Study:
- To characterize the clinical and radiological features of a specific group of intrinsic dorsal midbrain tumors in children.
- To evaluate the long-term outcomes and management strategies for these tumors.
Main Methods:
- Retrospective review of six pediatric patients with intrinsic dorsal midbrain tumors.
- Analysis of clinical presentation, computerized tomography (CT), and magnetic resonance (MR) imaging findings.
- Assessment of treatment outcomes, including cerebrospinal fluid (CSF) diversion and follow-up imaging.
Main Results:
- All patients presented with hydrocephalus and tectal calcification/increased attenuation on CT, with no contrast enhancement.
- MR imaging revealed focal tectal tumors with specific characteristics (T2 hyperintensity, no cystic component).
- No tumor progression was observed over long-term follow-up (8 months to 17 years); CSF diversion was the primary treatment.
Conclusions:
- This specific group of intrinsic dorsal midbrain tumors appears to be benign.
- Conservative management including CSF diversion, serial examinations, and MR imaging is recommended.
- These findings contrast with previously described periaqueductal and tectal tumors, highlighting a distinct entity.