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[Intracranial tumors in the 1st year of life]
M Caldarelli1, A Ceddia, C Di Rocco
1Istituto di Neurochirurgia, Università Cattolica del Sacro Cuore, Roma.
Insights
Early diagnosis of congenital brain tumors in infants is possible with advanced neuroimaging. This study highlights treatment outcomes and survival rates in 39 young children diagnosed with these rare conditions.
Area of Science:
- Pediatric Neurosurgery
- Neuro-oncology
- Congenital Abnormalities
Background:
- Congenital brain tumors are rare but can be diagnosed early with modern neuroimaging.
- This study focuses on a cohort of infants diagnosed within their first year of life.
Purpose of the Study:
- To report on the clinical characteristics, treatment, and outcomes of congenital intracranial tumors in infants.
- To analyze the challenges and results of managing these rare pediatric neoplasms.
Main Methods:
- Retrospective analysis of 39 infants diagnosed with intracranial tumors within the first 12 months of life.
- Review of neuroimaging, surgical interventions, adjuvant therapies, and follow-up data.
- Inclusion of data from a 11-year period at a single neurosurgical institute.
Main Results:
- Congenital brain tumors represented 14.4% of pediatric brain tumors in the study period.
- Supratentorial and midline locations were most common.
- Total mortality was 38.5%, with 20% of survivors being normal, 17% having minimal deficits, and 22% severely handicapped.
Conclusions:
- Early diagnosis of congenital brain tumors is feasible.
- Treatment strategies involve surgical resection, chemotherapy, or serial imaging, with radiotherapy often postponed.
- Outcomes vary significantly, with a substantial proportion of survivors experiencing long-term neurodevelopmental deficits.
Abstract:
The introduction of the new diagnostic tools for neuroimaging has resulted in the early recognition of congenital brain tumors. In the present report we describe 39 children, in whom the diagnosis of an intracranial tumor has been obtained during the first 12 months of life. These patients represent 14.4% of a pediatric population of 271 children with brain tumors, observed in the same period of time (11 years) in the Neurosurgical Institute of the Catholic University of Rome. Most of the tumors were located within the supratentorial compartment. Midline tumors were common. Sixteen children underwent the total removal of the tumor. Four infants could not be operated either because their poor general condition or the extension of the tumor. In one case, treatment was refused by the parents. The remaining children underwent the partial removal of the tumor, which was followed by chemotherapy (malignant tumors) or by serial neuroradiological examination (benign tumors), with the aim of postponing radiotherapy at the end of 2 years of age at least. The total mortality (surgical deaths: 7 cases) and deaths during the follow-up period (11 cases) was 38.5%. Out of the 24 surviving children, 8 (20%) are normal: 7 (17%) exhibit only minimal neurosurgical deficits; 9 (22%) are seriously handicapped. One child has been lost for the follow-up observation.