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Intracranial tumors of the first year of life
C Di Rocco1, A Iannelli, A Ceddia
1Department of Neurosurgery, Policlinico Gemelli, UCSC, Rome, Italy.
Insights
Early diagnosis of congenital brain tumors in infants is possible with advanced neuroimaging. Surgery remains the most effective treatment despite high risks, while radiotherapy and chemotherapy have limited roles in this vulnerable population.
Area of Science:
- Pediatric Oncology
- Neuroimaging
- Congenital Neurological Disorders
Background:
- Advances in neuroimaging facilitate earlier detection of congenital brain tumors.
- Congenital brain tumors are rare but present significant challenges in diagnosis and treatment.
Purpose of the Study:
- To analyze a series of congenital brain tumors diagnosed within the first year of life.
- To evaluate the efficacy and safety of different treatment modalities for infantile brain tumors.
Main Methods:
- Retrospective analysis of a personal series (39 children) and an international multicenter series (876 children).
- Focus on tumors diagnosed within the first 12 months of life.
- Review of surgical, radiotherapeutic, and chemotherapeutic interventions.
Main Results:
- Most congenital brain tumors in this cohort were supratentorial.
- Surgery, despite a high operative mortality, was the most effective therapeutic approach.
- Radiotherapy showed limited value due to infantile brain vulnerability.
- The role of chemotherapy remains controversial in this age group.
Conclusions:
- Early diagnosis of congenital brain tumors is achievable through modern neuroimaging.
- Surgical intervention is the primary treatment modality for infantile brain tumors.
- Current evidence suggests limited benefit from radiotherapy and an uncertain role for chemotherapy in neonates and infants with brain tumors.
Abstract:
The introduction of new diagnostic tools for neuroimaging has resulted in the early recognition of congenital brain tumors. In the present report we describe a personal series of 39 children and an International Multicenter Series of 876 children with brain tumors, in whom the diagnosis was obtained during the first 12 months of life. Most of the tumors were located within the supratentorial compartment. In spite of a relatively high operative mortality, surgery still appears to be the more effective therapy. Radiotherapy in this age group is of a scarce value, due to the vulnerability of the infantile brain. At the present time, chemotherapy still plays a controversial role.