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Congenital brain tumors in a series of 56 patients
Elżbieta Jurkiewicz1, Agnieszka Brożyna, Wiesława Grajkowska
1Department of Diagnostic Imaging, MR Unit, The Children's Memorial Health Institute, Warsaw, Poland. e-jurkiewicz@o2.pl
Insights
Congenital central nervous system (CNS) tumors in infants have unique characteristics. Despite advances, outcomes for these pediatric brain tumors remain poor, influenced by tumor factors and treatment.
Area of Science:
- Pediatric oncology
- Neuro-oncology
- Developmental neuroscience
Background:
- Infant central nervous system (CNS) tumors present distinct clinical, anatomical, and histopathological features compared to older children and adults.
- These differences significantly impact therapeutic response and patient outcomes.
Purpose of the Study:
- To analyze the characteristics and outcomes of congenital CNS tumors in infants.
- To identify factors influencing the prognosis of these rare pediatric brain tumors.
Main Methods:
- Retrospective review of 56 infants (32 weeks gestation to 12 months) diagnosed with CNS tumors.
- Analysis of clinical presentation, tumor location, histopathology, treatment, and outcomes using Kaplan-Meier plots and chi-square tests.
Main Results:
- Tumors were diagnosed at a median age of 5.2 months, with most occurring supratentorially (38 cases).
- Common histopathological types included glial cell tumors (18), embryonal tumors (15), and choroid plexus tumors (12).
- Tumor size, location, diagnosis timing, histology, and therapeutic choices influenced outcomes.
Conclusions:
- Congenital CNS tumors require neurosurgical intervention in most instances.
- Despite therapeutic progress, the prognosis for these infant brain tumors remains challenging.
- Early diagnosis and tailored treatment strategies are crucial for improving outcomes in pediatric CNS malignancies.
Introduction:
Central nervous system tumors diagnosed before the end of the first year of life differ from those found in older children and in adults. The differences include mode of clinical presentation, anatomical distribution, histopathological diagnoses, response to therapy, and outcome.
Materials And Methods:
The material consists of 56 children (23 girls and 33 boys), aged at recognition 32 Hbd-12 months. We reviewed charts and MR exams according to age of the onset of symptoms, location of tumors, treatment, histopathology, and outcomes. Data of the outcome were analyzed using Kaplan-Meier plots and chi-square test.
Results:
Eleven cases were recognized before 6 weeks of life, 24 before the age of 6 months, and 21 were diagnosed up to the end of 1 year of age. Thirty-eight tumors were located in the supratentorial compartment; 18 were infratentorial. Median age of tumors' recognition was 5.2 months; 4.3 months for supratentorial and 7.2 months for infratentorial tumors. We found 18 glial cell tumors (high and low grade), 15 embryonal tumors, and 12 choroid plexus tumors.
Conclusions:
The outcome of congenital CNS tumors depends on the size, location, time of diagnosis, histological type of the tumor, and therapeutic option. Neurosurgical procedures are necessary in most cases. Despite the notable advances in therapy, the outcome remains poor.
