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Most central nervous system tumours in children are diagnosed with little delay after admission
Ditte Juel Adolfsen Løhmann1, Preben Sørensen, Jesper Jørgensen
1Børneafdelingen, Aarhus Universitetshospital, Brendstrupgårdsvej 100, 8200 Aarhus N, Denmark. dadolfsen@gmail.com.
Insights
Delays in diagnosing pediatric central nervous system (CNS) tumors after initial symptoms can negatively impact outcomes. This study found most children received timely diagnosis and surgical intervention within days of admission and diagnosis, respectively.
Area of Science:
- Pediatric Oncology
- Neurosurgery
- Clinical Diagnostics
Background:
- Children with central nervous system (CNS) tumors often experience prolonged symptom intervals before diagnosis.
- Investigating diagnostic and surgical management delays is crucial for improving pediatric CNS tumor outcomes.
Purpose of the Study:
- To investigate diagnostic and surgical management delays in children with CNS tumors after their first admission with related symptoms.
- To identify factors influencing these delays and assess the timeliness of care.
Main Methods:
- Retrospective review of medical records for 46 consecutive pediatric CNS tumor patients.
- Analysis of clinical findings, symptom duration, time to radiological diagnosis, and time to initial surgical procedures.
Main Results:
- Headache, vomiting, and lethargy were common symptoms; delays varied by tumor grade and location.
- 80% of undiagnosed cases were scanned within four days, but 10% faced diagnostic delays exceeding one week.
- 68% of resectable tumors and 83% of tumors causing hydrocephalus underwent surgery within four days of diagnosis.
Conclusions:
- Delayed diagnosis and surgical management of pediatric CNS tumors can adversely affect patient outcomes.
- The majority of cases in this small center review were diagnosed and surgically managed promptly.
- Establishing clear performance standards for diagnostic and intervention timelines is necessary.
Introduction:
Children with central nervous system (CNS) tumours often have a long symptom interval before diagnosis. We investigated delays in diagnosis and surgical management after the first admission with tumour-related symptoms.
Material And Methods:
This study reviewed the medical records of 46 consecutive children with a CNS tumour admitted to a paediatric department. Clinical findings at the time of the first admission, duration of symptoms, time to radiological diagnosis and time to initial surgical procedures were recorded.
Results:
The series comprised 26 supratentorial, 19 fossa posterior and one spinal tumour with equal numbers of high-grade and low-grade tumours. Headache, vomiting and lethargy were the most frequent symptoms, and pre-admission delay depended on tumour grade as well as location. Six cases had been diagnosed prior to admission; of the 40 undiagnosed cases, 32 (80%) were scanned within four days, but in four cases (10%) diagnosis was delayed for more than a week. Resection was performed within four days of diagnosis in 68% of children with resectable tumours (21/31). Initial surgical management of tumours causing hydrocephalus was completed within four days of diagnosis in 83% (20/24).
Conclusion:
Delay in diagnosis and surgical management after the primary admission with symptoms caused by a tumour may influence the outcome negatively. In this review from a small centre, the majority of the cases were diagnosed and managed surgically within four days of admission and diagnosis, respectively. Criteria for good performance, i.e. accepted standards for time to diagnosis and intervention, need to be specified.
Funding:
Not relevant.
Trial Registration:
Not relevant.
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