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Brain tumors in infants
Seyyed Mohammad Ghodsi1, Zohreh Habibi2, Sara Hanaei2
1Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Science, Tehran, Iran.
Insights
Infant brain tumors require surgical resection, often followed by chemotherapy, for optimal outcomes. This study highlights key symptoms, diagnoses, and survival rates in young children with brain tumors.
Area of Science:
- Pediatric Neurosurgery
- Pediatric Oncology
- Childhood Brain Tumors
Background:
- Infant brain tumors exhibit distinct clinical and pathological characteristics compared to older children.
- Early diagnosis and treatment are crucial for improving prognosis in infants.
Purpose of the Study:
- To analyze the clinical presentation, surgical management, histopathological findings, and outcomes of primary brain tumors in infants.
- To identify factors influencing survival and disease control in this specific population.
Main Methods:
- Retrospective analysis of 31 infants (<12 months) treated for primary brain tumors between 2008 and 2014.
- Data collected included clinical symptoms, tumor location, surgical procedures, histopathology, and patient outcomes.
Main Results:
- Common symptoms included increased head circumference, bulging fontanel, and vomiting. Primitive neuroectodermal tumors were most frequent.
- Gross total resection was achieved in 19 patients. 30-day mortality was 19.3%. Overall survival was 58%, with 41.9% disease-free survival.
Conclusions:
- Surgical resection is the primary treatment for infant brain tumors.
- Adjuvant chemotherapy may be necessary for complete tumor control and improved survival rates.
Background:
Brain tumors in infants have different clinical presentations, anatomical distribution, histopathological diagnosis, and clinical prognosis compared with older children.
Materials And Methods:
A retrospective analysis was done in patients <12 months old who were operated on for primary brain tumor in Children's Hospital Medical Center since 2008 to 2014.
Results:
Thirty-one infants, 20 males and 11 females, with the mean age of 7.13 months (0.5-12) were enrolled. There were 16 supratentorial and 15 infratentorial tumors. The presenting symptoms included increased head circumference (16); bulge fontanel (15); vomiting (15); developmental regression (11); sunset eye (7); seizure (4); loss of consciousness (4); irritability (3); nystagmus (2); visual loss (2); hemiparesis (2); torticollis (2); VI palsy (3); VII, IX, X nerve palsy (each 2); and ptosis (1). Gross total and subtotal resection were performed in 19 and 11 cases, respectively. Fourteen patients needed external ventricular drainage in the perioperative period, from whom four infants required a ventriculoperitoneal shunt. One patient underwent ventriculoperitoneal shunting without tumor resection. The most common histological diagnoses were primitive neuroectodermal tumor (7), followed by anaplastic ependymoma (6) and grade II ependymoma. The rate of 30-day mortality was 19.3%. Eighteen patients are now well-controlled with or without adjuvant therapy (overall survival; 58%), from whom 13 cases are tumor free (disease free survival; 41.9%), 3 cases have residual masses with fixed or decreased size (progression-free survival; 9.6%), and 2 cases are still on chemotherapy.
Conclusion:
Brain tumors in infants should be treated with surgical resection, followed by chemotherapy when necessary.
