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Presentation and symptom interval in children with central nervous system tumors. A single-center experience
Chiara Stocco1, Chiara Pilotto2,3, Eva Passone3
1Department of Maternal and Child Health, IRCSS Burlo Garofolo, University of Trieste, Trieste, Italy. chiarastocco1@gmail.com.
Insights
Pediatric brain tumors often present with headache and vomiting. Early diagnosis is crucial, as survival depends on tumor grade, not diagnostic delay.
Area of Science:
- Pediatric Oncology
- Pediatric Neurology
- Neuro-oncology
Background:
- Central nervous system (CNS) tumors are a significant concern in pediatric oncology.
- Understanding early symptoms and diagnostic timelines is vital for improving outcomes in children.
Purpose of the Study:
- To describe the presenting symptoms and signs of CNS tumors in children.
- To evaluate the time interval between symptom onset and diagnosis in pediatric patients.
Main Methods:
- A retrospective observational study of 75 pediatric patients (5 months to 16 years) diagnosed between 2000 and 2011.
- Analysis of presenting symptoms, diagnostic findings, and time to diagnosis.
- Tumor characteristics including location and histology were recorded.
Main Results:
- Headache and vomiting were the most common presenting symptoms (31% each).
- At diagnosis, headache and vomiting were reported by 51% of patients; 68% had altered neurological exams.
- The median interval from symptom onset to diagnosis was 4 weeks; survival was linked to tumor grade, not diagnostic delay.
Conclusions:
- Headache and vomiting are key early indicators of brain tumors in children.
- Visual symptoms, behavioral changes, and neurological deficits are frequent.
- Prompt neurological and ophthalmological evaluations are recommended for suspected intracranial hypertension.
Purpose:
The aim of this study is to describe the symptoms and signs of central nervous system (CNS) tumors in a pediatric population and to assess the time interval between the onset of the disease and the time of the diagnosis.
Methods:
A retrospective observational study was conducted at our Oncology Pediatric Unit between January 2000 and November 2011. We included 75 children between 5 months and 16 years (mean age of 7.8 ± 4.7 years), with male to female ratio of 3:2. The tumor localization was supratentorial in 51% of cases, and the most frequent histological type was low-grade astrocytoma (48%).
Results:
Presenting symptoms were headache (31%), vomiting (31%), seizures (21%), and behavioral change (11%). The most common symptoms at diagnosis were headache (51%), vomiting (51%), visual difficulties (37%), seizures (24%), and behavioral change (21%). By the time of diagnosis, neurologic examination was altered in 68% of our patients. Vomiting (44%) and behavioral change (44%) were the most frequent symptoms in children under 4 years of age, headache (61%) and vomiting (54%) in children older than 4 years. The median interval between symptoms' onset and diagnosis was 4 weeks (range 0 to 314 weeks). A longer symptom interval was associated with younger age, infratentorial localization and low-grade tumors. The differences in symptom intervals between the different age, location, and grade groups were not statistically significant. Survival probability was influenced by tumor grade but not by diagnostic delay or age of the child.
Conclusions:
Headache and vomiting are the earliest and commonest symptoms in children with brain tumors. Visual symptoms and signs and behavioral change are often present. Abnormalities in neurological examination are reported in most of the children. Intracranial hypertension symptoms suggest the need for a neurological clinical examination and an ophthalmological assessment.
