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Study on primary central nervous system lymphoma in pediatric patients
1Department of Pediatric Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Insights
Primary central nervous system lymphoma (PCNSL) in children is rare, especially in immunocompetent individuals. This study highlights headache as a key symptom and notes the poor prognosis associated with this rare pediatric cancer.
Area of Science:
- Pediatric Oncology
- Neuro-oncology
- Immunology
Background:
- Primary central nervous system lymphoma (PCNSL) presents significant diagnostic and treatment challenges in pediatric patients.
- PCNSL in immunocompetent children is infrequently reported, necessitating further research into its characteristics and outcomes.
Purpose of the Study:
- To describe the demographic and clinical features of pediatric PCNSL.
- To analyze treatment strategies and patient outcomes in pediatric PCNSL cases.
Main Methods:
- Retrospective review of 11 immunocompetent pediatric patients diagnosed with PCNSL (January 2012 - April 2020).
- Data collection included demographics, presenting symptoms, tumor characteristics, treatment, and prognosis.
- Survival analysis was performed using Kaplan-Meier method and SPSS software.
Main Results:
- The cohort included 11 patients (10 males, 1 female) aged 4-15 years (median 10.6).
- Headache was the most frequent symptom (81.8%). Tumors occurred in both supratentorial and infratentorial regions.
- Average survival was 44.4 months, with 5 deaths within the follow-up period.
Conclusions:
- Headache is a primary symptom of pediatric PCNSL.
- PCNSL exhibits imaging features similar to other intracranial tumors and carries a poor prognosis.
- Pediatric neurosurgeons must be vigilant in diagnosing and managing intracranial lymphoma in children.
Background:
Primary central nervous system lymphoma (PCNSL) in pediatric patients presents diagnostic and treatment challenges, leading to delays and suboptimal strategies. Moreover, PCNSL in immunocompetent pediatric patients is rarely reported. This retrospective study aimed to describe the demographic and clinical features, as well as outcomes, of pediatric PCNSL cases.
Methods:
A retrospective review was conducted on 11 immunocompetent pediatric patients diagnosed with PCNSL between January 2012 and April 2020. Data regarding age, gender, initial presenting symptoms, tumor location, and radiological characteristics were collected. Treatment strategies and analyzed prognosis were documented. Survival curves were generated using the Kaplan-Meir method, and data were analyzed using SPSS (version 23.0, IBM Corp.).
Results:
The study cohort comprised 11 patients, including 10 males and 1 female. The age at diagnosis ranged from 4 to 15 years, with a median age of 10.6 years. Headache was the most common presenting symptom, observed in 81.8% (9/11) of patients. Tumor locations in the supratentorial and infratentorial regions exhibited a similar occurrence rate. All tumors showed strong contrast enhancement on T1-weighted images. The average survival time for the 11 patients was 44.4 months. Among them, 5 patients died by the last follow-up visit, with a mean survival time of 8.8 months (one patient died in a car accident).
Conclusion:
Headache is the predominant manifestation of PCNSL in pediatric patients. PCNSL demonstrates imaging characteristics resembling various intracranial tumors and is associated with a poor prognosis. Therefore, pediatric neurosurgeons should exercise caution in diagnosing and treating intracranial lymphoma.
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