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Intracranial tumors in the first year of life
Insights
Infantile brain tumors are often supratentorial and impact the central neural axis. Many survivors experience long-term neurological deficits, highlighting the need for effective childhood brain tumor treatments.
Area of Science:
- Pediatric Oncology
- Neurology
- Neurosurgery
Background:
- Childhood brain tumors are a significant health concern.
- Early diagnosis and treatment are crucial for improving outcomes.
- Tumors presenting in the first year of life require specific management strategies.
Purpose of the Study:
- To analyze the clinical characteristics, treatment, and outcomes of 18 infants with brain tumors.
- To identify common tumor types, locations, and presenting symptoms in this age group.
- To evaluate the efficacy of surgical and adjuvant therapies.
Main Methods:
- Retrospective analysis of 18 pediatric brain tumor cases diagnosed within the first year of life.
- Review of clinical data, including symptoms, tumor histology, surgical procedures, and adjuvant therapies.
- Assessment of patient outcomes, including survival rates and long-term neurological sequelae.
Main Results:
- Supratentorial tumors were predominant (78%), with 67% located in the central neural axis.
- Common presenting symptoms included cranial enlargement (56%) and vomiting (17%).
- Tumor types varied, with teratoma and medulloblastoma being most frequent among the analyzed cases. Nine patients died post-surgery, while 6 survivors experienced significant long-term neurological deficits.
Conclusions:
- Infantile brain tumors often present with non-specific symptoms and have a predilection for supratentorial and central neural axis locations.
- Surgical resection, often partial, combined with other therapies, was employed.
- Long-term survival is possible, but frequently associated with significant neurodevelopmental impairments, underscoring the need for improved therapeutic strategies.
Abstract:
Among 100 childhood brain tumors treated at Kobe Children's Hospital from May 1970 to June 1985, 18 of the children presented with symptoms during the first year of life. This paper analyzes these 18 cases. Supratentorial tumors (78%) were more common than infratentorial ones, and 67% of all the tumors were located in the central neural axis. Initial symptoms were cranial enlargement (56%), vomiting (17%), cranial deformity (11%), blepharoptosis, respiratory distress, and ataxia. Histological diagnosis of the tumors was as follows: teratoma (3 cases), medulloblastoma (3), glioblastoma (2), astrocytoma (2), ependymoma (2), craniopharyngioma (1), choroid plexus papilloma (1), hamartoma (1), lipoma (1), melanotic progonoma (1), and an undetermined type, probably medulloblastoma (1). Seventeen of the patients underwent craniotomy for tumor resection (4 total, 4 subtotal and 7 partial removal, and 2 biopsies). Additional therapeutic methods used separately and in various combinations included ventriculoperitoneal shunt, subduralperitoneal shunt, ventricular drainage, radiotherapy and chemotherapy. Nine patients died (average 98 days) after surgery. Of the 9 survivors, 6 are still alive after more than 5 years. Five of the 6 are mentally retarded and 4 are physically handicapped to some degree.