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Pediatric-Like Brain Tumors in Adults
Sandra Fernandes Dias1,2, Oliver Richards1, Martin Elliot3
1Department of Neurosurgery, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
Insights
Pediatric brain tumors rarely occur in adults, differing significantly from adult types. Adult treatment must consider these unique biological and tolerance differences, not just pediatric protocols.
Area of Science:
- Neuro-oncology
- Pediatric Oncology
- Oncology
Background:
- Pediatric brain tumors exhibit distinct pathological, molecular, and anatomical characteristics compared to adult tumors.
- These tumors, though typically childhood-onset, can present in adults de novo or as recurrences, complicating diagnosis and management.
- Limited literature exists for adult cases, often leading to reliance on pediatric treatment strategies without considering adult-specific biological differences.
Approach:
- This review synthesizes existing literature on pediatric-type brain tumors in adults.
- It focuses on clinical presentation, pathological classification, molecular profiles, and treatment responses.
- Emphasis is placed on highlighting the critical differences between pediatric and adult populations.
Key Points:
- Medulloblastoma, ependymoma, craniopharyngioma, pilocytic astrocytoma, and other pediatric tumor types require specific consideration in adult patients.
- Adult patients may not tolerate aggressive pediatric treatment regimens, and efficacy in adults is often unproven.
- Understanding the unique biology of these tumors in adults is crucial for effective management.
Conclusions:
- Pediatric brain tumors in adults represent a unique clinical challenge requiring tailored approaches.
- Treatment decisions must account for distinct tumor biology and patient tolerance in the adult population.
- Further research is needed to establish evidence-based guidelines for managing these rare adult tumors.
Abstract:
Pediatric brain tumors are different to those found in adults in pathological type, anatomical site, molecular signature, and probable tumor drivers. Although these tumors usually occur in childhood, they also rarely present in adult patients, either as a de novo diagnosis or as a delayed recurrence of a pediatric tumor in the setting of a patient that has transitioned into adult services.Due to the rarity of pediatric-like tumors in adults, the literature on these tumor types in adults is often limited to small case series, and treatment decisions are often based on the management plans taken from pediatric studies. However, the biology of these tumors is often different from the same tumors found in children. Likewise, adult patients are often unable to tolerate the side effects of the aggressive treatments used in children-for which there is little or no evidence of efficacy in adults. In this chapter, we review the literature and summarize the clinical, pathological, molecular profile, and response to treatment for the following pediatric tumor types-medulloblastoma, ependymoma, craniopharyngioma, pilocytic astrocytoma, subependymal giant cell astrocytoma, germ cell tumors, choroid plexus tumors, midline glioma, and pleomorphic xanthoastrocytoma-with emphasis on the differences to the adult population.
