[Clinico-pathological investigation for infantile brain stem glioma: report of two cases]

Thirty-three children harboring brain stem glioma were treated at Nagoya University, Department of Neurosurgery during in the 16-year period from 1976 to 1991. Infantile brain stem glioma is so rare and we have only two cases (6.1%) of all 33 cases. This paper reported clinico-pathological investigation of infantile brain stem glioma. Case 1: Patient 1 was born after 38 weeks gestation, and he showed no mental nor physical retardation. His parents noticed his torticollis at 4 months of age. MRI showed exophytic abnormal enhanced mass behind the medulla oblongata. The mass was partially removed by craniectomy, and its pathological study revealed astrocytoma grade II. Since 3 months after the operation, torticollis had been gradually improved and disappeared completely 6 months later. Case 2: Patient 2 born after 41 weeks gestation, two cafe-au-lait spots were seen on the abdominal skin and hemangiomas were seen on the left shoulder and femoral area. For the initial symptoms, left oculomotor palsy was recognized at 2 months old. CT showed intrinsic enhanced abnormal mass in the mid brain up to the pons and then it invaded into right frontal lobe soon. Open biopsy was performed and the pathological examination revealed astrocytoma grade III. After IAR therapy (Interferon-beta 140 x 10(4), ACNU 20 mg x 2. Radiation; whole brain 40.8 Gy, focal 9 Gy), although left oculomotor palsy was improved temporarily, the tumor enlarged invasively and the patient died at 11 months old.