Friday, July 7, 2017

A Brief Discussion Of CNS Tumors In Children



Brain Tumors in children tend to be located in the posterior fossa, in the midline, have greater differentiation and have slightly better survival figures than their counterparts in adults.

The anatomical grouping together of brain tumors masks their diverse biological differences. As a general rule brain tumors do not metastasize out of the CNS.

Treatment options for CNS tumors remains controversial but usually involves surgery and/or radiotherapy.

Clinical Features

Brian tumors are notoriously difficult to diagnose because of thier varied and often non-specific presentations. The mean time from onset of symptoms to diagnosis is usually around 5 to 6 months.

The most common presenting symptom is vomiting and headache. Other features that may be seen are changes in personality and mood, deterioration of school performance, growth failure, weight loss and seizures. Some children may present with disturbance of speech and developmental delay.

A brief discussion of different CNS tumors in children is given here:

Astrocytoma
  • Most commonly occurring brain tumor.
  • Range from low grade (benign) tumors, usually in the cerebellum, to high grade (malignant) tumors, usually supratentorial and in the brain stem.
  • The glioblastoma multiforme tumor has a near fatal prognosis.
Medulloblastoma
  • It is a primitive neuroectodermal tumor (PNET) occurring in the cerebellum.
  • Constitute 20% of the brain tumors.
  • The most commonly occurring high grade tumor.
  • Commonly metastasizes within the CNS, and it is the one tumor that can metastasize out of the CNS.
  • Prognosis is in the range of 50% 5 year survival.
Brain stem glioma
  • Constitutes 20% of brain tumors.
  • Can be either diffuse e.g diffuse pontine glioma or may be local.
  • Prognosis: has less than 10% survival.
Cranipharyngioma
  • Constitutes 8% of brain tumors.
  • Situated in the suprasellar region predominately.
  • Presenting features may be in the form of raised intracranial pressure, visual disturbances, pituitary dysfunction and psychological abnormalities .

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