Background:Very few hospital-based or population-based studies are published in the context to the epidemiologic profile of pediatric brain tumors (PBTs) in India and Indian subcontinent.Aim:To study the demographic and histopathologic profile of PBTs according to World Health Organization 2007 classification in a single tertiary health care center in India.Materials and Methods:Data regarding age, gender, topography, and histopathology of 76 pediatric patients (0–19 years) with brain tumors operated over a period of 24 months (January-2012 to December-2013) was collected retrospectively and analyzed using EpiInfo 7. Chi-square test and test of proportions (Z-test) were used wherever necessary.Results:PBTs were more common in males (55.3%) as compared to females (44.7%) with male to female ratio of 1.23:1. Mean age was 10.69 years. Frequency of tumors was higher in childhood age group (65.8%) when compared to adolescent age group (34.2%). The most common anatomical site was cerebellum (39.5%), followed by hemispheres (22.4%). Supratentorial tumors (52.6%) were predominant than infratentorial tumors (47.4%). Astrocytomas (40.8%) and embryonal tumors (29.0%) were the most common histological types almost contributing more than 2/3rd of all tumors. Craniopharyngiomas (11.8%) and ependymomas (6.6%) were the third and fourth most common tumors, respectively.Conclusion:Astrocytomas and medulloblastomas are the most common tumors among children and adolescents in our region, which needs special attention from the neurosurgical department of our institute. Demographic and histopathologic profile of cohort in the present study do not differ substantially from that found in other hospital-based and population-based studies except for slight higher frequency of craniopharyngiomas.
Intravascular papillary endothelial hyperplasia (IPEH) (Masson's tumor) is an unusual benign vascular lesion of the skin and subcutaneous tissue, consisting of papillary formations related to a thrombus and covered by a single layer of plump endothelial cells. The lesion is often mistaken with angiosarcoma and a group of other benign and malignant vascular lesions. The clinical and radiological findings are not specific, and the diagnosis is based on the histological examination. Intracranial lesions are extremely rare with only 32 cases been reported in the literature. Only two cases of IPEH presenting as scalp swelling have been reported in the literature. We report a case of a 3-month-old boy with IPEH of scalp in the left parietal region, which was involving the skull bone and extending intracranially.
Abdominal cerebrospinal fluid (CSF) pseudocyst is a rare complication of ventriculoperitoneal (VP) shunt. It is characterized by collection of cerebrospinal fluid in the peritoneal cavity, containing the distal end of the VP shunt catheter and is surrounded by a wall composed of fibrous tissue without an epithelial lining. In this article, we report four cases of abdominal cerebrospinal fluid pseudocyst in children with VP shunt, performed for tuberculous meningitis with hydrocephalus. We have described the etiopathogenesis, the symptomatology, the diagnostic investigations, the treatment method adopted, and proposed a simple and effective treatment protocol that has resulted in rapid resolution of symptoms in all our patients. Also, one of our cases had the largest abdominal CSF pseudocyst reported in the literature with respect to weight and height of the child.
Neurocysticercosis (NCC) is a parasitic infestation of the central nervous system. NCC parasitic infestation can be misdiagnosed as hydatid cyst or intraventricular epidermoid cyst that can cause a diagnostic dilemma. A 23-year-old male patient presented with headache and vomiting for 3–4 days and giddiness for 4–5 days. Magnetic resonance imaging with contrast was suggestive of a rim-enhancing lesion at the level of the foramen of Monro. Endoscopic excision of the lesion was done, and the patient had relief of a headache and vomiting immediately after the procedure. He is being followed up regularly. Intraventricular NCC occluding both foramen of Monro is a rare entity. Complete endoscopic surgical excision followed by appropriate drug therapy should be given to achieve a cure.
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