Brain Tumors in the First Two Years of Life: A Review of Forty Cases

Reed, Conti; Rosemberg, Sérgio; Gherpelli, José Luiz Dias; Matushita, Hamilton; Almeida, Gilberto G. M.; Diament, Aron Judka

doi:10.1159/000120728

Cited by 22 publications

(13 citation statements)

References 20 publications

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“…In the first two subgroups (PNET and ependymomas), the rapid progression of the disease (100% mortality within 24 months from surgery), and the lack of exceptions to Collins’ law, support the hypothesis that histologically malignant brain tumors in young children have a very aggressive biological behavior. A predominance of more aggressive lesions in early childhood has been reported, especially for tumors located in the posterior fossa [4, 9, 13, 19, 36, 43]. It might be assumed that the more immature is the nervous tissue, the more primitive-behaving tumors may be produced.…”

Section: Discussionmentioning

confidence: 99%

“…These patients are very vulnerable both intra- and postoperatively: incomplete brain myelinization in infants and physical restraints due to the smaller size of the undeveloped brain add difficulties to the surgical performance; rapid blood loss can be critical, leading to systemic hypotension and cardiac arrhythmias; electrolyte balance and body temperature need continuous monitoring [6]. For many years, the delay in diagnosis together with surgical and anesthesiological drawbacks have been related to high morbidity and mortality, especially for children in the first year of life and for those with tumors located in the posterior fossa [3, 7, 8, 9, 10, 11, 12]. Finally, as Cohen and Duffner pointed out, before new radiotherapy and chemotherapy strategies became available, parents were often inclined to withhold therapy entirely rather than commit the child to aggressive treatment where the likelihood of neurotoxicity sometimes overcame that of efficacy [2].…”

Section: Introductionmentioning

confidence: 99%

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Brain Tumors in Children Under 3 Years of Age

Sala¹,

Colarusso²,

Mazza³

et al. 1999

Pediatr Neurosurg

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Brain tumors in children under 3 years of age differ in clinical presentation and pathological behavior from those in older patients. In this study, we reviewed data from 39 children (24 males and 15 females) under 3 years of age who were treated for intracranial brain tumors since the introduction of magnetic resonance imaging. The purpose was to assess correlations between clinicoradiological and treatment-related factors, and their impact on prognosis. The following factors were analyzed: sex, age, duration of symptoms, intracranial hypertension on admission, tumor location, surgical removal and histology. Associations between these factors and correlations with prognosis were determined using bivariate analyses (² test) and Kaplan-Meier survival curves. Collins' concept of a period of risk recurrence was tested. Mean follow-up was 41 months (range 0-136). In March 1998, 20 children were still alive (51.2%) with a mean survival time of 65 months (range 2-136). The incidence of supratentorial tumors was significantly higher in children less than 1 year old (p = 0.027). Lateral tumors were 9/10 (90%) supratentorial versus only 7/26 (27%) midline tumors (p = 0.001). Outcome (dead or alive) was significantly better (p = 0.037) for low-grade astrocytomas (9/12 = 75% survival) when compared to ependymomas (2/6 = 33%) and primitive neuroectodermal tumors (3/12 = 25%). Total tumor removal was achieved in 20 cases and was associated with a better outcome (65 vs. 33% survival; p = 0.049). Survival analysis confirmed a worse prognosis for children with ependymomas and primitive neuroectodermal tumors (p = 0.011) and revealed a worse survival for children with intracranial hypertension on admission (p = 0.047). Total tumor removal was associated with a longer survival, although not significantly (p = 0.077). Finally, we found no exceptions to Collins' law.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Brain Tumors in Children Under 3 Years of Age

Sala¹,

Colarusso²,

Mazza³

et al. 1999

Pediatr Neurosurg

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“…The malignant histological nature of the tumor at this age may also affect the prognosis but not as signifi cantly as the extension of tumor resection 9 . In a recent study with 39 children younger than three years of age, the extension of tumor removal was the most important prognostic factor 10 .…”

Section: Discussionmentioning

confidence: 99%

“…The most common clinical manifestations depend on increased intracranial pressure, vomiting, macrocephaly, drowsiness/lethargy and delay in neurological development 9,11 . Focal neurological changes are more commonly observed in the second year of life 10 .…”

Section: Resumo -Objetivo E Métodomentioning

confidence: 99%

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Brain tumors in the first three years of life: a review of twenty cases

Espíndola

Matushita

Pimenta

et al. 2007

Arq. Neuro-Psiquiatr.

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-Objective and Method: To review the clinical and neuropathological findings as well as the type of therapy and outcome in 20 infants under 3 years-old with central nervous system (CNS) tumor. They were treated at the Department of Neurology, "Hospital das Clínicas" University of São Paulo Medical School, from January 1997 to May 2001. Results: Astrocytoma was the most common histological type (n=7), followed by ependymoma (n=3), medulloblastoma (n=2), craniopharyngioma (n=2) and desmoplastic ganglioglioma (n=2). The location of the tumor was predominantly supratentorial. Mean follow-up time was 20.2 months with recurrence in 7 cases. For each type of tumor we have emphasized the treatment currently recommended. Conclusion: Although follow-up time is not sufficient for analyzing survival, a trend of improvement in prognosis was noted, compared to another series of cases from our Institution that had been evaluated before 1990.KEY WORDS: brain tumors, children, central nervous system tumors, neuro-oncology treatment. Tumores do sistema nervoso central nos primeiros três anos de vida: revisão de vinte casosRESUMO -Objetivo e Método: Avaliar os aspectos clínicos e histopatológicos, o tipo de tratamento e a evolução de 20 crianças menores de três anos de idade, com o diagnóstico de tumor de sistema nervoso central, que foram tratadas em nossa Instituição no período de janeiro de 1997 a maio de 2001. Resultados: O astrocitoma foi o tumor mais comum (n=7), seguido pelo ependimoma (n=3), meduloblastoma (n=2), craniofaringioma (n=2) e ganglioglioma desmoplásico infantil (n=2). A localização do tumor foi predominantemente supratentorial. A média de seguimento foi 20,2 meses e houve recidiva em sete casos. Para cada tipo de tumor enfatizamos o tipo de tratamento recomendado na atualidade. Conclusão: Embora o tempo de seguimento não seja suficiente, ainda, para analisar a sobrevida, foi notada nítida tendência a melhor prognóstico em comparação com a casuística proviniente de nossa Instituição que analisou casos abordados antes da década de 90. SP -Brasil. E-mail: adrianaespindola@uol.com.br Nearly 8 to 20% of central nervous system (CNS) tumors occur in children under three years of age 1 . The prognosis is usually poor 2 due to diffi culties in surgical technique, the malignant histology most of these tumors and the impossibility of treating with radiotherapy 3,4 . The rate of survival is low, around 20 to 40% 4,5 ; however, after 1980, some institutions have obtained better rates of prognosis, reporting 56% of survival at 5 years and normal neurological development after treatment in 50% of the patients 6-8 . In small infants the most common histological types are ependymoma, medulloblastoma, choroid plexus papilloma, astrocytoma and teratoma. Supratentorial tumors are almost twice as frequent, particularly in the fi rst year of life 9,10 . PALAVRAS-CHAVE Dra. Adriana Ávila de Espíndola -Avenida Dr. Enéas de Carvalho Aguiar 255 / 5º andar / sala 5031 -05403-000 São PauloClinical signs and symptoms are usua...

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Pediatric brain tumors

Pollack

1999

Semin. Surg. Oncol.

102

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Pediatric brain tumors differ from adult brain tumors in several major ways. First, the types of tumors encountered in children are uncommon in adults, and vice versa. Second, tumors of the posterior fossa comprise a far greater percentage of tumors in children as compared to adults. Third, the value of extensive tumor resection, which is controversial for malignant brain tumors in adults, has been confirmed for a variety of childhood brain tumors. Fourth, chemotherapy has been shown to be effective in improving overall outcome in several childhood brain tumors, but has yet to be demonstrated to have a major benefit for adult tumors. In addition, to avoid the morbidity of irradiation on the developing nervous system, chemotherapy is increasingly used to delay or avoid using radiotherapy in children younger than 3 years of age with high‐grade and incompletely resected low‐grade tumors. Fifth, the prognosis for histologically similar tumors is often more favorable in children than adults. A review of general principles in the clinical presentation, diagnostic evaluation, and treatment of childhood brain tumors is followed by discussion of surgical management, adjuvant therapy, and outcome of the more common types of tumors. Semin. Surg. Oncol. 16:73–90, 1999. © 1999 Wiley‐Liss, Inc.

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Brain Tumors in the First Two Years of Life: A Review of Forty Cases

Cited by 22 publications

References 20 publications

Brain Tumors in Children Under 3 Years of Age

Brain Tumors in Children Under 3 Years of Age

Brain tumors in the first three years of life: a review of twenty cases

Pediatric brain tumors

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