Diagnosis and Treatment of Pediatric Brain Tumors

Hodzic, Mirsad; Ercegovic, Zlatko; Korkut, Dželil; Moranjkic, Mirza; Brkic, Harun; Jakupovic, Selma

doi:10.5644/ama2006-124.305

Cited by 2 publications

(2 citation statements)

References 13 publications

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“…Pediatric central nervous system (CNS) tumors are the second most common cancer affecting children after leukemia and the most common solid tumors occurring in this population. Brain tumors are responsible for the most cancer-related deaths in children [1]. The incidence rate of childhood and adolescent primary malignant and nonmalignant brain tumors in Poland is 2.03 per 100,000 children aged 0 to 19 years, which constitutes 14.98% of pediatric cancer morbidity [2].…”

Section: Introductionmentioning

confidence: 99%

Predicting the WHO Grading of Pediatric Brain Tumors Based on Their MRI Appearance: A Retrospective Study

Grudzień,

Klimeczek-Chrapusta,

Kwiatkowski

et al. 2023

Cureus

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The treatment of central nervous system (CNS) tumors constitutes a significant part of a pediatric neurosurgeon's workload. The classification of such neoplasms spans many entities. These include low-and high-grade lesions, with both occurring in the population of patients under 18 years of age.Magnetic resonance imaging serves as the imaging method of choice for neoplastic lesions of the brain. Through its different modalities, such as T1, T2, T1 C+, apparent diffusion coefficient (ADC), diffusionweighted imaging (DWI), susceptibility-weighted imaging (SWI), fluid-attenuated inversion recovery (FLAIR), etc., it allows the medical team to plan the therapeutic process accordingly while also possibly suggesting the specific tumor subtype prior to obtaining a definitive histological diagnosis.We conducted a retrospective study spanning 32 children treated surgically for brain tumors between July 2021 and January 2023 who had a precise histological diagnosis determined by using the 2021 WHO Classification of Tumors of the Central Nervous System. We divided them into two groups (high-grade and low-grade tumors, i.e., WHO grades 1 and 2, and grades 3 and 4, respectively) and analyzed their demographic data and preoperative MRI results. This was done using the following criteria: sub or supratentorial location of the tumor; lesion is circumscribed or infiltrating; solid, cystic, or mixed solid and cystic character of the tumor; number of compartments in cystic lesions; signal intensity (hypo-, iso-, hyperintensity sequences: T1, T2, T1 C+); presence of restricted diffusion; the largest diameter of the solid component and/or the largest diameter of the largest cyst in the transverse section. Then, we examined the results to find any correlation between the lesions' morphologies and their final assigned degree of malignancy.We found that the only radiological criteria correlating with the final WHO grade of the tumor were an infiltrative pattern of growth (25% of low-grade lesions, 75% of high-grade; p = 0.006) and the presence of a cystic component in the tumor (in 68.75% of low-grade tumors and 43.75% of high-grade tumors; p = 0.041). The only other feature close to attaining statistical significance was diffusion restriction (33.3% of lowgrade tumors, 66.7% high-grade; p = 0.055). Older children tended to present with tumors of lower degrees of malignancy, and there was a predominance of female patients (21 female, 11 male).

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Section: Introductionmentioning

confidence: 99%

Predicting the WHO Grading of Pediatric Brain Tumors Based on Their MRI Appearance: A Retrospective Study

Grudzień,

Klimeczek-Chrapusta,

Kwiatkowski

et al. 2023

Cureus

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“…Moreover, the age-standardized incidence rate of CNS cancers has increased by 17.3% from 1990 to 2016 (2). Pediatric brain and spine tumors are a subset of CNS cancers, representing roughly 17% of all childhood malignancies (3). They are the most common solid tumors of childhood and are the leading cause of cancer-related death in children and adolescents (4)(5)(6).…”

Section: Introductionmentioning

confidence: 99%

Pediatric neurosurgical-oncology scope and management paradigms in Sub-Saharan Africa: a collaboration among 7 referral hospitals on the subcontinent

Haizel-Cobbina,

Chotai,

Labuschagne

et al. 2023

Front. Oncol.

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BackgroundUnderstanding of the epidemiology and biology of pediatric CNS tumors has advanced dramatically over the last decade; however there remains a discrepancy in the understanding of epidemiologic data and clinical capacity between high- and lower-income countries.ObjectiveWe collected and analyzed hospital-level burden and capacity-oriented data from pediatric neurosurgical oncology units at 7 referral hospitals in Sub-Saharan Africa (SSA).MethodsA cross sectional epidemiological survey was conducted using REDCap at the 7 SSA sites, capturing 3-month aggregate data for patients managed over a total of 9 months. Descriptive statistical analyses for the aggregate data were performed.ResultsAcross the neurosurgical spectrum, 15% of neurosurgery outpatient and 16% of neurosurgery operative volume was represented by pediatric neuro-oncology across the 7 study sites. Eighty-six percent and 87% of patients who received surgery underwent preoperative CT scan and/or MRI respectively. Among 312 patients evaluated with a CNS tumor, 211 (68%) underwent surgery. Mean surgery wait time was 26.6 ± 36.3 days after initial presentation at the clinic. The most common tumor location was posterior fossa (n=94, 30%), followed by sellar/suprasellar region (n=56, 18%). Histopathologic analysis was performed for 189 patients (89%). The most common pathologic diagnosis was low grade glioma (n=43, 23%), followed by medulloblastoma (n=37, 20%), and craniopharyngioma (n=31, 17%). Among patients for whom adjuvant therapy was indicated, only 26% received chemotherapy and 15% received radiotherapy.ConclusionThe histopathologic variety of pediatric brain and spinal tumors managed across 7 SSA referral hospitals was similar to published accounts from other parts of the world. About two-thirds of patients received a tumor-directed surgery with significant inter-institutional variability. Less than a third of patients received adjuvant therapy when indicated. Multi-dimensional capacity building efforts in neuro-oncology are necessary to approach parity in the management of children with brain and spinal tumors in SSA.

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Diagnosis and Treatment of Pediatric Brain Tumors

Cited by 2 publications

References 13 publications

Predicting the WHO Grading of Pediatric Brain Tumors Based on Their MRI Appearance: A Retrospective Study

Predicting the WHO Grading of Pediatric Brain Tumors Based on Their MRI Appearance: A Retrospective Study

Pediatric neurosurgical-oncology scope and management paradigms in Sub-Saharan Africa: a collaboration among 7 referral hospitals on the subcontinent

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