Fetal brain tumors

Cavalheiro, Sérgio; Moron, Antônio Fernandes; Hisaba, W. J.; Dastoli, Patrícia; Silva, Nasjala Saba

doi:10.1007/s00381-003-0770-9

Cited by 63 publications

(38 citation statements)

References 20 publications

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“…The most frequent initial symptom reported in the literature, as in our study, is macrocephaly (in about one half of cases or more), rather than focal neurological signs, regardless of tumor histology or site [8,9,10,13,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34]. This symptom frequency is not only because the infant has open skull sutures that permit calvarial expansion in the presence of increased intracranial pressure due to hydrocephalus, a large tumor mass or both, but also due to the immaturity of the brain and the inability of the infant to complain of specific symptoms; these factors may delay diagnosis and permit tumor growth.…”

Section: Discussionmentioning

confidence: 99%

“…A location either inside or around the ventricle for these tumors accounted for the prevalence of hydrocephalus in 50–80% or more of cases [8,9,10,21,32,33] and explains the need for CSF diversion in one to two thirds of infants and neonates [10,33] as well as repeated cephalocenteses in 28% of fetuses [32]. Asai et al [22] reported that 31% of infants had intraventricular tumors with complicating hydrocephalus in the majority of cases, and that 66% of these patients required CSF diversion.…”

Section: Discussionmentioning

confidence: 99%

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Infantile Intracranial Neoplasms: Characteristics and Surgical Outcomes of a Contemporary Series of 21 Cases in an Egyptian Referral Center

El-Gaidi

Eissa²

2010

Pediatr Neurosurg

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Objective: To investigate the demographic, clinical, radiological, pathological and surgical features and outcomes of infantile intracranial neoplasms, the second most common neoplasm in infants. Patients and Methods: We conducted a retrospective study in the Department of Pediatric Neurosurgery at the Abo El-Reish Children’s Hospital from 2005 to 2008. Results: Out of 451 patients with primary intracranial neoplasms (age 0–14 years), 21 infants (<1 year) underwent surgery, representing 4.7% of total cases. The most common tumor was choroid plexus papilloma (23.8%), followed by teratoma (19%) then astrocytoma and ependymoma (14.3% each). Of the 21 surgical cases, 90% were intra-axial, 80% were in the supratentorial region, and 57% were intraventricular. There was only 1 case of intraoperative mortality (4.8%). Gross total excision was achieved in 65%, debulking in 30%, and biopsy in 5%. Three patients received chemotherapy, but none received radiotherapy. The statistically significant predictors of prognosis were the extent of resection and tumor grade. Conclusion: Although the prognosis for infantile intracranial neoplasms is worse than for older children, an overall promising outcome with low operative morbidity and mortality was achieved using gross total excision and appropriate adjuvant chemotherapy as part of a multidisciplinary approach.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Infantile Intracranial Neoplasms: Characteristics and Surgical Outcomes of a Contemporary Series of 21 Cases in an Egyptian Referral Center

El-Gaidi

Eissa²

2010

Pediatr Neurosurg

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“…24 There have been reports of cases in which patients have survived for a long time following complete resection, 1,13,14,22 and the prognosis is considered to be greatly improved if complete resection can be achieved. 2,5 For predicting outcome, the location and size of the mass are more important than the histological grade. 10,20 Because intracranial teratomas are usually hemorrhagic tumors, a large amount of intraoperative blood loss is often inevitable during resection, sometimes reaching and even exceeding the infant's blood volume.…”

Section: Discussionmentioning

confidence: 99%

Successful treatment of hemorrhagic congenital intracranial immature teratoma with neoadjuvant chemotherapy and surgery

Fukuoka¹,

Yanagisawa²,

Suzuki³

et al. 2014

PED

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Congenital intracranial immature teratomas carry a dismal prognosis, and the usefulness of chemotherapy for these tumors has not been elucidated. The authors report on the successful management of a case of congenital intracranial immature teratoma by using neoadjuvant chemotherapy and surgery after the failure of an initial attempt at resection. The patient was an infant who had begun vomiting frequently at the age of 12 days and had been admitted to a hospital at the age of 18 days with continued vomiting, increased head circumference, and disturbance of consciousness. A CT scan of the brain revealed a large mass in his posterior fossa and hydrocephalus. Surgery was performed on an emergent basis, but only minor tumor resection could be performed due to massive intraoperative hemorrhage. The histopathological diagnosis was immature teratoma. Postoperatively, the infant was in critical condition due to severe postoperative complications, and when he was transferred to the authors' institution 43 days after birth, his respiratory condition was still unstable because of lower cranial nerve palsy. Chemotherapy with carboplatin and etoposide resulted in moderate shrinkage of the tumor. Further chemotherapy led to improvement in the patient's general condition and weight gain, which allowed for a second attempt at resection. During this second surgery, which was performed when the child was 8 months of age, after 8 courses of chemotherapy, the tumor was completely resected with little bleeding. Histological findings from the second operation were consistent with mature teratoma. This case indicates that upfront chemotherapy may be effective for the initial management of such cases. Although the objective response to the treatment was modest, chemotherapy reduced the hemorrhagic nature of the tumor, facilitated improvement of the patient's general condition, and allowed for successful resection.

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“…wrodzony czaszkogardlak znajduje się na 6 miejscu pod względem częstości występowania po potworniaku (48%), gwiaździaku (36,9%), rdzeniaku zarodkowym (16%), guzie szyszynki (6,7%) i nerwiaku zarodkowym (6%) [172]. Do objawów klinicznych guza mózgu stwierdzanego po urodzeniu należą: makrocefalia, wodogłowie, duże ciemiączka, niezrośnięte szwy czaszkowe, bradykardia, zaburzenia oddychania, sinica, senność, wymioty, drgawki [168,170,[173][174][175]. U 15% dzieci stwierdza się towarzyszące inne wady wrodzone (serca, kośćca) [168,176].…”

Section: Czaszkogardlak Wrodzonyunclassified

Craniopharyngioma – epidemiology, pathogenesis, imaging, clinical symptoms

Moszczyńska¹,

Szalecki²,

Pasternak-Pietrzak³

et al. 2017

Pediatr. Endocrinol.

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Craniopharyngioma is a slowly growing, histologically benign tumor of the sellar region (I grade in WHO classification), there have been described rare cases of malignant transformation. It contributes to 5,6-14,1% of brain tumors in children. Incidence rate is 1,3-2,1/million/year and around 30-50% are diagnosed in children even as early as in their prenatal and neonatal period. There are 2 hypothesis of tumor etiopathology: the tumor origins from ectodermal remnants of Rathke's pouch (ameloblasticum type) or it arises from metaplasia of residual embryonal epithelium of the anterior pituitary gland and of the anterior infundibulum (papillary type). Adamantinomatous type is more frequent in children and papillary type dominates in adults. In around 50-95% of cases of adamantinomatous type an activating mutation in the gene CTNN1encoding β-catenin is present. BRAF V600E mutation is a genetic background of papillary craniopharyngioma, present in 95% of patients. The method of choice for craniopharyngioma diagnostics is MR imaging with contrast agents. The most frequent symptoms of craniopharyngioma are: increased intracranial pressure, visual disturbanSłowa kluczowe czaszkogardlak, włókna Rosenthala, p63, Ki67, szlak Wnt, bóle głowy, zaburzenia widzenia, niedoczynność przysadki, moczówka prosta StreszczenieCzaszkogardlak jest wolnorosnącym, histopatologicznie łagodnym guzem okolicy siodła tureckiego (I stopień wg klasyfikacji WHO), opisywano rzadkie przypadki złośliwej transformacji. Stanowi 5,6-14,1% guzów OUN u dzieci. Zapadalność wynosi 1,3-2,1/ mln/rok, 30-50% jest rozpoznawana w wieku dziecięcym, również w okresie prenatalnym czy noworodkowym. Dwie hipotezy podają etiopatogenezę guza: powstaje on z nabłonkowych pozostałości przewodu czaszkowo-gardłowego lub kieszonki Rathkego (typ szkliwiakowaty) albo w wyniku metaplazji resztkowych komórek nabłonka płaskiego przedniego płata przysadki i lejka (typ brodawkowaty).Typ szkliwiakowaty dominuje u dzieci, brodawkowaty u dorosłych. W 50-95% przypadków postaci szkliwiakowatej wykazano mutację aktywującą w genie CTNN1 kodującym β-kateninę. Mutacja BRAF V600E jest genetycznym podłożem wariantu brodawkowatego, stwierdzanym u 95% pacjentów. Metodą z wyboru w diagnostyce obrazowej czaszkogardlaka jest MR z kontrastem. Do typowych objawów czaszkogardlaka należą: wzmożone ciśnienie śródczaszko-we, zaburzenia widzenia, niedoczynność przysadki.

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Fetal brain tumors

Cited by 63 publications

References 20 publications

Infantile Intracranial Neoplasms: Characteristics and Surgical Outcomes of a Contemporary Series of 21 Cases in an Egyptian Referral Center

Infantile Intracranial Neoplasms: Characteristics and Surgical Outcomes of a Contemporary Series of 21 Cases in an Egyptian Referral Center

Successful treatment of hemorrhagic congenital intracranial immature teratoma with neoadjuvant chemotherapy and surgery

Craniopharyngioma – epidemiology, pathogenesis, imaging, clinical symptoms

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