Incidental Brain Tumors in the Pediatric Population: A Systematic Review and Reappraisal of Literature

Jumah, Fareed; Rallo, Michael S.; Quinoa, Travis; Raju, Bharath; Narayan, Vinayak; Gupta, Gaurav; Nanda, Anil

doi:10.1016/j.wneu.2020.02.178

Cited by 6 publications

(14 citation statements)

References 40 publications

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“…Nonetheless, treatment plans should be individually tailored to each patient after carefully weighing the risks and benefits of intervention versus surveillance. The lack of symptoms in our patient was likely due to small tumor size, which is frequently the case in many pediatric tumors [22]. However, the decision to intervene in our patient was preferred given the sensitive location of the lesion and the potential for symptom development (e.g., endocrinopathy and compression of optic chiasm) following tumor growth.…”

Section: Discussionmentioning

confidence: 93%

“…In this report, we demonstrate long-term tumor control in an incidentally discovered hypothalamic glioma. The approach to incidental brain lesions in pediatrics focuses on conservative management as the vast majority of these lesions is benign and requires no intervention [22][23][24]. Conservative management can also be considered in progressive lesions.…”

Section: Discussionmentioning

confidence: 99%

“…Conservative management can also be considered in progressive lesions. A recent systematic review showed that despite clinical or radiological progression in 22% of surveilled lesions, 62% of them remained asymptomatic and/or stopped growing and therefore continued to be safely observed [22]. Nonetheless, treatment plans should be individually tailored to each patient after carefully weighing the risks and benefits of intervention versus surveillance.…”

Section: Discussionmentioning

confidence: 99%

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Gamma Knife Radiosurgery in the Management of Hypothalamic Glioma: A Case Report with Long-Term Follow-Up

Jumah¹,

Abou‐Al‐Shaar²,

Mallela³

et al. 2021

Pediatr Neurosurg

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Background Optic pathway/hypothalamic gliomas are rare pediatric brain tumors. The management paradigm for these challenging tumors includes chemotherapy, radiotherapy, or surgical resection, but the optimal management strategy remains elusive. Gamma Knife radiosurgery (GKRS) has emerged as a promising treatment for such lesions as documented by a small number of cases in the literature. Case Presentation Herein, we present a rare case of hypothalamic glioma in a 13-year-old girl who was referred to our service due to growth of a an incidentally diagnosed hypothalamic lesion following head injury at the age of 8 years. The lesion demonstrated hypointensity on T1 and hyperintensity on T2 without enhancement. Given the growth of the lesion on serial imaging, a stereotactic biopsy was performed demonstrating low-grade glioma. The patient underwent GKRS treatment with a marginal dose of 15 Gy at 50% isodose line for a tumor volume of 2.2 ml. Annual radiological surveillance over the next 17 years demonstrated a gradual shrinkage of the lesion until it completely disappeared. The patient is currently a healthy 31-year-old female without any visual, endocrine, or neurocognitive complaints. Conclusion The outcome obtained after extended follow-up in our patient highlights the safety and efficacy of GKRS in the management of hypothalamic gliomas in pediatrics, which in turn can avoid potentially serious complications of surgery in this vulnerable patient population in this sensitive location.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Gamma Knife Radiosurgery in the Management of Hypothalamic Glioma: A Case Report with Long-Term Follow-Up

Jumah¹,

Abou‐Al‐Shaar²,

Mallela³

et al. 2021

Pediatr Neurosurg

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“…In a 2020 review article of incidental brain tumors in the pediatric population that included 14 studies representing more than 300 patients, the authors found that 23% of the tumors were diagnosed via head imaging obtained because of trauma. 6 Our patient was diagnosed with hepatoblastoma, which is the most common malignant liver tumor in children, but it is still exceedingly rare, comprising approximately 1% of all childhood cancers. 7,8 It is most frequently diagnosed in patients younger than 5 years of age, while older pediatric patients (5-18 years) comprise only 5% to 7% of cases.…”

Section: An Incidental Finding Of Hepatoblastoma Due To Bleeding After a Fall From Rollerblades Consultant360commentioning

confidence: 89%

An Incidental Finding of Hepatoblastoma Due to Bleeding After a Fall From Rollerblades

Guiner¹,

McCall²

2021

Consultant

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A 10-year-old boy with no significant medical history presented for evaluation after an unwitnessed fall forward from rollerblades onto asphalt. The patient reported no loss of consciousness after the fall and was able to ambulate home. Within an hour, he had developed 3 episodes of nonbloody, nonbilious emesis, vague abdominal pain, and became sleepier, according to his mother. He was brought in by emergency medical services to a level 1 pediatric trauma center, with a cervical collar and backboard in place. He was given a fluid bolus and ondansetron en route to the center. Physical examinationOn arrival (about an hour after the fall), the patient was tachycardic (heart rate, 148 bpm) and tachypneic (respiratory rate, 24 breaths/min), with a normal blood pressure and oxygen saturation level.Findings from the physical examination revealed that the boy was well nourished and alert (Glasgow Coma Scale score, 15), but he was exhibiting excessive sleepiness. He also had generalized abdominal pain with minimal guarding but no distension or overlying bruising. The remainder of the physical examination was unremarkable.

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“…5 In contemporary reviews of supratentorial pediatric midline tumors and tumor-like lesions, there is no mention or description of torcular pseudomass. [6][7][8][9] Presentation Most torcular pseudomasses were found in children younger than 1 year of age. 1 The developmental history is usually unremarkable.…”

Section: Observationsmentioning

confidence: 99%

Torcular pseudomass in a 14-month-old child: illustrative case

Villeneuve¹,

Muthialu

Cornwell

et al. 2022

Journal of Neurosurgery: Case Lessons

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BACKGROUND “Torcular pseudomass,” or redundant soft tissue in the torcular region, is not an infrequent incidental finding on advanced imaging of the brain in infants and young children. It was recently codified among pediatric neuroradiologists; however, its report in the pediatric neurosurgical community has not previously been elucidated. OBSERVATIONS The authors present a case of a 14-month-old child who presented with fever and a first-time seizure. Computed tomography of the head suggested an epidural abscess; however, magnetic resonance imaging characteristics of the lesion were consistent with torcular pseudomass, a normal variant. At the 3-month follow-up, the child was continuing to do well and had not had another seizure. There have been no indications for surgical intervention or additional radiographic surveillance. LESSONS The differential diagnosis for torcular pseudomass includes dural venous sinus thrombosis, dermoid cysts, occipital encephalocele, eosinophilic granuloma, and primary and metastatic tumors, such as neuroblastoma. The management of each of these disorders in the differential diagnosis may be much more invasive than continued observation in the case of torcular pseudomass. Therefore, it is important for pediatric neurosurgeons to become familiar with this developmental anomaly of the dura and occipital skull.

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Incidental Brain Tumors in the Pediatric Population: A Systematic Review and Reappraisal of Literature

Cited by 6 publications

References 40 publications

Gamma Knife Radiosurgery in the Management of Hypothalamic Glioma: A Case Report with Long-Term Follow-Up

Gamma Knife Radiosurgery in the Management of Hypothalamic Glioma: A Case Report with Long-Term Follow-Up

An Incidental Finding of Hepatoblastoma Due to Bleeding After a Fall From Rollerblades

Torcular pseudomass in a 14-month-old child: illustrative case

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