Pediatric Brain Tumors

Abstract

Cancer is the leading cause of death among US children between infancy and age 15. The leading cause of childhood cancer is leukemia (40%), followed by central nervous system tumors (27%). 1 The percentages are higher if ''benign'' tumors such as low-grade pilocytic astrocytomas (PAs) and craniopharyngioma are included. 2,3 There are an estimated 20,500 primary brain tumors diagnosed each year in the United States of America: 3750 cases occur in individuals aged less than 19 years and 2870 cases in those aged less than <15 years. 4 ' Pathology and LocationTumors are classified based on histology and location. The most common types of brain tumors in the pediatric age range are: PA (also known as juvenile PA or glioma, all grades), medulloblastoma, and ependymoma. Astrocytomas are of glial origin, medulloblastomas of embryonal cell origin, ependymomas of ependymal origin, and most pineal gland tumors are of germ cell origin. Craniopharyngiomas arise from the remnants of Rathke pouch, the embryologic structure that forms the anterior portion of the pituitary gland. Tumor locations are infratentorial (posterior fossa, to include the cerebellum and brainstem), supratentorial (cerebral hemispheres), and parasellar. Spinal cord tumors will not be discussed.PAs can occur anywhere in the brain: supratentorial and infratentorial, optic nerve/s, chiasm, hypothalamus, and brainstem. Medulloblastomas and ependymomas usually are found in the posterior fossa. Common parasellar tumors are craniopharyngiomas and germ cell tumors (GCTs), in addition to PAs. Approximately 50% of childhood brain tumors arise in the posterior fossa, a very uncommon location in adults. 4,5 The cause of most childhood brain tumors is unknown. Although >70% of children diagnosed with brain tumors will survive >5 years

Visual functions in children with craniopharyngioma at diagnosis: A systematic review

“…Damage of the visual pathway commonly manifests as decreased visual acuity (VA), visual field (VF) defects, typically bitemporal hemianopia, and/ or abnormal pupillary reponses [5][6][7][8][9][10][11]. Increased intracranial pressure as a result of obstructive mass effect of the tumour can lead to papilledema with subsequent optic atrophy and permanent vision loss as potential complications [8,12,13]. In addition, therapeutic interventions for CP such as tumour resection or post-surgical radiation therapy can lead to further visual loss.…”