Recurrent Brain Tumors in Children

Abstract

A significant cohort of children with central nervous system tumors will fail initial therapeutic intervention and demonstrate recurrent disease. Treatment of children with these recurrent tumors requires a comprehensive multidisciplinary approach, with consideration of both histologic classification and anatomic location of the tumor. The choice of the specific therapeutic modality selected should reflect institutional experience and seek-to advance the treatment of brain tumors in children. Children at Duke Medical Center with biologically indolent tumors and clinical or significant radiographic evidence of recurrence (low-grade/benign tumors with greater than 2-year recurrence-free interval) are usually treated by repeat surgical intervention. Children whose initial therapy did not include radiotherapy are considered for irradiation, while those previously irradiated are observed or occasionally considered for chemotherapy. Children with biologically aggressive tumors (high-grade lesions or early recurrence) are offered neurosurgical intervention if there is considerable mass effect, and subsequently enrolled on phase II chemotherapy protocols, reflecting an institutional commitment to exploring the role of this modality in the treatment of pediatric brain tumors. Children with recurrent brain tumors may derive benefit from this aggressive comprehensive approach, achieving a prolonged and quality survival.

Intraventricular pilocytic astrocytoma: A case report

“…Intraventricular neoplasms originate from cells forming the ependymal lining or the subependymal plate of the ventricular wall, choroid plexus, and glial lined structures such as septum pellucidum [5].…”

“…Pilocytic astrocytomas (PA) are World Health Organization (WHO) Grade I astrocytic neoplasms that is common in the pediatric population with a peak incidence between 8 and 13 years of age [1,5,7,9,10]. These tumors are most frequently encountered in infratentorial structures, like cerebellum or optic pathway.…”

Periventricular and Intraventricular Tumors in a Low-Income Country: Hard Learning Curve and Outcome of a Young Neurosurgeon from Burkina Faso

“…This led us to the word periventricular tumors. Thus, periventricular and intraventricular processes are life-threatening conditions because of their propensity to obstruct Cerebrospinal fluid pathways and to compress highly functional and vital structures [5,6]. Surgical resection alone or as the first step of multidisciplinary treatment remains a mainstay and should aim a total or maximal removal, while minimizing retraction or damage on normal brain tissue [5,7].…”