Naslov
Cerebellar tumors in childhood

Autori
Mrak, Goran ; Miklic, Pavle ; Melada, Ante ; Boban, Marko

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, ostalo

Izvornik
Paediatria Croatica / - Zagreb, 2003, 123-123

Skup
9th MEDITERRANEAN MEETING OF CHILD NEUROLOGY

Mjesto i datum
Dubrovnik, Hrvatska, 29.05.2003. - 31.05.2003

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
Brain tumor; glioblastoma; astrocytoma; hydrocephalus

Sažetak
Brain tumors are the most common solid neoplasm in childhood. From 45to 60% are located infratentorially, and benign (WHO gr. I, II) and malignant (WHO III, IV) tumors share almost the same frequency. Juvenile pylocitic astrocytomas constitute 28% of pediatric brain tumors, and meduloblastomas 15 to 20%. Patients and Methods We report on 20 children under 18 who had intrinsic cerebellar tumor and were treated by our team in Neurosurgical Department from January 1997 to December 2002. Patients were evaluated using CT and MRI. In most patients first line of diagnostic methods was CT, and for exact diagnostis of tumor type and preoperative planning a MRI scan was performed. Histology analysis showed in 12 patients cerebellar astrocytoma (10- juvenile pylocitic astrocytoma, 2- anaplastic astrocytoma (WHO gr. III), in 7 patients medulloblastoma, and in 1 haemangioblastoma. A greater prevalence of cerebellar astrocytoma was observed in female patients (10F ; 2M), when the oposite was with medulloblastomas (6M ; 1F). The one with haemangioblastoma was male. The symptoms were often insidious and nonspecific, especially in patients with cerebellar astrocytoma. In patients with medulloblastoma the duration of symptoms prior to diagnosis is considerably shorter which reflects the more rapid growth. The duration of symptoms before diagnosis varies from several weeks to months. The most frequent clinical presentation was increased intracranial pressure syndrome. Most cerebellar astrocytomas have cystic appearance on radiological scans, but the exact diagnosis could not be made only with CT or MRI. During surgery, 12 of the patients were in a pron position, whilst the remaining 6 patients were placed in sitting position, and two in lateral decubitus position. The position of patients depends on the tumor location, age and neurosurgeon preference. In all cases where the tumor is not infiltrating the brain stem total removal could be established. Ultrasonic aspiration was performed in all patients. 13 patients were operated only once , 4 patients twice, 3 patients three times during follow up period from 1-5 years. Obstructive hydrocephalus was present in 7 patients. In one patient that had decompensated hydrocephalus shunt was inserted before operation. In 5 patients hydrocephalus resolved after tumor removal, and in one the shunt was inserted after operation due to persistent symptomatic hydrocephalus. Discussion and Conclusions The most cerebellar tumors in childhood and adolescence are benign, and a great majority presents with increased intracranial pressure symptoms. Currently the best diagnostic method is MRI scanning, but could not always give exact diagnosis. Majority of tumors could be totally removed using microneurosurgical technique. While the best way of recurrent tumor management for cerebellar astrocytomas is reoperation, other malignant astrocytomas and medulloblastomas need further oncological therapy. Hydrocephalus verified preoperatively should be treated independently only in selected cases, and very rarely.

Izvorni jezik
Engleski

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