Primary Intracranial Tumors In Children

This section presents a brief overview of childhood tumors and reiterates some particular features of individual tumors. The histopathologic features of the tumors are covered in the appropriate sections.

In the pediatric age group, intracranial tumors are the most common tumors after leukemias. They are a major cause of cancer-related death in children. They may present at any time from birth on. Fetal tumors can be detected by the third trimester using ultrasonogra-phy; investigations are usually prompted by a sudden increased rate of uterine growth.

Signs of hydrocephalus—enlarging head, bulging fontanels, vomiting—and failure to thrive are common clinical manifestations in neonates and infants, whereas older children present with headaches, seizures, visual impairment, and focal neurologic deficits.

About 50% of tumors in children occur in the infratentorial compartment. The benign and relatively benign gliomas and the malignant embryonal tumors predominate. Their regional distribution is shown in Table 11.9. The malignant gliomas, meningiomas, and neurinomas rarely affect children.

Childhood tumors pose therapeutic challenges. The selection of appropriate therapy—surgery, radiation, and chemotherapy—is aimed not only at obtaining maximal therapeutic efficacy but also at avoiding any

table 1 1.9.

Distribution of Intracranial Childhood Tumors

Cerebellum

Ventricles

Sellar Region

Pineal Region

Pilocytic astrocytoma Medulloblastoma Dermoid cyst

Ependymoma Choroid plexus Papilloma Carcinoma

Craniopharyngeoma Germinoma

Pineoblastoma Pineocytoma Germinoma Teratoma

Optic Nerve/Chiasma Hypothalamus

Cerebral Hemispheres

Brain Stem

Pilocytic astrocytoma

Diffuse astrocytoma Desmoplastic infantile astrocytoma/ganglioglioma Pleomorphic xanthoastrocytoma

Medulloepithelioma Central neuroblastoma Teratoid/rhabdoid tumor

Fibrillary astrocytoma

toxic damage to the maturing nervous tissue. Therapeutic decision-making takes several factors into account: patient's age, extent of tumor resection, histopathologic characteristics, and response to particular therapies.

A number of genetic alterations have been found in various pediatric tumors. One objective is to find consistent genetic alterations that can be applied as reliable prognostic and therapeutic guides.

Pregnancy And Childbirth

Pregnancy And Childbirth

If Pregnancy Is Something That Frightens You, It's Time To Convert Your Fear Into Joy. Ready To Give Birth To A Child? Is The New Status Hitting Your State Of Mind? Are You Still Scared To Undergo All The Pain That Your Best Friend Underwent Just A Few Days Back? Not Convinced With The Answers Given By The Experts?

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