-Objective and Method: To review the clinical and neuropathological findings as well as the type of therapy and outcome in 20 infants under 3 years-old with central nervous system (CNS) tumor. They were treated at the Department of Neurology, "Hospital das Clínicas" University of São Paulo Medical School, from January 1997 to May 2001. Results: Astrocytoma was the most common histological type (n=7), followed by ependymoma (n=3), medulloblastoma (n=2), craniopharyngioma (n=2) and desmoplastic ganglioglioma (n=2). The location of the tumor was predominantly supratentorial. Mean follow-up time was 20.2 months with recurrence in 7 cases. For each type of tumor we have emphasized the treatment currently recommended. Conclusion: Although follow-up time is not sufficient for analyzing survival, a trend of improvement in prognosis was noted, compared to another series of cases from our Institution that had been evaluated before 1990.KEY WORDS: brain tumors, children, central nervous system tumors, neuro-oncology treatment.
Tumores do sistema nervoso central nos primeiros três anos de vida: revisão de vinte casosRESUMO -Objetivo e Método: Avaliar os aspectos clínicos e histopatológicos, o tipo de tratamento e a evolução de 20 crianças menores de três anos de idade, com o diagnóstico de tumor de sistema nervoso central, que foram tratadas em nossa Instituição no período de janeiro de 1997 a maio de 2001. Resultados: O astrocitoma foi o tumor mais comum (n=7), seguido pelo ependimoma (n=3), meduloblastoma (n=2), craniofaringioma (n=2) e ganglioglioma desmoplásico infantil (n=2). A localização do tumor foi predominantemente supratentorial. A média de seguimento foi 20,2 meses e houve recidiva em sete casos. Para cada tipo de tumor enfatizamos o tipo de tratamento recomendado na atualidade. Conclusão: Embora o tempo de seguimento não seja suficiente, ainda, para analisar a sobrevida, foi notada nítida tendência a melhor prognóstico em comparação com a casuística proviniente de nossa Instituição que analisou casos abordados antes da década de 90. SP -Brasil. E-mail: adrianaespindola@uol.com.br Nearly 8 to 20% of central nervous system (CNS) tumors occur in children under three years of age 1 . The prognosis is usually poor 2 due to diffi culties in surgical technique, the malignant histology most of these tumors and the impossibility of treating with radiotherapy 3,4 . The rate of survival is low, around 20 to 40% 4,5 ; however, after 1980, some institutions have obtained better rates of prognosis, reporting 56% of survival at 5 years and normal neurological development after treatment in 50% of the patients 6-8 . In small infants the most common histological types are ependymoma, medulloblastoma, choroid plexus papilloma, astrocytoma and teratoma. Supratentorial tumors are almost twice as frequent, particularly in the fi rst year of life 9,10 .
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Dra. Adriana Ávila de Espíndola -Avenida Dr. Enéas de Carvalho Aguiar 255 / 5º andar / sala 5031 -05403-000 São PauloClinical signs and symptoms are usua...
