Intramedullary tumors in children: analysis of 24 operated cases

Abstract

Intramedullary tumors are rare. The authors reviewed 24 cases operated between 1996 and 2006. The study assessed the clinical characteristics and surgical results based upon the neurological function. Method: Medical records of patients with intramedullary astrocytoma and ependymoma were reviewed. The minimal follow up time was 6 months and, at the end of this period, a comparative analysis of the neurological function was performed based using the McCormick scale score. results: Most patients had astrocytoma (75%). Male gender was more prevalent (58.3%). The most common type of tumor was graded as I or II, and in three cases these were malignant. The total resection of the tumor was achieved in 20.8% of the cases. The statistical analysis did not show a statistically significant difference between preoperative and postoperative grades at McCormick scale. conclusion: The authors concluded that microsurgery to intramedullary tumors did not significantly alter the neurological function after six months. Key words: astrocytoma, ependymoma, microsurgery, spinal cord.tumores intramedulares em crianças: análise de 24 casos operados resuMo Os tumores intramedulares são doenças raras. Os autores analisaram 24 casos operados entre 1996 e 2006. O estudo analisou as características clínicas e o resultado da cirurgia quanto à função neurológica. Método: Foram analisados pacientes com astrocitomas e ependimomas intramedulares. O tempo mínimo de acompanhamento foi de 6 meses e ao final deste período foi realizada a avaliação comparativa da variação do estado neurológico baseado na escala de McCormick. resultados: A maioria dos pacientes era de astrocitoma (75%). O gênero masculino foi mais prevalente (58,3%). A maioria dos tumores era de grau I ou II, 3 casos eram malignos. A ressecção total do tumor ocorreu em 20,8% dos casos. A avaliação estatística demonstrou que não houve diferença significativa entre o estado neurológico na escala de McCormick pré-operatória e pós-operatória. conclusões: Os autores concluem que a microcirurgia para ressecção dos tumores intramedulares não ocasionou variação funcional significativa nos pacientes após seis meses da cirurgia. Palavras-chave: astrocitoma, ependimoma, microcirurgia, medula espinhal.

Surgical outcomes of pediatric spinal cord astrocytomas: systematic review and meta-analysis

“…36 We found a male preponderance among the patients in this review, which appears to be consistent with previous reports. 15,38 We also found that among individuals studied, patients first presented to care near the middle of childhood (mean 8.6 years) and underwent surgery only slightly later (mean 10.1 years old). The vast majority of tumors were located in the cervical or thoracic spine, and the most common presenting symptoms were motor.…”

“…Using data from studies that enabled extraction of data on astrocytomas only, we evaluated survival outcomes. 1,2,5,7,[9][10][11][12][13][14][15]17,18,21,22,[25][26][27][29][30][31][32][33][34]36,37,[39][40][41] We extracted individual patient data to calculate the 5-year OS stratified by histological grade and extent of resection using the Kaplan-Meier estimator. OS and the 95% CI were plotted for each study using forest plots.…”

“…5,19 Astrocytoma is the most common pediatric IMSCT and thus is the focus of this paper. 1,15,16,23 Children with spinal cord astrocytoma often present several months after the onset of symptoms, 8 with the degree of preoperative neurological function at diagnosis correlating with worse postoperative outcomes. 6,7,21,27,35 At clinical presentation, the most commonly reported symptoms are pain, motor deficits, frequent falls, sensory symptoms, and sphincter dysfunction.…”