Brain Stem Tumors of Childhood and Adolescence

Abstract

Forty children and adolescentsshowed clinical and radiographic evidence of brain stem tumors. The typical case is characterized by the insidious onset of cranial nerve involvement, pyramidal tract signs, ataxia, and behavioral changes without increased intracranial pressure. Of 28 patients who received radiation therapy, 21 (75%) showed clinical improvement. The average length of survival in the treated group was 47.2 months compared to 15.5 months in the untreated group. In general, patients who responded best to radiation therapy and survived longest were those with less extensive neurological involvement but longer duration of symptoms prior to diagnosis. In 26 pathologically verified cases, it appeared that the degree of tumor anaplasia was inversely related to survival time.Tumors of the central nervous system (CNS) are not uncom¬ mon in the pediatrie age group and have been estimated to comprise about 11% of all childhood neo¬ plasms.1 One particular site of tu¬ mor growth, the brain stem, makes up 10% to 20% of all CNS tumors in children.20 The pediatrician, therefore, who is usually the first to see the child in the course of this neoplastic process, should be par-

Current Management of Brain Stem Gliomas

“…Epstein and Wisoff [14], Hoff man et al [18] and Stroink et al [45] suggest, however, that cervico medullary tumors are more often lowgrade (juvenile pilocytic astrocytoma) and may be a continuum of the tumors that occur in the cervical spinal cord. Our experience and that of others sug gests that focal tumors carry a better prognosis than tumors that diffusely involve the brain stem [5,10,14,18,20,27,36,37,45]. In our judgment, no prospective study has confirmed that location of tumor has a prog nostic significance.…”

Malignant glioma of the brain-stem: A clinicopathological analysis of 13 cases

“…Another paediatric series confirmed 10 of 40 cases as being, histologically, glioblastoma multiforme, or mixed glioma with anaplasia (Panitch and Berg, 1970). White's (1963) series, restricted to brain-stem tumours in adults, had histological verification in 28 of 44 cases.…”

“…In a series restricted to children (Panitch and Berg, 1970), patients with benign astrocytomas had symptoms for an average of 17-0 months before diagnosis and survived for an average of 32-4 months after diagnosis was confirmed. The group of patients with 'mixed gioma with anaplasia' were diagnosed 3-0 months after the onset of symptoms and survived an additional 6-4 months in the average case.…”

Intrinsic tectal low grade astrocytomas: is surgical removal an alternative treatment? Long-term outcome of eight cases

“…They may also occur in adults but are rare and corresponded to 8% in a series of 48 brain stem tumors 15 . These tumors are silent presenting very often only late-onset aqueduct stenosis and hydrocephalus 3,16,17 . The diagnosis of low-grade astrocytomas of the tectal region was difficult until the advent of MRI 18 .…”