Delay in the diagnosis of paediatric brain tumours

Dobrovoljac, Milana; Hengartner, Heinz; Boltshauser, Eugen; Grotzer, Michael A.

doi:10.1007/s00431-002-1088-4

Cited by 126 publications

(125 citation statements)

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“…Although a delay has been reported in the diagnosis of pediatric cancer, the delays reported in the literature to date to our knowledge appear to be in the range of a few weeks. [15][16][17] Although these studies did not differentiate between children with abnormalities and those without abnormalities, the reported range of delays could not be the main factor in the higher rate of cancer diagnosed during the first year of life in children with abnormalities.…”

Section: Discussionmentioning

confidence: 84%

Congenital abnormalities and childhood cancer

Agha

Williams

Marrett

et al. 2005

Cancer

129

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BACKGROUNDThe examination of specific characteristics of neoplasms diagnosed in children have suggested that a significant proportion can be attributed to a genetic mutation or genetic predisposition. Although the study of a genetic predisposition to cancer in children remains in the early stages, congenital abnormalities could provide essential information for mapping predisposing lesions in children with cancer.METHODSIn the current study, 2 large cohorts of children with and without congenital abnormalities were followed for the occurrence of cancer and death up to 18 years. Through this study, the risk of developing cancer by age at diagnosis, effects of birth characteristics on cancer risk, and possible associations between specific anomalies and tumor types were examined.RESULTSBased on the follow‐up of 90,400 children, the risk of developing cancer during the first year of life was found to be nearly 6 times higher in children with anomalies (rate ratio [RR] of 5.8; 95% confidence interval [95% CI], 3.7–9.1). Children with birth defects were found to be at a higher risk for developing leukemia (RR of 2.7; 95% CI, 2.1–3.6), tumors of the central nervous system (RR of 2.5; 95% CI, 1.8–3.4), sympathetic nervous system tumors (RR of 2.2; 95% CI, 1.4–3.4), and soft tissue sarcomas (RR of 1.9; 95% CI, 1.0–3.5). Among children with birth defects, children with Down syndrome, nervous system anomalies, and anomalies of the urinary system had the highest incidence rates of cancer. In the presence of birth defects, other factors such as birth weight, gestational age, age of the mother, and birth order were not found to be associated significantly with the risk of cancer.CONCLUSIONSThe significant relative risks found in the current study provided evidence of links between the presence of abnormalities and the development of cancer. Some “cancer‐prone” abnormalities were identified in the current study. Such anomalies may be markers of other exposures or processes that increase the risk of developing cancer. Cancer 2005. © 2005 American Cancer Society.

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Section: Discussionmentioning

confidence: 84%

Congenital abnormalities and childhood cancer

Agha

Williams

Marrett

et al. 2005

Cancer

129

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“…Accordingly, only the length of the prediagnostic symptomatic interval (PSI) can provide some indirect evidence regarding the kinetics of tumour growth: Not only are differences documented between different types of brain tumours, with malignant tumours (e.g. MBs) having shorter PSIs than low-grade tumours [4,10,12,17,19], but considerable variability is seen within the patient group with MB [2,8]: In a large prospective series, we found PSIs ranging from 0 to 24 months, with a median of 2 months. Interestingly, the group of patients with the longest PSIs had lower stage disease at diagnosis and a better overall survival probability than that with shorter PSIs [6].…”

Section: Discussionmentioning

confidence: 99%

Natural history of a medulloblastoma: 30 months of wait and see in a child with a cerebellar incidentaloma

et al. 2013

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INTRODUCTION:With the increasing use of neuroimaging studies, the discovery of incidental neoplastic lesions is becoming more frequent. However, standard procedures are lacking, and little is known about their optimal management. CASE REPORT: We here present the case of a boy with a cerebellar mass incidentally discovered on a CT scan performed after head trauma. In another scan performed after another incident of head trauma 14 months earlier, the lesion could be seen after retrospective examination. In view of the asymptomatic clinical and stable radiological status and the presumed diagnosis of a low-grade glioma, a watch-and-wait strategy was elected. After clinical and radiological progression was observed, the tumour was resected, 2½ years after the initial imaging study. Histological evaluation revealed a WNT pathway-activated classical medulloblastoma. DISCUSSION: To our knowledge, this is the first description of such a long natural history and pre-symptomatic period of a medulloblastoma. The long period of stability followed by a period of accelerated tumour growth is compatible with increasing biological aggressiveness, possibly related to the stepwise accumulation of genetic changes. DOI: https://doi.org/10.1007/s00381-013-2077-9Posted at the Zurich Open Repository and Archive, University of Zurich ZORA URL: https://doi.org/10.5167/uzh-81611 Accepted Version Originally published at: Zeilhofer, Ulrike B; Scheer, Ianina; Warmuth-Metz, Monika; Rushing, Elisabeth J; Pietsch, Torsten; Boltshauser, Eugen; Grotzer, Michael A; Gerber, Nicolas U (2013). Natural history of a medulloblastoma: 30 months of wait and see in a child with a cerebellar incidentaloma. Child's Nervous System, 29 (7) ABSTRACTWith the increasing use of neuroimaging studies, the discovery of incidental neoplastic lesions is becoming more frequent. However, standard procedures are lacking and little is known about their optimal management. We here present the case of a boy with a cerebellar mass incidentally discovered on a CT scan performed after head trauma. In another scan performed after another incident of head trauma 4 months earlier, the lesion could be seen after retrospective examination. In view of the asymptomatic clinical and stable radiological status and the presumed diagnosis of a low-grade glioma, a watch-and-wait strategy was elected. After clinical and radiological progression was observed, the tumour was resected, 2½ years after the initial imaging study. Histological evaluation revealed a WNT pathway-activated classical medulloblastoma. To our knowledge, this is the first description of such a long natural history and pre-symptomatic period of a medulloblastoma. The long period of stability followed by a period of accelerated tumour growth is compatible with increasing biological aggressiveness, possibly related to the stepwise accumulation of genetic changes.

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“…In this study the ratio of power in the delta-theta band (1)(2)(3)(4)(5)(6)(7)(8) to that in the alpha-beta band as an indicative of gain (loss) in low (high) frequency power [19] is considered.…”

Section: ) Power Ratio Index (Pri)mentioning

confidence: 99%

“…All the five conventional EEG bands are considered in this study i.e., [1,4] Hz for the delta (i=d), [4,8] Hz for theta (i=t), [8,13] Hz for alpha (i=a), [13,30] Hz for beta (i=b) and [30,40] Hz for gamma (i=g) bands, respectively i.e., RIR d represents RIR of delta band and so on.…”

Section: ) Relative Intensity Ratio (Rir)mentioning

confidence: 99%