MALIGNANCY GRADE and LONG-TERM SURVIVAL IN BRAIN TUMOURS of INFANCY and CHILDHOOD

Abstract

281 histologically verified brain tumours in children were revised and reclassified according to degree of histological malignancy. Survival graphs based on 100 per cent follow-up after 15-40 years show that, of those who survived for more than 1 month after diagnosis and possible operation, 40 per cent were still alive more than 15 years later. There was a clear correlation between survival and degree of malignancy. Sixty-five per cent of those with tumours of malignancy grade I and only 3 per cent of those with malignancy grade IV were alive after 15 years.

A study of childhood brain tumors based on surgical biopsies from ten North American institutions: sample description

“…Previous childhood brain tumor databases have been subject to the biases of case collections obtained from single institutions as pointed out by Gjerris [24,25]; studies of single tumor types (e.g., 3 6 39 35 13 5 Ganglioglioma 11 3 5 42 13 26 Glioblastoma 0 0 17 34 28 21 Oligodendroglioma 7 3 28 28 18 17 Medulloblastoma 7 8 40 33 9 3 Ependymoma 6 16 40 24 9 5 Choroid Plexus Papilloma 43 18 20 12 6 0 Pineoblastoma 7 31 28 21 14 0 Germinoma 2 4 7 38 42 7 Teratoma 29 0 24 19 29 0 Neurilemmoma 13 4 0 35 17 30 Neurofibroma 0 0 0 50 25 25 Meningioma 16 11 11 29 26 8 Craniopharyngioma 1 2 27 43 16 10 Unclassified tumor 14 17 35 20 10 3 astrocytoma at one institution); diagnoses provided by numerous pathologists who, because of the relative infrequency of these tumors, are not likely to have had much experience with these diseases (e.g., reference 26); or are case collections in which both autopsy and surgical cases are intermingled [27]. Unfortunately, inconsistent histologic definitions of brain tumors ...…”

“…The range for specifically named glioblastomas from 0.8% (or 2.4% if 'most malignant not classi-fied gliomas' are included) in the Danish series [24] to 26.4% in one report from the Connecticut Tumor Registry [26] is disquieting. Even more bothersome are the discrepancies in the proportions of glioblastomas and astrogliomas in the two reports from the Connecticut Tumor Registry [26,27].…”

“…Wide discrepancies in location and in histologic typing among various reports were pointed out by Gjerris and his group [24,25], specifically the different neuropathologic judgments found in Ziilch [29] and Russell and Rubinstein [30]. The many, and sometimes conflicting, histologic definitions were decried by Behrend as interfering with epidemiologic studies [28].…”

Atherosclerotic Disease of the Aortic Arch and the Risk of Ischemic Stroke

“…3 The objective criteria by which histologic features are used to make diagnoses may be applied inconsistently 3 or interpreted by different observers in the same 4,5 or separate data bases. 4,6,7 The histologic appearance of childhood brain tumors is often heterogeneous, suggesting very different tumors within the same specimen 3 -a characteristic that makes efforts to categorize such tumors according to standard World Health Organization (WHO) criteria 8 problematic. WHO histologic criteria may be applicable to more than one diagnosis; in one study, the histologic criteria for as many as four disparate tumors were similar.…”

Spinal extradural metastasis from a medulloblastoma

“…Medull oblastomas a re tu mou rs of neuroe pithelial origin, locat ed in the poste rior fossa a nd common in childre n . They constitute ab out 20 % of all intrac ra nial tumours in childre n (14,16).…”