Pediatric intramedullary spinal cord tumors

Abstract

The objective of this review was to analyze the literature on the management of intramedullary spinal cord tumors to determine whether enough information was available for treatment guidelines to be established. Using standard computerized search techniques, databases containing medical literature were queried for keywords related to intramedullary spinal cord tumors, beginning in 1966. Of the 445 articles published in English and with potential relevance, only 75 articles were included in the final analyses. Based on the strength of their recommendations for the treatment of this controversial condition, articles were divided into class I, class II and class III data. There were no class I studies related to any aspect of the treatment of intramedullary spinal cord tumors. Based on this critical review of literature, gross total removal of an ependymoma confirmed by immediate postoperative magnetic resonance imaging and adjunctive treatment for high-grade tumors using radiotherapy, with or without chemotherapy, can be recommended as standards of therapy. With the strength of a guideline, radiotherapy should be withheld after gross total removal of intramedullary ependymomas and radical resection of low-grade intramedullary astrocytomas. The use of intraoperative ultrasonography and evoked potentials, important surgical adjuncts, can also be considered guidelines. The radical resection of intramedullary low-grade astrocytomas is an option.

Pediatric Spinal Cord Tumors and Masses

“…The types of tumors seen in children tend to be different then the adult types. In evaluating the trends seen in this population, we had a large percentage of developmental tumors (dermoid, epidermoid, and teratomas) which differs from other, similar reports on tumors in this population (3,4,23,24). This does, however, counter a report by Townsend et al in a small case series of 10 patients (9).…”

“…This does, however, counter a report by Townsend et al in a small case series of 10 patients (9). In addition, the majority of tumors identified in this study were intramedullary, which is in general agreement with previous published data (3,9,10,17,25,26). Specifically, astrocytomas in this study were abundant and restricted to the cervico-thoracic region, and were intramedullary, which is in agreement with a report by Aguste and Gupta (10).…”

“…Within this group, spinal cord tumors are a relatively rare diagnosis and account for 1% to 10% of all pediatric central nervous system tumors (1)(2)(3). The most common spinal cord tumors are intramedullary (4).…”

Prognostic factors in intramedullary astrocytomas: a literature review

“…This traditional approach is more prone to bias than a metaanalysis or systematic review; however, we endeavored to unreservedly include all studies. Such an approach has been successfully used before also in other topics [21,31,50]. Moreover, studies of intramedullary astrocytoma report patient characteristics and results in a very varying fashion, practically precluding a meta-analysis or systematic review.…”

Spinal glioblastoma with brain relapse in a child: clinical considerations

“…Intramedullary glioblastoma is uncommon in all ages of life, but in children are extremely rare. [6][7][8] Intramedullary glioblastoma shows a slight predilection for the second and third decades of life, the mean age ranging from 28.5 years in the 20-case series of the Mayo Clinic 9 to 18.1 years according to the review of the literature undertaken by Fortuna in 1971. 10 Our patient was a 6-year-old.…”