Introduction:
Brain tumors are second most common childhood malignancy after leukemia. It contributes to 20% of pediatric cancers. With the improvement in imaging, surgical modalities, radiation therapy & chemotherapy, the outlook of children with brain tumors has improved. These combined modalities give the maximum benefit to the patients however the early diagnosis is important for good results.
Aetiology:
Though it is unclear, certain familial syndromes are associated with brain tumors showing genetic predisposition.
Neurofibromatosis
Ataxia telengiectasia
Tuberous sclerosis
Von Hipple- Lindau disease
Types:
Astrocytoma
Medulloblastoma
Ependymoma
Glioblastoma
Craniopharyngioma
Pineal gland tumors
Choroids plexus tumors
Meningioma
Neuroblastoma
Primitive neuroectodermal tumors
Rhabdoid tumors
Symptoms:
Projectile vomiting
Headache
Irritability
Unable to balance while walking
Weakness of limbs
Convulsions
Behavioral changes
Investigations:
CT/MRI –brain ( Plain & Contrast films)
CSF examination for malignant cells
Complete blood counts
Biochemistry
Chest X-Ray
Treatment:
Surgery-
Complete excision or debulking surgery should be the aim. The ventriculoperitoneal shunt (VP shunt) can be done in sick child for rapid decompression in raised intracranial tension. If the complete excision is not possible stereotactic biopsy or craniotomy with biopsy of the tumor is done.
Radiotherapy-
With the modern radiotherapy (use of linear accelerator) the radiotherapy related complications are minimized. The Radiotherapy should be avoided below 3 years as the brain is still developing. In case of spinal metastasis the RT is also given to the spine.
Chemotherapy- The use of platinum based chemotherapy after surgery and radiotherapy for minimum residual disease improved the prognosis in children with brain tumors.
Subscribe to:
Posts (Atom)
