gms | German Medical Science

63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

13. - 16. Juni 2012, Leipzig

Brain tumours in the first year of life – a report of 22 patients in our institution

Meeting Abstract

  • G. Kammler - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Hamburg-Eppendorf
  • U. Kordes - Abteilung für pädiatrische Hämatologie und Onkologie, Universitätsklinikum Hamburg-Eppendorf
  • P. Emami - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Hamburg-Eppendorf
  • C. Hagel - Abteilung für Neuropathologie, Universitätsklinikum Hamburg-Eppendorf
  • M. Westphal - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Hamburg-Eppendorf

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocSA.02.01

DOI: 10.3205/12dgnc311, URN: urn:nbn:de:0183-12dgnc3113

Veröffentlicht: 4. Juni 2012

© 2012 Kammler et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: There is no general agreement on the term congenital brain tumours. Most authors agree on the definition of definitely congenital, probably and possibly congenital. Children younger than 12 months of age represent about 2% of all pediatric brain tumours and still have a poor prognosis. The purpose of this description was to analyze the specific clinical features, diagnosis and survival in terms of treatment.

Methods: This study analyzed retrospectively 22 infants with brain tumours treated in our institution between 1998 and 2011. Their clinical records were examined concerning age at diagnosis, clinical symptoms, MRI-studies, surgical procedures, histology and adjuvant therapy.

Results: 22 infants, including 15 girls and 7 boys, were diagnosed and treated between 1998 and 2011. The median age at diagnosis was 4 months, ranging between antenatal diagnosis at 34 weeks of gestation to 11 months. The main clinical feature in our group was macrocrania, an enlargement of the head, in up to 70% with diastasis of the cranial sutures or a tense fontanel. Focal neurological symptoms were seen in only 5 patients, three patients were diagnosed during prenatal ultrasound. Six patients had definitely congenital tumours and became symptomatic during the first week of life. All patients underwent surgery. Histology showed 33% (7) benign tumours, while 67% (14) had malignant tumours with rhabdoid tumours and anaplastic ependymoma in the posterior fossa as the most frequent malignant tumour types. The location favors the supratentorial compartment, less than half of the tumours presented in the posterior fossa, one large tumour (myofibroma) showed an extradural localization. Resection was complete in six patients, subtotal in 12 patients. One patient underwent stereotactic biopsy, due to the location of the lesion and two had an endoscopic biopsy. One patient died perioperatively. 15 patients received adjuvant chemotherapy.

Conclusions: Brain tumours still account for the majority of solid tumours in children. Tumours of the central nervous system in infants are rare and show a great spectrum of histological types. Most of the tumours have a massive size at diagnosis so that prognosis is still poor. The detection of a congenital brain tumour does not preclude normal development but warrants early intervention. Given the wide spectrum of possible histologies, an early multidisciplinary approach assures optimal outcome.