Artikel
The spectrum of paediatric skull tumours
Das Spektrum pädiatrischer Schädeltumoren
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Veröffentlicht: | 4. Juni 2021 |
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Gliederung
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Objective: Skull tumors are rare in childhood and no comprehensive data exist. Affected children may be treated by different medical specialities. This retrospective study provides an overview and recommendations for diagnostics and treatment.
Methods: This is a retrospective study of a consecutive single unit series of patients who underwent surgery for tumors affecting the skull. Patient characteristics, imaging, histopathology, treatment and prognosis were investigated.
Results: 65 patients (58% female, 42% male) have been operated between March 2009 and February 2020. Mean age at time of surgery was 5.4 years (0.17-20.83). 64 patient had visible or palpable masses, one was suffering from diabetes insipidus (multilocular Langerhans hostiocytosis, LCH). All patients received CT- or MRI imaging. Histology: dermoid cyst (29;44.6%), dermoid cyst with dermal sinus (2;3.1%), LCH (8;12%), fibrous dysplasia (4;6.2%), aneurysmatic bone cyst (3;4.6%), ossifying fibroma (2;3.1%) and osteoma (2;3.1%). The remaining cases suffered from rare entities (fasciitis, myofibroma, hemangioma etc). 2 patients developed a 2nd malignant tumor manifestation (sarcomas) in the skull region after treatment for primary brain tumors (secondary glioblastoma, anaplastic meningioma). 3 patient received chemotherapy alone, 2 radio-chemotherapy. All others have been cured with surgery alone. Skull base tumors have been treated by an interdisciplinary surgical team. Radiological diagnosis was not conclusive in cases other than dermoid cysts. A blinded radiological evaluation was performed by 2 independent radiologists. Typical tumor related locations and age groups have been identified.
Conclusion: Nearly one half of skull tumors are dermoid cysts, which can easily be diagnosed and operated. The other half represents a broad variety of different pathologies, which cannot be predicted by imaging. It is recommended to manage all skull tumors surgically and an oncological team should always be involved, since skull tumors can be part of a systemic or malignant disease. In complex tumors of the skull base an interdisciplinary surgical team provides best results. CT and/or MRI is necessary in all cases.