Brain tumours in infancy - A clinicopathological study

Abstract

To investigate the clinlcopathologlcal features of brain tumours within the first year of life in Infants presenting to the Adelaide Children’s Hospital Department of Histopathology, surgical material from 1972 to 1993 and autopsies from 1962 to 1993 were reviewed. Twenty-four Infants were found, including 23 surgical cases and one autopsy case (age = 5 days to 1 year; ave = 7 months; M:F = 17:7). The most common presenting clinical symptoms were vomiting and macrocranla; other non-specific manifestations included irritability, poor feeding, loss of weight, malaise and rhinorrhoea. One case had been Identified on antenatal ultrasound performed for possible macrosomia at 34 wks. The tumours consisted of seven low- grade astrocytomas, one glioblastoma multiforme, six medulloblastomas, three teratomas, two gangliogliomas and one ependymoma. Rare neoplasms included a metastatic hepatoblastoma to the choroid plexus, a mixed primitive neuroectodermal tumor/malignant astrocytoma, a subependymoma/astrocytoma, and a choroid plexus papilloma attached to the meningeal surface associated with a developmental malformation of the ventricles. Fifty-eight percent of the tumours were located in the supratentorial region. This study demonstrates that a wide range of brain tumours occur during the first year of life with a male predominance, which differ significantly, in both clinical presentation and location from those found in the older child. Metastatic malignancy, although rare, may still occur and the location of the tumour may be affected by associated congenital malformations. Antenatal ultrasound examination may be useful in identifying congenital Intracranial tumours.