Childhood Brain Tumors

Abstract

1. John Crawford, MD, MS* 1. *University of California San Diego and Rady Children’s Hospital, San Diego, CA. * Abbreviations: CNS: : central nervous system CSF: : cerebrospinal fluid CT: : computed tomography MRI: : magnetic resonance imaging NF-1: : neurofibromatosis type 1 NF-2: : neurofibromatosis type 2 WHO: : World Health Organization Brain tumors are the most common solid tumor of childhood and the No. 1 cause of death among all childhood cancers. The pediatrician is pivotal in both the diagnosis and long-term management of brain tumors. A lack of awareness of the clinical signs and symptoms of brain tumors may delay diagnosis and worsen patient outcomes. After completing this article, readers should be able to: 1. Recognize the presenting signs of brain tumor (eg, headache, deteriorating school performance, ataxia, emesis). 2. Recognize the signs and symptoms of craniopharyngioma. Each year, more than 4,000 brain and central nervous system (CNS) tumors are reported in children age 0 to 19 years in the United States, according to the most recent data from the Central Brain Tumor Registry of the United States. (1) Although the incidence of five per 100,000 person-years is rare compared with other childhood malignancies, brain tumors are the most common solid tumor of childhood. Most importantly, brain tumors are the No. 1 cause of death among all childhood cancers, according to surveillance, epidemiology, and survival data. (2) Childhood brain tumors represent an anatomically and biologically diverse group of neoplasms that can present with both common and unusual symptoms. A lack of awareness of the clinical signs and symptoms of brain tumors may lead to a delayed diagnosis by clinicians. The pediatrician is pivotal in both the diagnosis and long-term management of brain tumors. This primary care–focused review will offer a practical overview of childhood brain tumors, including diagnosis, classification, management, and both early and late effects. Potential late effects of therapy include neurocognitive deficits, endocrinopathies, vasculopathies, and development of secondary neoplasms. A greater awareness of …