EPI-01REVIEW OF CLINICAL PRESENTATION AND TRAJECTORY OF PEDIATRIC PATIENTS (0-18 YEARS OF AGE) WITH A DIAGNOSIS OF PRIMARY BRAIN TUMOUR (BT) IN A PEDIATRIC TERTIARY CENTER

Abstract

INTRODUCTION: Recognition of BT remains a challenge among pediatric patients. Few studies have treated initial presentation, clinical evolution and healthcare system factors in the same cohort. OBJECTIVES: To determine the presentation patterns and health care trajectory of patients with primary BT. Compare presentation patterns between different age groups and different settings of diagnosis. METHOD: Through a retrospective chart review of patients ,18 yo diagnosed with primary BT by neuroimaging between 2003 and 2014. RESULTS: 288 patients were identified. Mean age at diagnosis: 7.44+0.29 years. 35% consulted only once prior to diagnosis. Mean time between the onset of symptoms and diagnosis: 147+19 days; or first consultation: 84+ 14 days. Most frequent symptoms/signs at onset and diagnosis were respectively: headache (44% vs 59%, p ,0.001), nausea/vomiting (31% vs 58%, p ,0.001), gait abnormalities (10% vs 32%, p ,0.001). 129 patients (45%) were diagnosed in an Emergency Department (ED), while 96 patients (33%) were diagnosed as outpatients. Symptoms/signs that differed for those diagnosed in ED were: headache (71% vs 42%, p ,0.001), nausea/vomiting (73 % vs32%,p,0.001), lethargy (26%vs9%,p 1⁄4 0.002).Clinical presentations of infants ,3 yo (20%) differed from other age groups. They presented mostly with lethargy(35%), irritability (33%),macrocephaly (26%).CONCLUSION: Headache is themostcommonpresentingsymptomofBT.Diagnosis ismost frequentlymade in theED.Thedelaybetween theonsetof symptomsanddiagnosis is up to five months, mostly after multiple consultations. Neuro-Oncology 18:iii40–iii41, 2016. doi:10.1093/neuonc/now071.1