Abstract
The aim of present study was to evaluate the incidence, clinical symptoms, pathological characteristics, surgical treatment strategies and prognosis of brain tumors in children aged two and under. The current study obtained data regarding 32 consecutive infants and young children aged two years and under, who were treated for brain tumors in the Children’s Hospital of Fudan University (Shanghai, China) between 2003 and 2013. The types of tumor, clinical manifestations, location, histological features, applied treatment strategies and outcomes were retrospectively evaluated. The male to female ratio was 1.13:1, and among a total of 32 tumors, 14 (43.8%) were suptratentorial and 18 (56.3%) were infratentorial. Intracranial hypertension was the most common onset symptom, and astrocytoma was the most common tumor type (10 cases; 31.3%), followed by ependymoma (nine cases; 28.1%) and medulloblastoma (six cases; 18.8%). Surgical tumor resection was performed in 20 patients (62.5%), who experienced a mean post-operative survival time of 67.6 months. By contrast, conservative treatment with medications was administered in 12 patients (37.5%), with a mean survival time of 25.3 months. Furthermore, four patients underwent conservative therapy combined with ventriculoperitoneal shunting to relieve intracranial pressure arising from cerebrospinal fluid accumulation, resulting in a mean survival time of 10.5 months. In conclusion, the present study indicates that surgical tumor resection may improve the overall prognosis of infants and young children aged two years and under who presented with brain tumors. In addition, ventriculoperitoneal shunts may facilitate pre- and post-operative improvement in clinical symptoms by relieving intracranial pressure; however, the shunts do not appear to increase long-term survival. Furthermore, high surgical risk is an important prognostic factor in this pediatric patient population.
Highlights
Intracranial tumors are relatively common in infants and young children; the number of cases is second only to leukemia [1] and the tumors are the most common type of solid tumor among the pediatric malignancies and have the highest mortality rates [2]
The clinical features, diagnosis and treatment strategies associated with brain tumors in infants and children under two years of age are unique
In the present 10‐year epidemiological study of such tumors in a single institution, it was identified that a marginally greater number of males were affected than females, that more tumors were infratentorial than suptratentorial (56.2 vs. 43.8%, respectively), that intracranial hypertension was the most common onset symptom and that astrocytoma was the most common tumor type
Summary
Intracranial tumors are relatively common in infants and young children; the number of cases is second only to leukemia [1] and the tumors are the most common type of solid tumor among the pediatric malignancies and have the highest mortality rates [2]. Intracranial tumors significantly affect quality of life and are one of the major causes of infant mortality [3,4]. The incidence of brain tumors in infants has reportedly been gradually increasing within recent years [5]. The clinical manifestations, location and histological features of brain tumors in infants and young children less than two years old reportedly differ by age [6]. The majority of intracranial tumors are low‐grade tumors [5], followed by ependymomas and medulloblastomas [10]
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