LGG-12. THE RATE OF GROWTH OF UNTREATED PEDIATRIC BRAIN TUMORS – A CASE SERIES

Abstract

Abstract INTRODUCTION: Radiological imaging (MRI or CT scan) provides the first line for diagnosis of brain tumors. Given the uniform fatality of malignant brain tumors, no ethical studies of rate of tumor growth without treatment are possible. Therefore, only observations from natural events can provide a clue to the rate of growth of untreated tumors. A case series of children with earlier brain scans who subsequently developed brain tumors is therefore being presented to gain an understanding of the natural evolution of these tumors. METHOD: Institutional Review Board approval was obtained. About 435 tumors treated between January 2005 and December 2015 were screened. All children with previous normal or abnormal brain imaging prior to the “diagnostic scan” were included in the study. Seven patients met the inclusion criteria and their demographic data, histology, and date of previous and diagnostic scan, clinical data including date of surgery were abstracted on to a spread sheet and analyzed for this study. The radiological evolution was reviewed with two attending radiologists. RESULTS: There were 6 males and 1 female. The mean age was 5.95 years (range 6 months to 17 years). Two patients (29%) had gangliogliomas and five patients (71%) had malignant tumors (3 medulloblastomas, one glioblastoma multiforme and one pineoblastoma). The median time from the normal scan to the diagnostic scan was 7 months for the malignant tumors and 64.75 months for the benign tumors (p = 0.37). It was observed that the gangliogliomas also started as diffuse non-enhancing lesions that evolved into the discretely enhancing tumors. CONCLUSION: The time for the evolution of malignant brain tumors is short and WHO I tumors like gangliogliomas are more diffuse than the MRI appearances may suggest.