The clinical analysis of giant infantile intracranial tumors

Abstract

Objective To analyze the characteristics of giant intracranial tumors in infants and to explore their treatment and prognosis. Methods This study retrospectively enrolled 18 cases of giant intracranial tumors in infants admitted to Neurosurgery Department of Children′s Hospital of Fudan University from January 2014 to December 2017. The clinical characteristics, treatment and prognosis were documented and analyzed. Clinical follow-up and imaging follow-up were applied to evaluate the prognosis. Among the 18 cases, 8 underwent excision of tumor and the other 10 cases refused tumor excision surgery. Ventricular-peritoneal shunt was undergone in 2 patients of them and 1 patient underwent external brain drainage. Results Of the 8 patients who underwent tumor resection, gross total resection was achieved in 5 cases, subtotal resection in 2 and biopsy in 1. One patient died from intraoperative hemorrhagic shock. Among the 7 patients with the surgery of tumor excision, 4 developed subdural effusion and 1 patient developed hydrocephalus. The clinical manifestation was improved after symptomatic treatment. Pathology results revealed 3 cases of choroid plexus (including 1 case of atypical choroidal papilloma), 1 case of medulloblastoma, 1 case of primordial embryonic tumor, 1 case of atypical teratoid/rhabdoid tumor and 1 case of nerve epithelial tumor. Five cases in tumor excision group were followed up including 1 patient developing growth retardation and 1 suffering from mild malfunction of nervous system. Eight in the group without tumor excision surgery died within 2 months after discharge and 2 of them were lost to follow-up. The range of follow-up duration was from 2 months to 3.7 years. Conclusions Giant intracranial tumors in infants are rare with an overall poor prognosis. To improve the prognosis, the characteristics of tumor, risk of treatment and complications should be taken into consideration to make therapeutic strategy. Key words: Brain neoplasms; Neurosurgical procedures; Infant; Prognosis