Abstract
Adult brain tumors mostly distinguish themselves from their pediatric counterparts. However, some typical pediatric brain tumors also occur in adults. The aim of this review is to describe the differences between classification, treatment, and outcome of medulloblastoma, pilocytic astrocytoma, and craniopharyngioma in adults and children. Medulloblastoma is a WHO IV posterior fossa tumor, divided into four different molecular subgroups, namely sonic hedgehog (SHH), wingless (WNT), Group 3, and Group 4. They show a different age-specific distribution, creating specific outcome patterns, with a 5-year overall survival of 25–83% in adults and 50–90% in children. Pilocytic astrocytoma, a WHO I tumor, mostly found in the supratentorial brain in adults, occurs in the cerebellum in children. Complete resection improves prognosis, and 5-year overall survival is around 85% in adults and >90% in children. Craniopharyngioma typically occurs in the sellar compartment leading to endocrine or visual field deficits by invasion of the surrounding structures. Treatment aims for a gross total resection in adults, while in children, preservation of the hypothalamus is of paramount importance to ensure endocrine development during puberty. Five-year overall survival is approximately 90%. Most treatment regimens for these tumors stem from pediatric trials and are translated to adults. Treatment is warranted in an interdisciplinary setting specialized in pediatric and adult brain tumors.
Highlights
In children, brain tumors are the most frequent solid cancer observed, with an incidence reported of 5.7 per 100,000 children, while in adults, the incidence is much higher with 29.9 per 100,000 persons [1]
It is to be assumed that the knowledge of how to deal with these pediatric brain tumors might be limited within the adult word since their incidence is lower in the adult population
It differs from other low-grade gliomas (LGG), as it is not a precursor of diffuse gliomas, which occur in both age groups and tend to undergo malignant transformation, especially in adults [13,58,59]
Summary
Brain tumors are the most frequent solid cancer observed, with an incidence reported of 5.7 per 100,000 children, while in adults, the incidence is much higher with 29.9 per 100,000 persons [1]. Pediatric and adult brain tumors do differ in their incidence and in histology, molecular pathology, location, and outcome [1]. Some typical pediatric brain tumors, at times, occur in adults. Medulloblastoma, pilocytic astrocytoma, and craniopharyngioma differ essentially in their incidence, location, histology and molecular pathology, treatment strategies, or outcomes between the two age groups. It is to be assumed that the knowledge of how to deal with these pediatric brain tumors might be limited within the adult word since their incidence is lower in the adult population. The aim of this review is to give an overview of these three classical pediatric brain tumors and emphasize on their incidence, behavior, classifications, treatment strategies, and outcome in the adult population, while comparing to their pediatric counterparts.
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