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Understanding Common Brain Tumors in Children: Characteristics and Implications

This article focuses on various types of brain tumors that commonly affect children, including retinoblastoma, intraocular melanoma, astrocytomas, meningiomas, medulloblastomas, and ependymomas. We delve into their characteristics, such as the age at diagnosis, prognosis, and typical symptoms. Additionally, we explore the underlying causes, including increased intracranial pressure leading to Duret hemorrhages. By reviewing case studies, we provide insights into diagnosis and treatment options for these tumors, emphasizing the importance of early detection and intervention.

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Understanding Common Brain Tumors in Children: Characteristics and Implications

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  1. CNS Path no. 3

  2. What tumour am I? • Retinoblastoma • Most common eye tumour of childhood • 90% cases diagnosed before 7yrs old • Usually fatal once it spreads outside the orbit • Intraocular melanoma • Most common primary ocular malignancy in caucasians • Most arise in the posterior choroid • May spread btw sclera and retina or may produce bulbous masses projecting into the vitreous cavity and pushing the retina ahead

  3. Multiple = metastatic carcinoma

  4. Meningioma • Arise from? • Arachnoid granulations

  5. Astrocytoma • What is green arrow pointing at?? • Duret haemorrhages • Astrocytomas are classified as a form of glioma. What are the other 2 forms? • Oligodendroglioma • Ependymoma

  6. WHAT causes Duret haemorrhages to occur? • Occur secondary to an increased ICP – causing transtentorialherniation. • The pathophysiology of Duret haemorrhage remains under debate: either arterial origin (stretching and laceration of pontine perforating branches of the basilar artery), versus venous origin (thrombosis and venous infarction). • Multifactorial causation seems the likely explanation.

  7. A 5y/o boy presents w/ ataxia, headaches 1/52. Sudden onset vomiting, becomes comatose.CT = 4cm mass in cereballarvermis + dilation of cerebral ventricles.LP = Small dark cells with blue nuclei.WHICH NEOPLASM IS MOST LIKELY? • Schwannoma • Ependymoma • Glioblastomamultiforme • Medulloblastoma • Mets • don’t seed to CSF • Arise in ventricles • Seeds to CSF but not seen in kids • CORRECT! • Uncommon in children Medulloblastoma fits with CF’s, location, and cytological findings. Cells seed into the CSF Common tumour of young children.

  8. Incidental CT finding: 5cm well circumscribed mass beneath dura, compressing underlying left lateral parietal lobe. After resection – histology shows it is composed of elongated cells with pale, oblong nuceli and pink cytoplasm.WHICH NEOPLASM IS MOST LIKELY ? • Meningioma • Tuberculoma • Medulloblastoma • Schwannoma • Ependymoma • CORRECT! • Unlikely • Childhood and posterior fossa • Wrong location • Arises in ventricles • Meningioma arise from arachnoid granulations, often attached to the dura. Most often seen in adult women. • Well circumscribed lesions.

  9. 56yo male, presents with grand mal seizure – no prior seizure Hx. MRI shows three lesion 1-3cm in diameter, located at grey-white junction of cerebral hemispheres. WHAT NEOPLASM? Metastatic carcinoma

  10. 45 yo female, presents with unilateral headaches. WHICH NEOPLASM IS MOST LIKELY? • CORRECT! • Occur within cerebral hemi’s • Arise from w/in ventricles • Unusual location, not multiple • Meningioma. • Gliomas • Ependymal • Mets

  11. 45 yo female presents with diminished hearing on left. CT = well circumscribed 4cm mass adjacent to left pons, extending into inferior cerebella hemisphere. WHICH NEOPLASM IS MOST LIKELY? • Rare in this location • Wrong location • CORRECT! • Normally found in childhood • Normally arises in ventricles • Schwannoma’s often arise from 8th cranial nerve = acoustic neuroma • Slow growing and benign. • Meningioma • Astrocytoma • Schwannoma • Medulloblastoma • Ependymoma

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