Central Nervous System (CNS) tumors in an under 1 year-old population. A review of our series in Cruces University Hospital and of the literature

Abstract

Here, we present a review of CNS tumors diagnosed in an under one year-old population in Cruces University Hospital. We studied under one year-old patients diagnosed between 2001 and 2016 in Cruces University Hospital, and reviewed location, approach, presence/absence of hydrocephalus, survival and follow-up. Sixteen under one year-old patients were diagnosed among a series of 158 <14 year old children during that period. Fourteen patients had supratentorial tumors, 1 had an infratentorial tumor and one had an intraspinal cervical tumor. The sample included 10 gliomas (2 high grade, 8 low grade), 3 infratentorial primitive neuroectodermal tumors (PNET), 1 atypical choroidal plexus papilloma, 1 atypical teratoid/rhabdoid tumor, 1 supratentorial PNET and 1 neuroectodermal melanocytic tumor. Fourteen patients were operated on; in twelve of them we employed craniotomy with variable resection. Two of these needed consecutive craniotomies. In two patients, stereotactic biopsy was carried out due to the suspicion of an optic pathway glioma. Two patients were not amenable for surgical resection or biopsy and thus were not operated. Except for one patient who is alive after a follow-up of five years, the rest of the patients diagnosed of high-grade tumors died during follow up, two of them passing away during the surgical procedure. All patients diagnosed with a low-grade tumor are alive with a median follow-up of 3.8 years, except for one patient who died four years post-operation. Congenital tumors show a different pattern than tumors in other pediatric ages. The prognosis of high grade lesions continues to be discouraging despite apparent improvements.