Clinical and pathological features of infant and young children brain tumors: single center report of 100 cases

Abstract

Objective To investigate the special clinical manifestations, pathological spectrum and locations of infant and young children (0-3 years old) brain tumors that differed from those of the older children population (4-18 years old). Methods Children (< 18 years old) with brain tumors who underwent surgical treatment in our department from January 2011 to December 2018 were collected and were divided into 2 groups: 0-3 years old and 4-18 years old according to their age, and tumors, pathological spectrum, locations, clinical manifestations were summarized and compared between 2 groups. Results Among the 100 cases of infant and young children brain tumors, the most common histopathological type was low ⁃ grade glioma, especially the pilocytic astrocytoma. Significantly, the incidence of ependymoma (P = 0.001) and choroid plexus papilloma/cancer (P = 0.000) was much higher than the older children brain tumors population, being the second and third most common brain tumor pathologies of the infant and young children patients. Embryonal neoplasms other than medulloblastoma were higher in this population than the older one (4-18 years old) as well (P = 0.013). The proportion of malignant tumors was higher on supratentorial location (P = 0.023). Huge tumor growth was more often seen in infant and younger children (P = 0.000), tumor diameter < 30 mm (χ2 = 33.939, P = 0.000), 30-60 mm (χ2 = 12.483, P = 0.000), and 61-100 mm (χ2 = 23.158, P = 0.000) had statistic difference with tumors > 100 mm in diameter. The overall survival (OS) rate in low⁃grade (WHOⅠ-Ⅱ) tumor group was significantly higher than that in high⁃grade (WHOⅢ-Ⅳ) tumor group (P = 0.000). Conclusions Brain tumors in infants and young children had special pathological spectrum and clinical manifestations being different from the older children tumor population. The prognosis of low⁃grade glioma in infants and young children was good and had the characteristics of chronic disease. Malignant brain tumors, including rare embryonal tumors, were prone to relapse and multiple metastases across the central nervous system. The young children couldn't suffer radiotherapy, and at the mean time, the choice and effect of chemotherapy were quite limited. To improve the quality of life and the prognosis of infants and young children with brain tumors required more extensive multi⁃disciplinary cooperation.

DOI：10.3969/j.issn.1672⁃6731.2019.12.011