Abstract
Children whose brain tumor involves two or more compartments at presentation differ clinically and pathologically from children whose brain tumor is confined to one compartment. In this study of 3,291 children with a brain tumor, at least 10% had a tumor that occupied two or three compartments at first hospitalization. Infratentorial tumors occupying multiple compartments were 1.7 times more likely to involve the cervicomedullary junction than the mesodiencephalic junction. Younger children (1–3 years) were more likely to have had multiple compartment tumors than older children. Children whose tumor was limited to the infratentorial compartment had a longer survival than children whose tumor also occupied other compartments. Ependymoma, anaplastic ependymoma, and astrocytoma (nos) were over represented among infratentorial multiple compartment tumors. Pilocytic astrocytoma, primitive neuroectodermal tumor (medulloblastoma), and desmoplastic medulloblastoma were less likely to have occupied multiple compartments at the time of the first surgical exploration. The distributions of histologic features in tumors at the cervicomedullary junction differed from those in tumors limited to the posterior fossa or to the spinal canal. Seizures were more likely if the tumor was confined to the supratentorial compartment, whereas nausea or vomiting and headache were more likely if the tumor was confined to the infratentorial compartment. Children whose tumor was confined to the spinal canal were significantly more likely to have bladder symptoms and back and/or abdominal pain than those whose tumor also involved compartments above the foramen magnum. We conclude that brain tumors apparently confined to one compartment at presentation are biologically and structurally different from tumors evident in two or more compartments.
Similar content being viewed by others
References
Jellinger K, Machacek E: Rare intracranial tumours in infancy and childhood. In: Voth D, Gutjahr FB, Langmaid C (eds) Tumours of the Central Nervous System in Infancy and Childhood, Springer-Verlag, Berlin, 1982
Park TS, Hoffman HJ, Hendricks EB, Humphreys RP, Becker LE: Medulloblastoma: Clinical presentation and management. Experiences at the Hospital for Sick Children, Toronto. J Neurosurg 58: 543–552, 1983
Cohen ME, Duffner PK: Brain Tumors in Children, Raven Press, New York, 1984
Pierre-Kahn A, Hirsch JF, Roux FX, Renier D, Sainte-Rose C: Intracranial ependymomas in childhood. Child's Brain 10: 145–156, 1983
Marks JE, Adler SJ: A comparative study of ependymomas by site of origin. Int J Radiat Oncol Biol Phys 8: 37–41,1982
Deutsch M: The impact of myelography on the treatment results for medulloblastoma. Int J Radiat Oncol Biol Phys 10: 999–1003, 1984
Deutsch M, Reigel DH: The value of myelography in the management of childhood medullablastoma. Cancer 45: 2194–2197, 1979
Allen JC, Epstein F: Medulloblastoma and other primary malignant neuroectodermal tumors of the CNS. The effect of patients' age and extent of disease on prognosis. J Neurosurg 57: 446–451, 1982
Harisiadis L, Chang CH: Medulloblastoma in children: A correlation between staging and results of treatment. Int J Radiat Oncol Biol Phys 2: 833–841, 1977
Packer RJ, Siegel KR, Schut L, Bruce DA, Sutton LN, Litmann P: Central nervous system spread of childhood brain tumors at diagnosis or at initial disease recurrence. Concepts Pediatric Neurosurgery, Karger, Basel 16–24, 1985
Childhood Brain Tumor Consortium: A study of childhood brain tumors based on surgical biopsies from ten North American institutions: Sample description. J Neuro-Oncol 6: 9–23, 1988
Young JL, Miller RW: Incidence of malignant tumors in U.S. children. J Pediatr 86: 254–258, 1975
Childhood Brain Tumor Consortium: The epidemiology of headache among children with brain tumor. J Neuro-Oncol 10: 31–46, 1991
Childhood Brain Tumor Consortium: The epidemiology of seizures in children with brain tumors. J Neuro-Oncol 12: 53–68, 1992
Zülch KJ: Histological typing of tumors of the central nervous system. International histological classification of tumors, no. 21. World Health Organization, Geneva, 1979
Rorke LB: The cerebellar medulloblastoma and its relationship to primitive neuroectodermal tumors. J Neuropathol Exp Neurol 42: 1–15, 1983
Rorke LB, Gilles FH, Davis RL, Becker LE: Revision of the World Health Organization classification of brain tumors for childhood brain tumors. Cancer 56: 1869–1886, 1985
Siegel S: The Kolmogorov-Smirnov two-sample test. In: Siegel S (ed) Nonparametric Statistics for the Behavioral Sciences, McGraw-Hill, New York 127–136, 1956
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Gilles, F.H., Leviton, A., Hedley-Whyte, E.T. et al. Childhood brain tumors that occupy more than one compartment at presentation. J Neuro-Oncol 14, 45–56 (1992). https://doi.org/10.1007/BF00170944
Issue Date:
DOI: https://doi.org/10.1007/BF00170944