Pediatric Brain Tumors

Abstract

Tumors of the central nervous system are the most common type of solid neoplasm found in children and are second only to leukemia in overall cancer frequency. Incidence is 2–5 in 100,000 with primary brain tumors accounting for 20% of deaths from cancer in children. Sixty percent of children who survive a brain tumor are left with a life-altering disability. The ratio of supratentorial to infratentorial tumors is age-specific. Many tumors remain undetected until they are relatively large in size due in part to the elasticity of the infant skull, compensation by the developing nervous system for deficits, and the difficulty in many instances of the child’s inability to cooperate in physical examinations. The WHO classification comprises a histological grading according to a four-tiered scheme ranging from WHO grade I (benign) to WHO grade IV (the most malignant). Immunohistochemical markers play an important role in the diagnosis of different tumor entities. The contribution of molecular genetics to brain tumor diagnostics is an ever-expanding field that has potential to significantly impact classification, prognosis, and therapeutic management of most CNS tumors. Different treatment modalities such as surgery, radiotherapy, and chemotherapy are widely used management entities; however, morbidity and mortality in pediatric brain tumors remains high. Novel targeted therapies and approaches to multidisciplinary treatment strategies are required if progress is to be achieved to cure most pediatric brain tumors.