A histomorphological study of central nervous system tumors in pediatric age group at tertiary care teaching hospital
DOI:
https://doi.org/10.18203/2320-6012.ijrms20262644Keywords:
Pediatric central nervous system, Histomorphological classification, Gliomas, Tumor gradingAbstract
Background: Central nervous system (CNS) tumors are the second most common malignancies in children after acute lymphoblastic leukemia and constitute a significant cause of morbidity and mortality. Their histopathological classification is essential for diagnosis, treatment planning and prognostication. The present study was undertaken to evaluate the histomorphological spectrum of pediatric CNS tumors in a tertiary care teaching hospital.
Methods: A retrospective observational study was conducted in the Department of Pathology, B. J. Medical College and tertiary care teaching hospital, Ahmedabad, from March 2022 to July 2024. A total of 100 CNS biopsy specimens from pediatric patients aged 0-12 years were included. Clinical, demographic, radiological and histopathological data were collected and analyzed. Tumors were classified and graded according to histomorphological features.
Results: Among the 100 cases studied, males constituted 59% and females 41%, with a male-to-female ratio of 1.4:1. The highest number of cases (34%) occurred in the 0-4 years age group. Supratentorial tumors accounted for 54% of cases, followed by infratentorial tumors (40%) and spinal tumors (6%). Gliomas were the most common tumor category (36%), followed by embryonal tumors (24%) and ependymal tumors (10%). Among gliomas, low-grade astrocytoma (44.4%) and pilocytic astrocytoma (27.8%) were predominant subtypes. Medulloblastoma represented 66.6% of embryonal tumors. Most tumors belonged to lower WHO grades, while all embryonal tumors classified as grade 4.
Conclusions: Gliomas were the most frequently encountered pediatric CNS tumors, with a predominance of supratentorial location and male preponderance. Histopathological evaluation remains indispensable for accurate classification and grading, thereby facilitating optimal management and prognostic assessment of pediatric CNS tumors.
References
Sklar CA. Childhood brain tumors. J Pediatr Endocrinol Metab. 2002;15(2):669-73.
Dolecek TA, Propp JM, Stroup NE, Kruchko C. CBTRUS statistical report: primary brain and central nervous system tumors diagnosed in the United States in 2005-2009. Neuro Oncol. 2012;14(5):v1-49.
Malbari F. Pediatric Neuro-Oncology. Neurol Clin. 2021;39(3):829-45.
Jain A, Sharma MC, Suri V, Kale SS, Mahapatra AK, Tatke M, et al. Spectrum of pediatric brain tumors in India: A multi-institutional study. Neurology India. 2011;59(2):208.
Kumar R, Liu APY, Orr BA. Advances in the classification of pediatric braintumors through DNA methylation profiling: from research tool to frontline diag-nostic. Cancer. 2018;124(21):4168-80.
Damodharan S, Puccetti D. Pediatric Central Nervous System Tumor Overview and Emerging Treatment Considerations. Brain Sci. 2023;13:1106.
Santos MM, Faria CC, Miguéns J. Pediatric central nervous system tumors: review of a single Portuguese institution. Childs Nerv Syst. 2016;32(7):1227-36.
Alexiou GA, Moschovi M, Stefanaki K, Sfakianos G, Prodromou N. Epidemiology of pediatric brain tumors in Greece, 1991-2008. Experience from the BAgia Sofia Children’s Hospital. Cen eur Neurosurg. 2011;72:1-4.
Lannering B, Sandstrom P, Holm S. Classification, incidence and survival analyses of children with CNS tumours diagnosed in Sweden 1984-2005. Acta Paediatr. 2009;98:1620-7.
Rickert CH, Paulus W. Epidemiology of central nervous system tumors in childhood and adolescence based on the new WHO classification. Childs Nerv Syst. 2001;17:503-11.
Kaatsch P, Rickert CH, Kuhl J, Schuz J, Michaelis J. Population-based epidemiologic data on brain tumors in German children. Cancer. 2001;92:3155-64