Pediatric Skull Base Tumors: A Management Challenge

Overview

Journal J Pediatr Neurosci

Specialty Pediatrics

Date 2021 Jul 28

PMID 34316306

Citations 8

Authors

Matheus F M Ballestero

Stephanie N F de Souza

Romilto C Pacheco Neto

Guilherme G P Gondim

Elvis T Valera

Maristella B F Dos Reis

Benedicto O Colli

Ricardo S de Oliveira

Affiliations

Soon will be listed here.

Abstract

Context: Skull base tumors are varied in children and are particularly challenging to pediatric neurosurgeons, with few papers in the literature describing the evolution, complications, and outcome. The authors evaluated long-term outcomes in children submitted to skull base tumor surgery and performed a literature review.

Aims: The aim of this study was to analyze surgical results, complications, and outcomes, on comparison with previous publications.

Materials And Methods: A retrospective analysis of children undergoing surgery at a single institution between 2000 and 2018 for lesions of the cranial base was carried out. In addition, a literature review was carried out describing a total of 115 children operated on for skull base tumors.

Statistical Analysis: Chi-squared and Fisher's exact tests were performed to compare the distribution of categorical variables and a nonparametric Mann-Whitney test was used to perform intergroup comparisons of continuous variables.

Results: Seventeen children ranging in age from 8 months to 17 years (mean, 10.9 years) underwent skull base approaches. Tumor types included schwannoma, meningioma, chondroid chordoma, mature teratoma, epidermoid cyst, hemangiopericytoma, rhabdomyosarcoma, myofibroblastic inflammatory tumor, fibromyxoid sarcoma, Crooke's cell adenoma, ossifying fibroma, osteoblastoma, nasopharyngeal angiofibroma and Ewing's sarcoma. Gross total resection was achieved in 6 patients (35.3%), 12 patients (70.6%) had benign histology, and 5 patients (29.4%) had a malignant tumor. Transient postoperative cerebrospinal fluid leak affected only one patient. Thirteen children (76.4%) had a residual neurological deficit at last follow-up evaluation. Three (17.6%) surviving patients received adjuvant therapy. The rate of recurrence or lesion progression was 17.6%.

Conclusions: Skull base tumors in children present a therapeutic challenge because of their unique pathological composition and can lead to considerable morbidity and mortality in pediatric age.

Citing Articles

Pediatric skull base tumors: Clinical features and surgical outcomes; a single center retrospective study with a review of literature.

Grutza M, Lenga P, Issa M, Seitz A, Sahm F, Milde T Brain Spine. 2024; 4:104136.

PMID: 39687083 PMC: 11647108. DOI: 10.1016/j.bas.2024.104136.

Primary Ewing's Sarcoma affecting the Central Nervous System: A single-center experience and Narrative review.

Kumarasamy S, Garg K, Singh P, Kumar A, Sharma R, Kedia S Childs Nerv Syst. 2024; 41(1):46.

PMID: 39671104 DOI: 10.1007/s00381-024-06707-y.

Pediatric skull inflammatory myofibroblastic tumor: a rare case report and literature review.

Khurana E, Mody S, Shah T, Bouffard J, Pedemonte M, Holover G Childs Nerv Syst. 2024; 40(11):3829-3835.

PMID: 38918263 DOI: 10.1007/s00381-024-06512-7.

Special Considerations in Pediatric Endoscopic Skull Base Surgery.

Valencia-Sanchez B, Kim J, Zhou S, Chen S, Levy M, Roxbury C J Clin Med. 2024; 13(7).

PMID: 38610689 PMC: 11013018. DOI: 10.3390/jcm13071924.

Neurosurgical Treatment and Outcome of Pediatric Skull Base Lesions: A Case Series and Review of the Literature.

Greuter L, Hallenberger T, Guzman R, Soleman J Children (Basel). 2023; 10(2).

PMID: 36832345 PMC: 9954611. DOI: 10.3390/children10020216.

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