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01.10.2015 | Special Annual Issue

Posterior fossa tumors in infants and neonates

verfasst von: Pietro Spennato, Giancarlo Nicosia, Lucia Quaglietta, Vittoria Donofrio, Giuseppe Mirone, Giuliana Di Martino, Elia Guadagno, Maria Laura del Basso de Caro, Daniele Cascone, Giuseppe Cinalli

Erschienen in: Child's Nervous System | Ausgabe 10/2015

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Abstract

Introduction

Management of posterior fossa tumors in infants and neonates is challenging. The characteristics of the young babies make surgery very difficult, sometimes precluding a safe complete removal.

Methods

A review of the literature was undertaken to examine the incidence, histology, surgical aspects, and prognosis of posterior fossa tumors in the first year of life. Therapeutical strategies of the most frequent tumor types are also discussed in detail.

Results

Histology is dominated by tumors with aggressive behavior, such as medulloblastomas, atypical teratoid/rhabdoid tumors, and anaplastic ependymomas. The most important surgical considerations in small children are the small circulating blood volume; the poor thermoregulation; and incomplete maturation of the brain, of the skull, and of the soft tissue. Treatment toxicity is inversely related to the age of the patients. Radiation therapy is usually considered as contraindicated in young children, with few exceptions. Proton therapy is a promising tool, but access to this kind of treatment is still limited. The therapeutic limitations of irradiation render resection of this tumor and adjuvant chemotherapy often the only therapeutic strategy in many cases.

Conclusions

The overall prognosis remains dismal because of the prevalent aggressive histologies, the surgical challenges, and the limitations of adjuvant treatment. Nevertheless, the impressive improvements in anesthesiology and surgical techniques allow, in the vast majority of the cases, complete removal of the lesions with minor sequelae in high-volume referral pediatric centers.

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Titel: Posterior fossa tumors in infants and neonates
verfasst von: Pietro Spennato
Giancarlo Nicosia
Lucia Quaglietta
Vittoria Donofrio
Giuseppe Mirone
Giuliana Di Martino
Elia Guadagno
Maria Laura del Basso de Caro
Daniele Cascone
Giuseppe Cinalli
Publikationsdatum: 01.10.2015
Verlag: Springer Berlin Heidelberg
Erschienen in: Child's Nervous System / Ausgabe 10/2015
Print ISSN: 0256-7040
Elektronische ISSN: 1433-0350
DOI: https://doi.org/10.1007/s00381-015-2783-6

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Posterior fossa tumors in infants and neonates