Overview of the management of central nervous system tumors in children
- Ching Lau, MD, PhD
Ching Lau, MD, PhD
- Chief, Hematology Oncology at Connecticut Children's Medical Center
- Professor at Jackson Laboratory for Genomic Medicine
- Head of Division of Pediatric Hematology-Oncology, University of Connecticut School of Medicine
- Wan-Yee Teo, MBBS, FAAP, MRCPCH (UK), PhD
Wan-Yee Teo, MBBS, FAAP, MRCPCH (UK), PhD
- Assistant Professor
- Duke-NUS Graduate Medical School
- Adjunct Assistant Professor, Department of Pediatrics, Section of Hematology-Oncology
- Baylor College of Medicine
Primary malignant central nervous system (CNS) tumors are the second most common childhood malignancies, after hematologic malignancies, and are the most common pediatric solid organ tumor (table 1) . It is the leading cause of death from childhood cancer, surpassing the mortality rate of acute lymphoblastic leukemia . Although advances in surgical intervention, radiotherapy, and chemotherapy have improved the survival rates in children with CNS tumors, mortality and morbidity associated with these disorders persist, especially with malignant brain tumors.
A general overview of the management and prognosis of CNS tumors in children will be reviewed here. The management and prognosis of the following specific CNS tumors that occur in children are discussed separately.
●Low-grade gliomas (see "Management of low-grade glioma")
●Malignant gliomas (see "Clinical manifestations and initial surgical approach to patients with high-grade gliomas")
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- MANAGEMENT STRATEGY
- Surgical approaches and techniques
- Preoperative and perioperative considerations
- - Increased ICP
- - Seizures
- - Endocrine abnormalities
- Long-term morbidity
- - Secondary neoplasms
- - Neurocognitive effects
- - Cerebrovascular disease
- - Endocrine abnormalities
- - Psychological effects
- - Social effects
- PALLIATIVE CARE
- SUMMARY AND RECOMMENDATIONS