Brain tumors in children

Tumori mozga su najčešći solidni tumori u djece i druge po učestalosti pedijatrijske neoplazme. Vodeći su uzrok smrtnosti u pedijatrijskih onkoloških pacijenata i neoplazme s najvećim morbiditetom. Obuhvaćaju raznoliku skupinu stanja različite etiologije, histološkog tipa, s različitom kliničkom slikom, liječenjem i prognozom. Većina simptoma tumora mozga posljedica je povišenog intrakranijalnog tlaka. Najčešći simptomi su glavobolja, mučnina, povraćanje, epileptički napadaji, smetnje vida i ataksija. U prvih nekoliko godina života mogu biti prisutni i razdražljivost, gubitak apetita, zaostajanje u razvoju i regresija usvojenih intelektualnih i motoričkih vještina. U školske djece simptomi uključuju slabiji uspjeh u školi, umor i promjene osobnosti. U tumore mozga ubrajaju se astrocitomi, tumori moždanog debla, ependimomi, optički gliomi, meduloblastomi i kraniofaringeomi. Dijagnostičke metode uključuju fizikalni pregled, neurološki pregled, CT, MRI, PET, angiografiju i lumbalnu punkciju. U liječenju se primjenjuju neurokirurški zahvat, kemoterapija i radioterapija. Ono ovisi o veličini i vrsti tumora, te općem stanju djeteta. Cilj liječenja može biti izlječenje ili olakšanje tegoba. Kirurška terapija je neophodna za većinu tumora mozga. Kod nekih je tumora moguća kompletna resekcija. U slučajevima kada tumor ne može biti u potpunosti uklonjen, kirurška terapija može pomoći sniziti intrakranijalni tlak i umanjiti simptome. Za određene se tumore koristi i radioterapija i sistemska kemoterapija. Prognoza ovisi o tipu tumora, njegovoj lokalizaciji i stadiju, brzini rasta te o mogućnostima liječenja.Brain tumors are the most common solid tumors in children and the second most common group of childhood cancers. Brain tumors remain the leading cause of cancer deaths and have the highest morbidity in pediatric oncology patients. They include a heterogeneous group of diseases with different origin, histological type, clinical presentation, treatment and prognosis. Many symptoms of a brain tumor are caused by an increased intracranial pressure. The most common symptoms are headache, nausea, vomiting, seizures, visual changes, and ataxia. In the first few years of life, other symptoms of tumors can include irritability, loss of appetite, developmental delay, and a drop in intellectual and physical abilities. In the school-aged child, other general symptoms of tumors can include poor school performance, fatigue, and personality changes. The different types of brain tumors include astrocytomas, brain stem gliomas, ependymomas, optic nerve gliomas, medulloblastomas, craniopharyngiomas. Diagnostic procedures for a brain tumor may include physical exam, neurological exam, CT, MRI, PET, angiogram and lumbar puncture. The treatment includes surgery, chemotherapy and radiation therapy. It depends on the size and type of tumor and the child’s general health. The goals of treatment may be to cure the tumor or to relieve symptoms. Surgery is needed for most primary brain tumors. Some tumors may be completely removed. In cases where the tumor cannot be removed, surgery may help reduce intracranial pressure and relieve symptoms. Chemotherapy or radiation therapy may be used for certain tumors. The prognosis is based upon many factors, including the type of tumor, its location and grade, the speed of growth, and treatment options