Clinical Analysis of 58 Cases of Intracranial Tumors in Korean Children.

Byun, Bark Jang; Rhim, Kwang She

Original Article

Journal of Korean Neurosurgical Society 1978;7(1): 15-30.

Department of Neurosurgery, Jung-Ang University, School of Medicine, Seoul, Korea.

ABSTRACT

It should be stressed that intracranial tumors in childhood are common. If the leukemia are excluded, intracranial neoplasms are the relatively common type of neoplasms seen in childhood. There are many different kinds of tumor which occur within the cranial cavity. These different tumors grow at different rates of speed and the diversity of location is sufficient so that there is a broad spectrum of different clinical syndromes. However, it is important to recognize the earliest symptoms because of the possibility of operable management and high cure rate on some cases. The author analyzed 58 cases of intracranial neoplasm which were histologically confirmed after operation and autopsy, seen at the Department of Neurosurgery, Jung-Ang University, Sung-Sim Hospital and National Medical Center over the recent several years. These tumors were explored surgically and the diagnosis was made through histological examination. The cases were reviewed as to history, development and progression of the neurological features, laboratory findings, neuroradiological findings, operative methods and pathology. The author emphasized some interesting points and the following were presented here-in as the results. 1) Among 58 cases of intracranial neoplasms in Korean children below 15 years old, the most common tumor was astrocytoma(36%), and the next common tumors were craniopharyngioma(15.5%), ependymoma(12%), and medulloblastoma(10.3%) in that orders. It was interesting that 3 cases of tuberculomas were found in recent three years(1975-1977) and all were located in the cerebellum. A 5 years old boy who was operated for 4 th. Ventricle medulloblastoma confirmed by clinicopathological finding, had another tumor, craniopharyngioma which was found at the postmortem examination. 2) The tumors were occupied on the infratentorial region in 30(5.7%) cases and supratentorial region in 28(48.3%) cases. The most frequent tumor in supratentorial region was craniopharyngioma and in infratentorial region was cerebellar astrocytoma. And the glioma and medulloblatoma were common in turn. 3) Fifty eight cases comprised 36 males and 22 females with a ratio of 1.5 to 1. The age ranged from 5 months old to 15 years old with the peak in the incidence between 5-11 years of age. 4) The main clinical symptoms and signs were headache(84.5%), vomiting(77.6%), papilledema(67.2%), and cranial nerve dysfunction(62%). It was interesting points that neck stiffness(27.6%) and abdominal pain(15.5%) were frequent complaints which should not overlook for the symptoms of simple gastritis or tuberculous meningitis. 5) The results of operative management obtained as follows with excellent in 4, good in 8, fair in 13, and poor in 9 cases. The overall mortality rare was 41% and recurrence rate was 14% during 5 years follow up.