Wilson C B
Cancer. 1975 Mar;35(3 suppl):950-6. doi: 10.1002/1097-0142(197503)35:3+<950::aid-cncr2820350716>3.0.co;2-l.
As the most frequent solid tumor occurring in childhood, brain tumors constitute an important segment of pediatric oncology. Neurologic manifestations may be deceptively mild and easily overlooked or misinterpreted, particularly in the very young, because of the remarkable resiliency of the immature central nervous system and the skull's ability to expand throughout the pre-adolescent years. The majority of childhood tumors produce increased intracranial pressure, usually the consequence of obstructive hydrocephalus. Specific neurologic deficits correspond to the tumor's location. The posterior fossa harbors two-thirds of childhood tumors, and each of the four common tumors in this location produces a characteristic syndrome. Supratentorial tumors occupy the cerebral hemisphere, the suprasellar area, and the pineal gland. Diagnostic studies have reached a state of great sophistication and precise anatomical localization. Surgery, either alone or with adjuvant radiotherapy, cures no more than one-third of all tumors; for the remainder, it has a diagnostic and palliative role. The introduction of operative microsurgery has advanced the art, particularly in the surgical treatment of craniopharyngiomas and pinealomas, but any significant improvement in the treatment of brain tumors as a group seems unlikely to be achieved by surgery alone.
作为儿童期最常见的实体瘤，脑肿瘤是儿科肿瘤学的重要组成部分。神经系统表现可能看似轻微，容易被忽视或误解，尤其是在幼儿中，这是因为未成熟的中枢神经系统具有很强的适应能力，且颅骨在青春期前能够扩张。大多数儿童肿瘤会导致颅内压升高，这通常是梗阻性脑积水的结果。特定的神经功能缺损与肿瘤的位置相对应。后颅窝容纳了三分之二的儿童肿瘤，该部位的四种常见肿瘤各自会产生一种特征性综合征。幕上肿瘤位于大脑半球、鞍上区和松果体。诊断研究已经达到了非常精细和精确的解剖定位水平。单独手术或联合辅助放疗，治愈的肿瘤不超过所有肿瘤的三分之一；对于其余的肿瘤，手术仅具有诊断和姑息作用。手术显微镜的引入推动了这一技术的发展，特别是在颅咽管瘤和松果体瘤的手术治疗方面，但仅靠手术似乎不太可能使脑肿瘤整体治疗取得显著改善。
