Morphological pattern and frequency of intracranial tumours in children.

OBJECTIVE

The objective of the present study was to observe the histopathological pattern of intracranial tumours and to provide a comprehensive data about its frequency in children less than 16 years and to correlate the site of lesion with the histological diagnosis.

DESIGN

A descriptive study.

PLACE AND DURATION OF STUDY

The study was carried out at the Department of Histopathology, Children's Hospital and Institute of Child Health, Lahore and King Edward Medical College, Lahore over a period of three years. (January 1999 - December 2002).

SUBJECTS AND METHODS

The histopathological data of 116 brain tumours of all the patients less than 16 years was collected and compared with the findings reported from centres in other parts of the country. The initial histopathological evaluation of these lesions was performed on H&E stained sections of paraffin embedded tissues. Special stains and immunohistochemistry were performed whenever indicated. Autolyzed biopsies and previously reported biopsies were not included.

RESULTS

The ages ranged from 5 days to 16 years with male to female ratio of 3:1. Glial tumours comprised the largest category 75.8% and among all the glial tumours astrocytomas were the commonest comprising 44.8% of all intracranial neoplasms. Medulloblastoma 15.5% ranked the second most common brain tumour followed by ependymoma, 10.3%. Out of 116 cases, 51 (44%) were supratentorial and 65 (56%) infratentorial in location. In infratentorial region 38 % of the tumours were in the cerebellum, 9.5 % in the brain stem and 8.5 % in the fourth ventricle. The majority of these tumours were astrocytomas 32 cases (49.2%), WHO I/II, medulloblastoma 18 cases (27.6 %) and ependymoma 6 cases (9.2%). In supratentorial region out of 51 cases the most common tumour was astrocytoma, 20 cases (39.2%), high grade WHO III/IV, ependymoma, mixed glial tumours and PNET 5.1% each. The less common tumours included craniopharyngiomas, choroid plexus papilloma and ganglioneuroblastoma 3.4% each. Choroid plexus carcinoma, haemangioma, non Hodgkin's lymphoma, oligodendroglioma and ganglioneuroma 1.7% each. Infratentorial location was more common between the age of 3-11 years (58.2%), by contrast in the under 3 years old a supratentorial location was more frequent.

CONCLUSION

Paediatric brain tumours are more common in infratentorial region and astrocytomas are the most common tumours. Supratentorial astrocytomas are more likely to be high grade than infratentorial. Males are affected more than females.