Intracranial Malignancy

Brain tumours are the second most common malignancy in children after the leukaemias. Those that metastasise tend to do so within the CNS. Benign tumours can also have profound consequences depending on where they are situated.

Signs and Symptoms: Brain tumours in children (and adults) can present quite insidiously and a high index of suspicion is often needed. Seizures may be the only presenting feature.

www.headsmart.org.uk provides a wealth of information for patients/relatives and medical professionals. Different tumours may present in different ways and the location of the tumour may also determine the extent of symptoms.

Surgical resection is usually required, with radiotherapy is some cases and rarely chemotherapy.

Cerebellar Astrocytoma- most common tumour in children, cystic and slow growing, require surgical treatment. Good prognosis (100% 5yr survival)

Medulloblastoma. Common, highly malignant, rapidly growing, arises from cerebellar vermis, metastasising to CSF pathways, often presents with hydrocephalus. Will require surgery and radiotherapy. 75% 5yr survival, 50% 10yr survival. The CT above shows the typical appearances of the tumour filling the fourth ventricle causing obstructive hydrocephalus with prominent temporal horns. The tumour is hyperdense compared normal brain matter, which is typical of medulloblastoma

Ependymoma- Account for 10% of childhood tumours, tend to metastasise, poor (40%) 5yr survival rate, requires surgery and radiotherapy.<br />
The CT above shows a right frontal tumour, with surrounding oedema and areas of calcification