ObjectiveTo review the clinical records of patients with central nervous system (CNS) embryonal tumors, not otherwise specified (NOS); and summarize their clinical features, diagnosis, and treatment.MethodWe reviewed the data of patients with intracranial tumors admitted to Department of Neurosurgery of West China Hospital, Sichuan University from January 2014 to December 2016, and retrospectively analyzed the clinical features, diagnosis, and treatment of seven patients with CNS embryonal tumors, NOS.ResultsThere were 4 males and 3 females, and the mean age was 25.4 years old. The tumor was located in cerebral hemisphere in 5 patients, and in third ventricle in 2. Clinical presentation included headache, nausea, and vomiting due to intracranial hypertension, and focal neurological signs. All patients underwent craniotomy for tumor resection and postoperative pathology confirmed CNS embryonal tumor, NOS. The patients were followed up for 6 months to 3 years, and 2 patients died during follow-up.ConclusionsCNS embryonal tumor, NOS is malignant intracranial lesion, and has been enlisted as a separate entity under classification of CNS embryonal tumors. It has its unique radiological features, including rare occurrence of perilesional edema, cystic changes, and clear demarcation. Through comprehensive treatment including surgical resection, chemotherapy, and radiation therapy, patients can enjoy prolonged survival and improved quality of life.
ObjectiveTo explore the clinical features and prognostic factors of diffuse brain stem glioma in children. MethodsA retrospective analysis was conducted on pediatric diffuse brain stem glioma diagnosed by pathology in West China Hospital of Sichuan University between January 2016 and May 2019. The demographic data, clinical manifestations, MRI findings, pathological results, and treatment were included in the prognosis study.ResultsA total of 39 cases of pediatric diffuse brain stem glioma confirmed by pathology were enrolled, including 21 males and 18 females aged between 3 and 14 years with an average of (8.1±2.8) years and mostly between 5 and 10 years (29 cases). The mean maximum diameter of gliomas was (4.46±0.81) cm. Among the 39 cases, there were 15 cases complicated with hydrocephalus and 16 cases whose tumors completely surrounded the basilar artery. The median survival time was 6 months. The one-year survival rate was 15.4%, and the two-year survival rate was 5.1%. Univariate analyses showed that the tumor enhancement and completely enclosed basilar artery had significant impact on the prognosis (P<0.05). Multiple Cox regression analysis showed that whether the basilar artery was completely wrapped was related to the prognosis [hazard ratio=4.596, 95% confidence interval (1.839, 11.488), P=0.001]. ConclusionsPediatric diffuse brain stem gliomas are common in children aged 5-10 years with poor prognosis. Whether the tumor completely surrounds the basilar artery is closely related to the short overall survival time.
