Pediatric supratentorial intraventricular tumors

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A variety of mass lesions can arise within or in proximity to the ventricular system in children. These lesions are relatively uncommon, and they present a unique diagnostic and surgical challenge. The differential diagnosis is determined by tumor location in the ventricular system, clinical presentation, age of the patient, and the imaging characteristics of the lesion. In this report the authors provide an introduction to and an overview of the most common pediatric supratentorial intraventricular tumors. The typical radiographic features of each tumor and location preference within the ventricular system are reviewed. Management and treatment considerations are discussed. Examination of tissue samples to obtain diagnosis is usually required for accurate treatment planning, and resection without adjuvant therapies is often curative. The critical management decision frequently involves determining which lesions are appropriate for surgical therapy. Care ful preoperative neuroimaging is extremely useful in planning surgery. Knowledge of the typical imaging characteristics of these tumors can help to determine the diagnosis with relative certainty when a tissue sample has not been obtained, because a small subset of these lesions can be managed expectantly.

Abbreviations used in this paper:CNS = central nervous system; CPP = choroid plexus papilloma; CPC = choroid plexus carcinoma; CSF = cerebrospinal fluid; CT = computerized tomography; GCT = germ cell tumor; HCGβ = human chorionic gonadotropin–β; JPA = juvenile pilocytic astrocytoma; ICP = intracranial pressure; MR = magnetic resonance; NF = neurofibromatosis; PNET = primitive neuroectodermal tumor; SGCA = subependymal giant cell astrocytoma.

A variety of mass lesions can arise within or in proximity to the ventricular system in children. These lesions are relatively uncommon, and they present a unique diagnostic and surgical challenge. The differential diagnosis is determined by tumor location in the ventricular system, clinical presentation, age of the patient, and the imaging characteristics of the lesion. In this report the authors provide an introduction to and an overview of the most common pediatric supratentorial intraventricular tumors. The typical radiographic features of each tumor and location preference within the ventricular system are reviewed. Management and treatment considerations are discussed. Examination of tissue samples to obtain diagnosis is usually required for accurate treatment planning, and resection without adjuvant therapies is often curative. The critical management decision frequently involves determining which lesions are appropriate for surgical therapy. Care ful preoperative neuroimaging is extremely useful in planning surgery. Knowledge of the typical imaging characteristics of these tumors can help to determine the diagnosis with relative certainty when a tissue sample has not been obtained, because a small subset of these lesions can be managed expectantly.

Abbreviations used in this paper:CNS = central nervous system; CPP = choroid plexus papilloma; CPC = choroid plexus carcinoma; CSF = cerebrospinal fluid; CT = computerized tomography; GCT = germ cell tumor; HCGβ = human chorionic gonadotropin–β; JPA = juvenile pilocytic astrocytoma; ICP = intracranial pressure; MR = magnetic resonance; NF = neurofibromatosis; PNET = primitive neuroectodermal tumor; SGCA = subependymal giant cell astrocytoma.

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Contributor Notes

Address reprint requests to: Timothy Mapstone, M.D., Department of Neurosurgery, Emory University School of Medicine, 1365-B Clifton Road, North East, Suite 6400, Atlanta, Georgia 30322, email: timothy_mapstone@emory.org.

© AANS, except where prohibited by US copyright law.

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