Abstract Issue

Volume 13 Issue 4 (April) 2024

Original Articles

Analysis of paediatric patients with posterior fossa tumor- observational retrospective and prospective study
Dr. Ranjan Kumar Jena, Ltcol C Lalsangzuala, Dr. Chinmaya Dash

Background: Brain tumor is quite common in paediatric age group and is one of the most common solid tumor in this age group, mainly in the posterior fossa. The present study was analysis of paediatric patients with posterior fossa tumor. Materials & Methods: 37 paediatric patients presented to the emergency department or outpatient department with posterior fossa tumor were selected. Parameters such as presenting symptoms and durations, clinical findings, pre-operative imaging like CT scan and MRI, details of surgical intervention performed, HPE reports, post-operative complications. Results: Out of 37 patients, males were 21 and females were 16. The common signs &symptoms were raised ICP in 37, cerebellar signs in 36, papilledema in 29, IX & X cranial nerve palsy in 21 and other cranial nerve palsy in 8 cases. The difference was significant (P< 0.05).Gross hydrocephalus was present in 73% (N= 27). Major site of involvement was 4th ventricle, followed by cerebellar vermis and then brain stem. Medulloblastoma tends to push 4th ventricle anteriorly while cerebellar astrocytoma and tuberculoma push it anterolateral and backwardly in brainstem glioma. Tumor bleed was seen in 13.5 % (N=5).The difference was significant (P< 0.05). Outcomewas recurrence/ residual in 16, cerebellar mutism in 12, meningitis in 7, shunt revision in 12, tracheostomy in 12, post-op chemo radiation in18, hemi/quadriplegia in 6, loss of vision in 2 and mortality in 21 cases. The difference was non- significant (P< 0.05). Conclusion: Paediatric brain tumor is one of the most common solid tumor in this age group with incidence as high as 2-3.5 per 10,000. Approximately 60-70 % of these tumors are located in posterior fossa. There is more male preponderance and majority of the patients are under 10 years of age. The most common tumors of paediatrics posterior fossa tumor reported in literatures are Medulloblastoma, followed by Pilocytic astrocytoma, brain stem glioma and ependymoma. Other less common types are choroid plexus papilloma, tuberculoma, dermoid and epidermoid. The most common sites are cerebellar hemisphere, cerebellar vermis, brain stem and 4th ventricle.

 
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