1
|
Gerrie SK, Branson HM, Lyons CJ, Marie E, Rajani H, Frayn CS, Hughes ECM, Navarro OM. Pediatric orbital lesions: neoplastic extraocular soft-tissue lesions. Pediatr Radiol 2024; 54:922-935. [PMID: 38480589 DOI: 10.1007/s00247-024-05891-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 02/14/2024] [Accepted: 02/18/2024] [Indexed: 05/24/2024]
Abstract
Pediatric neoplastic extraocular soft-tissue lesions in the orbit are uncommon. Early multimodality imaging work-up and recognition of the key imaging features of these lesions allow narrowing of the differential diagnoses in order to direct timely management. In this paper, the authors present a multimodality approach to the imaging work-up of these lesions and highlight the use of ocular ultrasound as a first imaging modality where appropriate. We will discuss vascular neoplasms (congenital hemangioma, infantile hemangioma), optic nerve lesions (meningioma, optic nerve glioma), and other neoplastic lesions (plexiform neurofibroma, teratoma, chloroma, rhabdomyosarcoma, infantile fibrosarcoma, schwannoma).
Collapse
Affiliation(s)
- Samantha K Gerrie
- Department of Radiology, BC Children's Hospital, 4500 Oak Street, Vancouver, BC, V6H 3N1, Canada.
- Department of Radiology, University of British Columbia, Vancouver, Canada.
| | - Helen M Branson
- Department of Diagnostic and Interventional Radiology, The Hospital for Sick Children, Toronto, Canada
- Department of Medical Imaging, University of Toronto, Toronto, Canada
| | - Christopher J Lyons
- Department of Ophthalmology, BC Children's Hospital, Vancouver, Canada
- Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, Canada
| | - Eman Marie
- Department of Diagnostic Imaging, McMaster Children's Hospital, McMaster University, Hamilton, Canada
| | - Heena Rajani
- Department of Radiology, BC Children's Hospital, 4500 Oak Street, Vancouver, BC, V6H 3N1, Canada
- Department of Radiology, University of British Columbia, Vancouver, Canada
| | - Cassidy S Frayn
- Department of Radiology, BC Children's Hospital, 4500 Oak Street, Vancouver, BC, V6H 3N1, Canada
- Department of Radiology, University of British Columbia, Vancouver, Canada
| | - Emily C M Hughes
- Department of Radiology, BC Children's Hospital, 4500 Oak Street, Vancouver, BC, V6H 3N1, Canada
- Department of Radiology, University of British Columbia, Vancouver, Canada
| | - Oscar M Navarro
- Department of Diagnostic and Interventional Radiology, The Hospital for Sick Children, Toronto, Canada
- Department of Medical Imaging, University of Toronto, Toronto, Canada
| |
Collapse
|
2
|
Lokdarshi G, Sihag P, Sen S, Gaur N. Spontaneous radiological regression of optic nerve glioma in a child: A dilemma. J Fr Ophtalmol 2024; 47:104028. [PMID: 38311491 DOI: 10.1016/j.jfo.2023.104028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 10/11/2023] [Accepted: 11/23/2023] [Indexed: 02/06/2024]
Affiliation(s)
- G Lokdarshi
- Oculoplastic and Ocular Oncology Services, IRIS Superspeciality Eye Hospital, Orchid Medical Centre, Ranchi, Jharkhand, India
| | - P Sihag
- Department of Radiology, All India Institute of Medical Sciences, Rajkot, Gujrat, India
| | - S Sen
- Moorfield Eye Hospital, London, UK
| | - N Gaur
- Department of Ophthalmology, All India Institute of Medical Sciences, Bilaspur, Himachal Pradesh, India.
| |
Collapse
|
3
|
Bennebroek CA, Schouten CR, Montauban-van Swijndregt MC, Saeed P, Porro GL, Pott JWR, Dittrich ATM, Oostenbrink R, Schouten-van Meeteren AY, de Jong MC, de Graaf P. Treatment evaluation by volumetric segmentation in pediatric optic pathway glioma: evaluation of the effect of bevacizumab on intra-tumor components. J Neurooncol 2024; 166:79-87. [PMID: 38150061 DOI: 10.1007/s11060-023-04516-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 11/16/2023] [Indexed: 12/28/2023]
Abstract
PURPOSE Progressive pediatric optic pathway gliomas (OPGs) are treated by diverse systemic antitumor modalities. Refined insights on the course of intra-tumoral components are limited. METHODS We performed an exploratory study on the longitudinal volumetric course of different (intra-)tumor components by manual segmentation of MRI at the start and after 3, 6 and 12 months of bevacizumab (BVZ) treatment. RESULTS Thirty-one patients were treated with BVZ (median 12 months, range: 2-39 months). During treatment the total tumor volume decreased with median 19.9% (range: - 62.3 to + 29.7%; n = 30) within the first 3 months, decreased 19.0% (range: - 68.8 to + 96.1%; n = 28) between start and 6 months and 27.2% (range: -73.4 to + 36.0%; n = 21) between start and 12 months. Intra-tumoral cysts were present in 12 OPGs, all showed a decrease of volume during treatment. The relative contrast enhanced volume of NF1 associated OPG (n = 11) showed an significant reduction compared to OPG with a KIAA1549-BRAF fusion (p < 0.01). Three OPGs progressed during treatment, but were not preceded by an increase of relative contrast enhancement. CONCLUSION Treatment with BVZ of progressive pediatric OPGs leads to a decrease of both total tumor volume and cystic volume for the majority of OPGs with emphasis on the first three months. NF1 and KIAA1549-BRAF fusion related OPGs showed a different (early) treatment effect regarding the tumor enhancing component on MRI, which did not correlate with tumor volume changes. Future research is necessary to further evaluate these findings and its relevance to clinical outcome parameters.
Collapse
Affiliation(s)
- Carlien A Bennebroek
- Department of Ophthalmology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1100DD, Amsterdam, The Netherlands.
- Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, The Netherlands.
| | - Christiaan R Schouten
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | - Peerooz Saeed
- Department of Ophthalmology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1100DD, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, The Netherlands
| | - Giorgio L Porro
- Department of Ophthalmology, Utrecht University Medical Center, Utrecht, The Netherlands
| | - Jan W R Pott
- Department of Ophthalmology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Anne T M Dittrich
- Department of Pediatrics, Radboud University Medical Center, Amalia Children's Hospital, Nijmegen, The Netherlands
| | - Rianne Oostenbrink
- ENCORE-NF1 Center, Department of General Pediatrics, Erasmus MC, Rotterdam, The Netherlands
| | | | - Marcus C de Jong
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Imaging and Biomarkers, Amsterdam, The Netherlands
| | - Pim de Graaf
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Imaging and Biomarkers, Amsterdam, The Netherlands
| |
Collapse
|
4
|
Kotch C, Si SJ, Desai K, Caminada P, Lo Russo FM, Li Y, Liu GT, Avery RA, Fisher MJ. The impact of changes in gadolinium-enhancement on disease progression in children with neurofibromatosis type 1-associated optic pathway glioma: a retrospective analysis. J Neurooncol 2023; 164:741-747. [PMID: 37803102 DOI: 10.1007/s11060-023-04468-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 09/26/2023] [Indexed: 10/08/2023]
Abstract
PURPOSE There has been limited investigation of imaging features associated with visual acuity (VA) decline and initiation of treatment for patients with neurofibromatosis type 1 (NF1) and optic pathway glioma (OPG). METHODS To evaluate the association of increased gadolinium enhancement with decline in VA, initiation of chemotherapy, and tumor growth, we performed a retrospective cohort study of children diagnosed with NF1-OPG between January 2006 to June 2016. Two cohorts were defined: a new diagnosis and a longitudinal cohort. Outcomes were examined at 1 and 2 years from initial diagnosis, and 1 and 2 years from initial increase in enhancement in the longitudinal cohort. RESULTS Eighty patients were eligible; all 80 contributed to the new diagnosis cohort and 73 to the longitudinal cohort. Fifty-six patients (70%) demonstrated enhancing NF1-OPG at diagnosis. 39% of patients in the new diagnosis cohort and 45% of those in the longitudinal cohort developed increased enhancement during the study period. There was no significant association between increases in enhancement and VA decline in the newly diagnosed or longitudinal cohorts, as well as with initiation of treatment in the longitudinal cohort. Although there was an association of enhancement increase with treatment in the new diagnosis cohort, this association was not maintained when stratified by concurrent change in tumor size. CONCLUSION Increased gadolinium-enhancement independent of a concurrent increase in tumor size on MRI should not be used as a marker of NF1-OPG progression and does not appear to be associated with visual decline or initiation of chemotherapy.
Collapse
Affiliation(s)
- Chelsea Kotch
- Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
- Hub for Clinical Collaboration, 3500 Civic Center Blvd, Philadelphia, PA, 19104, USA.
| | - Stephanie J Si
- Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- University of Hawai'i Cancer Center, University of Hawai'i at Manoa, Honolulu, HI, USA
| | - Kavita Desai
- Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Philippe Caminada
- Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Neonatology, Children's Hospital of Aarau, Aarau, Switzerland
| | - Francesco Maria Lo Russo
- Division of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Neuroradiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Yimei Li
- Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Grant T Liu
- Division of Ophthalmology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Departments of Ophthalmology and Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Robert A Avery
- Division of Ophthalmology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Departments of Ophthalmology and Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Michael J Fisher
- Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| |
Collapse
|
5
|
Paun L, Lavé A, Patet G, Bartoli A. Supratentorial Pediatric Midline Tumors and Tumor-like Lesions: Clinical Spectrum, Natural History and Treatment Options. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9040534. [PMID: 35455578 PMCID: PMC9032564 DOI: 10.3390/children9040534] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 03/29/2022] [Accepted: 04/05/2022] [Indexed: 04/10/2023]
Abstract
Childhood Central Nervous System tumors account for 25% of all pediatric tumors. Large availability and broadening of indications to imaging has made incidental findings more common. Among these, midline lesions have different clinical relevance depending on their intrinsic pattern of behaviour and on their specific location. In this narrative review we describe the natural history and treatment options of midline lesions in children.
Collapse
|
6
|
Surgical Management of Pre-Chiasmatic Intraorbital Optic Nerve Gliomas in Children after Loss of Visual Function—Resection from Bulbus to Chiasm. CHILDREN 2022; 9:children9040459. [PMID: 35455503 PMCID: PMC9029433 DOI: 10.3390/children9040459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 03/23/2022] [Accepted: 03/23/2022] [Indexed: 11/25/2022]
Abstract
Optic pathway gliomas in children carry significant morbidity and therapeutic challenges. For the subgroup of pre-chiasmatic gliomas, intraorbital and intradural resection is a curative option after blindness. We present a two-center cohort using different surgical approaches. A retrospective analysis was performed, including 10 children. Mean age at surgery was 6.8 years. Interval between diagnosis and surgery was 1–74 (mean 24 ± 5.5, median 10) months. Indications for surgery were exophthalmos, pain, tumor progression, or a combination. Eight patients underwent an extradural trans-orbital-roof approach to resect the intra-orbital tumor, including the optic canal part plus intradural pre-chiasmatic resection. Gross total resection was achieved in 7/8, and none had a recurrence. One residual behind the bulbus showed progression, treated by chemotherapy. In two patients, a combined supra-orbital mini-craniotomy plus orbital frame osteotomy was used for intraorbital tumor resection + intradural pre-chiasmatic dissection. In these two patients, remnants of the optic nerve within the optic canal remained stable. No patient had a chiasmatic functional affection nor permanent oculomotor deficits. In selected patients, a surgical resection from bulb to chiasm ± removal of optic canal tumor was safe without long-term sequela and with an excellent cosmetic result. Surgery normalizes exophthalmos and provides an effective tumor control.
Collapse
|