Congenital astrocytomas: the roentgenographic manifestations

Neuroradiologic findings of hypothalamic hamartoma with emphasis on computed tomography

Hypothalamic hamartoma is a relatively rare congenital malformation. Five new cases and 31 cases in the literature were evaluated in regard to neuroradiologic findings with emphasis on computed tomography. Five important computed tomography findings were observed: oval-shaped, isodense suprasellar mass; clear demarcation; no enhancement effect; absence of cystic component or calcification; and no effacement of the third ventricle. Clinical features, mechanism of the precocious puberty, and differential diagnosis are also discussed.

Perinatal (congenital and neonatal) neoplasms: a report of 110 cases

One hundred ten congenital and neonatal tumors encompassing a 25-year period are described and compared with similar published cases. Forty percent are classified as histologically malignant, and 65% of neonates with malignancies died. The types, frequency, and clinical features of neoplasms encountered in the perinatal period are markedly different from those observed in older children and adolescents. Their biological behavior and response to therapy are also dissimilar. Leukemia was responsible for the largest number of deaths followed by neuroblastoma and brain tumors.

Diagnosis and surgical treatment of childhood brain tumors

As the most frequent solid tumor occurring in childhood, brain tumors constitute an important segment of pediatric oncology. Neurologic manifestations may be deceptively mild and easily overlooked or misinterpreted, particularly in the very young, because of the remarkable resiliency of the immature central nervous system and the skull's ability to expand throughout the pre-adolescent years. The majority of childhood tumors produce increased intracranial pressure, usually the consequence of obstructive hydrocephalus. Specific neurologic deficits correspond to the tumor's location. The posterior fossa harbors two-thirds of childhood tumors, and each of the four common tumors in this location produces a characteristic syndrome. Supratentorial tumors occupy the cerebral hemisphere, the suprasellar area, and the pineal gland. Diagnostic studies have reached a state of great sophistication and precise anatomical localization. Surgery, either alone or with adjuvant radiotherapy, cures no more than one-third of all tumors; for the remainder, it has a diagnostic and palliative role. The introduction of operative microsurgery has advanced the art, particularly in the surgical treatment of craniopharyngiomas and pinealomas, but any significant improvement in the treatment of brain tumors as a group seems unlikely to be achieved by surgery alone.