CNS Tumors in Children

CNS Tumors in Children

Lukas Gaffney

  • Brain and central nervous system (CNS) tumors are the most common pediatric solid organ tumor and second most common malignancy overall behind leukemia.1

  • CNS tumors are the leading cause of cancer death in children aged 0 to 14 years.2

  • Associated morbidity and mortality have improved with more advanced treatment but are still significant.


  • The base of the skull contains 3 fossae: anterior, middle, and posterior.

  • The posterior fossa is the most inferior fossa and houses the cerebellum, medulla, and pons (Figure 57.1).

  • The cerebellum is separated from the cerebrum by the tentorium cerebelli, an extension of the dura mater.

  • Structures in or adjacent to the posterior fossa include the foramen magnum, jugular foramen, internal acoustic meatus, and the ventricular system distal to the third ventricle (Figure 57.2).


Incidence: According to the Central Brain Tumor Registry of the United States, the estimated incidence of primary nonmalignant and malignant CNS tumors is 5.4 cases/100 000 person-years for children and adolescents ≤19 years of age.3

  • Males are diagnosed more frequently than females.

  • Incidence decreases with age, with newborns (<1 year old) diagnosed at an annual age-adjusted rate of 6.22/100 000; 1- to 4-year-olds at 5.53/100 000; and both 5- to 9-year-olds and 10- to 14-year-olds at 5/100 000.4

  • CNS tumors are more common in Asian/Pacific Islanders (6.05/100 000) and whites (5.46/100 000) than Hispanics (4.36/100 000) or blacks (4.12/100 000).4

Figure 57.1 Medial views of the brain. (Reprinted with permission from Agur AMR, Dalley AF. Grant’s Atlas of Anatomy. 14th ed. Philadelphia, PA: Wolters Kluwer Health; 2017.)

Etiology: The etiology of most pediatric CNS tumors is unknown.

  • Exposure to ionizing radiation, particularly cranial irradiation for ALL treatment, increases risk.

  • A minority of cases are associated with genetic conditions, such as neurofibromatosis, tuberous sclerosis, and Turcot syndrome.


Classic presentation: Symptoms depend on tumor location and patient age. They are often nonspecific and may be confused for more common childhood conditions, leading to a median delay in diagnosis of ˜3 months.5

May 5, 2019 | Posted by in PEDIATRICS | Comments Off on CNS Tumors in Children
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