Nöroonkoloji
Özet
Çocukluk çağı merkezi sinir sistemi tümörleri, glial hücre kökenli olup tüm çocukluk çağı kanserlerinin %15-20'sini oluşturan ikinci en yaygın kanser grubudur. Klinik belirtiler tümörün yerleşim yerine, boyutuna ve büyüme hızına göre kafa içi basınç artışı veya fokal nörolojik defisitler şeklinde ortaya çıkar. Tanı süreci genellikle MR ve BT gibi görüntüleme yöntemlerine dayanırken, tedavi stratejileri tümör tipine bağlı olarak cerrahi, kemoterapi veya radyoterapiyi içermektedir. Nörofibromatozis gibi çeşitli genetik sendromlar, bu tümörlerin gelişiminde önemli birer risk faktörü oluşturmaktadır.
Central nervous system (CNS) tumors represent the second most common childhood cancer group, accounting for 15-20% of cases, with a significant majority originating from glial cells. Clinical symptoms typically manifest due to increased intracranial pressure or focal neurological deficits, heavily influenced by the tumor's size, growth rate, and location. Diagnostic processes rely on neuroimaging—particularly MRI—while therapeutic management is personalized based on histological classification, ranging from surgical resection to chemotherapy and radiotherapy. Underlying genetic syndromes, such as Neurofibromatosis, serve as critical predisposing factors in the development of many pediatric brain tumors.
Referanslar
Udaka YT, Packer RJ. Pediatric Brain Tumors. Neurol Clin. 2018;36:533-556.
Waker CA, Lober RM. Brain Tumors of Glial Origin. Adv Exp Med Biol. 2019;1190:281-297.
Kara B, Akbas H, Düzova M, Karabağlı H, Koksal Y. The Treatment Outcomes in Children with Medulloblastoma. J Pediatr Acad 2020; 1: 94-98.
GuerreiroStucklin AS, Ramaswamy V, Daniels C, Taylor MD. Review of molecular classification and treatment implications of pediatric brain tumors. Curr Opin Pediatr. 2018;30:3-9.
Lanzkowsky, Philip, Jeffrey M. Lipton, and Jonathan D. Fish, eds. Lanzkowsky's manual of pediatric hematology and oncology. Academic press, 2016.
Handb Clin Neurol. 2013;112:959-65.
Furtado AD, Panigrahy A, Fitz CR. CNS and spinal tumors. Handb Clin Neurol. 2016;136:1139-58.
Lampros M, Voulgaris S, Alexiou GA. Hydrocephalus in primary intradural spinal cord tumors: a systematic review of the literature in the pediatric population. Neurosurg Rev. 2020 Sep 11. doi: 10.1007/s10143-020-01386-0. Epubahead of print. PMID: 32918116.
Malbari F, Lindsay H. Genetics of Common Pediatric Brain Tumors. Pediatr Neurol. 2020;104:3-12.
Bleeker FE, Hopman SM, Merks JH, Aalfs CM, Hennekam RC. Brain tumors and syndromes in children. Neuropediatrics. 2014 ;45:137-61.
Aydın F, Altay D, Görükmez O et al. Glioblastoma and Colorectal Adenocarcinoma in an Adolescent Girl with Constitutional Mismatch Repair Deficiency Syndrome Mimicking Neurofibromatosis Type-I. J Pediatr Acad 2020; 1: 34-38.
Villanueva-Meyer JE, Mabray MC, Cha S. Current Clinical Brain Tumor Imaging. Neurosurgery. 2017;81:397-415.
Young RJ, Knopp EA. Brain MRI: tumor evaluation. J Magn Reson Imaging. 2006 ;24:709-24
Fisher PG, Tihan T, Goldthwaite PT et al. Outcome analysis of childhood low-grade astrocytomas. Pediatr Blood Cancer. 2008;51:245-50.
Ding C, Tihan T. Recent Progress in the Pathology and Genetics of Pilocytic and Pilomyxoid Astrocytomas. Balkan Med J. 2019 1;36:3-11.
Braunstein S, Raleigh D, Bindra R, Mueller S, Haas-Kogan D. Pediatric high-grade glioma: current molecular landscape and therapeutic approaches. J Neurooncol. 2017 ;134:541-49.
Baliga S, Gandola L, Timmermann B, et al. Brain tumors: Medulloblastoma, ATRT, ependymoma. Pediatr Blood Cancer. 2021 May;68 Suppl2:e28395. doi: 10.1002/pbc.28395. Epub 2020 May 9. PMID: 32386126.
Rolland A, Aquilina K. Surgery for recurrent medulloblastoma: A review. Neurochirurgie. 2021 ;67:69-75.
Siegfried A, Delisle MB. Médulloblastome. Anatomiepathologique [Medulloblastoma. Pathology]. Neurochirurgie. 2021;67:28-38.
Hu R, Hoch MJ. Application of Diffusion Weighted Imaging and Diffusion Tensor Imaging in the Pretreatment and Post-treatment of Brain Tumor. Radiol Clin North Am. 2021 ;59:335-47.
Campen CJ, Gutmann DH. Optic Pathway Gliomas in Neurofibromatosis Type 1. J Child Neurol. 2018 ;33:73-81.
Farazdaghi MK, Katowitz WR, Avery RA. Current treatment of optic nevre gliomas. Curr Opin Ophthalmol. 2019 Sep;30(5):356-363. doi: 10.1097/ICU.0000000000000587. PMID: 31246635; PMCID: PMC7410088.
Wummer B, Woodworth D, Flores C. Brain stem gliomas and current landscape. J Neurooncol. 2021;151:21-28.
Drapeau A, Walz PC, Eide JG et al. Pediatric craniopharyngioma. Childs Nerv Syst. 2019;35:2133-45.
Denyer S, Bhimani AD, Patil SN, Mudreac A, Behbahani M, Mehta AI. Treatment and survival of primary intracranial germ cell tumors: a population-based study using SEER database. J Cancer Res Clin Oncol. 2020;146:671-85.
