CLINICOPATHOLOGICAL PATTERN OF CHILDHOOD INTRACRANIAL TUMOURS IN THE NIGER DELTA

David Okon Udoh, Ali Elijah Usiholo, Mojisola Olutayo Udoh,                       

Department of Surgery

University of Benin Teaching Hospital, 

P.M.B. 1111, Benin City, Edo State, Nigeria.

E-mail: davidudoh07@gmail.com

ABSTRACT

Intracranial tumours are a mixed group of neoplasms originating from intracranial tissues with varying degrees of malignancy. In children, they are predominantly solid tumours and are second only to hematological malignancies.About two thirds are infratentorial, unlike in adults, gliomas constituting the majority. Though of great concern, literature is almost silent on the pattern of this disease from the Niger Delta regions of Nigeria.

Study Objective/Setting: To document the epidemiology, management and outcomes of childhood brain tumours in our teaching hospital setting in the Niger Delta region of Nigeria.

Methodology: Demographic, clinical, radiological and histopathological data of 57 patients aged ≤ 17 years treated for intracranial tumours from  inception of our neurosurgical unit in 2006 June to 2019 April were documented. Outcomes were also documented. Data was statistically analysed using SPSS 21.0.

Results: Childhood intracranial tumours represented approximately 8.0% of paediatric neurosurgical admissions and 27% of all intracranial tumours. Of the 57 patients studied, 37 were male (60%) and 23 (40%) were female i.e. ratio 1.5: 1. The age at presentation was 2 to 17 years; mean age was 9.79 (median 9.0) years in boys and 9.91 (median 10.5) years in girls. The duration of symptoms was 2 weeks to 48 months, forty-two percent presenting after 6 months of onset of symptoms. Headaches (65%), altered sensorium or frank coma (58%) and vomiting (44%) were the commonest symptoms. There were almost equal numbers of supra- and infratentorial tumours and 54% were gliomas. Cystic cerebellar astrocytoma (25%) followed by craniopharyngioma (14%), medulloblastomas (9%) and pineal region tumour (9%) were the most frequent histological types. Forty-eight patients underwent tumour resections. Mortality was 23%.

Conclusion: Intracranial tumours in children, though less common than congenital anomalies of the neuraxis, are associated with a very high mortality in paediatric neurosurgical patients. Besides the location and histological type, late presentation influences outcome significantly.

Keywords: Intracranial Tumours; Childhood; Predominantly Solid; Cystic Cerebellar Astrocytomas; Paediatric Neurosurgical.