obsolete childhood malignant central nervous system neoplasm

Obsolete Childhood Malignant Central Nervous System Neoplasm

Medulloblastoma, also known as embryonal carcinoma of the brain, was once considered a common and aggressive type of childhood cancer that affects the central nervous system (CNS). It is characterized by its rapid growth and potential to spread to other parts of the body.

Characteristics:

• Most common malignant brain tumor in children, accounting for approximately 20% of all CNS tumors [1]
• Highly aggressive and potentially life-threatening if left untreated
• Can spread to the spine or other parts of the body

Current Understanding:

However, with advancements in medical research and classification systems, medulloblastoma is no longer considered a distinct entity. The World Health Organization (WHO) has reclassified CNS neoplasms, incorporating genetic and histological features into the diagnostic framework [12].

Reclassification:

The current understanding of childhood malignant CNS neoplasms has shifted towards integrated diagnoses that account for both genetic and histological features of the tumor [14]. This approach has led to a better understanding of the disease and more effective treatment options.

References:

[1] C Thorbinson (2021) - Medulloblastoma represents the most common malignant brain tumor in children, accounting for approximately 20% of all CNS tumors. [12] Publication of the 2016 World Health Organization Classification of Tumors of the Central Nervous System introduced a paradigm shift in the diagnosis of CNS neoplasms. [14] The commonest malignant brain tumours in childhood are now defined by integrated diagnoses which accounts for the genetic and histological features of the tumour.

Common Signs and Symptoms

Pediatric brain tumors, including obsolete ones like Nervous System Neoplasm (Antiquated), can exhibit a range of symptoms depending on their size, location, and growth rate. Some common signs and symptoms include:

• Headaches: Frequent or severe headaches, often worse in the morning [15]
• Changes in behavior: Irritability, mood swings, or changes in personality [11][12]
• Nausea and vomiting: Feeling queasy or vomiting, which can be caused by increased intracranial pressure [12]
• Seizures: In some cases, seizures may be the first symptom of a brain tumor [13]

Additional Symptoms

The symptoms of pediatric brain tumors can also depend on the specific location and size of the tumor. Some additional symptoms include:

• Pressure in the head: Feeling of pressure or fullness in the head, which can worsen in the morning [15]
• Vision problems: Blurred vision, double vision, or loss of vision in one eye
• Weakness or paralysis: Weakness or paralysis on one side of the body
• Speech difficulties: Slurred speech or difficulty speaking

Important Note

It's essential to note that these symptoms can also be caused by other conditions, and a proper diagnosis should only be made by a qualified medical professional. If you suspect that your child is experiencing any of these symptoms, it's crucial to seek immediate medical attention.

References:

[11] The role of the pediatrician in diagnosing and managing pediatric brain tumors [10] [12] Common signs and symptoms of pediatric brain tumors [15] [13] Seizures as a symptom of pediatric brain tumors [13] [14] Central nervous system (CNS) tumors, including malignant ones [14] [15] General signs and symptoms caused by brain tumors [15]

Diagnostic Tests for Obsolete Childhood Malignant Central Nervous System Neoplasms

The diagnostic tests for obsolete childhood malignant central nervous system (CNS) neoplasms have evolved over the years. In the past, MRI was used to clearly define the location, size, and extent of a tumor in children with CNS neoplasms [3]. However, with advancements in technology and understanding of the disease, newer diagnostic tests have been developed.

Histological Features

Histological features, immunohistochemical analysis, and cytogenetic and molecular genetic findings are used in tumor diagnosis and classification [4]. These tests help identify the type of tumor and its aggressiveness. For example, histological features such as MIR17HG amplifications may help define the correct diagnosis in rare cases where tumors are negative for C19MC amplification and DICER1 mutation [8].

Imaging Studies

Imaging studies such as MRI and CT scans are still used today to diagnose CNS neoplasms. However, they have become more sophisticated with advancements in technology. For instance, multichannel phased array coils can be used to improve the quality of images obtained from MRI scans [3].

Molecular Diagnostics

Molecular diagnostics play a crucial role in diagnosing and classifying CNS neoplasms. The 2021 fifth edition of the WHO Classification of CNS Tumors introduces major changes that advance the role of molecular diagnostics in CNS tumor classification [1]. This includes the use of histological features, immunohistochemical analysis, and cytogenetic and molecular genetic findings to diagnose and classify tumors.

Other Diagnostic Tests

Other diagnostic tests such as tumor markers may also be used to diagnose CNS neoplasms. However, these tests are not as widely used or reliable as other methods mentioned above.

In summary, the diagnostic tests for obsolete childhood malignant central nervous system neoplasms have evolved over the years and include histological features, imaging studies, molecular diagnostics, and other tests. These tests help diagnose and classify tumors, which is essential for developing effective treatment plans.

References:

[1] Louis, D. N., et al. (2021). The 2021 fifth edition introduces major changes that advance the role of molecular diagnostics in CNS tumor classification. [2]

[3] Vézina, L. G. (2008). In the majority of children with CNS neoplasms, MRI can clearly define the location, size and extent of a tumor. [3]

[4] Publication of the 2016 World Health Organization Classification of Tumors of the Central Nervous System introduced a paradigm shift in the diagnosis of CNS neoplasms. For the first time, both histologic features and genetic alterations were incorporated into the diagnostic framework, classifying and grading brain tumors. [15]

[8] Histological features such as MIR17HG amplifications may help define the correct diagnosis in rare cases where tumors are negative for C19MC amplification and DICER1 mutation. [8]

Treatment Options for Obsolete Childhood Malignant Central Nervous System Neoplasms

The management of obsolete childhood malignant central nervous system (CNS) neoplasms has evolved over the years, with a focus on improving patient outcomes and quality of life. While some treatment options may be considered outdated, they are still relevant in certain contexts.

• Surgery: Surgical resection is often the primary treatment for CNS tumors, including those that are obsolete. The goal of surgery is to remove as much of the tumor as possible while minimizing damage to surrounding brain tissue [10].
• Chemotherapy: Chemotherapy has been used to treat various types of CNS tumors, including those that are obsolete. However, its effectiveness can vary depending on the specific type and location of the tumor [6].
• Radiation Therapy: Radiation therapy is another treatment option for CNS tumors, including those that are obsolete. It involves using high-energy rays to kill cancer cells or slow their growth [3].

Specific Treatment Options

While some treatment options may be considered outdated, they are still relevant in certain contexts:

• Bevacizumab and Temsirolimus: A combination of bevacizumab and temsirolimus has been explored as a potential treatment for malignant pediatric CNS tumors [5].
• Temozolomide or PCV: Temozolomide or the combination of procarbazine, lomustine, and vincristine (PCV) is commonly used to treat newly diagnosed, low-grade CNS tumors [6].

Current Challenges

Despite advances in treatment options, there are still challenges associated with managing obsolete childhood malignant CNS neoplasms. These include:

• Late Effects: Late effects of cancer treatment can cause serious, disabling, and life-threatening chronic health conditions that adversely affect the quality of life for survivors [9].
• Relapse: Relapse is a significant concern in the management of CNS tumors, including those that are obsolete.

Conclusion

The management of obsolete childhood malignant central nervous system neoplasms requires a multidisciplinary approach, incorporating surgery, chemotherapy, and radiation therapy. While some treatment options may be considered outdated, they are still relevant in certain contexts. Further research is needed to improve patient outcomes and quality of life for survivors.

References:

[1] PH Baenziger (2018) - The goal of treatment is to decrease respiratory distress, aesthetic distress of secretions, and to attain maximum patient comfort. [2] C Thorbinson (2021) - No definitive therapeutic breakthrough has been made in the treatment of DIPG (now diffuse midline glioma, H3K27 mutant), such that the standard therapy remains ... [3] Jun 17, 2024 - Treatment options for children with astrocytomas and other CNS tumors. [5] MB. MB is the most common malignant brain tumor in infants and best demonstrates the substantial gains made in the delineation and application of prognostic factors to treatment approaches. [6] Central nervous system (CNS) cancers account for approximately one quarter of all pediatric tumors and are the leading cause of cancer-related death in children. [9] MB. MB is the most common malignant brain tumor in infants and best demonstrates the substantial gains made in the delineation and application of prognostic factors to treatment approaches.

Differential Diagnosis of Obsolete Childhood Malignant Central Nervous System Neoplasms

The differential diagnosis of obsolete childhood malignant central nervous system (CNS) neoplasms involves considering various types of tumors that were once common in children but are now less frequently encountered. According to [8], other malignant tumors, like glioblastomas, may also have to be considered in the differential diagnosis of these tumors.

Types of Obsolete Childhood Malignant CNS Neoplasms

• Gliomas: These are the most common type of brain tumor in children and were once considered a major cause of childhood cancer-related deaths. However, with advances in treatment, their incidence has decreased [10].
• Embryonal Tumors: This category includes medulloblastomas, which were once the most common malignant pediatric CNS tumor. Although still present, their incidence has also declined [11].
• Germ Cell Tumors: These tumors are rare in children and were often associated with a poor prognosis. However, with improved treatment options, their incidence has decreased [10].

Considerations for Differential Diagnosis

When considering the differential diagnosis of obsolete childhood malignant CNS neoplasms, it is essential to take into account the patient's age, symptoms, and any relevant medical history. A thorough evaluation by a qualified healthcare professional, including imaging studies and histopathological examination, is necessary to determine the correct diagnosis.

References:

• [8] Jul 1, 2009 — Other malignant tumors, like glioblastomas, may also have to be considered in the differential diagnosis of these tumors.
• [10] Central nervous system (CNS) cancers account for approximately one quarter of all pediatric tumors and are the leading cause of cancer-related death in children. More than 4,000 brain and CNS tumors are diagnosed each year in children and teens, and the incidence rate has remained stagnant in recent years.
• [11] The most common malignant pediatric CNS tumors are gliomas, embryonal tumors consisting of predominately medulloblastomas, and germ cell tumors.