obsolete childhood supratentorial neoplasm

Obsolete Childhood Supratentorial Neoplasm

A childhood supratentorial neoplasm refers to a type of tumor that occurs in the upper part of the brain, above the tentorium cerebelli. This term is considered obsolete (1) and has been replaced by more specific and accurate classifications.

Synonyms: Pediatric Supratentorial Tumor

The definition of this term is not available (3), but it is often used to describe a range of tumors that occur in the supratentorial region, including:

• Supratentorial ependymomas, which are circumscribed gliomas arising in the cerebral hemispheres and may or may not be contiguous with the ventricular system (6).
• Childhood choroid plexus neoplasm, a rare tumor that arises from the choroid plexus in the brain and occurs during childhood (7).

Other types of supratentorial tumors in children include:

• Pilocytic astrocytoma, which is the most common type of low-grade glioma in children, accounting for 40% of pediatric gliomas and 11.53% of supratentorial CNS tumors (10).
• Craniopharyngiomas, unique tumors of the suprasellar region with an embryologic origin, which are the third most common cause of all intracranial tumors in children (9).

These tumors can vary in their severity and may be associated with symptoms such as seizures, hydrocephalus, or visual disturbances.

References:

• [1]
• [3]
• [6]
• [7]
• [9]
• [10]

Note: The information provided is based on the search results and may not reflect the current medical terminology or classification.

Common Signs and Symptoms of Obsolete Childhood Supratentorial Neoplasms

Supratentorial brain tumors in children, although rare, can exhibit a range of symptoms that may be nonspecific and require a delayed diagnosis. The following are some common signs and symptoms associated with obsolete childhood supratentorial neoplasms:

• Headache: A frequent presenting symptom, headache is often present in approximately 50-60% of patients (10).
• Vomiting: Vomiting was the second most common symptom, present in 46% of patients, and was often projectile in only one case in ten (11).
• Loss of vision: This symptom can occur due to compression or invasion of the optic nerve or chiasm.
• Convulsive seizures: Seizures are often seen in low-grade supratentorial lesions, either as an isolated finding or with other symptoms (14).
• Ataxia: Ataxia is a common presenting symptom, indicating cerebellar involvement.

Other Signs and Symptoms

In addition to the above-mentioned symptoms, children with supratentorial brain tumors may also experience:

• Papilledema: Swelling of the optic disc due to increased intracranial pressure.
• Unilateral weakness of the extremities: Weakness or paralysis on one side of the body.
• Increase in size or distortion of the head (in children under 5 years of age): This can be a sign of rapid tumor growth.
• Nystagmus: Involuntary eye movements.
• Cranial bruit: A sound heard over the skull, indicating abnormal blood flow.

Important Considerations

It is essential to note that these symptoms are often nonspecific and may not necessarily indicate a supratentorial brain tumor. A delayed diagnosis can occur in children with supratentorial tumors compared to those with infratentorial tumors (14).

References:

[10] [11] [14]

Diagnostic Tests for Obsolete Childhood Supratentorial Neoplasms

According to recent studies, the diagnosis of supratentorial brain tumors in children can be challenging due to their non-specific or even absence of symptoms, especially in infants [7]. As a result, treatment of pediatric brain tumors is very challenging given the unique physiology of children [7].

Imaging Features and Differential Diagnosis

The location of tumors might be one clue to differential diagnosis [4]. MR and CT findings in 40 children with 12 types of pathologically proven histological tumors were reviewed. The results showed that most supratentorial brain tumors are glial tumors, including astrocytoma (most common), oligodendroglioma, glioblastoma; Peripherally located tumors that involve cortex, are low grade, may cause seizures – ganglioglioma, dysembryoplastic neuroepithelial tumor, pleomorphic xanthoastrocytoma, oligodendroglioma [5].

Recent Changes to WHO Classification

The differential diagnosis of supratentorial brain tumours in children can be challenging, especially considering the recent changes to the WHO classification of CNS tumours published in 2021 [8]. Many new tumour types have been proposed which frequently present in children and young adults, and their imaging features are currently being described by the neuroradiology community.

Diagnostic Approaches

The approach to differential diagnosis of supratentorial brain tumors involves considering the location of the tumor, its histological type, and any clinical symptoms or signs [5]. Imaging modalities such as MR and CT scans play a crucial role in this process. The purpose of these investigations is to provide information that can aid in the differential diagnosis of pediatric supratentorial intra-axial tumors [4].

References:

[4] Context 4 [5] Context 5 [7] Context 7 [8] Context 8

Based on the provided context, it appears that there are various treatment options for supratentorial primitive neuroectodermal tumors (sPNET) in children.

Current and Obsolete Treatments

• Radiation therapy has been used in combination with chemotherapy and surgical resection to treat sPNET [12][13]. However, the role of radiation in the treatment of these tumors is still being clarified [15].
• Chemotherapy, including high-dose methotrexate, has been used as part of the treatment regimen for sPNET [

The differential diagnosis of supratentorial brain tumors in children can be challenging, especially considering the recent changes to the WHO classification of CNS tumours published in 2021 [10]. Many new tumor types have been proposed which frequently present in children and young adults and their imaging features are currently being described.

Some of the key considerations for differential diagnosis include:

• Glial tumors: Astrocytoma (most common), oligodendroglioma, glioblastoma
• Peripherally located tumors: These involve the cortex, are low-grade, and may cause seizures. Examples include:
  • Ganglioglioma
  • Dysembryoplastic neuroepithelial tumor (DNET)
  • Pleomorphic xanthoastrocytoma (PXA)
  • Oligodendroglioma

Other supratentorial tumors that can arise in children include:

• Congenital brain tumors: These are diagnosed antenatally or within the first 60 days of life
• Tumors of infancy: These occur in children younger than 1 year old

It's worth noting that supratentorial tumors may come to medical attention later compared with infratentorial tumors, as they are less commonly associated with ventricular obstruction [12][13].

In terms of imaging features and changes relevant to radiology, new or revised CNS tumor types other than infiltrating glioma have been proposed, which can be challenging for differential diagnosis [8].