儿童颅脑肿瘤的特点

Characteristics of children's brain tumors

目的儿童颅脑肿瘤为常见的儿童肿瘤。以5～14岁组患儿居多,男性略多于女性。儿童脑肿瘤幕下肿瘤较幕上肿瘤多见,幕下肿瘤约占60%左右,幕下多见于第4脑室,其次为小脑半球和小脑蚓部,以后颅窝和脑中线附近多见。幕上多见于大脑半球,其次为第3脑室和侧脑室。儿童脑肿瘤临床表现随肿瘤大小、性质、位置及其对周围脑组织结构损害的不同而各异。儿童脑肿瘤的病理组织学类型和成人有明显的不同,常见的良性肿瘤在儿童中很少见,而胶质瘤的发病率却远高于成人,最常见的病理组织类型是星形细胞瘤、髓母细胞瘤、室管膜瘤,生殖细胞肿瘤及颅咽管瘤等。儿童脑肿瘤的诊断应注意儿科特点及其临床表现的不典型性,详细地询问病史,特别是正确而完整的症状和体征,然后根据实际情况进行必要的检查,尽早明确诊断,减少早期误诊率。影像学检查是诊断儿童颅内肿瘤的重要方法,对可疑病例应尽早进行CT和MR检查。治疗首选手术切除,术后合理的放疗可巩固手术疗效、延长寿命,恶性肿瘤术后,先行放疗,再辅以化疗,可提高恶性肿瘤的疗效。

Children＇s brain tumors are the common tumors in children,which males are frequently affected than females,and most of patients are children aged 5-14 years old.The incidence rate of infratentorial tumor is higher than that of supratentorial tumor.The cases of infratentorial tumor in children accounted for 60%,and the main part is the fourth ventricle,followed by cerebellar hemisphere and cerebellar vermis,which often occurred in posterior fossa and near the midline.The main part of supratentorial tumor is the cerebral hemispheres,followed by the third ventricle and lateral ventricle.The clinical symptoms of childhood brain tumors are different with the size,characteristics,location and the damage around brain structure.The histopathological types of children＇s brain tumors are significantly different from that in adults.The benign tumors rarely happen in children,but the incidence rate of glioma in children is greatly higher than that in adults.The mostly pathological types were astrocytoma,medulloblastoma,ependymoma,germ cell tumor and craniopharyngioma.The diagnosis of brain tumor in children should pay attention to the pediatric clinical characteristics,atypical clinical manifestation and detailed medical history,especially the correct and complete symptoms.Then according to the actual situation,it is urgent to carry out the necessary examination,to confirm the diagnosis and reduce the early misdiagnosis rate.The imaging examination plays a very important role in the diagnosis of children＇s brain tumors,so CT and MR examinations should be carried out in suspected cases as soon as possible.Surgical resection is the first choice,and reasonable postoperative radiotherapy can consolidate the operation effect and prolong survival duration.The radiotherapy accompanied with chemotherapy can improve the curative effect in malignant tumor patients after surgery.