CHILDHOOD BRAIN

TUMORS
Nabilah binti Dato’ Ayob
060100814
Astrocytoma
 Astrocytoma is the most common brain
tumor, accounting for more than half of all primary
CNS malignancies.(Peads)
 Originate in glial-cells: called astrocytes.
 Astrocytomas come in four major subtypes:
 Juvenile pilocytic astrocytoma (grade 1)

 Fibrillary/diffuse astrocytoma (grade 2)

 Anaplastic astrocytoma (grade 3)

 Glioblastoma multiforme (grade 4)

 Most cases occur in the first decade of life Peak age at

5-9 years.
Astrocytoma
 Pilocytic astrocytomas arise throughout the
neuraxis, but preferred sites  optic nerve, optic
chiasm / hypothalamus, thalamus and basal
ganglia, cerebral hemispheres, cerebellum, and
brain stem.
 Diffuse astrocytomas may arise in any area of the
CNS but most commonly  cerebrum, particularly
the frontal and temporal lobes.
 Anaplastic astrocytoma arises in the same
locations as diffuse astrocytomas, with a
preference for the cerebral hemispheres
increased cellularity, marked mitotic activity, and a
Astrocytoma
 Glioblastoma multiforme subcortical white
matter of the cerebral hemispheres. Combined
frontotemporal location with infiltration into the
adjacent cortex, basal ganglia, and
contralateral hemisphere is typical.
 Glioblastoma most frequent  brain stem in
children. These tumors are highly cellular, with
high proliferative and mitotic activity.
 Juvenile pilocytic  Supratentorial
astrocytoma of the glioblastoma
cerebellum (MRI). multiforme(MRI)
 T2-weighted image  Grade 2
of a diffuse intrinsic diffuse astrocytoma
pontine glioma.
Medulloblastoma
 Medulloblastoma is the most common malignant
brain tumor in children, accounting for 10-20% of
primary CNS neoplasms and approximately 40%
of all posterior fossa tumors  Highly invasive
embryonal neuroepithelial tumor
 Cerebellar tumor arising predominantly from the
cerebellar vermis
 Morphologically similar tumors arising in the pineal
region are termed pineoblastomas, and those
arising in other CNS locations are called primitive
neuroectodermal tumors (PNETs)
Medulloblastoma
 The tumor may  Superiorly, above
spread the tentorium.
contiguously, to the  It also may spread
cerebellar peduncle via the CSF
and/or the floor of intracranially or to
the fourth ventricle the leptomeninges
 anteriorly, to the and spinal cord.
brainstem
 Inferiorly, to the
cervical spine
 MRI showing a  A cross-section of
medulloblastoma of medulloblastoma
the cerebellum. (PNET) sitting in the
cerebellum
Ependymoma
 Ependymoma neoplasm composed of glial cells
that have differentiated along ependymal lines.
 Most common  Ependymal lining of the
ventricles (most often the floor, roof, or lateral
recesses of the fourth ventricle) but it also arises in
the filum terminale and the central spinal canal.
 3rd most common brain tumor in
children, accounting for approximately 10% of
primary CNS neoplasms
 Tends to invade locally, even if histological
appearance is benign.
 Approximately 90% of tumors are intracranial, with
as many as 70% occurring in the posterior fossa.
  Anaplastic
 Ependymoma of the 4th
ventricle (CT-contrast) ependymoma of the
lateral ventricle in an 8-
- Ventricular week-old girl with
enlargement hydrocephalus
Craniopharyngioma
 Craniopharyngiomas histologically benign
neuroepithelial tumors that are predominately
observed in children aged 5-10 years.
 These tumors arise from squamous cell
embryologic rests found along the path of the
primitive adenohypophysis and
craniopharyngeal duct.
 Pediatric craniopharyngiomas are believed to
arise from cellular remnants of the Rathke
pouch, which is an embryologic structure that
forms both the infundibulum and anterior lobe
of the pituitary gland.
a) Note that the lesion is sharply demarcated and
smoothly contoured. This fluid-filled mass is
consistent with a typical craniopharyngioma.
b) Image demonstrates a cystic lesion in the typical
location of a craniopharyngioma.
Choroid plexus papillomas
 Choroid plexus papillomas may arise wherever a
choroid plexus exists. In all age groups, the sites
at which choroid plexus papillomas occur, in order
of frequency, are the lateral ventricles
(43%), fourth ventricle (39%), third ventricle
(10%), and cerebellopontine angle (8%).
 Of all choroid plexus papillomas, 20% occur in
patients younger than 1 year old, and 85% occur
in those younger than 10 years old.
 On gross pathologic examination, choroid plexus
papillomas appear as lobulated, encapsulated
masses.
 Demonstrates   Shows intense
enhancing lateral heterogeneous
ventricular mass(CT). enhancement 
extension into the third
ventricle.
A germ cell tumor/Germinoma
 Arises from primitive developing cells that form
in the embryo and may otherwise become the
reproductive system.
 Most commonly found in the pineal and
suprasellar regions.
 Approximately 2 percent of all pediatric brain
tumors. Half of it occur in young people (10-20
y.o)
 Mass in the epiphysial area
 These are typical localisations, the lesions crawl
along the floor of the 3rd ventricle.