title: Pediatric infratentorial gangliogliomas: a retrospective series.
abstract: OBJECTIVE
  The aim of this study was to retrospectively review the clinical presentation, the roles of surgery and adjuvant therapy, and the treatment-related morbidity in children with a ganglioglioma in the posterior fossa and to try and determine the prognostic factors.
  
  
  METHODS
  Between 1991 and 2006, 10 children were treated for a posterior fossa ganglioglioma at the authors' institution. The mean age of the children, the duration of symptoms prior to diagnosis, and the follow-up were 8.2, 2.4, and 3.9 years, respectively. Nine of the children presented with symptoms of raised intracranial pressure. Preoperative imaging showed enhancement in all patients; in eight it was in a patchy distribution. The operations consisted of radical resection (> 75%) in seven children, biopsy in two, and a total macroscopic excision in one.
  
  
  RESULTS
  The surgical procedure did not cause deterioration in the neurological condition in any of the children. There was no recurrence in the child who underwent total macroscopic excision of the tumor, and there has been no tumor progression in three children, two of whom have had no evidence of enhancement of the postoperative residual tumor. The tumor has progressed in six children, requiring further surgery in three, chemotherapy in four, and radiotherapy and second-line chemotherapy in one child to control the tumor.
  
  
  CONCLUSIONS
  The imaging of gangliogliomas in the posterior fossa showed patchy enhancement. The patients in whom it was possible to achieve a radical resection, aimed at removing at least the enhancing portion of the tumor, have not required further treatment. A second excision, for progressive tumors, is an effective adjuvant therapy.
authors.affiliation: Department of Pediatric Neurosurgery, Hôpital Necker-Enfants Malades, Paris, France.
authors.forename: Bertrand
authors.initials: B
authors.lastname: Baussard
authors.forename: Federico
authors.initials: F
authors.lastname: Di Rocco
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Garnett
authors.forename: Nathalie
authors.initials: N
authors.lastname: Boddaert
authors.forename: Arielle
authors.initials: A
authors.lastname: Lellouch-Tubiana
authors.forename: Jacques
authors.initials: J
authors.lastname: Grill
authors.forename: Stephanie
authors.initials: S
authors.lastname: Puget
authors.forename: Thomas
authors.initials: T
authors.lastname: Roujeau
authors.forename: Michel
authors.initials: M
authors.lastname: Zerah
authors.forename: Christian
authors.initials: C
authors.lastname: Sainte-Rose
mesh_terms: D000293:Adolescent; D017024:Chemotherapy, Adjuvant; D002648:Child; D002675:Child, Preschool; D003388:Cranial Fossa, Posterior; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D018303:Ganglioglioma / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D015192:Infratentorial Neoplasms / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D019635:Neurosurgical Procedures; D018714:Radiotherapy, Adjuvant; D019233:Retreatment; D012189:Retrospective Studies; D016896:Treatment Outcome