Pediatric central nervous system tumors: review of a single Portuguese institution.
BACKGROUND
Despite being the second most frequent tumor in children, pediatric central nervous system (CNS) tumors are rare, and the published European epidemiological data is limited. Our goal is to present the first surgical series of pediatric CNS tumors in Portugal and to review other similar worldwide series.


METHODS
Retrospective review of all patients younger than 19 years old, operated to a CNS tumor in the Neurosurgery Department at Hospital de Santa Maria (Lisbon, Portugal) between January 2004 and December 2014. Demographic data, tumor location, clinical data, histopathology, and surgical treatment were analyzed and compared to surgical series of pediatric CNS tumors published in PubMed indexed journals over the last 20 years.


RESULTS
We performed 253 surgeries in 215 patients, with a male:female ratio of 1.2:1 and a mean age of 9.2 years old. Primary brain tumors accounted for 95 % of all tumors and had more often a supratentorial location. Tumors of neuroepithelial tissue, particularly astrocytic tumors, embryonal tumors, neuronal and mixed neuronal-glial tumors, and oligodendrogliomas accounted for 81 % of cases. A gross-total resection was achieved in most cases. There was no mortality, and the overall morbidity was low.


CONCLUSIONS
The demography, topography, and clinical presentation of the tumors and the surgical results of this series are comparable to other European ones. We found a higher incidence of neuronal and mixed neuronal-glial tumors and oligodendrogliomas and a slight lower incidence of ependymomas. Our results should encourage further national multi-institutional studies to better characterize these tumors in the pediatric population.
Department of Neurosurgery, Hospital de Santa Maria-Centro Hospitalar Lisboa Norte, E.P.E., Av. Professor Egas Moniz, 1649-035, Lisbon, Portugal. mariamanesantos@gmail.com.
Maria M
MM
Santos
Department of Neurosurgery, Hospital de Santa Maria-Centro Hospitalar Lisboa Norte, E.P.E., Av. Professor Egas Moniz, 1649-035, Lisbon, Portugal.
Cláudia C
CC
Faria
Department of Neurosurgery, Hospital de Santa Maria-Centro Hospitalar Lisboa Norte, E.P.E., Av. Professor Egas Moniz, 1649-035, Lisbon, Portugal.
José
J
Miguéns
D000293:Adolescent; D016543:Central Nervous System Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009493:Neurosurgery / Q000379:methods* / Q000706:statistics & numerical data; D010372:Pediatrics; D011174:Portugal; D012189:Retrospective Studies
Central nervous system; Epidemiology; Pediatric tumors; WHO classification