Paediatric Spinal Tumours: Profile and Treatment Outcome in A Nigerian Tertiary Institution

Introduction Paediatric spinal tumours are rare, accounting for 1-10% of all childhood central nervous system tumours. There is a paucity of information on spinal tumours in Sub-Saharan Africans. This is particularly so in the Nigerian paediatric population where neuro-oncologic data is limited. Indeed, there is no previously published work on the profile of paediatric spinal tumours in the Nigerian neurosurgical literature. The authors aim to document the profile of paediatric spinal tumours in a Nigerian tertiary institution and to contribute to the available data on paediatric central nervous system tumours in West Africa. Methods We retrospectively evaluated data on paediatric patients who underwent surgery for spine tumours over a 20-year-period at our institution. Results A total of 12 patients were managed for paediatric spine tumours during the study period. These had a male: female ratio of 1:1.4 and their ages ranged between 3 and 18 years (mean: 12.83 ± 4.75 years). The highest incidence (6/12) was seen in the 15-18 years age group. The mean duration of symptoms was 10.2 months. More than half (7/12) of the patients presented with symptoms with duration of at least 6 months. Motor deficit was present in all patients at presentation. Two-thirds of the tumours were in the thoracic region, 1 was located in the cervical region, while the remaining 3 tumours were cervicothoracic. The tumour was extradural in location in 8 of our patients and intramedullary in the remaining 4. Astrocytoma (intramedullary in all cases) was the most predominant histological tumour type in (3/12) in our series. Postoperative neurological improvement occurred in 7 of the patients while 5 remained the same. There was no permanent postoperative neurological deterioration or perioperative mortality. Conclusion Paediatric spinal tumours mostly affected older children in our study group and were predominantly astrocytic in nature. The most common tumour location was extradural, involving mostly the thoracic spinal level. The preoperative neurological status correlates with the postoperative functional outcome. Therefore, the need for early diagnosis and treatment of these tumours cannot overemphasized.

An Overview of Central Nervous System Tumours

Central nervous system (CNS) tumours refer to tumours that occur in the tissues of the brain and/or spinal cord. These tumours arise as a result of abnormal growth of cells and may begin in different parts of the brain or spinal cord. There are many types of CNS tumours, which are further divided into subtypes. Despite decades of research conducted, CNS tumours remain among the deadliest of all cancers. It is most often challenging to treat these tumours, due to the risks involved, and biological characteristics associated with them. The classification, grading, and characterisation of CNS tumour plays a pivotal role in the management thereof. The current review provides an overview of CNS tumours, classification, grading and treatment, as well as their characterisation with specific focus on gliomas, ependymomas, oligodendrogliomas, meningiomas, medulloblastomas, schwannomas, gangliogliomas, and craniopharyngiomas. Doi: 10.28991/SciMedJ-2021-0304-8 Full Text: PDF

DIAGNOSTIC ACCURACY OF SQUASH CYTOLOGY OF ASTROCYTOMA

BACKGROUND: Primary Central nervous system tumours occupies less than 2% of overall human cancers in adults. The accurate diagnosis of intracranial tumour is necessary for therapeutic and prognostic purpose. Intraoperative smear cytology provides a rapid diagnosis which helps the neurosurgeon for immediate decision regarding the extent of surgery. To Objectives: determine the accuracy of squash preparation, by comparing it with histopathological sections and analysing the cytomorphological features of astrocytoma This was both retrospective and prospective study. We receive Methods: d nineteen radiologically and clinically suspected Astrocytoma in saline with xatives. Crush smear were made and stained with rapid Haematoxylin and Eosin. The corresponding biopsy materials were xed in 10% neutral buffered formalin and submitted for tissue processing. Staining was done with routine Haematoxylin and Eosin stain. The cytomorphologicalfeatures of these tumours were correlated with histopathological sections. In our study, we received Results: nineteen radiologically and clinically suspected Astrocytoma , tissue of all the tumours were soft and easy to smear . Glioblastomamultiforme was the most commonly encounterd tumor amomgneuroepithelial tumor constituting about 42.1% followed by diffuse astrocytoma (36.8%), WHOgrade II and IV tumors of astrocytoma were commonly encountered in ourstudy. Astrocytoma was common in males than females with majority of them fall in 5 th decade. we got 94.7% correlation between squash cytology and histopathology. Squash cytology is Conclusion: simple,rapid, accurate and cost effective diagnostic tool for Astrocytoma

Right frontal meningioma presenting as delusional parasitosis

Central nervous system tumours can occasionally present with psychiatric symptoms as the only manifestation and can often pose diagnostic challenges. A man in his early 60s presented to the psychiatry outpatient department with delusional parasitosis. His old age and an episode of urinary and faecal incontinence made the clinician consider neuroimaging at the very first visit itself. He was detected to have a right frontal meningioma with features of intracranial hypertension with midline shift, and he underwent emergency surgery. His delusional symptoms completely resolved after surgery and did not recur during the follow-up period of 2.5 years. A right frontal meningioma presenting as delusional parasitosis has probably not been reported in the literature before, and the case is being reported to highlight the rarity of its presentation, the importance of eliciting a detailed clinical history and the need for early neuroimaging in these cases.

Clinicopathological Study of Primary Central Nervous System Tumours - A Descriptive Study in a Tertiary Care Center Hospital of Dakshina Kannada

BACKGROUND The central nervous system (CNS) consisting of brain and spinal cord is a delicate and a complex organ. Even a minor lesion within the central nervous system can significantly affect the higher functions and the voluntary and involuntary systems of the body. The CNS tumours have become one among the leading cause of cancer death in the present days. Early diagnosis and proper grading of these tumours can significantly improve the patient outcome. This study was conducted with an objective of correlating the clinical features with histomorphological characteristics of the primary CNS tumours and to grade the primary CNS tumors based on World Health Organization (WHO) classification. METHODS This was a descriptive observational study. A total of 117 cases of primary CNS tumours were collected from January 2012 to June 2017 at the central diagnostic laboratory of A.J Institute of Medical Sciences and Research Centre, Mangalore belonging to the Dakshina Kannada district of Karnataka, India. Out of 117 cases, 35 cases were retrieved from the files and remaining 82 were fresh cases. The tissues were fixed in 10 % buffered formalin and routinely processed. The tissue sections were stained with haematoxylin and eosin and were classified based on WHO classification. Special stain like reticulin was done in selected cases to establish the diagnosis. Patient details including the complete clinical history was collected to correlate with the histological findings. RESULTS Meningeal tumours were the maximum (37.6 %) among the central nervous system tumours in present study. Clinically, most of them (40.9 %) presented with headache and seizures. The commonest clinical presentation of central nervous system tumours observed in the present study was seizures (31.6 %). Middle cranial fossa was the preferred site for the CNS tumours (35 %). The study showed a female preponderance for CNS tumour with a male to female ratio of 1 : 1.3. The mean age for primary CNS tumours observed in the present study was 43.94 years. CONCLUSIONS In the present study, a systematic analysis of primary central nervous system tumour has been done giving due importance to the clinical features. The present study also showed a significant correlation with that of other studies. Despite of having modern imaging technique, the histopathological examination remains as the gold standard in diagnosing CNS tumours. KEY WORDS CNS Tumours, Neuroepithelial Tumours, Meningioma, Astrocytoma, Schwannoma.