Ersin HACIYAKUPOĞLU, Kadir OKTAY, Semih Kıvanç OLGUNER, Mustafa Emre SARAÇ, Derviş Mansuri YILMAZ, Sebahattin HACIYAKUPOĞLU

Çocukluk Çağı Beyin Tümörleri

Çocukluk çağı beyin tümörleri erişkinlerden histopatolojisi, görünümü, biyolojik davranışı , sitogenezi, moleküller biyolojisi, fizyolojisi ve beyin gelişiminin etkilenmesi yönünden oldukça farklıdırlar. Erişkinlerde glioblastoma multiforme ve menengioma sık görülürken, çocuklarda pilositik astrositoma, medulloblastoma ve germ hücreli tümörlere daha sık rastlanır. Çocukluk çağı tümörleri orta hatta yerleştiklerinden nörolojik bulguları oldukça siliktir. Ancak beyin omurilik sıvı yolları tıkanıklığında intrakranial basınç artışı bulguları ortaya çıkar. Çocuklar için özel anestezi ve cerrahi teknikler kullanılmalıdır. Operasyonda stereotaktik cerrahi, nöroendoskopi, fonksiyonel ve intraoperatif manyetik rezonans görüntüleme ve nöromonitorizasyon kullanılır. Operasyon dışında radyoterapi (3 yaşından büyük çocuklarda), stereotaktik radyocerrahi, kemoterapi ve gen tedavileri uygulanabilir.

Anahtar Kelimeler:

Çocukluk çağı beyin tümörleri, Stereotaktik radyocerrahi, Alfa-fetoprotein, Human koryonik gonatropin, Radyoterapi, Kemoterapi

Pediatric Intracerebral Tumors

Histopathology, appearance, biological behaviour, cytogenesis, molecular biology, physiology and effects on the brain development of the pediatric intracerebral tumors are completely different from the tumours in adults. In adults, glioblastoma multiforme and meningiomas are seen mostly, but in children pilocytic astrocytoma, medulloblastoma and germ cell tumours are more common. When pediatric intracerebral tumours are detected, families should be supported and the physcosocial trauma affecting the family should be reduced. As pediatric intracranial tumours are located mostly in the midline, neurological symptoms of them are quite faint. As cerebrospinal fluid paths are obstructed, increased intracranial pressure symptoms appear. Special anesthetic and surgical techniques should be performed for children. Stereotactic surgery, neuroendoscopy, functional and intraoperative magnetic resonance imaging and neuromonitoring could be used. Radiotherapy (in patients aged 3 and more years old), stereotactic radiosurgery, chemotherapy and gene therapies could be performed as the other treatment modalities.

Keywords:

Pediatric intracerebral tumors, Stereotactic radiosurgery, Alpha-phetoprotein, Human chorionic gonadotropin, Radiotherapy, Chemotherapy,

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Roth J, Costantini S, Rosenfeld US. Management of brain tumors in the pediatric patients. Kaye HA, Laws RE (ed), Brain Tumors Elsevier Edinburg, 2012;329-46.
Smith MA, Freidlin B, Ries LA, Simon R. Trends in reported incidence of primary malignant brain tumors in children in the United States. J Natl Cancer Inst. 1998;90:1269-77.
Fisher JL, Schwartzbaum J, Wrensch M, et al. Epidemiology of brain tumors. Neurol Clin. 2007;25:867-70.
Wrensch M, Minn Y, Chew T, Bondy M, Berger MS. Epidemiology of primary brain tumors: current concepts and review of the literature. Neuro Oncol. 2002;4:278–99.
Kerbel R. Tumor angiogenesis. N Engl J Med. 2008;2039-49.
Bondy M, Wiencke J, Wrensch M, Kyritsis AP. Genetics of primary brain tumors: a review. J Neurooncol. 1994;18:69-81.
Ohgaki H, Kleihues P. Genetic pathways to primary and secondary glioblastoma. Am J Pathol. 2007;170:1445.
Singh SK, Clarke ID, Hide T. Cancer stem cells in nervous system tumors. Oncogene. 2004;23:67
Lowy DR, Willumsen BM. Function and regulation of RAS. Annu Rev Biochem. 1993;62: 851-91. Dirsk BP. Stem cell neurobiology In Neurooncology (Eds M Bernstein, SM Berger):28-36. Berlin, Thieme. 2008.
Akakın A, Özkan AK, Kılıç T. Anaplastik astrositomlar. Türkiye Klinikleri J Surg Med Sci. 2007;3:27
Ender K, Kaya A, İmran S, Kamil K, Mesut H. İntrakranial çocukluk çağı tümörleri. Bursa Devlet Hastanesi Tıp Bülteni. 1986;2:185-94.
Petito CK, DeGirolami U, Earle KM. Craniopharyngiomas: a clinical and pathological review. Cancer. 1976;37:1944-52.
Wen PY, Kesari S. Malignant gliomas in adults. N Engl J Med. 2008;359:492-507.
Hacıyakupoglu E, Oktay K, et al. Metastatic brain tumors. Cukurova Medical Journal. 2014;39:19120
Le Bihan D, Mangin JF, Poupon C, Clark CA, Pappata S, Molko N et al.. Diffusion tensor imaging: concepts and applications. J Magn Reson Imaging. 2001;13:534-36.