Pediatric brain tumors are the most common solid tumor in children (2500-3000 new diagnoses/year), accounting for approximately 20 % of all pediatric cancers. They represent the primary cause of death in this patient population with a 5-year survival of 60-70 %. The distribution of the central nervous system tumors is classified according to the anatomic compartment involved (see Table14.1). Overall, supratentorial and infratentorial tumors occur in equal frequency; supratentorial is more common in children with age inferior to 2 years; infratentorial tumors are more common between 4 and 10 years old. Brian tumors are classified histopathologically by cell type involved and graded for degree of malignancy by mitotic activity, infiltration, and anaplasia. Management of these patients can be challenging, as treatment is highly dependent on tumor histology, location, and patient age. Selection of an appropriate therapy can only occur if the correct diagnosis is made and the stage of the disease is accurately determined. The location of many tumors proximity to critical brain structures may preclude resection or make difficult to perform diagnostic biopsy, which may be inaccurate in providing a correct diagnosis. Recurrence is not uncommon in childhood brain tumors; thus, long-term management requires the coordinated efforts of a multidisciplinary team to correctly identify and treat relapsed disease.
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