Supratentorial hemispheric low-grade gliomas of childhood

Introduction
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By Roger Packer MD

Supratentorial hemispheric low-grade gliomas of childhood are also known as or subsume Cortical gliomas and Supratentorial astrocytomas. -ed.

In this clinical article, Dr. Roger Packer of the Children's National Medical Center reviews supratentorial low-grade gliomas, which are comprised of a variety of different histological subtypes. Outcome is excellent after gross total resection, but some tumors may arise from infiltration of critical areas of brain structure where aggressive surgery is relatively contraindicated. For these lesions, radiation therapy and, in some cases, chemotherapy may be indicated. In addition, biologically based therapy utilizing molecular-targeted agents is becoming an increasing reality. Dr. Packer of Children’s National Medical Center summarizes these new approaches and the clinical implications of new biological insights. New molecular information has been added and its clinical implications discussed.

Key Points

  • The most common presentation of supratentorial low-grade gliomas of childhood is a seizure.
  • Supratentorial, pilocytic astrocytomas of childhood can be cured after total resection without any additional chemotherapy.
  • Differential diagnosis may be difficult in infancy, as congenital astrocytomas may be difficult to classify.

In This Article

Introduction
Historical note and nomenclature
Clinical manifestations
Clinical vignette
Etiology
Pathogenesis and pathophysiology
Epidemiology
Prevention
Differential diagnosis
Diagnostic workup
Prognosis and complications
Management
Anesthesia
References cited
Contributors