LG-56: NON-INFILTRATING LOW GRADE GLIOMA (LGG) OF THE BRAIN STEM IN CHILDREN. ONE CENTER EXPERIENCE

BACKGROUND: Pediatric low grade glioma of brain stem constitutes 2-4 % of brain tumors in children. Patients with limited potential for tumor resection can be difficult to manage. MATERIAL AND METHODS: Analysis of clinical course of children with non-infiltrating brain stem tumors. RESULTS: Between 2006-2015 66 patients were diagnosed with non-infiltrating brain stem tumor, 22 had tumor in the midbrain and 44 in the pons or medulla oblongata. Out of 22 patients with midbrain tumor, 20 presented with hydrocephalus. Ten patients underwent surgery; 1 biopsy, 4 partial, 3 subtotal and 2 complete resections. Pilocytic astrocytoma was diagnosed in 9 pts and pilomyxoides astorcytoma in 1. All but 1 patient were managed with clinical and radiographic follow-up only. All patients are alive with stable disease from 1 to 8.5yrs, median 5yrs. Out of 44 pts with tumor in the pons and medulla oblongata 7 had hydrocephalus. 41 patients underwent surgery; 4 biopsy, 17 partial resection, 19 subtotal resection,1 complete resection. The following types of LGG were diagnosed; Pilocytic astrocytoma- 33pilomyxoid astrocytoma-3,ganglioglioma-2, pleomorphic xanthoastrocytoma-2, 1 biopsy was inconclusive. Out of 44 patients 12 received chemotherapy for LGG after surgery, 4 at disease progression. 28 patients did not receive any postoperative treatment. All but 1 patient are alive from 6 months to 8.5 years (median – 3.5 years) from diagnosis. One patient died at home of unknown reason. CONCLUSIONS: Most of our children with non-infiltrating brain stem LGG could be managed with postoperative clinical and radiographic follow-up only and with adjuvant therapy at progression as generally recommended.