QOS-20: INITIAL PRESENTATION OF CHILDREN WITH BRAIN TUMORS AT A SINGLE INSTITUTION IN JAPAN

Children with brain tumors present with diverse symptoms of various duration. We retrospectively analyzed the presenting symptoms and its duration in patients of less than 18 years old with newly-diagnosed central nervous system tumors who visited the National Center for Child Health and Development from April 2002 to March 2012. Information was obtained from the hospital medical records on age, sex, primary symptom, additional symptoms, imaging diagnosis, pathological diagnosis, and the interval between the onset of primary symptom and the imaging diagnosis. A total of 138 patients were analyzed. The median age at diagnosis was 5.8 years (range 2 months to 16 years). The male to female ratio was 1:0.94. Frequent symptoms at diagnosis were headache (22%), seizures (18%), focal weakness (17%) and vomiting (15%). Sixty-eight (49%) patients had only primary symptom, while 70 (51%) patients developed additional symptoms. The median interval between onset of primary symptom and imaging diagnosis was 30 days (range 0 to 60 months). Behavior or learning difficulties (p = 0.016), and visual or hearing disturbance (p = 0.0002) were significantly associated with longer interval. These findings emphasize the importance of high index of suspicion for brain tumor by primary care physicians who initially assess diverse symptoms of pediatric patients.