Tumores tectales en pediatría. RevisiÓn de ocho pacientes

Introduction. Tumours ofthe tectal region form, within the group of gliomas of the brain-stem, a sub-group with better prognosis which require a different therapeutic strategy. Objectives. A retrospective review of tectaltumours in children to find the most suitable therapeutic approach and the prognosis to be expected. Patients and methods. We reviewed 8 paediatric patients who, during the past 11 years, had developed tectal tumours diagnosed by means of neuro-imaging techniques. We evaluated their clinical features andespecially their clinico-radiologicalprogress. Results. The average age at the time ofdiagnosis was I 0 years. All cases presented with the clinical features of raised intracranial pressure secondary to obstruction of the aqueduct of Sylvius. MR was the key to visualization of the tectal lesion in all cases but one, which had already been shown on CT. The initial and only treatment given was a ventricular shunt. The average clinico-radiological follow-up in our series was 4 years, with good progress in all cases so that no other therapeutic measures were required. MR follow-up showed that the tumours were stable in all cases but one, which had increased slightly in size but without parallel clinical signs. Conclusion. In most cases tectal tumours in children follow a benign course. A ventricular shunt is usually the only treatment necessary. However, close clinical and radiological follow-up should be carried out to rule out growth of the tumour which make other treatment also necessary. MR is the method of choice for initial evaluation and follow-up ofthese tumours.