Çocukluk çağı posterior fossa tümörlerinin retrospektif değerlendirilmesi- klinik deneyimimiz

Amaç: Bu çalışmada amacımız, üçüncü basamak bir üniversite hastanesinin pediatrik posterior fossa tümörlerinin tanı ve tedavisini retrospektif olarak olarak değerlendirmektir. Gereç ve yöntem: Kliniğimizde Ocak 2011-Eylül 2021 tarihleri arasında posterior fossa tümörü nedeni ile opere olan pediatrik hastaların dosyaları retrospektif olarak incelendi. Hastaların demografik özellikleri, başvuru şikayetleri, nörolojik muayeneleri, operasyon bölgeleri, patolojik tanıları, postoperative dönemde komplikasyon gelişip gelişmediği, postoperatif başka tedavilerin uygulanıp uygulanmadığı açısından incelendi. Bulgular: Seksen pediatrik posterior fossa tümörü bulunan hastanın 43 tanesi kadın, 37 tanesi erkek idi. 65 hasta ilk defa opere edilirken, 8 hasta rezidü ve 4 hasta nüks tümör nedeni ile tekrar opere edildi. 60 hastada tümör total olarak çıkarılırken, 20 hastada subtotal (rezidü <3 cm2) çıkarıldı. En sık rastlanan tümör patolojisi medulloblastom ve pilositik astrositom idi. Hastalar en sık baş ağrısı nedeni ile başvurdular. Ependimomlar başvuru anında en genç hasta grubuna sahipti. Olguların 7 tanesinde postoperatif dönemde hidrosefali gelişti ve ventriküloperitoneal şant takılıldı. Medulloblastom hastalarında ventriküloperitoneal şant ihtiyacı daha fazla izlendi. En sık karşılaşılan postoperatif komplikasyon serebellar testlerde bozulma idi. Sonuç: Pediatrik posterior fossa tümörlerinde güvenli rezeksiyon ile yapılan cerrahi, tedavinin temeli olmaya devam etmektedir. Pediatrik posterior fossa tümörlerinin tedavisinin bir ekip çalışması olduğu unutulmamalıdır. Komplikasyonları ve mortaliteyi azaltmak için iyi tanımlanmış algoritmalara sahip ileriye dönük çalışmalara ihtiyaç vardır.

Anahtar Kelimeler:

BOS kaçağı, pediatrik posterior fossa tümörleri, hidrosefali, tümör

Retrospective analyses of pediatric posterior fossa tumors- clinical experience

Purpose: In this study, we aim to retrospectively evaluate surgical treatment of pediatric posterior fossa tumors in a tertiary university hospital. Materials and methods: The files of pediatric patients who were operated for posterior fossa tumor in our clinic between January 2011 and September 2021 were reviewed retrospectively. The demographic characteristics of the patients, their complaints, neurological examinations, operation areas, pathological diagnoses, complications, and whether other postoperative treatments were performed were evaluated.Results: Eighty pediatric patients with posterior fossa tumors were 43 females and 37 males. While 65 patients were operated for the first time, 8 patients were reoperated for residual tumors and 4 patients for recurrent tumors. Tumor was removed totally in 60 patients, subtotal (residual <3 cm2) in 20 patients. The most common tumor pathologies were medulloblastoma and pilocytic astrocytoma. Headache is the most common complaint at admission. Ependymomas had the youngest group of patients at the time of admission. Hydrocephalus developed in 7 of the cases postoperatively and a ventriculoperitoneal shunt was inserted. The need for ventriculoperitoneal shunt was observed more in medulloblastoma patients. The most common postoperative complication was deterioration in cerebellar tests.Conclusion: Surgery with safe resection remains the mainstay of treatment for pediatric posterior fossa tumors. It should be noted that the treatment of pediatric posterior fossa tumors is a team effort. Prospective studies with well-defined algorithms are needed to reduce complications and mortality.

Keywords:

Pediatric posterior fossa tumors, hydrocephalus, cerebrospinal fluid leak, tumors,

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