Researchers at Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India, studied the clinico-radiological profile, pathology, treatment and outcome of 65 pediatric patients (age < 18 years) with histopathologically proven diagnosis of intracranial glioblastoma. Male-to-female ratio was 2.6:1, with a mean age at diagnosis of 13.3 years (range 2-18 years). Most common presenting symptoms were headache with or without vomiting (n=51, 78%), seizures (n=42, 65%), and focal deficits (n=31, 47%). The tumor was supratentorial in 62 (95.4%) patients, frontal in 30%, and temporal in 9%; it was located deeply in 16 (25%), in the thalamus in 10 (12%). Obstructive hydrocephalus occurred in 13 (20%) patients and intratumoral bleeding in 5 (7.7%). Total tumor excision was achieved in 43 (66%) patients, and the remainder had incomplete excisions (n=22, 34%). Mean progression-free and overall survivals were 10 and 20 months, respectively; 3 patients survived for >5 years. Extent of resection was the independent predictor of survival (p=0.002). [1]

COMMENT. Glioblastoma is an uncommon brain tumor in children compared to the prevalence in adults. Of all CNS tumors in children glioblastoma accounts for ~3– 9%; the higher figure is that of Bailey P, Buchanan DN, and Bucy PC, in their classic study in Chicago [2]. The relative frequencies of the pathological varieties of intracranial space occupying lesions in children have changed over time; almost a century ago, tuberculoma was the most common lesion. [3]

The prevalence estimates for primary brain tumors in the United States are 35.4 per 100,000 person-years for children <20 years old and 278/100,000 for adults [4]. The prevalence for malignant brain tumors in children is 25/100,000 and for non-malignant tumors, 11/100,000.