Supratentorial Low-Grade Gliomas in Children Homepage

Author

Francisco Villarejo, M.D.

Section Editor

Kristian Aquilina, M.D.

Editor in Chief

Rick Abbott, M.D.

Introduction

LGGs in children comprise a heterogeneous group of slow-growing glial tumors that correspond to grades I or II on the W.H.O. histological tumor classification scale (1). This group includes astrocytomas, oligodendrogliomas, oligoastrocytomas, and ependymomas that appear in childhood or young adulthood. These tumors vary greatly in their behavior, depending on their histology and grade. Some tumors do not have clear borders when infiltrating the cerebral parenchyma, while others are clearly defined. Some grow and remain low grade, others become malignant, and still others remain stable and do not grow for years.

This chapter will not discuss the LGGs that have dedicated chapters (e.g., ependymomas).

Key Points

• W.H.O. grades I or II tumors: LGGs are a heterogeneous group of slow-growing glial tumors that correspond to grades I or II on the W.H.O. histological tumor classification scale.
• Seizures most common symptom: Seizures are the most common presenting feature, occurring in more than 80% of patients. This is due to the fact that these tumors are located near the cerebral cortex and are often associated with cortical dysplasias. Seizures are frequent in patients with tumors located in the frontal and/or temporal lobe and are sometimes chronic.
• Treatment controversial: The ideal treatment for LGGs is still controversial. Management can range from a conservative, wait-and-see approach, to a closed needle biopsy with either frame-based or frameless stereotaxy, or radical tumor resection.