Intracranial Tumors in Infancy and Childhood Basic Research, Diagnosis and Treatment Progress in Experimental Tumor Research Vol. 30 Series Editor F. Homburger, Cambridge, Mass. KARGER Basel München Paris London New York New Delhi Singapore Tokyo Sydney International Symposium on Pediatric Neurooncology (ISPNO), Toba, November 6-8, 1985 Intracranial Tumors in Infancy and Childhood Basic Research, Diagnosis and Treatment Volume Editors N. Kageyama, Nagoya, K. Takakura, Tokyo, F. Epstein, New York, N.Y., H. J. Hoffman, Toronto, L. Schut, Philadelphia, Pa. 1 figures and 61 tables, 1987 KARGER Basel München Paris London New York New Delhi Singapore Tokyo Sydney Progress in Experimental Tumor Research Library of Congress Cataloging-in-Publication Data International Symposium on Pediatric Neurooncology (1st: 1985: Toba-shi, Japan) Intracranial tumors in infancy and childhood. (Progress in experimental tumor research; vol. 30) Includes bibliographies and index.
I. Brain - Tumors - Congresses. 2. Tumors in children - Congresses. I. Kageyama. Naoki. II. Title. III. Series. [DNLM: 1. Brain Neoplasms - in infancy & childhood - congresses. W1 PR668T v. 30/WL 1605 1985i] RC254.A335 vol. 30 616.99 2 87-3205 [RC280.B7] [618.92 992] ISBN 3-8055-4436-7 Drug Dosage The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Copyright 1987 by S. Karger AG, P.O. Box, CH-4009 Basel (Switzerland) Printed in Switzerland by Friedrich Reinhardt AG, Basel ISBN 3-8055-4436-7 Contents Preface IX Sano, K. (Tokyo): Problems in the Treatment of Children with Brain Tumors 1 Basic Research of Neurooncology Takakura, K.; Inoya, H. (Tokyo); Nagashima, K. (Hokkaido); Ikeda, K.; Tomonaga, M.; Kondo, K. (Tokyo): Viral Neurooncogenesis 10 Gerosa, M.A. (Verona); Rosenblum, M.L. (San Francisco, Calif.); Stevanoni, G.; Nicolato, A. (Verona); Longatti, P. (Treviso); Bricolo, A.; Tridente, G. (Verona): Immunocytochemical Characterization of Long-Term Medulloblastoma Cultures: Preliminary Report 21 Hoshino, T. (San Francisco, Calif.): Proliferative Potential of Pediatric Brain
Tumors 31 Yoshida, J.; Wakabayashi, T.; Kito, A.; Kageyama, N.; Murata, Y.; Seo, H. (Nagoya); Kojima, N.; Yagi, K. (Gifu): Clinical Application of Monoclonal Antibodies against Glioma-Associated Antigens 44 Pathology and Classification Rorke, L. B. (Philadelphia, Pa.): Classification of Central Nervous System Tumors in Children 57 General Diagnosis and Treatment Zimmermann, R.A.; Bilaniuk, L.T.; Schut, L.; Packer, R.L.; Sutton, L.; Bruce, D. (Philadelphia, Pa.): Medical Imaging of Pediatric Brain Tumors 61 Contents VI Medulloblastoma Lapras, C.; Patet, J.D.; Mottolese, C.; Gharbi, S.; Philip, T.; Mentigny-Brunat, M. (Lyon): Treatment of Medulloblastomas. Experience of Different Protocols 81 Inoya, H.; Takakura, K.; Shitara, N.; Manaka, S. (Tokyo): Treatment of Medulloblastoma 91 Astrocytomas (A Group) Optic Glioma Kageyama, N.; Kanamori, M.; Yoshida, J.; Sugita, K. (Nagoya): Pathological Considerations on Follow-Up Results of Optic Glioma 100 Imes, R.K.; Hoyt, W.F. (San Francisco, Calif.): Childhood Chiasmal Gliomas. Update on the Fate of Patients in the 1969 San Francisco Study 108 Hoyt, W. F.; Fletcher, W.A.; Imes, R.K. (San Francisco, Calif.): Chiasmal Gliomas. Appearance and Long-Term Changes Demonstrated by Computerized Tomography 113 Astrocytomas (B Group) Cerebellar and Spinal Cord Astrocytomas Laws, E. R., Jr. ; Bergstralh, E. J. ; Taylor, W. F. (Rochester, Minn.): Cerebellar Astrocytoma in Children 122 Lapras, C.; Patet, J.D.; Mottolese, C.; Vitale, G. (Lyon): Cerebellar Astrocytomas in Children 128 Epstein, F. (New York, N.Y.): Spinal Cord Astrocytomas of Childhood 135
Astrocytomas (C Group) Brain Stem Tumors Hoffman, H.J. (Toronto): Benign Brainstem Gliomas in Children 154 Epstein, F. (New York, N.Y.): Intrinsic Brain Stem Tumors of Childhood. Surgical Indications 160 Ependymomas Group Rorke, L.B. (Philadelphia, Pa.): Relationship of Morphology of Ependymoma in Children to Prognosis 170 Marsh, W.R.; Laws, E.R., Jr. (Rochester, Minn.): Intracranial Ependymomas 175 Matsushima, T.; Kitamura, K.; Fukui, M. (Kyushu); Kinoshita, K. (Miyazaki); Fukushima, T. (Fukuoka); Kuromatsu, C. (Kyushu); Maeyama, R. (Kouseikan); Hasuo, K. (Kyushu): Choroid Plexus Papillomas 181 Leptomeningeal Dissemination and Metastasis Ushio Y.; Arita, N.; Hayakawa, T.; Yamada, K.; Koh, S.; Nagatani, M.; Yoshimine, T.; Mogami, H. (Osaka): Leptomeningeal Dissemination of Primary Brain Tumors in Children: Clinical and Experimental Studies 194 Contents VII Packer, R.J.; Schut, L.; Siegel, K. R. (Philadelphia, Pa.): Dissemination of Primary Central Nervous System Tumors of Childhood: Incidence and Clinical Implications 206 Matsukado, Y. M.; Kuratsu, J.; Uemura, S. (Kumamoto): Immunopathology of Leptomeningeal Dissemination of Brain Tumors 215 Hypothalamic Hamartoma and Precocious Puberty Hibi, I.; Fujiwara, K. (Tokyo): Precocious Puberty of Cerebral Origin: A Cooperative Study in Japan 224 Ganglioglioma in Children Sutton, L.N.; Packer, R.J.; Zimmermann, R.A.; Bruce, D.A.; Schut, L. (Philadelphia, Pa.): Cerebral Gangliogliomas of Childhood 239 Meningioma in Children Doty, J.R.; Schut, L.; Bruce, D.A.; Sutton, L.N. (Philadelphia, Pa.): Intracranial
Meningiomas of Childhood and Adolescence 247 Pineal Tumors Kageyama, N.; Kobayashi, T.; Kida, Y.; Yoshida, Y.; Kato, K. (Nagoya): Intracranial Germinal Tumors 255 Lapras, C.; Patet, J.D.; Mottolese, C.; Lapras, Ch. Jr. (Lyon): Direct Surgery for Pineal Tumors: Occipital-Transtentorial Approach 268 Hoffman, H.J. (Toronto): Pineal Region Tumors 281 Arita, N.; Ushio, Y.; Hayakawa, T.; Mori, S.; Bitoh, S.; Hasegawa, H.; Akagi, K.; Kano, M. (Osaka); Oku, Y.; Go, J. (Kansai); Takimoto, Y.; Mogami, H. (Osaka): Role of Tumor Markers in the Management of Primary Intracranial Germ Cell Tumors 289 Washiyama, K.; Sekiguchi, K.; Tanaka, R.; Yamazaky, K.; Kumanishi, T.; Oyake, Y. (Niigata): Immunohistochemical Study on AFP, HCG and PLAP in Primary Intracranial Germ Cell Tumors 296 Matsutani, M.; Takakura, K.; Sano, K. (Tokyo): Primary Intracranial Germ Cell Tumors: Pathology and Treatment 307 Craniopharyngioma Imura, H.; Kato, Y.; Nakai, Y. (Kyoto): Endocrine Aspects of Tumors Arising from Suprasellar, Third Ventricular Regions 313 Hoffman, H.J. (Toronto): Craniopharyngiomas 325 Contents VIII Laws, E.R. (Rochester, Minn.): Craniopharyngiomas in Children and Young Adults 335 Kobayashi, T.; Nakane, T.; Kageyama, N. (Nagoya): Combined Trans-Sphenoidal and Intracranial Surgery for Craniopharyngioma 341 Lapras, C.; Patet, J.D.; Mottolese, C.; Gharbi, S.; Lapras, Ch., Jr. (Lyon): Craniopharyngiomas in Childhood: Analysis of 42 Cases 350 Pituitary Adenoma in Children and Adolescent Laws, E.R.; Scheithauer, B.W.; Groover, R.V. (Rochester, Minn.): Pituitary Adenomas in Childhood and Adolescence 359 Lüdecke, D.K.; Herrmann, H.-D.; Schulte, F.J. (Hamburg): Special Problems with Neurosurgical Treatment of Hormone-Secreting Pituitary Adenomas in Children 362 Subject Index 371
Preface Intracranial tumors of infants and children are remarkably different from those of adults. Such tumors in early life are anaplastic and/or undifferentiated and these characteristics affect their prognosis. Hamartomas and teratomas, germinal tumors, craniopharyngiomas and gangliogliomas are intracranial tumors typically seen in early life and they produce clinical syndromes of endocrine as well as neurological nature. Because of the widely diverse character of these tumors their treatments are controversial, and there is much need for basic oncologic studies, sophisticated imaging and prolonged follow-up of large clinical series. The First International Symposium on Pediatric Neurooncology was held November 6-8, 1985, in Toba, Japan. The participating experts from throughout the world included neurosurgeons, neuroradiologists, neurooncologist, neuroophthalmologists, neuroendocrinologists and neuropathologists who presented and discussed papers on basic research, pathology and state of the art diagnostic methodology. Among the studies presented were some of the largest and most extended clinical investigations ever undertaken on pediatric intracranial neoplasms. This volume includes the most significant of these contributions and represents the latest knowledge in pediatric neurooncology. It is hoped that it will remain for years to come a guide for researchers in this field and that it will contribute to the advancement of pediatric neurooncology. Space limitations prevented the inclusion of the discussions in this volume. These have been published separately in the Proceedings of the First International Symposium on Pediatric Neurooncology by Nagoya University Press.