Supratentorial Tumors in the Pediatric Population

Primary brain and other central nervous system (CNS) tumors are the most common solid tumors in pediatric patients and are the leading cause of cancer-related mortality in pediatric children up to adolescence. The most common pediatric supratentorial tumors include low-grade glioma, high-grade glioma, pineal region tumors, germ cell tumors, and intraventricular tumors. Different tumors affect different age groups and pose different challenges for the neurosurgeon and neurooncologist. In recent years, there is a growing interest in better understanding of pediatric brain tumors, with emphasis on molecular subtyping that has led to growing research: on possible molecular fingerprinting and, later, on radiologic fingerprinting of different tumors. The variety of pediatric supratentorial tumors is wide and hence are the diagnostic features, diagnostic tools, and treatment options. The clinical presentation is often determined by the tumor type and location, because symptoms are produced by local invasion, compression of adjacent structures, and increased intracranial pressure. In this chapter, we examine the epidemiology, diagnosis, treatment, and relevant operative approaches for these lesions.