Central Nervous System Germinoma
Site Total % Male Female Male/female Pineal 73 45 68 5 14 Neurohypophyseal 52 32 26 26 1 Pineal + neurohypophyseal 17 10 15 2 7.5 Basal ganglia, thalamus 21 13 20…
Choroid Plexus Tumors
Fig. 19.1 (a) H&E stained histological sample of a WHO Grade I Choroid Plexus Papilloma. There is a single layer of epithelial cells overlying a fibrovascular core, resembling normal choroid…
Pituitary Tumors: Pituitary Adenomas and Langerhans Cell Histiocytosis Associated Diabetes Insipidus
Tumor Clinical manifestations Laboratory evaluation Preferred treatment modalities in children Prolactinoma Pubertal arrest, galactorrhea, menstrual abnormalities, pituitary deficiencies, visual symptoms, and headache Elevated serum PRL+/− elevated serum GH 1. Dopamine antagonists…
Central Nervous System Nongerminomatous Germ Cell Tumors
Fig. 15.1 Immature teratoma arising from the suprasellar area in a 13-year-old boy. (a) CT scan shows a mass in the third ventricle with low attenuation. Minute dots of high…
Proton Therapy for Skull Base Chordomas in the Pediatric and Adolescent Patient
Fig. 20.1 Target contouring of a large skull base chordoma with extensive extracranial extension following subtotal, transnasal/transsphenoidal resection. Gross tumor volume (GTV) includes residual gross disease, equivocal areas as per…
Spinal Tumors
Fig. 18.1 Fifteen-year-old girl with known diagnosis of neurofibromatosis type I was incidentally found to have lesions in distal thecal sac during surveillance imaging (sagittal T1 sequence post-gadolinium administration demonstrated…
CNS Leukemia
NCI risk (age/WBC) Favorable genetics Unfavorable characteristics Day 8 PB MRD (%) Day 29 marrow MRD (%) % of B-cell patients 5-year EFS (%) Low risk SR Yes None…
Endocrine Sequelae of Central Nervous System Irradiation
Hormone Dose at which risk of dysfunction is increased Endocrine consequence Recommendations for screening and evaluation as clinically indicated GH ≥18 Gy • Growth hormone deficiency • Growth velocity • Poor linear growth…
Ependymoma
Fig. 9.1 Left cerebellopontine angle ependymoma (upper left), IVth ventricle ependymoma (upper right), spinal cord ependymoma (lower left), and right fronto-parietal ependymoma (lower right) EPN accounts for 6–10% of brain…
Image Guidance in Pediatric Brain Radiotherapy
Fig. 24.1 (a) Electronic portal imaging device (EPID)-based imaging (b) compared to the digitally reconstructed radiograph (DRR) from the planning image set for whole brain treatment fields for a 15-year-old…
