High-grade glioma

Abstract

High-grade gliomas are defined as tumors of glial origin with a very low incidence rate in infants and young children. They form part of the spectrum of primary intrinsic CNS and spinal cord tumors of children although their proportionate frequency of all primary CNS and spinal cord tumors is significantly lower compared to the adult population. The overwhelming number of newly diagnosed cases are sporadic primary tumors presenting with either signs of raised intracranial pressure, seizures, or other more nonspecific neurological symptoms. The initial management is aimed at restoring CSF flow, alleviation of existing mass effect, and establishing a pathological diagnosis. Ideally, the primary surgical approach is aimed at achieving a macroscopic complete excision without postoperative severe and permanent neurologic deficits. While primary chemotherapy is the preferred mode of adjuvant treatment in infants under the age of 3 years, the standard of care in all other patients is the use of combined focal radiotherapy and chemotherapy. Long-term outcome remains poor albeit appears generally slightly better than their adult counterparts.