Pdoc-04 Multidiscplinary Approach to Pediatric Posterior Fossa Tumors, Our Clinical Experience: Case Series

Abstract Paediatric brain tumor is second only to leukemia in this age group and more than 60% are located infratentorial. The first treatment option is surgical resection with aim of complete total resection, the proximity to fourth ventricle and CSF pathways make these children prone to develop obstructive hydrocephalus and multiple other complications related to pre and post operative. Chemotherapy and radiotherapy as adjuvant management is also important after surgery to selected cases. The aim of this case series was to review the demographic and clinical presentation of posterior fossa tumor children prior to definitive management, duration to adjuvant therapy after surgery and complications related to surgical management. This was a two-year retrospective review from March 2022 to march 2024, all paediatric less than 18 years of age with brain tumor admitted to our neurosurgery pediatric ward were selected. Late presentation to hospital was observed in most of the patients, obstructive hydrocephalus that warrant an emergent CSF diversion was noted in majority of the children. All cases require surgery were performed more than 5 days after admission to hospital, histological results report majority of the tumor to be pilocytic astrocytoma, medulloblastoma and ependymoma, all brain stem tumors on MRI image were not operated and were offered chemotherapy. Complications related to surgery include CSF leak, wound dehiscence and re occurrence of tumor were observed in more than 5 cases. Delayed chemotherapy and radiotherapy was also noted in this study. This single institution study concluded that a prospective study is important and a well-defined protocol at assessing novel ways and approaches of management, is required to all children with posterior fossa tumor, this will minimise the complications observed in this study.