Epidemiology of primary brain tumor among adolescents and adults in Palestine: a retrospective study from 2018 to 2023.

BACKGROUNDS: Primary brain tumors (PBTs) are uncommon, but they significantly increase the risk of disability and death. There is a deficiency of data concerning the epidemiology and anatomical distribution of PBTs among adults in Palestine. METHODS: A retrospective descriptive study in which data were collected from the clinical reports of Palestinian patients diagnosed with PBTs at Al-Makassed Hospital during the period (2018-2023). RESULTS: In Palestinian adolescents and adults, the incidence rate of PBTs was 3.92 per 100,000 person-years. Glioblastoma (18.8%) was the most common type identified, and it was more common in males. Non-malignant tumors were more common than malignant tumors (2.41 vs. 1.52 per 100,000). The mortality rate from PBTs was 4.8%. The most common initial symptom was headaches, and it occurred more with non-malignant tumors (57.28% vs. 42.72%, p-value < 0.001). Cerebral meninges (26.3%) were the most common location for primary brain tumors (p-value < 0.001). CONCLUSION: This is the first study of primary brain tumor epidemiology in Palestine. The overall incidence of PBTs in Palestinian adolescents and adults was 3.96 per 100,000, which was lower than the incidence rate of primary brain tumors worldwide. More studies on the epidemiology and distribution of PBTs in Palestine are recommended.

Epidemiology and Anatomical Distribution of Primary Brain Tumors Among Children in Palestine: A 6-Year National Referral Institution Study.

OBJECTIVE: To investigate the incidence rate of primary brain tumors (PBTs) among Palestinian children over a 6-year interval. This study also aimed to identify the predominant histopathologic types identified in these children. METHODS: This retrospective epidemiologic study focused on PBTs in children (<15 years) in Palestine. The data were collected from the registry system at Al-Makassed Hospital in Jerusalem, a prominent referral institution in Palestine and the largest center for PBTs in the region, over a 6 years period from 2018 to 2023. RESULTS: The incidence rate of PBTs in children (<15 years) was 1.33 per 100,000 person-years, with a 5% mortality rate. Pilocytic astrocytoma was the most common type (24%), followed by medulloblastoma (15.2%) and glioblastoma (6.3%). About one half of the tumors in children were malignant. Headaches were the most common first sign or symptom. About 20% of brain tumors in children were situated within the ventricles, making it the most prevalent location of these tumors, followed by the cerebellum (15.19%) and frontal lobe (11.39%). CONCLUSIONS: This is the first national study in Palestine investigating PBTs in children. The crude incidence rate of primary brain tumors among Palestinian children was lower than the incidence rate in many countries around the world. It is recommended that more research be done on the epidemiology and distribution of PBTs in children in Palestine.

Recurrent lumbar intraspinal epidermoid cyst presenting as lower back pain, a case report.

INTRODUCTION: Intraspinal Epidermoid Cyst (IEC) is a very-rare, yet one of the most benign tumors of the Central Nervous System (CNS). Very few cases of IEC were reported world-wide. Presentations depend on the location of the tumor with pain being the most common presenting symptom. CASE PRESENTATION: A-35-year-old patient presented to the neurosurgical department for a regular follow up. Her history dates back to four years ago, when she first presented with back pain, which was later accompanied with fecal and urinary incontinence. Magnetic Resonance Imaging (MRI) showed a tumor at the level of L4-L5 which was surgically removed. Three years later, the patient presented to the clinic with similar symptoms. A repeat MRI showed a mass at L4-L5, which was surgically removed. Histological findings of both surgeries showed findings consistent with IEC. Currently the patient has no complaints. CLINICAL DISCUSSION: IEC has various presentations. Our case presented with back pain, and urinary and fecal incontinence. Diagnosis depends on imaging and histology. MRI is the imaging modality of choice for those tumors in the CNS. Surgical removal is associated with high recurrence as a result of the suboptimal resection due to the strong adhesions between the capsule and the spinal cord. CONCLUSION: Pain is the most common presenting symptom for IEC. Adjuvant radiotherapy, which should be implemented in the standard of care, is associated with a lesser degree of recurrence, in addition to regular follow-ups.