Epidemiology of pediatric primary tumors of the nervous system: a retrospective study of 633 cases from a single Moroccan institution.

BACKGROUND AND PURPOSE: There are several reports regarding the epidemiology of pediatric brain tumors. However, little is known about the profile of pediatric brain tumors in Africa especially in Morocco in particular. The authors report the results of epidemiological analysis of a retrospective review of childhood primary brain tumors in a single institution. METHODS: A retrospective review of all cases of primary brain from 1 month to 15 years diagnosed at the Department of Pathology of the Hospital of Specialities of Rabat between January 1991 and December 2009 was performed. RESULTS: Six hundred and thirty-three primary tumors of the central nervous system were reviewed with a mean of 33.31 cases per year. According to the gender, 55% of the tumors occurred in males and 45% in females. The mean age was 8.36 years. Of all the tumors, 47% were situated in the supratentorial compartment, 48% in the infratentorial compartment, and 5% in spinal cord. In the infratentorial compartment, 82% of tumors are located in the cerebellum, 15% in the fourth ventricle, 2% in the brain stem and 1% in the cerebellar pontine angle. In the supratentorial compartment, two third of the tumors were located in the cerebral hemispheres and the sellar region. Thus 39% of tumors are located in the cerebral hemispheres followed by the sellar/suprasellar region (30%), lateral and third ventricles (11%), pineal region (8%), meninges (5%), choroid plexus (4%), and optic chiasma/tracts (3%). The most common types of tumors diagnosed were pilocytic astrocytoma and medulloblastoma together accounting for nearly half of the cases (46%) (23.1% and 22.9% respectively), followed by craniopharyngiomas (9%), ependymomas grade II (6.5%), glioblastomas (6%), astrocytomas grade II (4.4%), ependymomas grade III (3.9%). The other tumors represent 22.6%. CONCLUSION: We think that our results reflect fairly well the incidence of tumors of the nervous system in children due to the fact that this study was performed through many years in a single institution with a homogeneous neuropathological approach.

Fetal head injury from intentional penetrating abdominal trauma in pregnancy.

A male fetus was extruded from the uterus following multiple lower abdominal stab wounds to the mother. He was brought to the emergency room at 8 hours of age. He had sustained a compound skull fracture with brain contusion. There was no neurological deficit. Debridement and primary wound closure were undertaken. His mother had multiple lacerations to the uterus and a laceration of the fundus of the bladder. Following resuscitation, she had repair of the uterus and bladder and made an uneventful recovery. At 3 years of age, the boy is developing normally.

Solitary giant neurofibroma of the scalp with calvarial defect in a child.

Neurofibroma of the scalp are mostly multiple as part of neurofibromatosis or other phakomatosis. De novo solitary types are less common and rarely erode the skull, unlike the intracranial counterpart. Skull erosion has been reported in adults with longstanding plexiform neurofibromas. We report a giant neurofibroma on the scalp of a five-year-old boy, managed in our center. Although this condition is a rare entity, it should be anticipated and the treatment strategy should include repair of the skull defect.