INTRAAXIAL ENDOPHYTIC TUMORS IN THE PONS AND OR MEDULLA-OBLONGATA .2.INTRAOPERATIVE FINDINGS, POSTOPERATIVE RESULTS, AND 2-YEAR FOLLOW-UP IN 25 CHILDREN/

Between July 1987 and June 1994 we operated upon 30 consecutive childr en suffering from endophytic intra-axial tumors located in the pens an d/or medulla oblongata. The 25 children operated on between July 1987 and October 1993 whose postoperative course could be assessed for a mi nimum of 2 years after operation were included in this study. Operabil ity of a brain stem tumor was shown to be independent of its size. A g ross tumor resection between 80% and 100% could be performed in half t hese cases, and subtotal or partial resection in the other half. The r adicality of resection was not influenced by tumor histopathology, but was dependent on intraoperative findings relating to its consistency, infiltration, and visibility. On follow up, 15 of the 25 children wer e found to have died within the period of 2 years. Two children died i n the immediate postoperative period (at 2 days and 2 weeks after surg ery), of acute brain stem swelling and an unsuspected bleeding disorde r, respectively. The other 13 of these 15 children died of tumor progr ession between 1 and 19 months after operation, with a median survival time of 9 months. In the group of the surviving 10 children the histo pathology was grade I astrocystoma in 6 cases, angioma in 2 cases, and grade II oligodendroglioma and grade II ependymoma in 1 case each. Po stoperatively, most of the children showed some increase in their preo perative deficits, but recovered after 2-3 months. After 2 years, 10 o f the 25 children who were followed up are alive and 9 of them attend regular school or kindergarten.