TECTAL TUMORS OF CHILDHOOD - CLINICAL AND IMAGING FOLLOW-UP

PURPOSE: This study was done to determine which clinical and imaging f indings best correlate with outcome in children with tectal tumors. ME THODS: A retrospective review was done of the medical records and imag ing studies of 32 children (16 boys and 16 girls; mean age, 8 years) w ith tectal tumors. Eight children had CT, 11 had MR imaging, and 13 ha d both CT and MR studies. Findings from surgical and pathologic report s as well as from follow-up examinations (mean follow-up period, 5 yea rs; range, 3.6 months to 17 years) were included in the review. RESULT S: All patients had hydrocephalus and all but one required CSF diversi on. The tectum was the center of the tumor in all cases and the majori ty of the tumors appeared isodense on CT scans, isointense on T1-weigh ted MR images, and hyperintense on T2-weighted images. Twenty patients required no further treatment. In this group, the mean maximum tumor diameter was 1.8 cm and enhancement occurred in two cases. At follow-u p, 18 patients had stable tumor size, one had an increase in tumor siz e with cyst formation but no worsening of symptoms, and one had a decr ease in tumor size. Twelve patients required further treatment (excisi on and/or radiotherapy) because of progression as indicated by either increased tumor size or worsening of symptoms. In this group, the mean maximum tumor diameter was 2.5 cm and contrast enhancement occurred i n nine cases. Further follow-up in this group showed decreased tumor s ize in eight and stable residual tumor in three. CONCLUSION: Tectal tu mors in childhood have variable behavior. MR imaging assists in the cl inical determination of which children need treatment beyond CSF diver sion. Larger tumor size and enhancement are radiologic predictors of t he need for further treatment.