Third ventricle tumors in children

Tumors of the third ventricle in children raise specific problems, owing to their clinical presentation, pathology, treatment, and outcome. The clinic al presentation is often unspecific at that age, many cases presenting with isolated macrocrania or delayed milestones. Some histological types are sp ecific of the pediatric group, such as the pilocytic astrocytoma or hypotha lamic hamartoma, and others types which are exceptional in adults are relat ively common in children, such as choroid plexus tumors. Surgery is especia lly dangerous in young children, because of the blood loss, and the hemisph eric collapse associated with the large hydrocephalus which is the rule in these patients. External irradiation is associated with a high rate of comp lications, above all a progressive intellectual delay, and endocrine disord ers. Chemotherapy has reduced the indication of irradiation, and, in some c ases, can be performed preoperatively to reduce tumor volume and intraopera tive blood loss. The therapeutic approach to these patients is thus pluridi sciplinar, and should be tailored for each case, with a follow-Lcp protract ed well into the adult age.