Paediatric brain tumours managed in Enugu, Southeast Nigeria: Review of one centre experience

Background: Nothing has been published about paediatric brain tumours (PBTs) in Southeast Nigeria. This pioneer study analyses the tumour characteristics and management outcome of PBTs in Enugu, Southeast Nigeria. Methodology: Retrospective longitudinal study utilising information from medical, radiology and histopathology records of all paediatric tumour cases managed at Memfys Hospital for Neurosurgery, Enugu, a major referral centre, from 2006 to 2017. Results: The total number of cases was 54. Peak age group at the diagnosis were 0-5 years (37.0%) and >10 years (40.8%). Frequent presenting symptoms of supratentorial tumours were limb weakness (70%), convulsions (50%) and altered consciousness (48%). Infratentorial tumours presented mostly with gait disturbance (82%), vomiting (72%) and altered consciousness (48%). There were 51 (94.4%) primary and three metastatic tumours. Supratentorial tumours were 28 (51.9%) and infratentorial tumours were 26 (48.1%). Histopathologic types were glioma 20 (37.0%), medulloblastoma 13 (24.1%), craniopharyngioma 11 (20.4%), meningioma 2 (3.7%) and others 8 (14.8%). The most common supratentorial tumours were gliomas 11 (39.3%) and craniopharyngioma 11 (39.3%), and the most common infratentorial tumour was medulloblastoma 13 (50.0%). Gross total resection (GTR) was achieved in 28 (51.9%) and subtotal resection (STR) in 26 (48.1%). Patients with Karnofsky score ≥70% had 16 (65.2%) GTR and patients with ≤60% score had more STR 18 (58.1%). At 1-year post-surgery, 16 (64%) of those with GTR lived normal lives compared with only 4 (20%) of STR. Among GTR group, 7 (28.0%) died compared to the 11 (55.0%) deaths recorded following STR. Overall, 55.6% of patients were at least independent at 1 year. Conclusion: Glioma, medulloblastoma and craniopharyngioma are the most common PBTs. The management outcome is good and affected by extent of tumour resection.