PDOC-14 CASE SERIES ON THE MANAGEMENT OF POSTERIOR CRANIAL FOSSA TUMORS AND CHALLENGES ENCOUNTERED IN A LOW RESOURCE SETTING: ZIMBABWE

Abstract OBJECTIVES To investigate the management and challenges encountered in caring for patients with posterior cranial fossa tumors in Zimbabwean government central hospitals and their outcomes. METHODS Clinical and surgical records of six paediatric patients diagnosed with posterior cranial fossa tumors and managed at Parirenyatwa group of hospitals and Sally Mugabe Central Hospital over the past 8months were accessed from the hospital archives and utilized to fill in a previously created assessment tool. RESULTS Six cases of posterior fossa tumors were analysed. The ages ranged from 2 to 12 years, with a female-to-male ratio of 2:1. None of the patients underwent standard emergency posterior fossa tumor excision. All of the patients initially had a ventriculoperitoneal shunt inserted for active hydrocephalus due to the unavailability of theatre time, surgical sundries, ICU beds, and blood products. A single patient deceased after developing a complication of upward herniation whilst four patients proceeded to have uneventful excisions of posterior fossa tumors. For the cases that had surgical tumor excision, an average waiting period of 2 weeks was observed between ventriculoperitoneal shunting and surgical excision. One patient was lost to follow-up after shunting. CONCLUSION There are delays in emergency neuro-oncological service delivery in Zimbabwe leading to delayed excision of posterior fossa tumors. These delays have been bridged by CSF diversion through the placement of ventriculoperitoneal shunts while awaiting definitive surgery. Despite these challenges and delays, the outcomes are generally satisfactory.