Tumores intramedulares pediátricos: revisión de 6 casos

Abstract

Introduction: Intramedullary spinal cord tumors are rare. However, in children they can reach up to 35% of spinal tumors, with astrocytomas being the first in frequency. Most are low-grade, and therefore complete tumor resection is the treatment of choice. The aim of this paper is to present a series of cases, emphasizing radical surgical resection, presenting symptoms and outcome according to tumor histology.
Methods: A retrospective study was carried out with patients under 18 years of age with a diagnosis of intramedullary spinal cord tumors, who had undergone surgical resection at our institution in the period 2019-2021. Presenting symptoms, pre and postoperative magnetic resonance, tumor lineage, intraoperative electrophysiology, degree of resection and clinical outcome were analyzed using the McCormick scale.
Results: Six patients whose average age was 9.9 years (range 9 months-17 years) were treated. The predominant clinical manifestation was sensory deficit (37%), followed by motor deficit (27%). The average time from the onset of symptoms to diagnosis was 9.4 months, except for one atypical case with a history of eight years with hyperhidrosis. Gross-total resection was achieved in 68%, subtotal in 16% and partial in 16%. The functional status six months postoperatively remained stable in 50%, and improved in 17%.
Conclusion: Radical resection of pediatric intramedullary spinal cord tumors can be achieved with preservation of neurological function in the long term. Tumor histology is the most important prognostic factor.