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Topical Review Article: Brainstem Glioma: I. Pathology, Clinical Features, and Therapy

Pediatric Neuro-Oncology Program and the Department of Pediatrics, University of Florida College of Medicine, Gainesville, FL

Kimberly Rehder, MD

Pediatric Neuro-Oncology Program and the Department of Pediatrics, University of Florida College of Medicine, Gainesville, FL

Thomas A. Eskin, MD

Department of Pathology, University of Florida College of Medicine, Gainesville, FL

Latif M. Hamed, MD

Department of Ophthalmology, University of Florida College of Medicine, Gainesville, FL

Eileen B. Fennell, PhD

Department of Clinical and Health Psychology, University of Florida College of Medicine, Gainesville, FL

Ronald G. Quisling, MD

Department of Radiology, University of Florida College of Medicine, Gainesville, FL

J. Parker Mickle, MD

Department of Neurosurgery, University of Florida College of Medicine, Gainesville, FL

Robert B. Marcus, Jr, MD

Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL

Walter E. Drane, MD

Department of Nuclear Medicine, University of Florida College of Medicine, Gainesville, FL

Nancy P. Mendenhall, MD

Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL

W. Mark McCollough, MD

Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL

Amos Kedar, MD

Pediatric Neuro-Oncology Program and the Department of Pediatrics, University of Florida College of Medicine, Gainesville, FL

Gliomas that arise in the brain stem have been associated with a poor prognosis. Diagnostic neuroimaging readily identifies the tumor as it extends between normal brainstem structures. Histologic sampling of tumor with stereotactic methods is notoriously unreliable in establishing a definitive prognosis. Clinical trials that incorporate high-dose chemotherapy, autologous bone marrow rescue, and irradiation hold promise of better tumor control by overcoming the inaccessibility of the central nervous system to standard doses of chemotherapy. We review the pathology, clinical features, neuroimaging features, and current therapeutic concepts relative to brainstem glioma. The pediatric neurologist has a pivotal role in identifying and monitoring children with this malignancy. (J Child Neurol 1993;8:112-128).

Journal of Child Neurology, Vol. 8, No. 2, 112-128 (1993)
DOI: 10.1177/088307389300800203


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