Management of unusual tumors of the pediatric cerebellum: report of three cases and review of the literature

Brain tumor is the most common of the solid tumors seen in childhood and infancy. The incidence of pediatric brain stem tumor is 2.4/100,000 live births/year. In approximately 50 per cent of cases the tumor is in the infratentorial compartment, mostly intra-axial. Primitivie neuroectodermal tumor and low grade cerebellar astrocytoma are the most common encountered histological types, followed by brain stem giloma, ependymoma, and an aplastic cerebellar astrocytoma. The management of children with cerebellar tumors generally follow a multi-disciplinary approach using a disease-specific protocol, surgery, radiotherapy and chemotherapy. The use of computed axial tomography and magnetic resonance imaging aids perioperative management and with present-day technology extensive surgery is safer than before. Two hundred and one from 261 children with posterior fossa tumor managed at this institution from 1982 - 1994 had an intra-axial cerebellar tumor, nine of which were of unusual histology and included one case each of pleomorphic xanthoastrocytoma, yolk sac tumor and atypical teratoid/rhabdoid tumor. We present our management and the outcome of these three unusual cases.