High-grade gliomas in pediatric patients: case report and literature review

High-grade gliomas have been known among adult population, especially during the fourth and seventh decade of life, differently from the pediatric population. In contrast to adults, high-grade gliomas are significantly less common than low-grade lesions, consisting of a consensus matter over the clinical manifestations, therapy, and follow up. In the pediatric population, high-grade lesions characterized a discrete prevalence in males (1.7:1 e 3:2). Tumor localization out of the cerebral hemispheres in the adult population is exception, in contrast to children pattern which consists of a diffuse pattern. The most common sites to present with expressive lesion consists of frontal lobe (27%) and brainstem (25%). A number of cytogenetic and molecular factors have been associated with outcome, especially p53 protein, presented in 75% immunohistochemical evaluations, related to 6-7 months of survival. Tumor complete resection should be associated as part of the treatment, especially in hemispheric lesions located in regions considered not eloquent. The correlation of the extension of the resection and the period free from the disease consist of important factors to be considered in case of aggressive reintervention. Surgical treatment associated to radiotherapy and chemotherapy provides 11-33 months of survival. The present case report describes male patient, 5 years old, diagnosed with high-grade glioma located in frontotemporoparietal left lobe, submitted to surgical and chemotherapy and radiotherapy.