Childhood brain tumors: a 15-year survey.

Eighty-seven children with histologically confirmed brain tumors were reviewed. Fifty-nine of the tumors were in the posterior fossa, 19 were cerebral gliomas, and nine were miscellaneous supratentorial tumors, including five craniopharyngiomas and two papillomas of the choroid plexus. In the posterior fossa there were 22 astrocytomas, 11 medulloblastomas, and ten ependymomas, indicating that half of the cerebellar tumors are benign. Of the patients with cerebellar astrocytomas, 15 are alive and 10 are probably cured. The cerebellar ependymomas have a very poor prognosis with only one long-term survivor and an average survival time of 14 months. The medulloblastoma group has only four survivors, and some of these are less than two years postoperative. Of 11 patients having cerebral astrocytoma, only three are leading satisfactory lives, three are dead, and five are handicapped to a significant degree. Of the eight patients with supratentorial ependymoma, all are dead with the longest survival being six years. It is emphasized that a benign cerebellar astrocytoma is the single most likely tumor in childhood, and many of these patients can be cured and survive without significant neurologic deficit.