Clinicopathological Analysis of Pediatric Brain Tumors: A Single-Center Study

Mahlagha  Zahedi; Shokouh  Taghipour Zahir; Mohammad  Peymani

doi:10.18502/ijpho.v15i4.19628

Mahlagha Zahedi Hematology and Oncology Research Center, Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Shokouh Taghipour Zahir Hematology and Oncology Research Center, Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Mohammad Peymani General physician, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

DOI: https://doi.org/10.18502/ijpho.v15i4.19628

Keywords: Brain neoplasms, Clinical presentation, Iran, Pathology, Pediatric

Abstract

Background: Pediatric brain tumors, comprising 20-25% of childhood cancers, are the second most common pediatric malignancy with a global incidence of 2-5 per 100,000 children, varying by region and healthcare access. In high-income countries, advanced MRI and molecular diagnostics based on the 2021 WHO classification have improved the survival rates to 70-80%. In low- and middle-income countries like Iran, limited neuroimaging, neurosurgery, and molecular profiling cause diagnostic delays of 4-6 months, disease advancement, and survival rates below 60%.

Materials and Methods: A cross-sectional descriptive study was conducted at Shahid Rahnamoun Hospital, Yazd analyzing 32 pediatric patients (aged ≤ 15 years) diagnosed with brain tumors from 2013 to 2023. The data on demographics, presenting symptoms, tumor types and locations, were extracted from pathology department records. The tumors were classified histologically according to the 2021 World Health Organization (WHO) central nervous system tumor classification, without routine molecular subtyping due to resource constraints. Statistical analysis was performed using Fisher’s exact tests in SPSS version 22, with the level of significance set at p < 0.05.

Results: The patients had a mean age of 7.1 ± 3.5 years, and the male-to-female ratio was 1.3:1. Astrocytoma was the most common tumor (40.6%), followed by medulloblastoma and glioblastoma (12.5%, each). The frontal lobe (22.2%) and cerebellum (19.4%) were the most frequent tumor sites. Headache (56.3%) and seizures (37.5%) were the prevalent symptoms. The significant associations included cerebellar tumors with balance disorders (p = 0.006), fourth ventricle tumors with speech disorders (p = 0.018), and thalamic tumors with decreased consciousness (p = 0.002).

Conclusion: This study highlights the distinct clinicopathological patterns of pediatric brain tumors in Yazd, with elevated meningioma rates suggesting potential diagnostic biases or environmental influences. Improved imaging, molecular profiling, and multicenter investigation of regional risk factors are essential to enhance the outcomes in Iran.