Pediatric and Adult Low-Grade Gliomas: Where Do the Differences Lie?

Two thirds of pediatric gliomas are classified as low-grade (LGG), while in adults only around 20% of gliomas are low-grade. However, these tumors do not only differ in their incidence but also in their location, behavior and, subsequently, treatment. Pediatric LGG constitute 65% of pilocytic astroc...

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Autores principales:	Ladina Greuter, Raphael Guzman, Jehuda Soleman
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	pediatric low-grade glioma malignant transformation Pediatrics RJ1-570
Acceso en línea:	https://doaj.org/article/5d153b8019464699a43dd3e66cb584b7
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spelling	oai:doaj.org-article:5d153b8019464699a43dd3e66cb584b72021-11-25T17:15:11ZPediatric and Adult Low-Grade Gliomas: Where Do the Differences Lie?10.3390/children81110752227-9067https://doaj.org/article/5d153b8019464699a43dd3e66cb584b72021-11-01T00:00:00Zhttps://www.mdpi.com/2227-9067/8/11/1075https://doaj.org/toc/2227-9067Two thirds of pediatric gliomas are classified as low-grade (LGG), while in adults only around 20% of gliomas are low-grade. However, these tumors do not only differ in their incidence but also in their location, behavior and, subsequently, treatment. Pediatric LGG constitute 65% of pilocytic astrocytomas, while in adults the most commonly found histology is diffuse low-grade glioma (WHO II), which mostly occurs in eloquent regions of the brain, while its pediatric counterpart is frequently found in the infratentorial compartment. The different tumor locations require different skillsets from neurosurgeons. In adult LGG, a common practice is awake surgery, which is rarely performed on children. On the other hand, pediatric neurosurgeons are more commonly confronted with infratentorial tumors causing hydrocephalus, which more often require endoscopic or shunt procedures to restore the cerebrospinal fluid flow. In adult and pediatric LGG surgery, gross total excision is the primary treatment strategy. Only tumor recurrences or progression warrant adjuvant therapy with either chemo- or radiotherapy. In pediatric LGG, MEK inhibitors have shown promising initial results in treating recurrent LGG and several ongoing trials are investigating their role and safety. Moreover, predisposition syndromes, such as neurofibromatosis or tuberous sclerosis complex, can increase the risk of developing LGG in children, while in adults, usually no tumor growth in these syndromes is observed. In this review, we discuss and compare the differences between pediatric and adult LGG, emphasizing that pediatric LGG should not be approached and managed in the same way as adult LCG.Ladina GreuterRaphael GuzmanJehuda SolemanMDPI AGarticlepediatric low-grade gliomamalignant transformationPediatricsRJ1-570ENChildren, Vol 8, Iss 1075, p 1075 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	pediatric low-grade glioma malignant transformation Pediatrics RJ1-570
spellingShingle	pediatric low-grade glioma malignant transformation Pediatrics RJ1-570 Ladina Greuter Raphael Guzman Jehuda Soleman Pediatric and Adult Low-Grade Gliomas: Where Do the Differences Lie?
description	Two thirds of pediatric gliomas are classified as low-grade (LGG), while in adults only around 20% of gliomas are low-grade. However, these tumors do not only differ in their incidence but also in their location, behavior and, subsequently, treatment. Pediatric LGG constitute 65% of pilocytic astrocytomas, while in adults the most commonly found histology is diffuse low-grade glioma (WHO II), which mostly occurs in eloquent regions of the brain, while its pediatric counterpart is frequently found in the infratentorial compartment. The different tumor locations require different skillsets from neurosurgeons. In adult LGG, a common practice is awake surgery, which is rarely performed on children. On the other hand, pediatric neurosurgeons are more commonly confronted with infratentorial tumors causing hydrocephalus, which more often require endoscopic or shunt procedures to restore the cerebrospinal fluid flow. In adult and pediatric LGG surgery, gross total excision is the primary treatment strategy. Only tumor recurrences or progression warrant adjuvant therapy with either chemo- or radiotherapy. In pediatric LGG, MEK inhibitors have shown promising initial results in treating recurrent LGG and several ongoing trials are investigating their role and safety. Moreover, predisposition syndromes, such as neurofibromatosis or tuberous sclerosis complex, can increase the risk of developing LGG in children, while in adults, usually no tumor growth in these syndromes is observed. In this review, we discuss and compare the differences between pediatric and adult LGG, emphasizing that pediatric LGG should not be approached and managed in the same way as adult LCG.
format	article
author	Ladina Greuter Raphael Guzman Jehuda Soleman
author_facet	Ladina Greuter Raphael Guzman Jehuda Soleman
author_sort	Ladina Greuter
title	Pediatric and Adult Low-Grade Gliomas: Where Do the Differences Lie?
title_short	Pediatric and Adult Low-Grade Gliomas: Where Do the Differences Lie?
title_full	Pediatric and Adult Low-Grade Gliomas: Where Do the Differences Lie?
title_fullStr	Pediatric and Adult Low-Grade Gliomas: Where Do the Differences Lie?
title_full_unstemmed	Pediatric and Adult Low-Grade Gliomas: Where Do the Differences Lie?
title_sort	pediatric and adult low-grade gliomas: where do the differences lie?
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/5d153b8019464699a43dd3e66cb584b7
work_keys_str_mv	AT ladinagreuter pediatricandadultlowgradegliomaswheredothedifferenceslie AT raphaelguzman pediatricandadultlowgradegliomaswheredothedifferenceslie AT jehudasoleman pediatricandadultlowgradegliomaswheredothedifferenceslie
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Pediatric and Adult Low-Grade Gliomas: Where Do the Differences Lie?

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