Pediatric pineal region tumor

Brief introduction of tumors in children with pineal region The incidence of tumorofpineal regions in children is more than 2 times higher than that of adults. Tumors can cause hydrocephalus and intracranial hypertension, which can cause the eyes to be incapable of looking up, tinnitus, hearing loss and endocrine disorders. Sexual dysfunction, obesity, lethargy, etc., the age of onset of different tumor types may be slightly different, the peak age of germ cell tumors is 12 to 14 years old, and the peak incidence of teratoma is 7 to 8 years old, and this part of the The peak incidence of glioma is 13 to 15 years old. The males in the pineal region accounted for an absolute majority, and the males in this group accounted for 79.8%. The children in the pineal region were different from the adult in pathological nature. Children with germ cell tumors and teratomas were more common. The tumors and meningioma are more common. The tumors derived from embryonic germ cells account for 69.4%, of which germ cell tumors account for 36%, teratomas account for 26%, and glial tumors account for 20%. The tumor of the pineal parenchymal cells is 8%. basic knowledge Sickness ratio: 0.0001% Susceptible people: children Mode of infection: non-infectious Complications: hydrocephalus, ataxia, diabetes insipidus, precocious puberty, epilepsy

Tumor of tumor in pineal region of children

(1) Causes of the disease

The hamartoma is not actually a true tumor, but a congenital brain tissue dysplasia. Diebler et al believe that this disease is a kind of neural tube insufficiency syndrome that occurs in the 5th to 6th week of pregnancy. A lump, the nerve cells that make up such a deformity are similar to the nerve tissue in the gray nodule. There are two types of tumors in the neuroepithelial tissue. One type is formed by the interstitial cells of the nervous system (ie, glial cells), called glioma. The other type is formed by the parenchymal cells of the nervous system (ie, neurons). There is no general name. Because of the pathogenic and morphological aspects, the two types of tumors cannot be completely distinguished now, and gliomas are common. Neuronal tumors are included in gliomas, and tumors of neuroepithelial origin are the most common intracranial tumors, accounting for approximately 44% of the total number of intracranial tumors.

(two) pathogenesis

In addition to teratoma with a complete capsule, it is a localized non-invasive growth, and most of the other tumors are invasive growth, and can be disseminated along the cerebrospinal fluid or distant metastasis such as bone, liver and lymph nodes, mainly the following three Big category:

1. Tumor obstruction: The outlet of the third ventricle causes obstructive hydrocephalus and intracranial hypertension.

2. Adjacent structural compression: If the upper quadrant of the midbrain is pressed, the eyes can not be seen, the inside of the hypothalamus, the knee is compressed, there may be tinnitus, hearing loss.

3. Endocrine disorders: Tumors in the pineal region can secrete melatonin, which affects the secretion of gonadotropins from the pituitary gland, which can be manifested as stunting, sexual dysfunction, obesity, and lethargy.

Pediatric pineal area tumor prevention

Refer to the general tumor prevention methods, understand the risk factors of tumors, and formulate corresponding prevention and treatment strategies to reduce the risk of tumors. There are two basic clues to prevent tumors. Even if tumors have begun to form in the body, they can help the body to improve resistance. These strategies are as follows:

1. Avoid harmful substances (promoting factors): It can help us avoid or minimize exposure to harmful substances.

Some related factors of tumorigenesis are prevented before the onset, and many cancers can be prevented before they are formed. A report in the United States in 1988 compared the international malignant tumors in detail and proposed many external factors of known malignant tumors. In principle, it can be prevented, that is, about 80% of malignant tumors can be prevented by simple lifestyle changes, and traced back. In 1969, Dr. Higginson's research concluded that 90% of malignant tumors are caused by environmental factors," "Environmental factors", "lifestyle" refers to the air we breathe, the water we drink, the food we choose to make, the habits of activities, and social relationships.

2. Improve the body's immunity against tumors: Can help to strengthen and strengthen the body's immune system and cancer.

The focus of our current cancer prevention efforts should first focus on and improve those factors that are closely related to our lives, such as quitting smoking, eating properly, exercising regularly, and losing weight. Anyone who follows these simple and reasonable lifestyles can Reduce the chance of cancer.

The most important thing to improve the function of the immune system is: diet, exercise and control troubles. Healthy lifestyle choices can help us stay away from cancer. Maintaining good emotional state and proper physical exercise can keep the body's immune system at its best. Tumors and prevention of other diseases are equally beneficial. Other studies have shown that appropriate activities not only enhance the body's immune system, but also reduce the incidence of colon cancer by increasing the peristalsis of the human intestinal system. Here we mainly understand the diet in preventing tumorigenesis. Some questions.

Human epidemiology and animal studies have shown that vitamin A plays an important role in reducing the risk of cancer. Vitamin A supports normal mucosa and vision. It directly or indirectly participates in most of the body's tissue functions. Vitamin A is present in animal tissues. In the liver, whole eggs and whole milk, the plant is in the form of -carotene and carotenoids, which can be converted into vitamin A in the human body. Excessive intake of vitamin A can cause adverse reactions in the body and -carrot This is not the case with carotenoids, and the low vitamin A content in the blood increases the risk of malignant tumors. Studies have shown that those with low levels of vitamin A intake in the blood increase the likelihood of lung cancer, while those with low blood levels in smokers Levels of vitamin A ingestors have the potential to double lung cancer. Vitamin A and its mixture can help remove free radicals in the body (free radicals can cause damage to genetic material), and secondly stimulate the immune system and help differentiate cells in the body. Ordered tissue (while the tumor is characterized by disorder), some theories suggest that vitamin A can help early carcinogens Invasion mutated cells become reversed the occurrence of the normal growth of cells.

In addition, some studies suggest that supplementation with -carotene alone does not reduce the risk of cancer, but rather increases the incidence of lung cancer. However, when -carotene binds to vitamin C, E and other antitoxin substances, its protective effect. It is shown, because it can increase free radicals in the body when it is consumed by itself. In addition, there are interactions between different vitamins. Both human and mouse studies have shown that the use of -carotene can reduce 40% of vitamins in the body. At E-level, a safer strategy is to eat different foods to maintain a balanced vitamin to protect against cancer, as some protective factors have not been discovered so far.

Vitamin C, E is another anti-tumor substance that prevents the harm of carcinogens such as nitrosamines in food. Vitamin C protects sperm from genetic damage and reduces the risk of leukemia, kidney cancer and brain tumors in their offspring. Vitamin E can reduce the risk of skin cancer. Vitamin E has the same anti-tumor effect as vitamin C. It is a scavenger that protects against toxins and scavenges free radicals. The combination of vitamins A, C and E protects the body against toxins. Better than applying it alone.

At present, research on phytochemistry has attracted widespread attention. Phytochemistry is a chemical found in plants, including vitamins and other substances found in plants. Thousands of plant chemicals have been found, many of which have anticancer properties. The protective mechanism of these chemicals not only reduces the activity of carcinogens but also enhances the body's immunity against carcinogens. Most plants provide antioxidant activity that exceeds the protective effects of vitamins A, C, and E, such as a cup of cabbage. Contains 50mg of vitamin C and 13U of vitamin E, but its antioxidant activity is equivalent to the antioxidant activity of 800mg of vitamin C and 1100u of vitamin E. It can be inferred that the antioxidant effect in fruits and vegetables is far better than what we know. The effect of vitamins is strong, and no doubt natural plant products will help prevent cancer in the future.

Tumor complications in children with pineal region Complications hydrocephalus ataxia disorder diabetes insipidus precocious epilepsy

Can cause hydrocephalus, ataxia, can lead to diabetes collapse, precocious puberty, sexual development and stagnation, epilepsy and so on.

Tumor symptoms in children with pineal area Common symptoms Light reflex disappearance Early maternal ataxia Tinnitus Increased intracranial pressure Eyeball tremor Spinal cord compression Two eyes Upper visual disorder Drowsiness Diabetes

1. Increased intracranial pressure (95.5%): The tumor protrudes to the posterior or anterior and posterior of the third ventricle to narrow and block the aqueduct, which can cause obstructive hydrocephalus to cause increased intracranial pressure.

2. Symptoms of brain compression: Tumor compression in the quadrilateral upper quadrant may cause difficulty in both eyes (Parinaud syndrome), dilated pupils or unequal, light reflex disappeared (accounting for 61.4%); tumor growth oppressed hypothalamus and Tinnitus or hearing loss may occur in the medial geniculate body; torso ataxia or nystagmus may occur in the upper cranial or upper iliac crest of the cerebellum; direct invasion of the tumor or dissemination along the ventricle to the hypothalamus may result in diabetes collapse , sleepiness and other symptoms of hypothalamic damage.

3. Endocrine symptoms: Tumor cells with normal tumor compression reduce melatonin secretion, remove the inhibition of melatonin secretion by melatonin, which can lead to precocious puberty (17.1%), as shown in Figure 1, there are also a few It is characterized by stagnant sexual development.

4. Other symptoms: Some children may have seizures and symptoms of bilateral pyramidal tract compression.

5. Spinal canal metastasis: Germ cell tumors can occur due to tumor cell loss and spinal cord metastasis, and spinal cord damage appears.

When the child has increased intracranial pressure and difficulty in visualizing both eyes, the possibility of posterior tumor of the third ventricle should be considered. If the boy is accompanied by precocious puberty, the teratoma in this area should be considered.

Examination of tumors in children's pineal region

Cytological examination of exfoliated tumors in cerebrospinal fluid is helpful for diagnosis; increased levels of tumor markers chorionic gonadotropin (HCG), alpha-fetoprotein (AFP) and carcinoembryonic antigen (CEA) in serum and cerebrospinal fluid contribute to diagnosis. Can be used as an indicator of efficacy evaluation and recurrence monitoring.

1. Skull X-ray film: In addition to the signs of increased intracranial pressure, germ cell tumors can be seen with pathological calcification.

2. CT: pineal somatic tumors are mostly rounded lesions with clear boundaries, equal or high confounding density, scattered calcification, and banding around the ventricles, slightly high-density lesions. The borders of germ cell tumors are irregular, sometimes butterfly-like, with bullet-like calcification, and some can be seen in the lateral cerebral ventricle. This can be diagnosed. Teratomas contain fat, bones and teeth are mostly mixed density, and lower than cerebrospinal fluid. The density of the fat density area and the high density area close to the bone density, MRI: the surrounding structure of the tumor shows better, with signal unevenness and enhanced characteristics.

Diagnosis and diagnosis of tumors in pineal region of children

Different from other causes of hydrocephalus, ataxia and other diseases, auxiliary examination of MRI and cerebrospinal fluid cytology, help differential diagnosis.

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