Infant brain tumours: a tale of two cities.

INTRODUCTION: Infantile brain tumours (age < 1 year) are increasingly being diagnosed due to advances in prenatal and perinatal diagnostic imaging. We present here our retrospective study of 64 infant brain tumours that brings to the fore the epidemiology, clinical presentation, pathology and outcome of this unique subset of paediatric brain tumours presenting to two tertiary referral centres in Kolkata in India and Lille in France between the years 1999 and 2014.

METHODS: Data was retrospectively collected from Kolkata (n = 30) and Lille (n = 34) for patients presenting with infant brain tumours and analysed for factors such as age at presentation, clinical features, gender, location of tumour, pathology, management and outcome. Follow-up was available for all patients.

RESULTS: Mean age at presentation was 6.8 months at Kolkata and 6.3 months at Lille. More than two-thirds of tumours in both the groups were supratentorial and presented with signs of raised intracranial pressure. There was also a similar proportion of tumours presenting as congenital tumours. At Kolkata, germ cell tumours (n = 7) were the most common while low-grade gliomas (n = 11) formed the largest group at Lille. Kolkata had a higher incidence of high-grade gliomas (n = 5) and PNETs (n = 4) while ATRT (n = 3) and choroid plexus carcinoma (n = 4) were more common at Lille. Surgery was the mainstay of treatment at both centres.

CONCLUSION: Brain tumours in infants presenting to tertiary centres in Europe and India are challenging to manage and usually have dismal prognosis. These tumours differ markedly in the pathology and, therefore, overall outcome. Surgery forms mainstay of treatment. Radiotherapy is best avoided in this age group.