Patient's question:
My daughter, now 356 months old, started showing reluctance to walk independently around July 2014. In October, she was found to have hand tremors. By late October 2014, a brain tumor was discovered in her thalamus and basal ganglia. She is being treated at Tiantan Hospital.On November 4, she underwent a left occipital horn ventriculoperitoneal shunt surgery, using a MEDTRONIC adjustable shunt. On November 15, she had a right frontal craniotomy for subtotal resection of the thalamic tumor. During the surgery, the right thalamic intracranial lesion was noted to be poorly demarcated, with a meaty appearance and firm consistency. Postoperative imaging revealed that about 50% of the tumor was resected. Pathological examination confirmed it as an astrocytoma, WHO grade II.
She has now been discharged and is recovering well, though she still experiences hand tremors. She can walk a few steps independently in a safe environment. The attending surgeon mentioned that another surgery could be performed, entering through the triangle area, but the surgical risk is very high, with significant risks of paralysis or aphasia. It is recommended to consider tumor surveillance, with chemotherapy being an option.
Doctor's answer:
Patient's family, hello. Postoperative residual 2-grade pediatric astrocytoma. If symptoms persist, chemotherapy is required.The impact of chemotherapy on 2-grade pediatric astrocytoma is primarily short-term, with common manifestations including leukopenia and thrombocytopenia. In most cases, the probability of chemotherapy significantly affecting the child's quality of life is low.
Chemotherapy is an effective treatment for 2-grade pediatric astrocytoma.
China is the same as the United States in treating pediatric astrocytoma, especially for children under 10. After surgery, chemotherapy is the primary treatment, while radiotherapy should be delayed as much as possible in children.