Most central nervous system tumours in children are diagnosed with little delay after admission

INTRODUCTION: Children with central nervous system (CNS) tumours often have a long symptom interval before diagnosis. We investigated delays in diagnosis and surgical management after the first admission with tumour-related symptoms.

MATERIAL AND METHODS: This study reviewed the medical records of 46 consecutive children with a CNS tumour admitted to a paediatric department. Clinical findings at the time of the first admission, duration of symptoms, time to radiological diagnosis and time to initial surgical procedures were recorded.

RESULTS: The series comprised 26 supratentorial, 19 fossa posterior and one spinal tumour with equal numbers of high-grade and low-grade tumours. Headache, vomiting and lethargy were the most frequent symptoms, and pre-admission delay depended on tumour grade as well as location. Six cases had been diagnosed prior to admission; of the 40 undiagnosed cases, 32 (80%) were scanned within four days, but in four cases (10%) diagnosis was delayed for more than a week. Resection was performed within four days of diagnosis in 68% of children with resectable tumours (21/31). Initial surgical management of tumours causing hydrocephalus was completed within four days of diagnosis in 83% (20/24).

CONCLUSION: Delay in diagnosis and surgical management after the primary admission with symptoms caused by a tumour may influence the outcome negatively. In this review from a small centre, the majority of the cases were diagnosed and managed surgically within four days of admission and diagnosis, respectively. Criteria for good performance, i.e. accepted standards for time to diagnosis and intervention, need to be specified.

FUNDING: Not relevant.

TRIAL REGISTRATION: Not relevant.