Consensus for surgical management of brain stem tumours (UK paediatric neurosurgical group)16
| Anatomical site/ imaging characterisitics | Probable pathology | Surgical management |
|---|---|---|
| Midbrain | ||
| Tectal plate | Low grade astocytoma, exclude non-germinomatous germ cell tumours by measuring tumour markers | Observe/cerebrospinal fluid diversion if necessary, consider debulking if tumour progresses |
| Other | As for Pons | As for Pons |
| Pons | ||
| Diffuse | High grade astrocytoma | No biopsy proceed to radiotherapy |
| Focal solid/cystic | Low/high grade astrocytoma | Drain cysts/debulk solid component DXT depending upon severity of neurological signs |
| Exophytic | Low/high grade astrocytoma | Debulk |
| Medulla | As for Pons | Neurological, results of surgery poor |
| Cervico-medullary | Low grade astrocytoma | Radical removal |
DXT, dual x ray therapy.