Background: Central nervous system (CNS) metastases occur in 20-30% of adult patients with systemic cancers. but they rarely occur in children with solid tumours.
Aim: clinical and prognostic characteristics of CNS recurrence in children treated for solid tumours were analysed.
Patients and methods: The retrospective study enrolled 218 children treated for solid tumours in the Department of Paediatric Haematology and Oncology, Lublin Medical Academy, from January 1992 to December 2002. The diagnosis in this group was as follow: soft tissue sarcomas -- 51 patients, bone tumours -- 50. Wilms' tumour -- 48, neuroblastoma (NBL) -- 36, germ cell tumours -- 33: Children with primary CNS tumours, retinoblastoma, lymphoma and rare tumours were not analysed.
Results: CNS metastases were diagnosed in five children (2.3%) - (2 boys. 3 girls; aged 2,5 to 17 years). Two of them were treated due to Wilms' tumour, one -- NBL, one -- teratoma malignum, one -- leiomyosarcoma. None of the children with bone tumours had CNS metastases. Diagnosis of CNS metastases was confirmed by imaging studies (CT, MRI). The median time from initial diagnosis to the detection of CNS metastases was 14 months. Two children underwent surgical resection of solitary metastases. One of them was also irradiated and received chemotherapy and only this child is alive and achieved complete remission. Other children died, with median period of 32 days.
Conclusions: CNS metastases may occur in children with the recurrence of primary neoplastic disease. The prognosis is grave.