Pediatric Posterior Fossa ATRT: A Case Report, New Treatment Strategies and Perspectives

Luca Paun; Alexandre Lavé; Gianpaolo Jannelli; Kristof Egervari; Insa Janssen; Karl Schaller; André O von Bueren; Andrea Bartoli

doi:10.3390/brainsci13050712

Pediatric Posterior Fossa ATRT: A Case Report, New Treatment Strategies and Perspectives

Brain Sci. 2023 Apr 24;13(5):712. doi: 10.3390/brainsci13050712.

Authors

Luca Paun^{1

2}, Alexandre Lavé^{1

3}, Gianpaolo Jannelli^{1

4}, Kristof Egervari^{5

6}, Insa Janssen¹, Karl Schaller¹, André O von Bueren⁷, Andrea Bartoli¹

Affiliations

¹ Division of Neurosurgery, Department of Clinical Neurosciences, Geneva University Hospitals and University of Geneva Faculty of Medicine, 1205 Geneva, Switzerland.
² Department of Neurosurgery, Site Sainte-Anne, Groupe Hospitalier Universitaire Paris Psychiatrie et Neurosciences, Université Paris Cité, 75014 Paris, France.
³ Department of Neurosurgery, Bicêtre Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris-Saclay, 94270 Le Kremlin-Bicêtre, France.
⁴ Department of Spine and Spinal Cord Surgery, Hôpital Pierre Wertheimer, Hospices Civils de Lyon, 69002 Lyon, France.
⁵ Department of Pathology and Immunology, University of Geneva, 1211 Geneva, Switzerland.
⁶ Division of Clinical Pathology, Geneva University Hospitals, 1205 Geneva, Switzerland.
⁷ Department of Pediatrics, Obstetrics and Gynecology, Division of Pediatric Hematology and Oncology, Geneva University Hospitals, 1205 Geneva, Switzerland.

Abstract

Posterior fossa atypical teratoid rhabdoid tumor (ATRT) is a rare childhood tumor usually associated with a dismal prognosis. Although upfront surgical gross total resection (GTR) has classically been the first line of treatment, new multimodal treatments, including two-stage surgery, are showing promising results in terms of overall survival (OS) and complication rate. We present a case of a 9-month-old child treated with two-staged surgery and chemotherapy. When deemed risky, multimodal treatments, including staged surgeries, can be a safe alternative to reduce surgical mortality and morbidity. At 23 months old, the patient had normal global development and no major impact on quality of life. We, therefore, discuss the most recent advancements from a treatment perspective, including molecular targeting.

Keywords: ATRT; case report; multimodal treatment; pediatric; posterior fossa.

Publication types

Case Reports

Grants and funding

This research received no external funding. The authors declare that the article content was composed in the absence of any commercial or financial relationships that could be construed as potential conflicts of interest.