SHORT COURSE

Thursday Morning - March 7, 8:00 AM - 11:30 AM




37. Diagnostic Issues in Pediatric Brain Tumors - ABCs for Sorting Out the Routine and the "Zebras"

Adekunle M. Adesina, MD, PhD, Texas Children's Hospital, Baylor College of Medicine, Houston, TX
Christine E. Fuller, MD, Medical College of Virginia, Virginia Commonwealth University, Richmond, VA

The complexity of many pediatric brain tumors, frequently exhibiting differing histologic features from those seen in adult tumors, can be bewildering and intimidating even to the trained neuropathologist. Even pediatric brain tumors that share similar histologic features to those of adults, often have different biologic potential than their adult counterparts.

This course will provide both a broad general overview of common and not-so-common pediatric brain tumors, as well as cover important differential diagnostic considerations and appropriate diagnostic work-up in each diagnostic category. The specific topics and subtopics are as follows: 1) The small blue cell tumor dilemma: Medulloblastoma / PNET vs. Atypical Teratoid-Rhabdoid Tumor and Malignant Gliomas, 2) Ependymal tumors and their mimics: Ependymoma vs. PNET (Ependymoblastoma / Medulloepithelioma) vs. Choroid Plexus Carcinoma, 3) Pleomorphic cells do not a glioblastoma make: Glioblastoma vs. Pleomorphic Xanthoastrocytoma, 4) Pediatric spindle cell tumors include more than just meningioma: Desmoplastic Ganglioglioma vs. Meningioma, 5) Beware the great mimicker: Pilocytic Astrocytoma vs. a myriad of other gliomas including Glioblastoma, and 6) Glioneuronal potpourri: Dysembryoplastic Neuroepithelial Tumor vs. Ganglioglioma vs. Pilocytic Astrocytoma

The target audience includes (i) general surgical pathologists who encounter pediatric brain tumors in daily practice, (ii) pediatric surgical pathologists, and (iii) trainees including residents and specialty fellows in pediatric, surgical, and neuropathology.

Upon completion of this educational activity, participants should be able to: 1) Develop appropriate age-related and site-specific differential diagnoses for pediatric brain tumors; 2) Recognize the plethora of histologic variations seen in low grade glial tumors such as the pilocytic astrocytoma and their potential mimicry of high grade tumors such as the glioblastoma; 3) Review the differential diagnoses of common groups of pediatric brain tumors and the salient distinguishing histologic features of embryonal tumors and their variants, glial tumors, and glio-neuronal tumors, etc.; and 4) Recognize the histologic features of developmental tumors such as dysembryoplastic neuroepithelial tumors and their phenotypic overlap with conventional tumors, as well as their presentation in the context of epilepsy related disorders. Pre-meeting illustrative cases will be available for review on the USCAP website prior to the course and a syllabus will be provided to participants at the course. Registrants will also have access to after meeting materials on the USCAP website.