Malignant Parasellar Lesions in Children

Tumors of the parasellar region comprise approximately 15-20% of intracranial tumors encountered In children. The predominant members in this group are glioma and craniopharyngioma. Meningioma and pituitary tumor are less common causes. Each of these tumors is considered benign but may exhibit significant local growth potential in the correct setting. Germ cell tumors are rare, malignant, although variable in degree, and consequently far more aggressive and dangerous. Fortunately, these tumors comprise only 0.5- 3% of intracranial tumors in children. There is a predilection for them to arise in the pineal and suprasellar regions. Germ cell tumors are much more common in Orientals than In Caucasians or other races. The racial predilection is easily appreciated by a cursory literature review. Metastatic invasion of the parasellar region can be a feature of other malignant tumors in childhood, such as medulloblastoma. The emphasis here is on the clinical presentation, classification, workup, treatment and survival f children with parasellar germ cell tumors.