Clinical Aspects and Delay in Diagnosis of Children with Central Nervous System Tumors at the National Cancer Institute of Colombia
Keywords:
Neoplasms, Central Nervous System, Children, Symptoms, DiagnosisAbstract
Objective: To determine the clinical presentation and the time interval between the clinical presentation and diagnosis of central nervous system tumors in children treated at the National Cancer Institute (NCI).
Methods: We studied a retrospective and prospective cohort of 64 patients between January 1, 2008 and August 31, 2010. The analysis was performed using descriptive statistics. Exploratory analysis was performed using x² test. Results were considered statistically significant with value P<0,05.
Results: Of the 64 patients included for analysis 36 (56,3%) were male. The median age was 8 years with a range of 0 to 17,12.5% were from a rural area of the country. Headache, vomiting, seizures, gait abnormalities and strabismus were the most frequent clinical manifestations. 60,9% of patients were assessed at their first visit by a general medical, 12,5% by a pediatrician, and 6.3% by an ophthalmologist. The average consultation prior to the suspicion diagnosis was of three. In 72% of patients the doctor who treated the child for the first time do not suspect the presence of a brain tumor and the initial diagnosis was migraine in 18.8%. The most frequent location was in cerebral hemispheres 37,5%. The median interval between symptoms and diagnosis was 41 days and an average of 122 days (SD ± 181).
Conclusions: The delay in making the diagnosis of brain tumor and low diagnostic suspicion due to a multifactorial origin by nonspecific symptoms, shortness of patients in their early years to express symptoms, and parents and medical staff to detect.
Author Biographies
Amaranto Suárez, Instituto Nacional de Cancerología
Clínica de Oncología Pediátrica, Instituto Nacional de Cancerología, Bogotá D.C., Colombia
Milena Castellanos, Universidad de la Sabana
Departamento de Pediatría, Universidad de la Sabana, Chía, Cundinamarca, Colombia
Ana Simbaqueba, Universidad de la Sabana
Departamento de Pediatría, Universidad de la Sabana, Chía, Cundinamarca, Colombia
Óscar Gamboa, Instituto Nacional de Cancerología
Subdirección de Investigaciones y Salud Pública, Promoción y Prevención, Instituto Nacional de Cancerología, Bogotá D.C., Colombia
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