Malignant transformation of low-grade glioma
In children, the most common benign tumors in the central nervous system are called LGGs. Unlike LGGs in adults, LGGs in children progress to malignancy, with an incidence rate of up to 10%. This transformation can sometimes occur even without adjuvant radiation therapy.
There have been two cases reported in India where LGGs in children transformed into malignant tumors. In one case, a 7-year-old girl had a tumor in the left temporal region, which was initially diagnosed as a benign pilocytic astrocytoma (WHO grade I). However, after eight years, the tumor transformed into a malignant form. In the second case, a 10-year-old boy had a tumor in the left frontoparietal region, initially diagnosed as a benign ganglioglioma (WHO grade I). After 10 months, the tumor progressed into a more severe form called anaplastic ganglioglioma (WHO grade III).(27)
These cases, along with other studies on the genetic factors involved in the malignant transformation of LGGs in children, highlight the need to identify patients at risk of transformation early on. This will allow for a more aggressive treatment approach to be taken. A study published in 2020 emphasized the limited treatment options for high-grade pediatric gliomas and the potential harmful effects of radiotherapy in children. Therefore, regular screening and follow-up are crucial in preventing the transformation of LGGs in children.(24)