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)