Neuropediatrics 2025; 56(S 01): S1-S24
DOI: 10.1055/s-0045-1812127
Neurooncology

A Rare Complication on the Spot: Tumor-Associated Hemorrhages in Pediatric LGG

Authors

  • J. Großer

    1   Charité Universitätsmedizin Berlin, Klinik für Pädiatrie mit Schwerpunkt Neurologie, Berlin, Germany

  • B. Brigitte

    2   Universitätsklinikum Augsburg, Klinik für Diagnostische und Interventionelle Neuroradiologie, Augsburg, Germany

  • A. Koch

    3   Charité-Universitätsmedizin Berlin, Institut für Neuropathologie, Berlin, Germany

  • D. Capper

    3   Charité-Universitätsmedizin Berlin, Institut für Neuropathologie, Berlin, Germany

  • T. Thole-Kliesch

    4   Charité-Universitätsmedizin Berlin, Klinik für Pädiatrie mit Schwerpunkt Hämatologie und Onkologie, Berlin, Germany

  • I. Fernandes Arroteia

    4   Charité-Universitätsmedizin Berlin, Klinik für Pädiatrie mit Schwerpunkt Hämatologie und Onkologie, Berlin, Germany

  • D. Gorodezki

    5   Universitätsklinikum Tübingen, Abteilung für pädiatrische Hämatologie und Onkologie, Tübingen, Germany

  • M. Mynarek

    6   Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Pädiatrische Hämatologie und Onkologie, Hamburg, Germany

  • B. Bernbeck

    7   Westfälisches Kinderzentrum Klinikum Dortmund, Kinderonkologisches Zentrum, Dortmund, Germany

  • M. van Buiren

    8   Universitätsklinikum Freiburg, Zentrum für Kinderheilkunde und Jugendmedizin, Pädiatrische Hämatologie und Onkologie, Freiburg, Germany

  • J. Scheer-Preiss

    9   Städtisches klinikum Braunschweig, Zentrum für Kinder- und Jugendheilkunde, Braunschweig, Germany

  • C. Zinke

    10   Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Klinik und Poliklinik für Kinder- und Jugendmedizin, Dresden, Germany

  • O. Witt

    11   Universitätsklinikum Heidelberg, Deutsches Krebsforschungszentrum (DFKZ), Heidelberg, Germany

  • M. Karremann

    12   Universitätsmedizin Mannheim, Pädiatrische Hämatologie und Onkologie, Mannheim, Germany

  • S. Vieth

    13   Universitätsklinikum Schleswig-Holstein, Klinik für Kinderonkologie und rheumatologie, Kiel, Germany

  • A. Tigges

    14   Pädiatrische Hämatologie und Onkologie, Universitätsklinikum Münster, Münster, Germany

  • N. Jorch

    15   Evangelisches Klinikum Bethel, Klinik für Kinder- und Jugendmedizin, Bielefeld, Germany

  • P. Hernáiz Driever

    4   Charité-Universitätsmedizin Berlin, Klinik für Pädiatrie mit Schwerpunkt Hämatologie und Onkologie, Berlin, Germany
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    Background/Purpose: Tumor-associated hemorrhages are rare complications in pediatric low-grade glioma (pLGG). While pLGG generally presents excellent survival rates, intracranial bleedings correlate with high morbidity and mortality. Recent studies discuss potential molecular risk factors such as FGFR and PTPN11 mutations in the tumor. With the rise of targeted therapies that influence the underlying tumor-driving molecular patterns, the need to understand the relationship between this rare complication and molecular features grows. The German national registry HIT-LOGGIC for pLGG offers a platform of consultation to 60 pediatric oncology centers.

    Methods: Patient characteristics and course of the oncological disease are documented in the HIT-LOGGIC registry. We invited physicians of corresponding centers to report cases of tumor-associated hemorrhages based on existing data. Tumor pathology and molecular information, as well as MRI, were centrally reviewed.

    Results: We identified 30 patients from 15 centers. One patient was excluded from analysis due to intracranial hemorrhage during the neonatal period. Median age at diagnosis was 6 years, with four infants under the age of 24 months at onset. In 76.6% of the cohort, acute hemorrhage led to the diagnosis of the tumor. In all but one case, subsequent antitumoral therapy followed, foremost surgical intervention in 96%. Of the 22 of the 27 patients with distinct neuropathological diagnoses, pilocytic astrocytoma is reported as the most common entity. Sixty-one percent of cases with available molecular data show alterations of FGFR, compared to the estimated rate of 15% of FGFR mutations in all pLGG.

    Conclusion: This work presents the largest case series of tumor-associated intracranial hemorrhages in pLGG to date. FGFR seems to be an important risk factor. To verify the results discussed in this study and to remove recall bias, further prospective studies are necessary.


     

    No conflict of interest has been declared by the author(s).

    Publication History

    Article published online:
    26 September 2025

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