Epidemiology of Neonatal Brain Tumors and Their Incidence

Neonatal brain tumors (NBTs) are a rare but critical concern in the field of pediatric oncology, with an incidence rate of approximately 1 in 10,000 live births (Al Shoufy et al., 2025). These tumors generally occur within the first 28 days of life, distinguishing them from brain tumors that manifest later in childhood. While the overall incidence is low, NBTs can significantly impact the infant’s development and quality of life. The most prevalent types of NBTs include teratomas and gliomas, which exhibit unique histological features compared to tumors observed in older children (Al Shoufy et al., 2025).

Recent studies suggest that the incidence of NBTs may be influenced by environmental carcinogens and genetic factors, indicating a multifactorial etiology. For instance, maternal exposure to certain chemicals during pregnancy has been linked to a higher risk of brain tumors in neonates. Understanding these epidemiological factors is essential for developing preventive strategies and interventions that can mitigate risk.

Classification of Neonatal Brain Tumors: Types and Characteristics

Neonatal brain tumors can be classified into several categories based on their histological characteristics and cell of origin. The primary types include:

Teratomas: These tumors are composed of multiple tissue types and may contain hair, muscle, and other structures. Teratomas are most often found in the sacrococcygeal region but can appear in the head and neck area as well.
Gliomas: These tumors arise from glial cells and include various subtypes, such as astrocytomas and oligodendrogliomas. Gliomas can present with a range of symptoms depending on their location and growth rate.
Medulloblastomas: Although more common in older children, rare cases have been documented in neonates. These tumors are highly aggressive and can metastasize quickly.
Neuroblastomas: While primarily a tumor of the sympathetic nervous system, neuroblastomas can occasionally present with central nervous system involvement.

Each type of tumor presents its own unique challenges in terms of diagnosis and management, necessitating a tailored approach to treatment.

Clinical Features and Diagnosis of Neonatal Brain Tumors

The clinical presentation of NBTs often includes non-specific symptoms, making early diagnosis challenging. Common signs may include:

Macrocephaly: Increased head size is a notable indicator, often associated with increased intracranial pressure.
Hydrocephalus: Accumulation of cerebrospinal fluid (CSF) can lead to swelling and is frequently observed in infants with brain tumors.
Neurological Deficits: These may include seizures, developmental delays, and abnormal reflexes.
Feeding Difficulties: Infants may exhibit poor feeding due to increased intracranial pressure or associated neurological issues.

Diagnosis typically involves a combination of imaging techniques, including ultrasound, MRI, and sometimes CT scans. Ultrasound is often the first-line imaging modality due to its safety and accessibility in neonatal patients. MRI provides detailed anatomical information and can help evaluate the extent of the tumor and its effect on surrounding structures.

Table 1: Common Clinical Features of Neonatal Brain Tumors

Clinical Feature	Description
Macrocephaly	Enlarged head size due to increased intracranial pressure
Hydrocephalus	Accumulation of CSF leading to ventricular dilation
Neurological Deficits	Seizures and developmental delays may occur
Feeding Difficulties	Poor feeding habits linked to neurological impairments

Treatment Options for Neonatal Brain Tumors: Surgery and Beyond

The management of NBTs is particularly complex due to the vulnerability of neonates. Surgical intervention remains the cornerstone of treatment, with the goal of complete tumor resection whenever feasible. The potential complications and risks associated with surgery necessitate a careful assessment of the benefits versus risks for each individual case.

Surgery: This is the primary treatment modality for NBTs. The extent of the resection can significantly influence prognosis. In cases where complete resection is not possible, debulking procedures may be performed to alleviate symptoms caused by mass effect.
Chemotherapy: The use of chemotherapy in neonates is controversial due to the potential for toxicity and long-term developmental effects. However, certain protocols may be utilized, particularly for aggressive tumors such as medulloblastomas.
Radiotherapy: While traditionally used in older children and adults, the use of radiotherapy in neonates is limited due to the risks of radiation-induced damage to developing tissues. It may be considered in select cases where the tumor is not amenable to surgery.
Supportive Care: Management of symptoms, including hydrocephalus, may require the placement of a ventriculoperitoneal shunt to manage CSF drainage.

Risk Factors Associated with Neonatal Brain Tumor Development

Several risk factors have been identified in the development of NBTs, which include:

Genetic Predispositions: Certain genetic syndromes, such as neurofibromatosis and Li-Fraumeni syndrome, have been associated with an increased risk of brain tumors.
Environmental Exposures: Maternal exposure to teratogens, such as radiation or certain chemicals during pregnancy, may increase the likelihood of developing brain tumors in neonates.
Infections: Some studies have suggested that prenatal infections may play a role in tumorigenesis.

Table 2: Potential Risk Factors for Neonatal Brain Tumors

Risk Factor	Description
Genetic Predispositions	Conditions like neurofibromatosis increase susceptibility
Environmental Exposures	Maternal exposure to harmful substances during pregnancy
Infections	Prenatal infections that could affect fetal development

Frequently Asked Questions (FAQ)

What are the common types of neonatal brain tumors?
The most common types include teratomas, gliomas, medulloblastomas, and neuroblastomas.

How are neonatal brain tumors diagnosed?
Diagnosis typically involves imaging techniques like ultrasound, MRI, and CT scans, alongside clinical evaluations.

What are the treatment options for neonatal brain tumors?
Treatment options primarily include surgery, chemotherapy, radiotherapy, and supportive care.

What risk factors are associated with neonatal brain tumors?
Risk factors include genetic predispositions, environmental exposures during pregnancy, and certain infections.

What is the prognosis for infants diagnosed with neonatal brain tumors?
Prognosis varies significantly based on tumor type, location, and treatment response, making early diagnosis and intervention critical.

References

Al Shoufy, M., Kafa, G., Ibrahim, B., Ibrahem, H., Dakour, A., Haidar, A., & Alshehabi, Z. (2025). Exploring neonatal brain tumors: a narrative review about epidemiology, classification, and management. Annals of Medicine and Surgery, 26, 38-45. DOI: 10.1097/MS9.0000000000003229.
Zhang, Z., & Wang, X. (2025). The neural mechanism and pathways underlying postoperative nausea and vomiting: a comprehensive review. European Journal of Medical Research, 17(6). DOI: 10.1186/s40001-025-02632-1.
Zhong, M., Pan, G., Tan, J., Yao, J., Liu, Y., Huang, J., Jiang, Y., Zhu, D., & Zhao, J. (2025). Venetoclax confers synthetic lethality to chidamide in preclinical models with transformed follicular lymphoma. Clinical Epigenetics, 18(6). DOI: 10.1186/s13148-025-01878-0.
Berezna, T., Synoverska, O., Fomenko, N., Pylyuk, I., Lazurkevych, K., Bedei, V., & Kotyk, T. (2025). Fatal pediatric case of Kounis syndrome and sepsis: a case report. International Journal of Emergency Medicine, 26(3). DOI: 10.1186/s12245-025-00886-4.