Surgical Outcomes of Posterior Fossa Tumors in Children and Adults in Douala (Cameroun): Résultats Chirurgicaux des Tumeurs de la Fosse Cérébrale Postérieure chez l’Enfant et l’Adulte à Douala (Cameroun)

Abstract

Introduction. Posterior fossa tumors are life-threatening because small lesions can rapidly cause brainstem compression and hydrocephalus. In high-income settings, progress in imaging, microsurgery, and adjuvant therapy has improved survival, but outcomes from neurosurgical units in Cameroon remain poorly described. The aim of this study was to characterize presentation, surgical management, and early outcomes of patients operated on for posterior fossa tumors at Laquintinie Hospital in Douala. Materials and methods. We conducted a two-year retrospective descriptive study (2022–2023) including all patients with radiologically confirmed posterior fossa tumors who underwent surgery with histopathological confirmation. Demographic, clinical, imaging, operative, and early postoperative data were collected from records. Management of hydrocephalus, surgical approaches, histological type, complications, access to adjuvant treatment, and early mortality were described. Results. Ten patients were included (sex ratio 2.34, mean age 15.3 years), with a predominance of children. Raised intracranial pressure was the main presentation (9/10). Hydrocephalus required endoscopic third ventriculostomy or ventriculoperitoneal shunting in six patients, followed by suboccipital craniectomy tailored to tumor location. Histology showed pilocytic astrocytoma in six cases, ependymoma in two, medulloblastoma in one, and cerebellopontine angle arachnoid cyst in one. Three patients died: one from postoperative meningitis and septicemia and two from tumor recurrence without timely radiochemotherapy. Conclusion. Posterior fossa tumor surgery is feasible in our setting with acceptable short-term results, but infectious complications and limited access to adjuvant oncological treatment remain critical barriers to improved survival.