Background: Adult brainstem gliomas, in contrast to pediatric brainstem gliomas, are uncommon and typically less invasive. Adult and pediatric brainstem gliomas differ noticeably in a few key ways that have a big impact on how they’re treated and how they do. In a small series of brainstem gliomas with confirmed histology, the aim of this study was to compare the clinicohistopathological, neuroradiological, and molecular markers across these two age groups.

Method: Retrospective analysis was performed on individuals with brainstem gliomas that had been histologically confirmed between 2020 and 2022. Data on a disease’s clinical progression, neuroradiological results, molecular biomarkers, and histological findings were examined.

Results: Ages from two to sixty were represented (median 30 years). Children had a female to male ratio of 1.1:1, while adults had a ratio of 2.5:1. Ataxia (52.9%) and headache (52.4%) were the two most prevalent presenting symptoms in children and adults, respectively. Adults experienced ocular problems more frequently than children (p=0.067). A greater percentage of children developed diffuse and hyperintense masses involving the pons on the post-contrast T1 weighted MRI (52.9 percent versus 17.4 percent). The most frequent type of astrocytoma, grade III, made up 69.1 % of the tumors according to histology. Adults had much higher expression of the BSGs MGMT promoter than children (p=0.003). The gross complete resection was achieved in 68.8 % of adults, compared to 43 % in pediatric patients, with the exception of just one patient who passed away before to surgery.

Conclusion: Adult and pediatric brainstem gliomas may differ clinically, radiologically, and molecularly, and these changes in tumor biology may be the cause. The bulk of the tumors were grade III astrocytomas, and there was no discernible difference between the two groups according to the histological analysis. Children still frequently develop diffuse tumors as infiltrative lesions. The expression of the BSGs MGMT promoter in adults was substantially higher than in children (p=0.003). We recommend comprehensive complete resection for resectable cancers since it is linked to a good result.

Keywords: Brainstem, Glioma, Pediatrics, Adults, Histopathology, Molecular