Brain tumor - children
Glioblastoma multiforme - children; Ependymoma - children; Glioma - children; Astrocytoma - children; Medulloblastoma - children; Neuroglioma - children; Oligodendroglioma - children; Meningioma - children; Cancer - brain tumor (children)Overview
A primary brain tumor is a group (mass) of abnormal cells that start in the brain. This article focuses on primary brain tumors in children.
Review Date: 12/27/2009
Reviewed By: Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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The cause of primary brain tumors is unknown. Primary brain tumors may be:
Brain tumors are classified depending on the exact site of the tumor, the type of tissue involved, and whether or not it is cancerous. Brain tumors can directly destroy brain cells. They may also indirectly damage cells by pushing on other parts of the brain. This leads to swelling and increased pressure within the skull.
Tumors may occur at any age, but many specific tumors are more common at a certain age. However, most brain tumors are rare in the first year of life. Some of the most common childhood brain tumors include:
SPECIFIC TUMOR TYPES
Astrocytomas are usually noncancerous, slow-growing cysts. They most commonly develop in children ages 5 - 8.
Brainstem gliomas occur almost only in children. The average age of development is about 6 years old. The tumor may grow very large before triggering symptoms.
Ependymomas make up about 8 - 10% of pediatric brain tumors. The tumors are located in tiny passageways (ventricles) in the brain, and block the flow of cerebrospinal fluid (CSF).
Medulloblastomas are the most common type of childhood brain cancer. They occur more often in boys than girls, usually around age 5. Most medulloblastomas occur before the age of 10.
Symptoms may be subtle and only gradually become worse, or they may occur very quickly.
Headache is probably the most common symptom. Headache symptoms that may occur with brain tumors include:
Patients with brain tumors may have a seizure.
Sometimes the only symptoms of brain tumors are mental changes, which may include:
Other possible symptoms are:
Call a health care provider if a child develops persistent headaches or other symptoms of a brain tumor.
Go to the emergency room if a child has a seizure that is unusual or suddenly develops stupor (reduced alertness), vision changes, or speech changes.
Early treatment often improves the chance of a good outcome. Treatment, however, depends on the size and type of tumor and the general health of the child.
The following are treatments for specific types of tumors:
Astrocytoma -- The main treatment is surgery to remove the tumor.
Brainstem gliomas -- Surgery is usually not possible because of the tumor's location in the brain. Radiation and chemotherapy are used to shrink the tumor and prolong life.
Ependymomas -- Treatment may include surgery, radiation therapy, and chemotherapy.
Medulloblastomas -- Surgery alone does not cure this type of cancer. Chemotherapy and radiation are often used in combination with surgery.
The goals of treatment may be to cure the tumor, relieve symptoms, and improve brain function or the child's comfort.
Surgery is necessary for most primary brain tumors. Some tumors may be completely removed. Those that are deep inside the brain or that enter brain tissue may be debulked instead of entirely removed. Debulking is a procedure to reduce the tumor's size.
In cases where the tumor cannot be removed, surgery may help reduce pressure and relieve symptoms.
Radiation therapy and chemotherapy may be used for certain tumors.
Other medications used to treat primary brain tumors in children include:
Comfort measures, safety measures, physical therapy, occupational therapy, and other such steps may be required to improve quality of life. Counseling, support groups, and similar measures may be needed to help in coping with the disorder.
About 3 out of 4 children survive at least 5 years after being diagnosed with a brain tumor.
Long-term brain and nervous system problems may result from the tumor itself, or from treatment.
Parents need to make sure that children receive needed support services at home and school.
The health care provider will perform a physical exam. Infants may have the following physical signs:
The following tests may be used to detect a brain tumor and identify its location: