Childhood Brain Tumors

Types

Astrocytomas are the most common brain tumors seen in children. The cells have a star-like shape and can form on any part of the brain or spinal cord:

Cerebellar astrocytomas form in the lower back part of the brain and account for 15-25% of all brain tumors.

Low-grade astrocytomas may be located in the posterior fossa and can often be surgically removed without additional therapy.

Anaplastic astrocytomas (grade III) look abnormal and grow rapidly.

Glioblastoma multiforme (GMB) are grade IV tumors and are very aggressive.

Ependymomas account for 9% of all brain tumors and occur in the lining of the brain or develop along the spinal cord. These tumors are usually benign and grow very slowly.

Primitive neuroectodermal tumors are highly malignant and behave aggressively. They are most often found in the frontal, temporal or parietal lobes of the brain.

Choroid Plexus tumors are rare cancers of gland tissues that produce cerebrospinal fluid.

Atypical Teratoid-Rhabdoid tumors (ATRT) are highly aggressive tumors that occur mostly in very young children.

Symptoms

• Headache
• Vomiting
• Seizures
• Blurred vision and impaired speech
• Mood changes
• Poor coordination; difficulty with balance
• Weakness or tingling in the arms and legs
• Increased head circumference and bulging fontanel ("soft spot") in infants

Tests & Procedures

Brain Tumors are diagnosed by computerized tomography (CT scan), magnetic resonance imaging (MRI) and tissue examination. A CT scan will reveal brain abnormalities and an MRI will detect tumors beneath the bones of the skull. Microscopic examination of tumor tissue (biopsy) will identify cancer cells. A physician may order further tests using lumbar puncture, withdrawing bone marrow, biochemistry and a bone scan to see if the tumor has spread beyond the brain. At M. D. Anderson, sedation may be used for younger children who are unable to stay still for these tests.

Treatment

Treating a brain tumor requires a multidisciplinary approach, starting with surgery to remove the tumor and followed by chemotherapy and/or radiation therapy if necessary. Before surgery, children are often given steroids to reduce swelling in the brain and anticonvulsant medications to prevent seizures. Neurosurgeons (a specialist in childhood brain surgery) will remove as much of the tumor as possible and remove a tissue sample for analysis. They will also create a pathway for chemotherapy drugs and radiation.

Chemotherapy is the standard treatment for children under 3 because radiation therapy may affect the developing brain. Chemotherapy may be cancer-killing drugs taken daily, an injection into a blood vessel or muscle once a week or infusion through IV for several days at a time each month. For young children, chemotherapy is often used to eliminate or delay the need for radiation therapy.

Radiation therapy directs high-dose X-rays to kill the tumor cells and shrink the tumor. It is usually given daily for 6 - 8 weeks.

M.D. Anderson’s pediatric brain tumor team has expertise in treating complex brain tumors. The team consists of neurosurgeons, neurologists, radiation oncologists and other doctors who specialize in the type of treatment a child requires.

Clinical Trials for Pediatric Brain Tumors

The most innovative treatments for childhood are offered as part of clinical trials, which are closely monitored studies to test the safety and effectiveness of new treatments. Go to M. D. Anderson's list of current pediatric clinical trials to see if your child might be eligible.