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A brain tumor is a group (mass) of abnormal cells that start in the brain.
This article focuses on primary brain tumors in children.
Glioblastoma multiforme - children; Ependymoma - children; Glioma - children; Astrocytoma - children; Medulloblastoma - children; Neuroglioma - children; Oligodendroglioma - children; Meningioma - children; Cancer - brain tumor (children)
The cause of primary brain tumors is unknown. Primary brain tumors may be:
Brain tumors are classified depending on:
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 tumors are more common at a certain age. However, most brain tumors are rare in the first year of life.
COMMON 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 at which they develop is about 6 years old. The tumor may grow very large before causing symptoms.
Ependymomas 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 age 10.
Symptoms may be subtle and only gradually become worse, or they may occur very quickly.
Headaches are probably the most common symptom. Patterns that may occur with brain tumors include:
Patients with brain tumors may have a seizure. This may be the first symptom or sign.
Sometimes the only symptoms of brain tumors are mental changes, which may include:
Other possible symptoms are:
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:
Early treatment often improves the chance of a good outcome. Treatment depends on the size and type of tumor and the child's general health.
The following are treatments for specific types of tumors:
The goals of treatment may be to cure the tumor, relieve symptoms, and improve brain function or the child's comfort.
Surgery is needed 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 without completely removing it.
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 the family cope with the disorder.
For additional information, see cancer resources.
How well the child does depends on many things, including the exact type of tumor. About 3 out of 4 children survive at least 5 years after being diagnosed.
Long-term brain and nervous system problems may result from the tumor itself, or from treatment. Children may have problems with attention and concentration, memory, processing information, planning, insight, initiative or desire to do things, and the ability to stay organized and on-task. Children younger than age 7 (and especially those younger than age 3) appear to have the greatest risk for these problems.
Parents need to make sure that children receive needed support services at home and school.
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.
Buckner JC, Brown PD, O'Neill BP, Meyer FB, Wetmore CJ, Uhm JH. Central nervous system tumors. Mayo Clin Proc. 2007;82(10):1271-1286.
National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Central nervous system cancers. V.2.2009.
Wilne S, Koller K, Collier J, Kennedy C, Grundy R, Walker D. The diagnosis of brain tumours in children: a guideline to assist healthcare professionals in the assessment of children who may have a brain tumour. Arch Dis Child. 2010;95:534-539.