A brain tumor occurs when there is a genetic alteration in the normal cells in the brain. The alteration causes the cells to undergo a series of changes that result in a growing mass of abnormal cells. Primary brain tumors involve a growth that starts in the brain, rather than spreading to the brain from another part of the body.
Brain tumors may be low grade (less aggressive) or high grade (very aggressive). The cause of primary brain tumors is unknown, although some tumors have germ line mutations and tend to be hereditary. The majority result from somatic mutations and are not hereditary.
Central nervous system tumors (tumors of the brain and spine) are the most common solid tumor in children. There are approximately 4,500 new brain tumors each year, and they are the most common cause of cancer deaths.
Signs and symptoms of a brain tumor in children vary greatly and depend on the brain tumor type, size, location and rate of growth. Some signs and symptoms may not be easy to detect because they're similar to symptoms of other conditions.
What are the signs of a brain tumor in a child?
Some of the more common symptoms include:
Other possible signs and symptoms, depending on the tumor location, include:
Low-grade gliomas are brain tumors that originate from glial cells, which support and nourish neurons in the brain. Glial tumors, or gliomas are divided into four grades, depending on their cells' appearance under a microscope. Grade 1 and 2 gliomas are considered low-grade and account for about two-thirds of all pediatric tumors.
In addition to their grade, low-grade gliomas are also classified based on their location and by the kind of glial cell – astrocytes, oligodendrocytes or ependymocytes – from which they arise.
Glioblastoma Multiformes (GBMs) are high-grade gliomas that arise from the brain’s supportive tissue, known as glial cells. These are aggressive tumors that rapidly infiltrate adjacent healthy brain tissue and, as a result, are difficult to treat.
The majority of GBMs, roughly 65%, occur in the cerebral hemispheres, which control higher functions like speech, movement, thought and sensation. They can also develop in the part of the brain that identifies sensations such as temperature, pain and touch and the region of the brain that controls balance and motor function.
These tumors are usually diagnosed between the ages of 5 and 9, and occur in boys and girls equally. GBMs occur with increased frequency in children with certain genetic syndromes, including neurofibromatosis 1, Li-Fraumeni syndrome, hereditary nonpolyposis colon cancer and tuberous sclerosis. Most GBMs, however, have no known cause.
Surgery is usually the first step in treating brain tumors in children.
Certain types of brain tumors located near the bottom of the skull, also called skull-base tumors, can be removed through the nose using tools called endoscopes. Because the base of the skull is close to the nostrils and roof of the mouth, your child’s surgeon can access the tumor more easily and safely with endoscopic endonasal surgery by going through the nostrils, minimizing the need for more invasive procedures.
Surgery is also performed for a biopsy — a sample of tissue taken to examine the types of cells found in the tumor. This helps establish a diagnosis and treatment plan. This is frequently done when the tumor is surrounded by sensitive structures that may be damaged by surgical removal.
Other therapies used to treat brain tumors include:
Effects of Treatments
Late effects are problems that patients can develop after cancer treatments have ended. For survivors of pediatric brain tumors, late effects may include cognitive delay (problems with learning and thinking), seizures, growth abnormalities, hormone deficiencies, vision and hearing problems, and the possibility of developing a second cancer, including a second brain tumor.
Because these problems sometimes don't become apparent until years after treatment, careful observation and medical follow-up are needed to watch for them.
In some cases, short-term effects might improve with the help of physical, occupational, or speech therapy and may continue to improve as the brain heals.
In other cases, kids may have side effects that last longer, including learning disabilities; medical problems such as diabetes, delayed growth, or delayed or early puberty; physical disabilities related to movement, speech, or swallowing; and emotional problems linked to the stresses of diagnosis and treatment. Some of these problems may become more severe over time.
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