 Tectal Glioma
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A tectal glioma is low-grade tumor arising from a type of cell of the central nervous system known as a glial cell. These tumors originate from a specific type of glial cell known as an astrocyte. Astrocytes make up a supportive structure of the brain and spinal column. They are named for their star-like appearance.
Tectal gliomas are classified as grade I pilocytic astrocytomas or grade II fibrillary astrocytomas. They arise from the tectum or roof of the brain stem (the section of the brain that controls vital functions of the body such as respiration, heart rate and blood pressure). Most children with tectal gliomas are between the ages of 3 and 16 years.
As you read further below, you will find general information about tectal gliomas. If you would like to view summary information about brain tumors first, see the overview on brain tumors.
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Medical research has not identified a genetic cause of this tumor. Tectal gliomas appear to develop spontaneously, meaning there is no identifiable cause.
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Due to the relatively slow growth rate of these tumors, children tend to present to the doctor with symptoms that have been occurring for many months. Some children, however, will have a more sudden onset of symptoms. The following are the most common symptoms of a tectal glioma, however each child may experience symptoms differently. Common symptoms may include:
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- Most present with symptoms of increased pressure within the brain. These symptoms include:
- headache (generally upon awakening in the morning)
- others may experience abnormal eye movements and gait
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The symptoms of a brain tumor may resemble other conditions or medical problems. Always consult your child's physician for a diagnosis.
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Diagnostic procedures for tectal glioma may include:
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- physical examination - the child may demonstrate evidence of increased pressure in the brain
- computerized tomography scan (also called a CT or CAT scan) - a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. CT scans are more detailed than general x-rays. For tectal glioma, a CT scan of the brain is usually done.
- magnetic resonance imaging (MRI) - a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body. For tectal glioma, MRIs of the brain and spine are usually done.
- biopsy - a tissue sample from the tumor will be taken through a needle during a simple surgical procedure performed by a surgeon to confirm the diagnosis
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Specific treatment for a tectal glioma will be determined by your child's physician based on:
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- your child's age, overall health, and medical history
- type, location, and size of the tumor
- extent of the disease
- your child's tolerance for specific medications, procedures, or therapies
- how your child's doctors expect the disease to progress
- your opinion or preference
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Due to the very delicate structures surrounding the tectum, surgical removal of the tumor is limited. Management of increased pressure within the brain is often accomplished by surgically inserting a device (a shunt) or by a third ventriculoscopy (the endoscopic creation of a pathway for cerebral spinal fluid to drain into the third ventricle) to drain excess fluid accumulating within the brain.
The use of chemotherapy and/or radiation therapy is generally not indicated. Children with tectal gliomas are followed for evidence of progressive disease through frequent MRI scanning (approximately every 3 months initially).
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Children with a tectal glioma may have side effects related to the tumor itself and its treatment. Symptoms at the time of diagnosis related to increased pressure within the brain, such as headache, vomiting and lethargy, and/or from compression of the nerves that control movement of the extremities, are often relieved by creating a pathway to drain the fluid within the brain (cerebral spinal fluid) through such procedures as surgical placement of a shunt or third ventriculoscopy. Dexamethasone, an oral steroid, may be prescribed to assist in controlling symptoms of increased pressure within the brain.
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Tectal gliomas are associated with a high rate of cure. Many children will demonstrate an increase in tumor size by MRI, however most will remain asymptomatic and not require further treatment other than serial MRI scanning.
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There is no standard recommended treatment for progressive/recurrent tectal gliomas. Dana-Farber Cancer Institute is one of nine institutes in the nation belonging to the Pediatric Brain Tumor Consortium. The consortium is dedicated to the development of new and innovative treatments for children with progressive/recurrent brain tumors not responsive to standard therapies. Children with progressive/recurrent tectal gliomas would be eligible for a number of experimental therapies available through the consortium.
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Children's Hospital and Dana-Farber Cancer Institute are conducting numerous research studies that will help clinicians better understand and treat tectal glioma. For more information on current research, see the Brain Tumor Program.
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