Lily Goumnerova, MD, FRCSC

Liliana C. Goumnerova, MD, FRCSC

Director, Pediatric Neurosurgical Oncology Dana Farber/Boston Children’s Hospital Cancer Center; Director, QI Program Department of Neurosurgery

Associate Professor Neurosurgery, Harvard Medical School

"What motivates me personally as a neurosurgeon is seeing my patients thriving 10 or 15 years down the road."

Medical Services

Specialties

  • Arachnoid Cysts
  • Brain Tumors
  • Chiari Malformations
  • Craniopharyngioma
  • Endoscopic Third Ventriculostomy
  • Ependymoma
  • Endoscopy
  • Glioma
  • Neurosurgery
  • Hematology Oncology
  • Hydrocephalus
  • Minimally Invasive Surgery
  • Medulloblastoma
  • Spinal Cord Tumors
  • Tethered Spinal Cord

Departments

  • Neurosurgery
  • Hematology / Oncology

Languages

  • English

Programs

  • Brain Tumor Center
  • Neurosurgical Service
To schedule an appointment: Call 617-355-6008 or Request an Appointment
Lily Goumnerova, MD, FRCSC

Growing up as the child of a Bulgarian diplomat during the Cold War, I was raised all over the world and was taught to value education and independence.  

I thought I might want to be an architect because I loved tinkering and working with my hands, but gravitated toward medicine because I couldn't draw and enjoyed science.

When I left Bulgaria for medical school in 1977, I could not return to my home country for a long time. I really love what I do -- and I have to, because neurosurgery was not an easy field to break into as a young woman in the 1980s. I value my relationships with mentors who have helped to show me that I am a neurosurgeon first, regardless of gender.

What motivates me personally as a neurosurgeon who operates primarily on children with brain tumors is seeing my patients thriving 10 or 15 years down the road. I value developing long-term relationships with my patients, and am involved in their follow up care for years.

I also pride myself on the open-minded outlook that I gained from living in Brazil, Sri Lanka and Italy as a child and making a critical decision at a young age to move abroad. I thrive on working with the many international patients who choose Boston Children's Hospital, as well as developing a twinning fellowship program in neuro-oncology and pediatric neurosurgery in Cairo, Egypt (Children’s Cancer Hospital Egypt 57357).

Experience and Education

Education

Undergraduate

Medical Academy, 1977

Sofia, Bulgaria

Medical School

University of Toronto Faculty of Medicine, 1980

Toronto, Canada

Internship

Saint Joseph's Health Centre, 1980-1981

Toronto, Canada

Residency

Neurosurgery-University of Ottawa, 1981-1986

Ottawa, Canada

Fellowship

Pediatric Neurosurgery-Hospital for Sick Children, 1987-1988

Toronto, Canada

Fellowship

Neuroscience Research-David Mahoney Institute of Neuroscience, University of Pennsylvania, 1988-1990

Philadelphia, Pennsylvania

Certifications

  • ABNS - American Board of Neurological Surgery

  • ABPNS - American Board of Pediatric Neurological Surgery

  • Neurology (FRCSC)

  • Neurological Surgery

  • Pediatric Neurological Surgery

Research

My research has contributed to a new understanding of the biology of medulloblastomas, a common form of brain tumors found in children.

Through basic molecular science, colleagues and I have documented the processes that lead to medulloblastoma formation, how they can be differentiated into subtypes and how outcomes can be predicted once a type is known. We identified a neurotrophin, Trkb, as a predictor of outcome. I have studied developmentally regulated genes in cerebellar development and their potential role in medulloblastoma, specifically shh, gli and ptc.

This work has led to the creation of assays for gene expression and allows us to predict the outcome of embryonal tumors in children. These models have been incorporated into therapeutic protocols conducted by the national cancer cooperative, the Boston Children's Oncology Group.

I am involved in several other investigations, both clinical and basic, into different aspects of brain tumor tumorigenesis and treatment. We are studying the long-term effects of our therapies on survivors of pediatric brain tumors. I am a principal investigator looking at the milieu of astrocytoma cells, and its role in tumorigenesis. And I am interested in stereotactic radiosurgery in brain tumors, looking at its effect as adjuvant and upfront therapy.

My research has led to many important publications that shaped this understanding and have paved the way for new outcomes predictors and potential treatments. These include:

Goumnerova L, Richard MT, Addison D, Montpetit V, Stewart DJ. Intracarotid infusion of PCNU (NSC 95466): Preclinical toxicological study in dogs. J Neurooncol 1987 5(3):205-9 PMID 3681384

Segal RA, Goumnerova LC, Kwon YK, Stiles CD, Pomeroy SL. Expression of the neurotrophin receptor TrkC is linked to a favorable outcome in medulloblastoma. Proc Natl Acad Sci U S A. 1994 91(26):12867-71 PMID 7809137

Goumnerova LC, Segal RA, Kwon YK, Stiles CD, Pomeroy SL. Coordinate expression of neurotrophin-3 and trk C linked to a more favorable prognosis in medulloblastoma. J Neurooncol 1995 24:136

Goumnerova LC, Frim DM. Treatment of hydrocephalus with third ventriculocisternostomy: outcome and CSF flow patterns. Pediatr Neurosurg 1997 27(3):149-52 PMID 9548525

Poussaint TY, Kowal JR, Barnes PD, Zurakowski D, Anthony DC, Goumnerova L, Tarbell NJ. Tectal tumors of childhood: clinical and imaging follow-up. AJNR Am J Neuroradiol 1998 19 (5):977-83 PMID 9613524

Kim JY, Sutton ME, Lu DJ, Cho TA, Goumnerova LC, Goritchenko L, Kaufman JR, Lam KK, Billet AL, Tarbell NJ, Wu J, Allen JC, Stiles CD, Segal RA, Pomeroy SL. Activation of neurotrophin-3 receptor TrkC induces apoptosis in medulloblastomas. Cancer Res 1999 59 (3):711-9 PMID 9973222

Yamini B, Goumnerova LC, Frim DM. Endoscopic approach to noncommunicating fluid spaces in the shunted patient. Pediatr Neurosurg 1999 31(5):237-41 PMID 10681677

Frim DM, Goumnerova LC. In vivo intracranial pressure dynamics in patients with hydrocephalus treated by shunt placement. J Neurosurg 2000 92(6): 927-32 PMID 10839251

Pomeroy SL, Tamayo P, Gaasenbeek M, Sturla LM, Angelo M, McLaughlin ME, Kim JY, Goumnerova LC, Black PM, Lau C, Allen JC, Zagzag D, Olson JM, Curran T, Wetmore C, Biegel JA, Poggio T, Mukherjee S, Rifkin R, Califano A, Stolovitzky G, Louis DN, Mesirov JP, Lander ES, Golub TR. Prediction of central nervous system embryonal tumour outcome based on gene expression. Nature 2002 415(6870):436-42 PMID 11807556

Kim JY, Nelson AL, Algon SA, Graves O, Sturla LM, Goumnerova LC, Rowitch DH, Segal RA, Pomeroy SL. Medulloblastoma tumorigenesis diverges from cerebellar granule cell differentiation in patched heterozygous mice. Dev Biol 2003 263(1):50-66 PMID 14568546

Klimo P Jr, Goumnerova LC. Endoscopic third ventriculocisternostomy for brainstem tumors. J Neurosurg 2006 105(4 Suppl):271-4 PMID 17328276

Ahn ES, Goumnerova L. Endoscopic biopsy of brain tumors in children: Diagnostic success and utility in guiding treatment strategies. J Neurosurg Pediatr. 2010 5(3):255-62 PMID 20192642

Cho YJ, Tsherniak A, Tamayo P, Santagata S, Ligon A, Greulich H, Berhoukim R, Amani V, Goumnerova L, Eberhart CG, Lau CC, Olson JM, Gilbertson RJ, Gajjar A, Delattre O, Kool M, Ligon  K, Meyerson M, Mesirov JP, Pomeroy SL. Integrative genomic analysis of medulloblastoma identifies a molecular subgroup that drives poor clinical outcome. J Clin Oncol 2011 29(11):1424-30 Epub 2010 Nov 22 PMID 21098324

Maher CO, Goumnerova L. The effectiveness of ventriculocystocisternostomy for suprasellar arachnoid cysts. J Neurosurg Pediatr 2011 7(1): 64-72.

Ramkissoon LA, Horowitz PM, Craig JM, Ramkissoon SH, Rich BE, Schumacher SE, McKenna A, Lawrence MS, Bergthold G, Brastianos PK, Tabak B, Ducar MD, Van Hummelen P, MacConnaill LE, Poussaint-Young T, Cho YJ, Taha, H, Mahmoud M, Bowers DC, Margraf L, Tabori U, Hawkins C, Packer RJ, Hill DA, Pomeroy SL, Eberhart CG, Dunn IF, Goumnerova L, Getz G, Chan JA, Santagata S, Hahn WC, Stiles CD, Ligon AH, Kieran MW, Beroukhim R, Ligon KL. Genomic analysis of diffuse

pediatric low-grade gliomas identifies recurrent oncogenic truncating rearrangements in the transcription factor MYBL1. Proc Natl Acad Sci USA 2013 110(20):8188-93 PMID: 23633565

Kim AH, Thompson EA, Governale L, Santa C, Cahill K, Kieran MW, Chi SN, Ullrich NJ, Scott RM, Goumnerova LC. Recurrence after gross total resection of low-grade pediatric brain tumors: The frequency and timing of postoperative imaging. J Neurosurg Pediatr 2014 14(4):356-64, Epub 2014 Jul 25 PMID 25962303

Jernigan SC, Berry JG, Graham DA, Goumnerova L. The comparative effectiveness of ventricular shunt placement versus endoscopic third ventriculostomy for initial treatment of hydrocephalus in infants. J Neurosurg Pediatr 2014 13(3):295-300 PMID 24404970

Fontebasso AM, Papillon-Cavanagh S, Schwartzentruber J, Nikhbakht H, Gerges N, Fiset PO, Bechet D, Faury D, De Jay N, Jones DTW, Sturm D, Johann P, Tomita T, Goldman S, Nagib M, Bendel A, Goumnerova L, Bowers D, Leonard JR, Rubin JB, Alden T, Browd S, Geyer JR, Jallo G, Cohen K, Gupta N, Prados MD, Carret AS, Ellezam B, Klekner A, Bognar L, Hauser P, Garami M, Myseros J, Ligon A, Albrecht S, Pfister SM, Ligon KL, Majewski J, Jabado N, Kieran MW.Recurrent somatic mutations in ACVR1 in pediatric midline high-grade astrocytoma. Nat Genetics 2014 46(5):462-6. Epub 2014 Apr 6 PMID 24705250

Roguski M, Martello G, McClain C, Soriano S, Rockoff M, Kieran MW, Chi SN, Manley PE, Ullrich NJ, Marcus KJC, Proctor M, Smith ER, Madsen J, Warf BC, Scott RM, Goumnerova LC. Predictors of gross total resection in patients with pediatric low grade glial and glioneuronal tumors undergoing intraoperative MRI-assisted resection: a clinical study. Submitted J Neurosurg Pediatr 2015.

Phoenix TN, Patmore DM, Boop S, Boulos N, Jacus MO, Patel YT, Rouseel MF, Mourface M, Goumnerova L, Perreault S, Wadhwa E, Cho Y-J, Stewart CF, Gilbertson RJ. Medulloblastoma genotype dictates blood brain barrier phenotype. Submitted Nature 2015.

Bandopadhayay P, Ramkissoon L, Bergthold G, Jain P, Wala J, Schumacher S, Urbanski L, O’Rourke R, Zeid R, Gibson W, Pelton K, Ramkissoon S, Kang YJ, Knoff D, Paolella B, Gladden-Young A, Varlet P, Pages M, Horowitz P, Federation A, Malkin H, Tracy A, Seepo S, Ducar M, VanHummelen P, Bowers D, Giannini C, Varlet A, Puget S, Hawkins C, Klekner A, Bognar L, Eberhart C, Rodriguez F, Hill A, Santagata S, Stiles C, Bradner J, Jabado N, Goren A, Grill J, Ligon A, Goumnerova L, Kieran M, Ligon K, Beroukhim R, Resnick A. The MYB-QK1 rearrangement in angiocentric glioma drives tumorigenicity through a tripartite mechanism. Submitted Nature Genetics 2015

Professional History

I am a pediatric neurosurgeon committed to the best possible outcomes for children with brain tumors at Boston Children's Hospital, Dana-Farber Cancer Institute and through my efforts to raise standards of care here and abroad.

I completed my residency at the University of Ottawa, in Canada, and was a fellow in pediatric neurosurgery at the Hospital for Sick Children in Toronto and in Neuroscience at the University of Pennsylvania. My joint training in both neurosurgery and basic neuroscience has helped me to treat patients at the highest level and conduct research that is forging new ground in our understanding of brain cancer biology.

I am a director of the combined program in pediatric neurosurgical oncology at Dana-Farber/Boston Children's Cancer and Blood Disorders Center. I co-direct Boston Children's Hospital's Brain Tumor program, a multidisciplinary program that is a model nationwide and that I helped to establish.

Since 1992, I have been in charge of the Neurosurgery Department's Quality Improvement program. I have developed an outcomes database for the Department of Neurosurgery and am working on standardizing outcome measures in our field. My work in this area aims to establish national outcomes measures for pediatric neurosurgical procedures for the first time. Boston Children's Hospital's industry-leading intraoperative MRI technology has contributed to this effort, allowing me to see whether we are accomplishing our goals as  surgery progresses, and helping to set new benchmarks and leading to the best possible outcomes.

I am committed to improving care overseas, through my relationship with CCHE (Children’s Cancer Hospital Egypt) 57357 in Cairo, Egypt  We have established a “twinning training program” between Boston Children’s/Dana Farber Cancer Institute and CCHE 57357 in Pediatric Oncology and are developing a similar training program in pediatric neurosurgery.

I have been honored to receive some of my field's most prestigious honors, including the Young Investigator Award from the American Association of Neurological Neurosurgeons in 1996 and the Women in Medicine prize in 2009 from Boston Children's Hospital.

To schedule an appointment: Call 617-355-6008 or Request an Appointment

Locations

The future of pediatrics will be forged by thinking differently, breaking paradigms and joining together in a shared vision of tackling the toughest challenges before us.”
- Sandra L. Fenwick, President and CEO

Boston Children's Hospital 300 Longwood Avenue, Boston, MA 02115 617-355-6000 | 800-355-7944

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