Our Health Topics

Cervico Medullary Astrocytoma

  • Overview

    A cervico-medullary low-grade glioma (also called a cervico-medullary low-grade astrocytoma) is a tumor that arises from a type of cell of the central nervous system called a glial cell.

    • Cervico-medullary low-grade gliomas originate from a specific type of glial cell known as an astrocyte.
    • Astrocytes make up the supportive network of the brain, and are named for their star-like appearance.
    • Cervico-medullary low-grade gliomas are astrocytomas that arise from the junction of the brain and spinal cord.

    How Dana-Farber/Children’s Hospital Cancer Center approaches cervico-medullary low-grade glioma

    We understand that you may have a lot of questions when your child is diagnosed with acute cervico-medullary low-grade glioma.

    • Is it painful?
    • Does my child need to be hospitalized?
    • How will it affect my child long term?
    • What do we do next?

    We’ve tried to provide some answers to those questions in the following pages, and our experts can explain your child’s condition fully. 

    Also, we hold a weekly brain tumor clinic for newly diagnosed patients currently receiving treatment. Each time you come for an appointment, you meet with every specialist on your child’s team: your pediatric neuro-oncologist, neurologist, neurosurgeon, endocrinologist, psycho-oncologist and School liaison.

    Dana-Farber/Children’s Hospital Cancer Center’s Pediatric Brain Tumor Program offers the following services.

    • Access to high-tech resources, like the intra-operative MRI, which allows our pediatric neurosurgeons to visualize the tumor as they operate with MRI scans. This means they can remove as much of the tumor as possible, and sometimes eliminate additional surgeries.
    • Expert neuropathological review, using advanced molecular diagnostic testing, to identify your child’s exact type of tumor. This information helps predict which treatments are more likely to work.
    • Access to unique Phase I clinical trials, from our own investigators, the Children’s Oncology Group and the Pediatric Oncology Experimental Therapeutics Investigators Consortium. Studies offer treatment options beyond standard therapy.
    • Ongoing care from pediatric neurologists familiar with the early symptoms and side effects of brain tumors and their treatments.
    • Access to one of the nation’s few dedicated pediatric brain tumor survivorship programs. This weekly clinic offers ongoing care to manage late effects caused by your child’s tumor or the treatment they received.
  • In-Depth

    What causes cervico-medullary low-grade glioma?

    The vast majority of children with cervico-medullary low-grade gliomas develop these tumors spontaneously, meaning that there is no identifiable cause.

    If your child has certain genetic syndromes, including neurofibromatosis and tuberous sclerosis, she may be at higher risk of developing tumors of glial origin, including cervico-medullary low-grade gliomas.

    What are the symptoms of cervico-medullary low-grade gliomas?

    Due to the relative slow growth rate of cervico-medullary low-grade gliomas, your child’s symptoms may have been occurring for many months when she sees the doctor or she may have a more sudden onset of symptoms. While each child may experience symptoms differently, some of the most common include:

    • symptoms caused by increased pressure within the brain, including:
    • neck discomfort and difficulty moving some of all of the limbs of her body

    The symptoms of a brain tumor may resemble other conditions or medical problems. Always consult your child's physician for a diagnosis.

  • Tests

    How is cervico-medullary glioma diagnosed?

    Diagnostic procedures for a cervico-medullary low-grade glioma may include:

    • physical examination- your child may demonstrate increased pressure in the brain or difficulty moving her neck or arms
    • 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 cervico-medullary low-grade gliomas, 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 cervico-medullary low-grade gliomas, an MRI of the brain and spine is usually done.
    • biopsy–To confirm the diagnosis, a tissue sample from the tumor may be taken using a needle during a simple surgical procedure.
  • What treatments are available for cervico-medullary glioma?

    Surgery

    Surgery has multiple roles in the diagnosis and treatment of gliomas, including release of pressure on the brain, biopsy and tumor removal.

    If your child has a brain tumor, the first treatment is usually surgery to remove as much of the tumor as possible.

    • Tumor specimens are examined by neuropathologists to determine the exact diagnosis.
    • When possible, it's best to completely remove the entire tumor. In general, the more of the tumor that is removed, the greater the chance for survival.
      • Tumors of the cerebral hemispheres are in general more easily removed than those of the midline, inner-brain structures.

    Radiation therapy

    Our doctors use precisely targeted and dosed radiation to kill cancer cells left behind after your child's surgery. This is important to control the growth of the tumor, and it helps increase survival in high-grade gliomas.

    Chemotherapy

    Chemotherapy (“chemo”) is a drug that interferes with the cancer cell's ability to grow or reproduce. For some kinds of tumors, chemotherapy before surgery may help shrink the tumor, making it possible to remove.

    How is chemotherapy given?

    Different chemotherapies may be given:

    • as a pill to swallow
    • as an injection into the muscle or fat tissue
    • intravenously (directly to the bloodstream, also called IV)
    • intrathecally (directly into the spinal column with a needle)

    How is chemotherapy used?

    This depends on many factors. Some things to keep in mind:

    • A number of combinations of chemotherapy drugs are currently being used to stabilize and, in some cases, to shrink the size of the tumor.
    • Depending on the type of cancer, chemotherapy drugs may be given in a specific order.
    • Chemotherapy may be used alone for some types of cancer, or in conjunction with other therapy such as radiation or surgery.

    Does chemotherapy come with bad side effects?

    While chemotherapy can be quite effective in treating some cancers, the drugs do not differentiate normal healthy cells from cancer cells. Because of this, there can be many adverse side effects during treatment. Being able to anticipate these side effects can help your child, family and your child's health care team prepare for and sometimes prevent these symptoms from occurring.

  • Research & Innovation

    What is the latest research on cerebellar low-grade gliomas?

    Dana-Farber/Children’s Hospital Cancer Center is a member of the Pediatric Oncology Therapeutic Experimental Investigators Consortium (POETIC), a collaborative clinical research group offering experimental therapies to patients with relapsed or refractory disease.

    We’re also the New England Phase I Center of the Children's Oncology Group. The DFCHCC is also home to the only dedicated pediatric low-grade glioma program (Pediatric Low-Grade Astrocytoma (PLGA) Research Program). In addition to the discovery of a number of novel targets, this program has initiated a number of phase II protocols using molecular inhibitors for children with progressive/recurrent low-grade glioma.

    There are many ways in which your child might benefit from our medical research program. Our doctors and scientists have made many breakthrough discoveries about diseases like polio and leukemia; our ongoing innovative research continues to push the boundaries of the way pediatric medicine is practiced.

    It’s possible that your child will be eligible to participate in one of our current clinical trials. These studies are useful for a multitude of reasons:

    Some trials are designed to evaluate the effectiveness of a particular drug, treatment or therapy on a specific disease; others help doctors to better understand how and why certain conditions occur. At any given time,

    We have hundreds of clinical trials underway. Of course, your motives as a parent needn’t be entirely altruistic—you’ll naturally want to know how taking part in a trial can immediately benefit your child. If your child’s physician recommends participation in one of Children’s clinical trials, that likely means that your child’s physician believes that the plan outlined in that trial represents the absolute best, latest care your child can possibly receive.

    And participation in any clinical trial is completely voluntary: We will take care to fully explain all elements of the treatment plan prior to the start of the trial, and you may remove your child from the medical study at any time.

    To search for a cancer trial at Dana Farber/Children’s Hospital Cancer Center, go to:
    http://www.dana-farber.org/Research/Clinical-Trials/Clinical-Trials-by-Diagnosis.aspx?did=21.     

    To search the NIH’s list of clinical trials taking place around the world, go to: http://www.clinicaltrials.gov/ct2/search

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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.”
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