KidsMD Health Topics

Tectal Gliomas

  • A tectal glioma is low-grade tumor forming in the tectum, which can be thought of as the roof of the brain stem.

    • The brain stem is the part of the brain that controls vital body functions such as respiration, heart rate and blood pressure.

    • Tectal gliomas originate in a certain type of glial cell (meaning that they make connective tissue in the brain), known as an astrocyte, for its star-like shape.

    • Most children with tectal gliomas are between 3 and 16 years old.

    As you read further, 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.

    How Dana-Farber/Boston Children’s Cancer and Blood Disorders Center approaches tectal gliomas

    We understand that you may have a lot of questions when your child is diagnosed with a tectal 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, from your pediatric neuro-oncologist, neurologist, and neurosurgeon, to your pediatric endocrinologist, psycho-oncologist and School liaison.

    Dana-Farber/Boston Children’s Cancer and Blood Disorders Center’s Pediatric Brain Tumor Center offers the following services.

    • Access to high-tech resources, like the intra-operative MRI, which allow 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 eliminating additional surgeries.

    • Expert diagnosis by neuropathologists using advanced molecular diagnostic testing to identify your child’s type of tumor. Knowing the molecular composition of a tumor 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, which apply personalized medical approaches.

    • Specialized 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.

  • How are tectal gliomas classified?

    The World Health Organization (WHO) has developed a grading scale of tumors according to their appearance under a microscope and other factors. These grades are useful for predicting how the tumor will progress.      

    Using the WHO scoring system, in ascending order of severity, tumors are graded as:

    • grade I (benign)
    • grade II (atypical)
    • grade III (anaplastic – refers to lack of structure in the cell)
    • grade IV (sarcomatous – the most serious kind of tumor)

    Tectal gliomas are classified as grade I or grade II tumors.

    What causes a tectal glioma?

    These tumors tend to develop spontaneously, meaning that there is no identifiable cause, and no genetic link has been established.

    What are the symptoms of a tectal glioma?

    Since these tumors grow relatively slowly, your child may see the doctor with symptoms that may have been occurring for many months, or symptoms may come on rapidly. While each child may experience symptoms differently, some of the most common include:

    • symptoms of increased pressure within the brain, such as:
    • abnormal eye movements and difficulties with walking

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

  • How is a tectal glioma diagnosed?

    Diagnostic procedures for tectal glioma may include:

    • 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 your child’s 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 taken through a needle during a simple surgical procedure to confirm the diagnosis
  • Dana-Farber/Boston Children’s Cancer and Blood Disorders Center is home to some of the world's most skilled pediatric oncologists. And while we're known for our science-driven approach to treating conditions like red blood cell disorders, our doctors never forget that your child is a child, and not just a patient.

    We specialize in innovative, family-centered care. From your first visit, you'll work with a team of professionals who are committed to supporting all of your family's physical and psychosocial needs.

    What are the treatments for a tectal glioma?

    Surgeons may relieve symptoms caused by pressure within your child's brain by:

    • surgically inserting a device called a shunt, which drains excessive fluid in your child's body
    • conducting a procedure called a third ventriculoscopy, during which the surgeon creates a pathway to drain excess fluid into the third ventricle (a space within the brain that can accommodate this fluid)

    Chemotherapy or radiation therapy also generally not prescribed for tectal glioma. Your child will be followed for evidence of progressive disease through frequent MRI scans (about every three months to start).

    How are side effects managed?

    Tectal glioma may lead to side effects related to the tumor itself and to its treatment. Symptoms related to increased pressure within the brain may be treated with:

    • a shunt or third vertriculoscopy, as described above
    • an oral steroid such as Dexamethasone

    What is the expected outcome after treatment for tectal glioma?

    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.

    What about progressive or recurrent disease?

    There is no standard recommended treatment for progressive/recurrent tectal gliomas.

    We are 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 are also the New England Phase I Center of the Children's Oncology Group. If your child has progressive or recurrent tumor, she may be eligible for a number of experimental therapies available through these groups, or from one of our independent clinical investigators.

  • What is the latest research on tectal glioma?

    Scientists at Boston 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 Center research page.

    Clinical trials

    For many children with rare or hard-to-treat conditions, clinical trials provide new options.

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