What is a brain tumor?
Brain tumors are relatively rare in children, occurring in only five of every 100,000 children. Although childhood brain tumors can be benign (non-cancerous) or malignant (cancerous), both types can be life-threatening. Nevertheless, children with brain tumors generally have a better prognosis than adults with a similar condition.
About 2,200 children and adolescents in the United States are diagnosed with a brain tumor each year. Most children and adolescents who develop brain tumors survive into adulthood. However, many will face physical, psychological, social, and intellectual challenges related to their treatment.
Brain tumors are commonly treated with surgery and/or other therapies including chemotherapy and radiation. However, as scientists continue to learn more about the specific genetic mutations that occur in childhood brain tumors, they are starting to develop targeted treatments (precision medicine) that can be used in brain tumor treatment.
Dr. Katherine Warren, clinical director of Pediatric Neuro-Oncology at Dana-Farber/Boston Children's Cancer and Blood Disorders Center.
Types of childhood brain tumors
If your child is diagnosed with a brain tumor, you will learn there are many different brain tumor types and classifications based upon the tumor’s cell structure, composition, rate of growth, location, and other characteristics. The name and classification of the tumor may change as your doctor gains information about your child’s brain tumor or if the tumor changes over time.
The types of brain tumors most common in children are not the same as those most common in adults. Childhood brain tumors frequently appear in different locations and behave differently than brain tumors in adults. Learn more about the specific types of brain tumors.
Choroid plexus brain tumors
Choroid plexus tumors arise in the tissue located in the spaces of the brain called ventricles. This tissue makes cerebrospinal fluid (CSF), which surrounds the brain and spinal cord. These rare tumors are seen more often in younger children. Between 10 and 20 percent of brain tumors that occur within the first year of life are choroid plexus tumors.
Germ cell tumors of the brain
Germ cell tumors of the brain, including germinoma, develop from germ cells — the cells that later become sperm in the testicles or eggs in the ovaries; during the fetal period, these cells may get “trapped” in the brain.
There are four stages or grades of gliomas, according to how the cells look under a microscope. Ordered from least severe to most severe, they are:
- grade I (pilocytic)
- grade II (fibrillary)
- grade III (anaplastic)
- grade IV (glioblastoma multiforme or GBM)
Gliomas also can be named according to the type of glial cells involved or the location of the tumor. Glioma diagnoses include:
- angiocentric glioma
- astrocytoma: pilocytic astrocytoma, fibrillary astrocytoma, or anaplastic astrocytoma
- diffuse intrinsic pontine glioma (DIPG)
- gliomatosis cerebri
- dysembryoplastic neuroepithelial tumor (DNET or DNT)
- ganglioglioma and glial neuronal tumors
- optic nerve (pathway) glioma
- pleomorphic xanthoastrocytoma (PXA)
- tectal glioma (a brainstem glioma)
- thalamic and hypothalamic astrocytoma
- atypical teratoid rhabdoid tumor (ATRT)
- primitive neuroectodermal tumors (PNET) and pineoblastoma
Brain Tumors | Symptoms & Causes
What are the symptoms of brain tumors?
Each child may experience symptoms of a brain tumor differently, and symptoms vary depending on the size and location of the tumor — both in the brain and elsewhere in the central nervous system.
Brain tumors can cause pressure on the brain, causing the following symptoms:
- vomiting (usually in the morning)
- personality changes
Symptoms of brain tumors in the cerebellum, including cerebellar pilocytic astrocytoma and medulloblastoma, include:
- vomiting (usually occurs in the morning, without nausea)
- uncoordinated muscle movements
- problems walking
Brain tumors in the brainstem, such as diffuse pontine glioma and tectal glioma, can cause the following symptoms:
- vision changes, including double vision
- paralysis of nerves and/or muscles of the face or half of the body
- respiratory changes
- clumsy, uncoordinated walking
Symptoms of brain tumors in the cerebrum, including ganglioglioma, glioblastoma multiforme, and oligodendroglioma, include:
- visual changes
- slurred speech
- paralysis or weakness on one half of the body or face
- personality changes or impaired judgment
- short-term memory loss
- communication problems
Tumors in the optic pathway (eyes), such as optic nerve glioma, may cause symptoms such as:
- visual problems
- puberty or growth abnormalities
- excessive urination
Symptoms of tumors in the spine (sometimes spreading from a tumor at a higher point on the spinal cord), including meningioma, may include:
- bowel or bladder dysfunction
- back pain
- weakness or loss of sensation in one area of the body, depending on where in the spine the tumor is located
What causes brain tumors?
Brain tumors may develop when brain cells acquire mutations in the DNA that allow the cells to continue living after they would normally expire. It's important to discuss treatment options with your child's physician.
Brain Tumors | Diagnosis & Treatments
How are brain tumors diagnosed?
Diagnostic procedures for brain tumors are used to determine the exact type of tumor a child has and whether the tumor has spread. These may include:
- physical examination
- magnetic resonance imaging (MRI)
- magnetic resonance spectroscopy (MRS)
- computerized tomography (CT or CAT) scan
- lumbar puncture (spinal tap)
After all tests are completed, doctors will be able to outline the best treatment options.
What are the treatment options for brain tumors?
Treatment for brain tumors in children has progressed tremendously in the last decade. These treatments include neurosurgery, radiation therapy, or chemotherapy.
Neurosurgery for brain tumors
Usually the first treatment to remove as much of the tumor as possible and to relieve pressure on the brain. In general, the more of the tumor that is removed, the greater the chance for survival
Radiation therapy and chemotherapy for brain tumors
Precisely targeted and dosed radiation to kill cancer cells left behind after surgery. In tumors that have spread, radiation therapy can be sometimes delivered to the entire brain and spine. Chemotherapy includes drugs that interfere with cancer cells’ ability to grow or reproduce.
How we care for brain tumors
Children with brain tumors are treated through the Brain Tumor Centerat Dana-Farber/Boston Children's Cancer and Blood Disorders Center, a world-renowned destination for children with malignant and non-malignant brain and spinal cord tumors. Our brain tumor specialists have extensive expertise in treating all types of brain tumors.