Cancer Center

Brain Tumors in Children

The Pediatric Neuro-Oncology Program and the Pediatric Surgical Oncology Program at The Children’s Hospital of Philadelphia are among the largest in the nation. Families choose us because we have vast experience treating brain tumors in children and have every possible therapy available.

We also have immediate access to a brain tumor database, which allows us to conduct ongoing molecular analysis of the different brain tumor types to determine their causes. Our research constantly provides us with ways to best utilize the four treatment options for tumors: surveillance, surgery, chemotherapy and radiation therapy, to produce the best outcome for your child. Read about our outcomes in our stories of brain tumors in children.

What are brain tumors?

A brain tumor is a growth of abnormal cells or the uncontrolled growth of normal cells in the brain. Primary brain tumors involve a growth that starts in the brain, rather than spreading to the brain from another part of the body. Tumors may be benign (noncancerous) or malignant (cancerous). Tumors may destroy brain cells or damage cells by producing inflammation by pressing on other parts of the brain. This pressure causes cerebral edema (brain swelling) and increased intracranial pressure (the pressure within the skull). The cause of primary brain tumors is unknown, although some tumors such as retinoblastoma tend to be hereditary. Others tumors, such as craniopharyngioma, are present from birth.

How common are brain tumors in children?

Central nervous system tumors (tumors of the brain and spine) make up about 20 percent of all childhood cancers; they are the second most common form of childhood cancer after leukemia. Brain tumors are the most common solid tumor in children. Approximately 2,000 children in the United States are diagnosed with a brain tumor each year.

What are the signs and symptoms of a pediatric brain tumor?

The symptoms of a pediatric brain tumor vary according to the size, type and location of the tumor. Symptoms may occur when a tumor presses on a nerve or damages certain parts of the brain. They may also occur when the brain swells or there is fluid buildup in the skull. The most common symptoms include:

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What types of tumors are found in the brain and spine?

The most common childhood brain tumors are astrocytoma, medulloblastoma, ependymoma and brain stem glioma. Gliomas account for 75 percent of brain tumors in young children but less than 50 percent in adults. Tumors found in craniospinal cavities may arise from the brain and/or spinal cord, or from other tissues or structures near them. Childhood tumors that arise in other organs of the body rarely spread to the nervous system, with the exception of neuroblastomas.

Gliomas

The most common type of brain tumor at all ages is a glioma. Gliomas consist of glial cells, which form the supportive tissue of the brain. The two major types of glial tumors are astrocytomas and ependymomas.

Mixed neuronal-glial tumors

Tumors containing a mix of glial cells (most commonly astrocytes) and neurons (ganglion cells) occur more often in children than in adults. They may arise anywhere in the nervous system but most typically appear in the cerebrum, an area of the brain involved in motor function and personality. Surgery to remove the tumors often is effective.

Embryonal tumors

Up to 25 percent of nervous system tumors that occur in infants and children are tumors made up of poorly-differentiated neuroepithelia cells. When the nervous system develops, neuroepithelia cells are those that differentiate into glial (supportive tissue) and nerve cells.

The two main types of embryonal tumors are:

Choroid plexus papilloma/carcinoma

These tumors may also be found in ventricles. They may be both benign and malignant, and may spread throughout the nervous system. They are filled with blood vessels (vascular), making them difficult to remove because of their tendency to bleed.

Tumors arising from non-neuroepithelial tissue

The intracranial (inside the skull) and intraspinal (within the spine) cavities contain tissues and structures that may give rise to tumors, a number of which are more common in children than adults. These tumors include:

Meningeal tumors

The brain and spinal cord are covered with membranes called dura mater, arachnoid and pia mater. Tumors called meningiomas may develop in these membranes, but are more common in adults than children.

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How do we diagnose a brain tumor in your child?

After taking a complete medical history and doing a physical examination of your child, we may use the following diagnostic tests to determine if a brain tumor is present:

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How are pediatric brain tumors treated?

Surgery for Pediatric Brain Tumors

Surgery is usually the first step in treating brain tumors in children. Our goal within the Pediatric Surgical Oncology Program is to remove all or as much of the tumor as possible while maintaining neurological function. Pediatric brain tumor patients have a particular advantage when coming to CHOP because of the extensive experience of our neurosurgeons and the close collaboration between neurosurgery, neuro-oncology, radiation oncology and diagnostic radiology. Learn more about surgery for brain tumors in the video below.

VIDEO APPEARS HERE
 

Surgery is also performed for a biopsy — a sample of tissue taken to examine the types of cells found in the tumor. This helps establish a diagnosis and treatment plan. This is frequently done when the tumor is surrounded by sensitive structures that may be damaged by surgical removal.

Other therapies used to treat brain tumors include:

As with any cancer, prognosis and long-term survival vary greatly from child to child. Prompt medical attention and aggressive therapy are important for the best prognosis. Continuous follow-up care is essential for a child diagnosed with a brain tumor, because the side effects of radiation and chemotherapy as well as second malignancies can occur in survivors of brain tumors.

Rehabilitation for lost motor skills and muscle strength may be required. Children's Hospital speech therapists and physical and occupational therapists specialize in the unique needs of children undergoing this type of rehabilitation.

Late effects/cancer survivorship

Some children treated for a pediatric brain tumor may develop complications years later. Our Cancer Survivorship Program provides information about the potential long-term effects of the specific treatment your child received, including ways of monitoring and treating these effects.

Reviewed by: Peter C. Phillips, MD, The Children's Hospital of Philadelphia
Date: May 2005

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