Types of Brain and Spinal Cord Tumors, Symptoms and Diagnosis
The Jaydie Lynn King Neuro-oncology Program at Phoenix Children's Hospital is the only comprehensive pediatric program of its kind in Arizona, combining the expertise of subspecialists in the Barrow Neurological Institute at Phoenix Children's Hospital and the Center for Cancer and Blood Disorders (CCBD). We offer family-centered, multidisciplinary, coordinated care to provide hope, healing and the best healthcare for children and their families.
Brain and spinal cord tumors are the second most common cancers (after leukemia) affecting children. They make up about 21 percent of all childhood tumors.
When a child is diagnosed with a brain tumor, we present their case to the Phoenix Children’s Neuro-oncology Tumor Board, a group of physicians from a variety of specialties including radiation oncology, Neuro-oncology, neurosurgery, neuroradiology, pathology and neurology. Together, we decide the best treatment plan for each and every child.
Types of tumors commonly seen in children
- Astrocytomas: Glial cell tumors that are derived from connective tissue cells called astrocytes. These cells can be found anywhere in the brain or spinal cord. Astrocytomas are the most common type of childhood brain tumor. Astrocytomas are generally subdivided into high-grade, medium-grade, or low-grade tumors. High-grade astrocytomas are the most malignant of all brain tumors. Astrocytomas are further classified for presenting signs, symptoms, treatment, and prognosis, based on the location of the tumor. The most common location of these tumors is in the cerebellum, where they are called cerebellar astrocytomas. These tumors usually cause symptoms of increased intracranial pressure, headache, and vomiting. There can also be problems with walking and coordination, as well as double vision.
- Primitive neuroectodermal tumors (PNET)/medulloblastoma: Both PNETs and medulloblastomas are in the same family of tumors. PNET can occur anywhere in the brain of a child, whereas medulloblastomas occur in the back of the brain. Both of these tumor types can metastasize (spread) to other parts of the central nervous system (i.e. the spinal cord). PNETs and medulloblastomas are treated very similarly with a combination of surgery, radiation, and chemotherapy, although PNETs tend to be more aggressive overall from medulloblastomas.
- Brain stem tumors: Tumors found in the brain stem. Most brain stem tumors cannot be surgically removed because of the remote location and delicate and complex function this area controls. Brain stem gliomas occur almost exclusively in children; the group most often affected is the school-age child. The child usually does not have increased intracranial pressure, but may have problems with double vision, movement of the face or one side of the body, or difficulty with walking and coordination.
- Ependymomas: Also glial cell tumors. They usually develop in the lining of the ventricles or in the spinal cord. The most common place they are found in children is near the cerebellum. The tumor often blocks the flow of the CSF (cerebral spinal fluid, which bathes the brain and spinal cord), causing increased intracranial pressure. Ependymomas can be slow growing, compared to other brain tumors, but may recur after treatment is completed. Recurrence of ependymomas results in a more invasive tumor with more resistance to treatment. About 5 percent to 10 percent of childhood brain tumors are ependymomas.
- Germ cell tumors: Comprise less than 4 percent of brain tumors in children. They most commonly occur in the middle of the brain, specifically near the pituitary and pineal glands. There are two major types of germ cell tumors: germinomas, and non-germinomatous germ cell tumors (NGGCT). Since these tumors are near structures in the brain which secrete hormones, often patients will have decreased amounts of these hormones and require supplementation. Given their location, often these tumors cannot be completely surgically removed and are only biopsied at the time of surgery. Further therapy for these tumors includes radiation, chemotherapy, or both.