Brain tumor in children

Brain tumors are the most common solid tumor affecting children and adolescents. Childhood brain tumors are diagnosed in nearly 5,000 children each year. Because of their location, some childhood brain tumors and their necessary treatments can cause long-term impairment of intellectual and neurological function. Some forms of brain cancer can also be life-threatening.

The skull contains only brain parenchyma and cannot contain any other tissue. Therefore, as brain tumors grow and enlarge, these tumors will increase the pressure during the endoscopy. Increased intracranial pressure is caused by excess tissue in the brain as well as obstruction of the flow path of cerebrospinal fluid.
Symptoms include:
Headache. Convulsions. Nausea and vomiting. Irritability. Coma and drowsiness. Changes in personality and mental activity. Macrocephaly (big head syndrome) in infants with skull bones that do not close properly. Coma and death, if untreated. Dysfunction of brain tissue due to a growing tumor can cause a variety of other symptoms, depending on the location of the tumor. For example, if a brain tumor is located in the cerebellum at the back of the head, the child may have difficulty with movement, walking, balance, and coordination. If the tumor is located near areas where the senses can affect the visual tract, the child may experience vision changes.

A child with symptoms of a brain tumor should be thoroughly evaluated by a pediatrician or pediatric neurologist to find the source of the problem.
A doctor's evaluation usually includes brain imaging with an MRI scan. If an MRI scan shows a brain tumor, the next step is for the patient to seek a neurosurgery consultation. The pediatric neurosurgeon will work with the whole family to develop the best treatment plan for the child.
Other specialists may be on the child's treatment team, such as a pediatric oncologist (a specialist in childhood cancer), an ophthalmologist (if a child's tumor affects them) vision), epilepsy doctor (to address seizures), radiation oncologist.

When developing the most appropriate treatment plan for a child with a brain tumor, the neurosurgery team will need to know:
Tumor location: This is determined by brain imaging, using one or more types of imaging imaging such as CT or MRI. Because there are many important structures in the brain, there are places where tumors can grow that are not suitable for surgery. Careful evaluation by the neurosurgeon will determine the accessibility of the tumor and the safest approach. Brain Tumor Type: Looking at tumor cells under a microscope can reveal the type of brain tumor and give doctors detailed information about how the tumor is likely to grow or metastasize. Brain Tumor Grade: Grade refers to how “aggressive” the tumor cells are. The higher the grade, the more aggressive the tumor.

Brain tumors can be divided into the following grades:
In situ: Starts in the brain. Metastasis: Starts in other parts of the body and spreads to the brain. Benign: Growth retardation; no cancer. Benign tumors can still be difficult to treat if they are growing in or around certain structures of the brain. Malignancy: Cancer. Unlike benign tumors, which tend not to metastasize, malignant tumors can be very aggressive. They grow quickly and can move to areas other than the original tumor and to other areas of the brain or body. 4.1. Astrocytomas, including multiple trophoblastic neoplasms Astrocytomas are the most common type of glioma, accounting for about half of all childhood brain tumors. This form of tumor is most common in children between the ages of 5 and 8.
Tumors develop from glial cells called astrocytes, which are most common in the cerebrum (large upper part of the brain). of the brain) but can also be in the cerebellum (the back part of the brain).
Assessing the extent of astrocytoma is very important. Treatment will be based on whether the tumor is slow growing (low grade, grade 1 or grade 2) or fast growing (high grade, grade 3 or 4). Most childhood astrocytomas (80%) are low grade. Sometimes, they start in the spine or spread there.
There are four main types of astrocytoma in children:
Astrocytoma (Grade 1): This slow-growing tumor is the most common brain tumor in children. Astrocytomas are usually cystic (fluid-filled). When this tumor grows in the cerebellum, surgical removal is often the only treatment needed. Pilot astrocytes growing in other locations may require other therapies. Diffuse astrocytoma (Grade 2): This brain tumor invades surrounding normal brain tissue, making complete surgical removal more difficult. A fibrous astrocytoma can cause seizures. Homologous astrocytoma (Grade 3): This brain tumor is malignant. Symptoms depend on the location of the tumor. These tumors require a combination of several treatments. Glioblastoma multiforme (Grade 4): This is the most malignant type of astrocytoma. It grows quickly and often causes pressure in the brain. These tumors require a combination of multiple treatments. 4.2. Other childhood brain tumors Brainstem glioma: Tumors in this location can be very difficult to treat. Most of these tumors are located in the midbrain and cannot be surgically removed, especially diffuse intrinsic glioma or DIPG. Some brain stem tumors have a more favorable location and can be treated with surgery. They are usually treated with non-surgical methods. Choroidal plexus tumors: These tumors are found in the choroid plexus — the part of the brain in the spaces in the brain, called the ventricles, that produce the cerebrospinal fluid, which surrounds and cushions the brain and spinal cord. These tumors can cause an accumulation of cerebrospinal fluid, leading to hydrocephalus. They can be benign or malignant and often require surgery as part of treatment. Craniopharyngiomas are benign tumors that develop near the pituitary gland. They can develop as solid tumors or cysts (empty sacs filled with fluid). About 10% to 15% of pituitary tumors are craniocervical tumors. Paraplastic neuroepithelial neoplasms: These rare benign tumors grow in the tissues that cover the brain and spinal cord, and often cause seizures. Ependymomas are another type of glioma that form from the cells that give rise to, support, nourish, and provide pathways for the ventricles (open areas inside the brain through which cerebrospinal fluid flows). Your doctor will order surgery plus radiation treatment in most cases. Germ cell tumors: These tumors can be benign or malignant. They develop from germ cells, which form from eggs in women and sperm in men. During normal embryo and fetal development, germ cells usually become eggs or sperm. Myeloblastoma: These malignant brain tumors account for about 15% of brain tumors in children. Myeloblastoma forms in the cerebellum and mainly occurs in children between the ages of 4 and 9, affecting boys more often than girls. Myeloblastoma can metastasize (metastasize) along the spinal cord. They often require surgery plus other treatments. Optic glioma: These tumors are found in or around the optic nerves — tumors that transmit messages from the eye to the brain. Optic neuromas are commonly seen in children with neurofibromatosis, a genetic disorder that affects the skin and nervous system. They can cause vision loss and hormone problems because of their frequent location near the base of the brain. They are often difficult to treat due to the sensitive brain structures around them.

One or more of these approaches should be included in the child's brain tumor treatment plan:
5.1. Surgery Most brain tumors in infants and children require surgical removal, or at least a biopsy, as part of treatment. The surgeon may recommend surgery to remove as much of the tumor as safely as possible as a first step and to reduce the intracranial pressure caused by the tumor. For low-grade or slow-growing tumors, surgery may be the only intervention needed.
5.2. Follow-up care after surgery The recovery process is different for each child. Children who are diagnosed and treated promptly can recover after surgery.
Some pediatric patients may experience some temporary neurological deficits, such as muscle weakness. In most cases, this will go away soon after surgery, unless there is significant permanent damage before the child is diagnosed. Physical, occupational, and speech therapy can help improve strength, function, and speed of recovery.
Routine follow-up after surgery with the child's neurosurgeon is also important to monitor neurological function and treatment side effects as well as prevent tumor recurrence.
5.3. Radiation Therapy This therapy focuses a beam of high-energy radiation on the tumor tissue and a small amount of surrounding tissue. Some tumors, such as medulloblastoma, require extra radiation to the entire brain and spinal cord. Radiation is used very cautiously in babies and toddlers because their brains are developing.
5.4. Chemotherapy Chemotherapy is used for many types of brain tumors including aggressive, high-grade tumors. Chemotherapy can be given as a pill (oral), intravenously (IV, through a vein), injected directly into the cerebrospinal fluid, or injected directly into the left cavity after surgery to remove a tumor. Brain.
Childhood cancer has a low incidence, clinical symptoms are sometimes poor, but the common feature is a good response to treatment and a high cure rate. The above are basic understanding so that parents can prepare psychologically for themselves as well as for their children before starting the treatment process.
For the treatment of cancer in children to be highly effective, early detection of the disease plays a very important role. Parents should check their children's health regularly and regularly. Vinmec International General Hospital provides a Children's General Health Checkup Package for children under 18 years old, with comprehensive examination services, assessment of basic liver and kidney functions, blood sugar, nutritional status. , hepatitis B virus, eyes, teeth, ears, nose and throat, cardiopulmonary scan, abdominal ultrasound, perform biochemical tests, ... help early detect abnormalities in the baby's body.
The results of the patient's examination will be returned to the home. After receiving the results of the general health examination, if you detect diseases that require intensive examination and treatment, you can use services from other specialties right at the Hospital with quality treatment and services. outstanding customer service.

References: hopkinsmedicine.org, mayoclinic.org