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Brain tumor - children

Definition

A brain tumor is a group (mass) of abnormal cells that grow in the brain.

This article focuses on primary brain tumors in children.

Alternative Names

Glioblastoma multiforme - children; Ependymoma - children; Glioma - children; Astrocytoma - children; Medulloblastoma - children; Neuroglioma - children; Oligodendroglioma - children; Meningioma - children; Cancer - brain tumor (children)

Causes

The cause of primary brain tumors is often unknown. Some primary brain tumors are related to other syndromes or can run in a family. They can be:

Brain tumors are classified based on:

Brain tumors can directly kill brain cells. They can also damage cells by pushing on other parts of the brain. This leads to swelling and increased pressure inside the skull.

Tumors can occur at any age. Many tumors are more common at a certain age. In general, brain tumors in children are very rare.

COMMON TUMOR TYPES

Astrocytomas are usually noncancerous, slow-growing tumors. They most often develop in children ages 5 to 8. Also called low-grade gliomas, these are the most common brain tumors in children.

Medulloblastomas are the most common type of childhood brain cancer. Most medulloblastomas occur before age 10.

Ependymomas are a type of childhood brain tumor that can be benign or malignant. Therapy to control the tumor is based on the location and type of ependymoma.

Brainstem gliomas are very rare tumors that occur almost only in children. The average age at which they develop in children is about age 6.

Symptoms

Symptoms may be subtle and slowly become worse, or they may occur very quickly.

Headaches are often the most common symptom. But only very rarely do children with headaches have a tumor. Headache patterns that may occur with brain tumors include:

Sometimes, the only symptoms of brain tumors are mental changes, which may include:

Other possible symptoms are:

Exams and Tests

The health care provider will perform a physical exam. Infants may have the following physical signs:

Older children with brain tumors may have the following physical signs or symptoms:

The following tests may be used to detect a brain tumor and identify its location:

Treatment

Treatment depends on the size and type of tumor and the child's general health. The goals of treatment may be to cure the tumor, relieve symptoms, and improve brain function or the child's comfort.

Surgery is needed for most primary brain tumors. Some tumors may be completely removed. In cases where the tumor can't be removed, surgery may help reduce pressure and relieve symptoms. Chemotherapy or radiation therapy may be used for certain tumors.

The following are treatments for specific types of tumors:

Medicines used to treat children with primary brain tumors include:

Comfort measures, safety measures, physical therapy, occupational therapy, and other such steps may be required to improve quality of life.

Support Groups

You can ease the stress of illness by joining a cancer support group. Sharing with others who have common experiences and problems can help you and your child feel less alone.

Outlook (Prognosis)

How well a child does depends on many things, including the type of tumor. In general, about 3 out of 4 children survive at least 5 years after being diagnosed.

Long-term brain and nervous system problems may result from the tumor itself or from treatment. Children may have problems with attention, focus, or memory. They may also have problems processing information, planning, insight, or initiative or desire to do things.

Children younger than age 7, especially younger than age 3, seem to be at greatest risk of these complications.

Parents need to make sure that children receive support services at home and at school.

When to Contact a Medical Professional

Contact a provider if a child develops headaches that do not go away or other symptoms of a brain tumor.

Go to the emergency room if a child develops any of the following:

References

Kieran MW, Chi SN, Manley PE, et al. Tumors of the brain and spinal cord. In: Orkin SH, Fisher DE, Ginsburg D, Look AT, Lux SE, Nathan DG, eds. Nathan and Oski's Hematology and Oncology of Infancy and Childhood. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 57.

National Cancer Institute website. Childhood brain and spinal cord tumors treatment overview (PDQ): health professional version. www.cancer.gov/types/brain/hp/child-brain-treatment-pdq. Updated October 8, 2021. Accessed September 9, 2023.

Zaky W, Ater JL, Khatua S. Brain tumors in childhood. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 524.