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What Is a Brain Tumor?

Signs and Symptoms

A tumor is any mass caused by abnormal or uncontrolled growth of cells. Tumors in the brain are categorized according to several factors, including where they're located, the type of cells involved, and how quickly they're growing.

Medical terms doctors may use to describe brain tumors include:

  • Low-grade vs. high-grade: Usually, low-grade tumors are slow-growing, while high-grade tumors are fast-growing and aggressive. High-grade tumors can invade nearby tissue or spread elsewhere in the body, and are more likely to recur after treatment. They are generally associated with a worse outlook.
  • Localized vs. invasive: A localized tumor is confined to one area and is generally easier to remove, as long as it's in an accessible part of the brain. An invasive tumor has spread to surrounding areas and is more difficult or impossible to remove completely.
  • Primary vs. secondary: Primary brain tumors originate in the brain. Secondary brain tumors are made up of cells that have spread (metastasized) to the brain from somewhere else in the body. In children, most brain tumors are primary

What Causes a Brain Tumor?

Like all tumors, brain tumors originate when a normal cell begins to grow abnormally and multiply too quickly. Eventually these cells develop into a mass called a tumor. The exact cause of this abnormal growth is unknown, though research continues on possible genetic and environmental causes.

Some kids who have certain genetic conditions have a greater chance of developing brain tumors. Diseases such as neurofibromatosis, von Hippel-Lindau disease, and Li-Fraumeni syndrome are all associated with a higher risk of brain tumors.

Common Types of Brain Tumors

There are many different types of pediatric brain tumors, ranging from those that can be cured with minimal therapy to those that cannot be cured even with aggressive therapy.

Some of the most common types are:

Astrocytomas :

Astrocytomas come in four major subtypes: juvenile pilocytic astrocytoma, fibrillary astrocytoma, anaplastic astrocytoma, and glioblastoma multiforme.

An important feature in determining the outlook for patients with astrocytomas is location, because this directly affects the chance for a cure. Tumors that can be completely removed surgically are much more likely to be cured, while those that can't be completely removed are, in general, less curable.

Ependymomas :

Ependymomas are treated primarily with surgery and radiation therapy. If the tumor can be completely removed, patients with ependymomas may need no additional treatments. However, some completely removed ependymomas and most incompletely removed ependymomas will require further treatment — usually radiation therapy and sometimes also chemotherapy.

Brainstem Gliomas :

Brainstem gliomas refer to a group of tumors of the brainstem that differ primarily by location. Most are curable with surgery and/or radiation therapy except the most common and serious type, the diffuse pontine glioma. These tumors, which originate in a part of the brainstem called the pons, are rarely curable even with aggressive therapy. Treatment for diffuse pontine gliomas usually includes radiation therapy, which lengthens survival and improves quality of life, but is rarely curative.

Medulloblastomas and Primitive Neuroectodermal Tumors (PNETs)

Medulloblastomas and primitive neuroectodermal tumors are very similar brain cancers and appear almost identical under the microscope. Medulloblastomas, by definition, can only occur in the posterior fossa or cerebellum (back part of the brain), while primitive neuroectodermal tumors can occur anywhere in the brain or spinal cord. These cancers are highly sensitive to chemotherapy and radiation therapy, so modern treatment regimens are usually curative. Although treatment regimens are effective, late side effects of therapy can be a significant problem.

Craniopharyngiomas :

Craniopharyngiomas are low-grade tumors that arise in the middle of the brain near the pituitary gland. As a result of their location, many patients have endocrinologic (hormone) problems when the tumor is diagnosed and after it is treated.

While craniopharyngiomas can be cured with surgery alone, most pediatric centers do not attempt total removal of the tumor at diagnosis unless it can be accomplished without injury to the sensitive surrounding structures. Total removal of the tumor without consideration of these surrounding structures can cause permanent hormone deficiencies that can be difficult to manage.

Therefore, for most patients, only partial removal of the tumor is done at diagnosis, followed by radiation therapy for any remaining tumor. This approach usually results in effective treatment of the tumor without causing lifelong hormone deficiencies.

Germ Cell Tumors

These brain tumors usually arise from two special areas in the middle of the brain — the areas around the pituitary and pineal glands. Germ cell tumors include two main types, germinomas and nongerminomatous germ cell tumors.

Germinomas are sensitive to chemo and radiation therapy and both are usually used to help achieve an excellent cure rate. Nongerminomatous germ cell tumors include several different types of tumors which, in general, are not as curable as germinomas. Nongerminomatous germ cell tumors are treated with surgery, chemotherapy, and radiation therapy.


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