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Paediatric Brain Tumours

A brain tumour is the growth of abnormal cells in the brain.  When most normal cells grow old or get damaged, they die, and new cells take their place. Sometimes, this process goes wrong. New cells form when the body doesn't need them, and old or damaged cells don't die as they should. The buildup of extra cells often forms a mass of tissue called a growth or tumour.

Brain tumours are classified as either benign (non cancerous) or malignant (cancerous).  Brain tumours are also classified as either primary or metastatic.  When a brain tumour originates in the brain it is referred to as a primary brain tumour.  Metatastic brain tumours begin as cancer elsewhere in the body and then spread to the brain.

Among children, the most common types of brain tumours are:

  • Medulloblastoma: The tumour usually arises in the cerebellum. It's sometimes called a primitive neuroectodermaltumour.
  • Pilocytic astrocytoma: In children, this low grade tumour occurs anywhere in the brain but most commonly in the cerebellum. The most common astrocytoma among children is juvenile pilocytic astrocytoma.
  • Ependymoma: The tumour arises from cells that line the ventricles or the central canal of the spinal cord. It's most commonly found in children and young adults.
  • Brain stem glioma: The tumour occurs in the lowest part of the brain. It can be a low-grade or high-grade tumour. The most common type is diffuse intrinisicpontineglioma.

Childhood brain tumours are the second most frequent malignancy of childhood and the most common form of solid tumour. Tumours in childhood differ significantly from adult tumours in their sites of origin, histological features, clinical presentations, and tendency to spread throughout the nervous system early in the course of illness. Brain tumours in infants and adults usually arise in the cerebrum, whereas brain tumours in children ages 1-12 are more commonly found in the cerebellum. A large proportion of brain tumours in adults are the result of metastasis (spread) from non-primary brain sites. In contrast, childhood brain tumours are mainly primary CNS lesions, meaning they originate within the central nervous system instead of spreading from other parts of the body to the CNS.

The symptoms of a brain tumour depend on tumour size, type, and location. Symptoms may be caused when a tumour presses on a nerve or harms a part of the brain. Also, they may be caused when a tumour blocks the fluid that flows through and around the brain, or when the brain swells because of the buildup of fluid called hydrocephalus.

These are the most common symptoms of brain tumours:

  • Headaches (usually worse in the morning)
  • Nausea and vomiting
  • Changes in speech, vision, or hearing
  • Problems balancing or walking
  • Changes in mood, personality, or ability to concentrate
  • Problems with memory
  • Muscle jerking or twitching (seizures or convulsions)
  • Numbness or tingling in the arms or legs

Treatment

The options are surgery, radiation therapy, and chemotherapy. Many patients get a combination of treatments.

The choice of treatment depends mainly on the following:

  • The type and grade of brain tumour
  • Its location in the brain
  • Its size
  • Your age and general health

Your surgeon will discuss the best treatment options available for your particular situation.

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