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Written by Kathy Warren, MD, pediatric oncologist, National Cancer Institute
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INTRODUCTION: Although ependymomas are the third most common type of brain tumor in children (following astrocytoma and medulloblastoma), they are relatively rare, with approximately 200 cases diagnosed in the US each year in children and adults less than 25 years of age. Ependymomas account for 6-12% of brain tumors in children less than 18 years of age, but 30% of brain tumors in children less than 3 years of age 1. The average age at diagnosis is 4-6 years 2-4. The underlying cause and basic biology of these tumors is not fully understood, and the optimal staging and treatment of ependymomas in children requires more study.
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Brain Stem Gliomas in Childhood |
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Written by Paul G. FIsher, M.D., pediatric neurologist & Dana R. Foer, PA-C
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by Dana R. Foer, PA-C and Paul Graham Fisher, M.D., MHS Brain stem tumors are perhaps the most dreaded cancers in pediatric oncology, owing to their historically poor prognosis, yet they remain an area of intense research. Brain stem tumors account for about 10 to 15% of childhood brain tumors. Peak incidence for these tumors occurs around age 6 to 9 years. The term brain stem glioma is often used interchangeably with brain stem tumor. More precisely, glioma encompasses tumor pathology types such as ganglioglioma, pilocytic astrocytoma, fibrillary astrocytoma, anaplastic astrocytoma, and glioblastoma multiforme. |
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Written by Kenneth J. Cohen, M.D., Director, Pediatric Neuro-Oncology, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins and Kaleb Yohay, M.D., Pediatric Neurology, Johns Hopkins University School of Medicine
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Normal brain is made up of several cell types including neurons, the main functional cell of the brain, and glia, which play a supportive role to the neurons. Glia are further subdivided into different types, each type with a different function, including oligodendrocytes which cover the axons of neurons with sheathes of myelin, and astrocytes which serve many functions including taking up excess neurotransmitters and creating the blood-brain barrier. Gliomas are tumors of glial cells, particularly astrocytes and oligodendrocytes. About 2/3 of all childhood brain tumors are gliomas.
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Written by Roger J. Packer, M.D., Chairman, Department of Neurology, Children's Medical Center, Washington DC
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Medulloblastoma is the most common primary central nervous system tumor which arises in childhood. Its management represents both the progress and limitations involved in patient care over the last 20 years. Medulloblastomas arise in the fourth ventricle, between the brain stem and the cerebellum. Common symptoms are unsteadiness, headaches, and vomiting due to hydrocephalus (from blockage of cerebrospinal fluid flow). Diagnosis is usually within one to three months of the onset of symptoms, as this is a fast-growing tumor. Occasionally due to bleeding within the tumor, a patient will be in a coma or severe distress at diagnosis. While there has been significant improvement in survival for children with this disease, much progress needs to be made.
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Brain Tumor Types