The formation of abnormal cells is called a brain tumor in a child. This disease affects areas that control the most important functions of the body and affect the vital processes of the whole body. This is one of the most common forms of cancer and benign lesions in children.
Classification
After the establishment of the main signs and the implementation of diagnostic tests, the neoplasm can be classified in view of the following general characteristics:
- A benign brain tumor in a child grows slowly and does not penetrate nearby tissues. In this case, a pathological neoplasm is dangerous in that, gradually increasing, it begins to squeeze neighboring areas of the brain, which provokes the occurrence of certain symptoms.
- Malignant brain damage includes low-grade formations (with a small degree of aggressiveness) and high-grade tumors that quickly grow and spread to other tissues of the organ.
- Primary formations that originate in the brain.
- Secondary tumors, which are composed of cells metastasizing from other parts of the body.
Astrocytoma
This brain tumor in a child is the primary intracerebral neuroepithelial tumor originating from astrocytes (stellate cells). Astrocytoma in children can have a different degree of malignancy. Its symptoms depend on the location and are divided into general (loss of appetite, weakness, headaches) and focal (hemigipesthesia, hemiparesis, impaired coordination, speech disorders, hallucinations, behavior change). This neoplasm is diagnosed taking into account clinical data, the results of MRI, CT and histological studies of tumor tissue. Therapy of astrocytoma in children is usually a combination of several methods: surgical or radiosurgical treatment, chemotherapy and radiation.
Can a 10-month-old baby show a brain tumor? Brain astrocytoma can develop at any age, but is most often observed in children. This neoplasm is the result of the oncological degeneration of star-shaped astrocytes. Until recently, it was believed that these cells perform auxiliary supporting functions in relation to neurons of the nervous system. However, modern studies in neurophysiology have shown that astrocytes perform a protective function, preventing injury to neurons and suppressing chemicals formed as a result of their vital activity.
Accurate data on the factors provoking a similar pathological transformation of astrocytes is not yet available. Presumably in this process excess radiation, prolonged exposure to chemicals, and viruses play a role. A significant role is played by the hereditary factor, since in children with astrocytoma, genetic disorders in the TP53 gene are often detected.
Brain astrocytoma is subdivided into “ordinary” or “special”. The first category includes fibrillar, hematocytic and protoplasmic astrocytoma of the brain. The “special” category includes pyelocytic, subependymal, and cerebellar microcystic brain astrocytomas in children.
Astrocytomas are also subdivided according to the level of malignancy. Pyelocytic astrocytoma belongs to grade I, fibrillar to grade II, anaplastic to grade III, and glioblastoma to grade IV.
Ependymoma
This brain tumor in a child is formed from the ependymal tissue of the ventricular system of the brain. Clinically, it is manifested by signs of high intracranial pressure, ataxia, impaired vision and hearing, seizures, impaired speech, swallowing reflexes. Diagnosis is carried out mainly with the help of brain MRI, EEG, spinal puncture, histological studies. The basis of therapy is a radical excision of the ependymoma with further radiation or chemotherapy.
Ependymoma originates from ependymocytes, which are epithelial-like cells that form a thin lining of the cerebral ventricles and the spinal canal. These pathological neoplasms account for up to 7% of all brain tumors in children and belong to the category of gliomas. About 60% of patients with such a tumor are children under five years of age. According to the prevalence of ependymoma, it takes 3rd place among cerebral tumors and its malignant course is most often observed.
Brain ependymoma in children is most often formed in the posterior cranial fossa. The tumor is characterized by a slow increase, the absence of germination in neighboring cerebral tissues. Nevertheless, as the growth of such a neoplasm, it can cause compression of the brain. Metastasis of the process occurs mainly along the cerebrospinal fluid paths and does not extend beyond the nervous system. The most commonly observed retrograde metastases in the structure of the spinal cord.
Numerous scientific studies have discovered the SV40 virus, which is in the tumor cells in an active state. But so far, his role in the development of the neoplasm is not clear. It is assumed that the formation occurs due to the influence of common oncogenic factors: radioactive radiation, chemical carcinogens, long-term adverse conditions (for example, hyperinsolation), viruses (human papillomas, herpes virus, etc.).
In addition, the participation of hereditary factors in the formation of ependym should not be ruled out. A combination of cerebral brain tumors in children with Recklinghausen neurofibromatosis, familial colon polyposis, endocrine neoplasia syndrome is known.
In view of the data of modern classification, 4 varieties of ependyma are distinguished, which differ in the degree of benignity and the course of the tumor process. Myxopapillary ependymoma is considered the most benign. Subependymoma is characterized by a gradual benign growth, often an asymptomatic course and a rare recurrence. Classical ependymoma is most often noted. It can cause blockage of the cerebrospinal fluid. It recurs often, over time, it can degenerate into an anaplastic ependymoma, which leaves about 1/4 of all ependyma. It is characterized by rapid growth and metastasis, as a result of which it is called: ependymoblastoma, undifferentiated ependymoma, malignant ependymoma.
Medulloblastoma
This neoplasm of the brain in children is a malignant tumor of medulloblasts, which are immature cells and glia, and is localized, as a rule, in the worm of the cerebellum located next to the fourth ventricle. Characteristic are signs of cancer intoxication in a child, increasing intracranial hypertension and cerebellar ataxia. The diagnosis is made when assessing the clinical picture, the results of the study of cerebrospinal fluid, CT, PET, biopsy. Therapy includes surgical removal of the neoplasm, restoration of spinal cord fluid circulation, chemotherapy.
Medulloblastoma is an extremely malignant pathology. The tumor develops in the cerebellar worm, and in children after six years it is sometimes localized in the hemispheres of the brain. In most cases, it quickly metastasizes through the cerebrospinal fluid channels, which differs from other brain tumors and is in second place among malignant neoplasms of the brain in children in frequency of occurrence. Most often develops in boys.
The age when medulloblastoma is most often detected is 5-10 years. However, it is not exclusively a “childhood” pathology; it can be detected at any age. Usually, the development of medulloblastoma is sporadic. However, there is a hereditary factor in the occurrence of the disease.
Why such a neoplasm of the brain develops in children, remains unclear at the moment. Only the risk factors for such a pathology are known, they include the age of less than 10 years, exposure to ionizing radiation, carcinogens of food, paints, viral infections (cytomegalovirus, herpes, HPV, infectious mononucleosis) that damage the cell genome.
Medulloblastoma is a primitive neuroectodermal formation. It is usually located subtentorially, under the outline of the cerebellum, sprouting into it and filling the entire fourth cerebral ventricle. This leads to the blocking of cerebrospinal fluid outflow, as the tumor begins to block the fluid circulation paths. The intracranial pressure in the child rises sharply, the bulbar sections are damaged due to the germination of a pathological neoplasm in the brain stem. The first signs of a brain tumor in a child are important to recognize in a timely manner.
The histological picture is an accumulation of proliferating, small, poorly differentiated, rounded, embryonic cells with a hyperchromic nucleus and a thin cytoplasm. According to the structure, the following varieties of such a neoplasm are distinguished:
- medullomyoblastoma having muscle fibers;
- melanotic medulloblastoma, consisting of neuroepithelial cells, which contain melanin;
- lipomatous medulloblastoma having fat cells.
Craniopharyngioma
This benign brain tumor in a child is a cystic-epithelial neoplasm localized in the Turkish saddle and developing from the epithelium of Ratke’s pocket. As the neoplasm grows and progresses, the child has an increase in the level of intracranial pressure, developmental delay, visual impairment, adenohypophysis hypofunction. The most informative method for diagnosing this pathology is CT, which allows you to determine the structure and presence of calcifications in the tumor. Therapy is surgical, after which the patient is prescribed radiation therapy aimed at stopping the subsequent growth of a pathological neoplasm.
Craniopharyngioma is located, as a rule, in the hypothalamic-pituitary zone. As it progresses, cysts can form in the tissues of the tumor, which are filled with high-level fluid and proteins. The incidence of craniopharyngiomas is approximately 3% of all types of brain tumors in children. The most common occurrence of neuroepithelial craniopharyngioma (about 9% of cases), and the peak of the development of pathology falls on the age of 5 to 13 years. Another variety of this formation is papillary.
Clinicians consider heredity and various mutations to be the main causes of craniopharyngiomas. In addition, some other factors have an adverse effect on the development of pathological education, especially if their effect occurred in the first trimester of pregnancy. The causes of craniopharyngiomas in children include the influence of medications, poisons, toxins, radiation, early toxicosis, diseases of the pregnant woman (diabetes mellitus, kidney failure, etc.). Craniopharyngioma is divided into 2 types: papillary and adamantinomatous.
Symptoms of a brain tumor in children
Signs of a brain tumor in children are:
- Anorexia, vomiting (usually in the morning).
- Severe drowsiness, loss of strength or impaired activity, pallor.
- Painful condition, especially after vomiting, excessive anxiety.
- Irritability and loss of interest in activities (games, etc.).
- Eye disorders - abnormal eye movement, double vision, blurred vision.
- Lack of coordination, weakness in the legs, impaired gait (frequent tripping).
- Attacks of seizures are a common sign of a brain tumor in children.
- Head enlargement.
- Numbness of the body.
- Involuntary urination, frequent constipation.
- Headache.
- Hyperreflexia and cranial nerve palsy.
- Lag in development.
Where to go if there are symptoms of a brain tumor in children?
Diagnostics
Diagnosis of tumors involves a comprehensive examination. Due to the need for diagnosis on modern equipment, the child may need general anesthesia. A neurological examination is carried out, which is aimed at assessing the basic functions that indicate the proper functioning of the nervous system or its violation. The study includes visual, auditory and tactile reactions of the child.
Diagnostic methods allow you to identify the localization and the first signs of a brain tumor in children when studying parameters: impaired coordination, reflex disorders. Another study is MRI, in which the necessary part of the brain is well visualized. In this case, a special contrasting substance is used.
Is it necessary to remove a brain tumor in children?
Treatment
Treatment of a brain tumor in children should be as effective as possible and avoiding possible adverse reactions. Therapy is carried out using three main methods:
- Surgical removal of the tumor.
- Chemotherapy.
- Radiation therapy.
Surgical treatment of a brain tumor in children is aimed at removing the pathological focus. This method shows the greatest effectiveness in combination with other measures. Surgery for a brain tumor in a child is almost impossible with damage to the main trunk, since this area contains vital areas. Intervention is successful if the child develops a benign neoplasm. In this case, the prognosis for recovery after removal of a brain tumor in children is significantly improved.
Radiation therapy
Radiation therapy is used for contraindications to surgical treatment. The method is not recommended for the treatment of babies under 3 years old, since undesirable consequences can occur due to irradiation - intellectual and physical retardation. Such therapy has a positive effect in neoplasms of a rapidly growing nature or small size.
The use of chemotherapy is necessary if the patient has a high level of tumor malignancy. Treatment is permitted even if the child is less than three years old. What is the prognosis for a brain stem tumor in children, many are interested.
Forecast
Modern treatment methods significantly increase the chances of recovery. The prognosis for a brain tumor in children can be positive, which is determined mainly by the fact that a malignant or benign neoplasm takes place.
The result of therapy depends on many factors:
- a type of tumor;
- the size and location of the lesion, which affects the prognosis of the success of surgical treatment;
- severity and stage of development of pathology;
- patient age;
- the presence of concomitant tumors.
It is proved that the prognosis after the removal of a pathological formation in childhood is much better than in adults.