Neuroblastoma Screening (PDQ®): Screening - Patient Information [NCI] - Stage Information and Treatment of Newly Diagnosed and Recurrent Childhood Spinal Cord Tumors
There is no uniformly accepted staging system for childhood primary spinal cord tumors. These tumors are classified and treated based on their location within the spinal cord and histology. Refer to one of the following PDQ summaries for more information on the staging and treatment of newly diagnosed and recurrent childhood spinal cord tumors:Childhood Astrocytomas Treatment.Childhood Central Nervous System Embryonal Tumors Treatment.Childhood Ependymoma Treatment.In general, at the time of recurrence, low-grade spinal cord glial tumors can be treated with re-resection with or without the use of radiation therapy. Recurrent low-grade and high-grade tumors that cannot be re-resected can be treated on protocols designed for histologically similar brain tumors.
Neuroblastoma Screening (PDQ®): Screening - Patient Information [NCI] - Treatment Option Overview for Childhood Ependymoma
Many of the improvements in survival in childhood cancer have been made as a result of clinical trials that have attempted to improve on the best available, accepted therapy. Clinical trials in pediatrics are designed to compare new therapy with therapy that is currently accepted as standard. This comparison may be done in a randomized study of two treatment arms or by evaluating a single new treatment and comparing the results with those previously obtained with existing therapy. Because of the relative rarity of cancer in children, all patients with aggressive brain tumors should be considered for entry into a clinical trial. To determine and implement optimum treatment, treatment planning by a multidisciplinary team of cancer specialists who have experience treating childhood brain tumors is required. Radiation therapy of pediatric brain tumors is technically very demanding and should be carried out in centers that have experience in that area in order to ensure optimal results.
Neuroblastoma Screening (PDQ®): Screening - Patient Information [NCI] - General Information About Childhood Ependymoma
Childhood ependymoma is a disease in which malignant (cancer) cells form in the tissues of the brain and spinal cord. The brain controls vital functions such as memory and learning,the senses (hearing,sight,smell,taste,and touch),and emotion. The spinal cord is made up of bundles of nerve fibers that connect the brain with nerves in most parts of the body. About 1 in 11 childhood brain ...
Neuroblastoma Screening (PDQ®): Screening - Patient Information [NCI] - Stage Information and Treatment of Newly Diagnosed and Recurrent Childhood Brain Tumors
There is no uniformly accepted staging system for childhood brain tumors. These tumors are classified and treated based on their histology and location within the brain (Table 1).Table 1. The Staging and Treatment of Newly Diagnosed or Recurrent Tumors According to Type of Tumor or Pathologic SubtypeTumor TypePathologic SubtypeStaging and Treatment of Newly Diagnosed and Recurrent DiseaseCNS = central nervous system.Astrocytomas and Other Tumors of Glial Origin –Low-Grade AstrocytomasDiffuse fibrillary astrocytomaChildhood Astrocytomas TreatmentGemistocytic astrocytomaOligoastrocytomaOligodendrogliomaPilocytic astrocytomaPilomyxoid astrocytomaPleomorphic xanthoastrocytomaProtoplasmic astrocytomaSubependymal giant cell astrocytoma–High-Grade AstrocytomasAnaplastic astrocytomaChildhood Astrocytomas TreatmentAnaplastic oligoastrocytomaAnaplastic oligodendrogliomaGiant cell glioblastomaGlioblastomaGliomatosis cerebriGliosarcoma Brain Stem
Neuroblastoma Screening (PDQ®): Screening - Patient Information [NCI] - Stages of Adult Brain Tumors
There is no standard staging system for adult brain and spinal cord tumors.The extent or spread of cancer is usually described as stages. There is no standard staging system for brain and spinal cord tumors. Brain tumors that begin in the brain may spread to other parts of the brain and spinal cord, but they rarely spread to other parts of the body. Treatment of brain and spinal cord tumors is based the following:The type of cell in which the tumor began.Where the tumor formed in the brain or spinal cord.The amount of cancer left after surgery.The grade of the tumor.Treatment of brain tumors that have spread to the brain from other parts of the body is based on the number of tumors in the brain.Imaging tests may be repeated after surgery to help plan more treatment.Some of the tests and procedures used to diagnose a brain or spinal cord tumor may be repeated after treatment to find out how much tumor is left.
Neuroblastoma Screening (PDQ®): Screening - Patient Information [NCI] - Cellular Classification of Pituitary Tumors
Pituitary adenomas can be classified according to staining affinities of the cell cytoplasm, size, endocrine activity, histologic characteristics, hormone production and contents, ultrastructural features, granularity of the cell cytoplasm, cellular composition, cytogenesis, and growth pattern. Recent classifications, however, omit criteria based on tinctorial stains (i.e., acidophilic, basophilic, and chromophobic) because of the poor correlation between staining affinities of the cell cytoplasm and other pathological features of pituitary tumors, such as the type of hormone produced and cellular derivation.[1,2]A unifying pituitary adenoma classification incorporates the histological, immunocytochemical, and electron microscopic studies of the tumor cells, and stresses the importance of hormone production, cellular composition, and cytogenesis. This classification emphasizes the structure-function relationship and attempts to correlate morphologic features with secretory
Neuroblastoma Screening (PDQ®): Screening - Patient Information [NCI] - Treatment Option Overview
Primary Brain TumorsRadiation therapy and chemotherapy options vary according to histology and anatomic site of the brain tumor. For high-grade malignant gliomas—glioblastoma, anaplastic astrocytoma, anaplastic oligodendroglioma, and anaplastic oligoastrocytoma—combined modality therapy with resection, radiation, and chemotherapy is standard. Since anaplastic astrocytomas, anaplastic oligodendrogliomas, and anaplastic oligoastrocytomas represent only a small proportion of central nervous system gliomas, phase III randomized trials restricted to them are not generally practical. However, since they are aggressive and are often included in studies along with glioblastomas, they are generally managed in a fashion similar to glioblastoma. Therapy involving surgically implanted carmustine-impregnated polymer wafers combined with postoperative external-beam radiation therapy (EBRT) has a role in the treatment of high-grade gliomas regardless of
Neuroblastoma Screening (PDQ®): Screening - Patient Information [NCI] - Newly Diagnosed Childhood Brain Stem Glioma Treatment
Diffuse Intrinsic Pontine GliomasConventional treatment for children with diffuse intrinsic pontine glioma (DIPG) is radiation therapy to involved areas. Such treatment will result in transient benefit for most patients, but over 90% of patients will die within 18 months of diagnosis. The conventional dose of radiation therapy ranges between 54 Gy and 60 Gy given locally to the primary tumor site in single daily fractions. Hyperfractionated (twice daily) radiation therapy techniques have been used to deliver a higher dose, and studies using doses as high as 78 Gy have been completed. Evidence demonstrates that these increased radiation therapy doses do not improve the duration or rate of survival for patients with DIPG whether given alone,[1,2] or in combination with chemotherapy. Hypofractionated radiation therapy does not improve survival.[Level of evidence: 2A] Studies evaluating the efficacy of various radiosensitizers as a means for enhancing the therapeutic
Spinocerebellar Ataxia with Axonal Neuropathy
SCAN1 is a neurodegenerative disorder that is inherited in an autosomal recessive pattern. Spinocerebellar ataxia with axonal neuropathy (SCAN1) is characterized by late childhood-onset of a slowly progressive cerebellar ataxia,followed by areflexia and signs of peripheral neuropathy. Gaze nystagmus and cerebellar dysarthria usually develop after the onset of ataxic gait. As the disease ...
Neuroblastoma Screening (PDQ®): Screening - Patient Information [NCI] - Classification of Central Nervous System Tumors
The classification of childhood central nervous system (CNS) tumors is based on histology and location. Tumors are classically categorized as infratentorial, supratentorial, parasellar, or spinal. Immunohistochemical analysis, cytogenetic and molecular genetic findings, and measures of mitotic activity are increasingly used in tumor diagnosis and classification, and will likely alter classification and nomenclature in the future.Primary CNS spinal cord tumors comprise approximately 1% to 2% of all childhood CNS tumors. The classification of spinal cord tumors is based on histopathologic characteristics of the tumor and does not differ from that of primary brain tumors.[2,3,4]Infratentorial (posterior fossa) tumors include the following:Cerebellar astrocytomas (most commonly pilocytic, but also fibrillary and less frequently, high-grade).Medulloblastomas (classic, desmoplastic/nodular, extensive nodularity, anaplastic, or large cell) and variants.Ependymomas (cellular, papillary,