Growth Hormone-Producing Pituitary Tumors Treatment
Standard Treatment Options for Growth Hormone (GH)-Producing Pituitary TumorsStandard treatment options for GH-producing pituitary tumors include the following:Surgery (usually a transsphenoidal approach).Dopamine analogues, such as bromocriptine.Somatostatin analogues, such as octreotide. The GH-receptor antagonist, pegvisomant.[1,2]Surgery and postoperative radiation therapy.Treatment for patients with acromegaly includes surgical, radiation, and medical therapies. Treatment will depend on the size and extent of the tumor and the need for rapid cessation of hormone function that results in serious clinical sequelae (i.e., hypertension and cardiomyopathy). Microadenomectomy or macroadenoma decompression is approached transsphenoidally in most patients. Increasingly, endoscopic surgery is used to allow the entire surgical field to be viewed and to allow tumor tissue that would otherwise be inaccessible with rigid instruments to be safely resected. Complete return of GH
General Approach to Care for Children with Brain and Spinal Cord Tumors
Important concepts that should be understood by those treating and caring for a child who has a brain tumor or spinal cord tumor include the following: The cause of most childhood brain tumors remains unknown.Selection of an appropriate therapy can only occur if the correct diagnosis is made and the stage of the disease is accurately determined.Children with primary brain or spinal cord tumors represent a major therapy challenge that, for optimal results, requires the coordinated efforts of pediatric specialists in fields such as neurosurgery, neuropathology, radiation oncology, pediatric oncology, neuro-oncology, neurology, rehabilitation, neuroradiology, endocrinology, and psychology, who have special expertise in the care of patients with these diseases.[2,3] For example, radiation therapy of pediatric brain tumors is technically demanding and should be performed in centers that have experience in this area.For most childhood brain and spinal cord tumors, the optimal treatment
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,
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
Treatment Option Overview
How are adult brain tumors treated? Different types of treatment are available for patients with adult brain tumor. Some treatments are standard (the currently used treatment),and some are being tested in clinical trials. Before starting treatment,patients may want to think about taking part in a clinical trial. A treatment clinical trial is a research study meant to help improve current ...
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