Treatment of Recurrent Childhood Low-Grade Astrocytomas
Childhood low-grade astrocytomas may recur many years after initial treatment. Recurrent disease is usually at the primary tumor site, although multifocal or widely disseminated disease to other intracranial sites and to the spinal leptomeninges has been documented.[1,2] Most children whose low-grade fibrillary astrocytomas recur will harbor low-grade lesions; however, malignant transformation is possible.At the time of recurrence, a complete evaluation to determine the extent of the relapse is indicated. Biopsy or surgical resection may be necessary for confirmation of relapse because other entities, such as secondary tumor and treatment-related brain necrosis, may be clinically indistinguishable from tumor recurrence. The need for surgical intervention must be individualized on the basis of the initial tumor type, the length of time between initial treatment and the reappearance of the mass lesion, and the clinical picture. An individual plan needs to be tailored based on patient
Neuroblastoma is a cancer that primarily affects children. It begins in nerve tissue in the neck,chest,abdomen,or pelvis. It usually originates in the abdomen in the tissues of the adrenal gland. By the time it is diagnosed,the cancer often has spread,most commonly to the lymph nodes,liver,lungs,bones,and/or bone marrow. Risk of neuroblastoma Neuroblastoma is the most common type of ...
Incidence and Mortality About 7% of all malignancies in children under the age of 15 are neuroblastomas. About one quarter of cancers in the first year of life are neuroblastomas,making this the most frequent histological type of infant cancer.[ 1,2 ] The incidence rate of the disease in children younger than 1 year is about 35 per million but declines rapidly with age to about 1 per million ...
This cancer treatment information summary provides an overview of the diagnosis,classification,treatment,and prognosis of childhood brain stem gliomas. The National Cancer Institute provides the PDQ pediatric cancer treatment information summaries as a public service to increase the availability of evidence-based cancer information to health professionals,patients,and the public. These ...
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Changes to this Summary (11 / 16 / 2012)
The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.General InformationAdded text to state that ATRX is involved in epigenetic gene silencing and telomere length; ATRX mutation without MYCN amplification is associated with age at diagnosis in adolescents and young adults with metastatic neuroblastoma (cited Cheung et al. as reference 48).Added Schleiermacher et al. as reference 56.Stage InformationRevised text to state that before resection of the primary tumor, bone should be assessed by metaiodobenzylguanidine (MIBG) scan, which is applicable to all sites of disease, and by technetium 99 scan if the results of the MIBG scan are negative or unavailable. Also added text to state that additional imaging of isolated or equivocal positive lesions is recommended if the primary tumor does not take up MIBG (cited Taggart et al. as reference 5).Revised
Changes to This Summary (07 / 23 / 2010)
The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.Evidence of BenefitAdded text about a study that compared neuroblastoma incidence and mortality rates in Japan in three cohorts: children born before screening between 1980 and 1983, and those born during screening between 1986 and 1989, and between 1990 and 1998 (cited Hiyama et al. as reference 32).This summary is written and maintained by the PDQ Screening and Prevention Editorial Board, which is editorially independent of NCI. The summary reflects an independent review of the literature and does not represent a policy statement of NCI or NIH. More information about summary policies and the role of the PDQ Editorial Boards in maintaining the PDQ summaries can be found on the About This PDQ Summary and PDQ NCI's Comprehensive Cancer Database pages.
Treatment of Intermediate-Risk Neuroblastoma
In North America,the Children’s Oncology Group (COG) is investigating a risk-based neuroblastoma treatment plan that assigns all patients to low-risk,intermediate-risk,and high-risk groups based on age,International Neuroblastoma Staging System (INSS) stage,and tumor biology (i.e.,MYCN gene amplification,Shimada classification,and DNA ploidy). (Risk groups are defined in Table 1 of the ...
The prognosis and treatment of recurrent or progressive neuroblastoma depends on many factors including initial stage,tumor biological characteristics at recurrence,the site and extent of the recurrence or progression,and on the previous treatment as well as individual patient considerations. In selected patients originally diagnosed with low- or intermediate-risk disease,recurrence may be ...
Stage Information for Pituitary Tumors
As with other tumors of the central nervous system (CNS), no tumor, nodes, metastases-based American Joint Committee on Cancer classification and staging system for pituitary tumors exists. Pituitary tumors are classified according to size and divided into microadenomas (i.e., the greatest diameter is <10 mm) and macroadenomas (i.e., the greatest diameter is ≥I0 mm). Most pituitary adenomas are microadenomas. The most widely used radioanatomical classification was based primarily on a neuroradiological examination including skull x-rays, pneumoencephalography, polytomography, and carotid angiography. Subsequently validated by the application of more accurate magnetic resonance imaging (MRI) and computed tomography, this radioanatomical classification places adenomas into 1 of 4 grades (I–IV) and has been augmented by additional studies including immunohistochemistry and electron microscopy. Currently, MRI is considered the imaging modality of choice for the diagnosis