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. Surveillance imaging will frequently identify asymptomatic recurrences.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
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Important It is possible that the main title of the report Astrocytoma is not the name you expected. Please check the synonyms listing to find the alternate name(s) and disorder subdivision(s) covered by this report. ...
Nonfunctioning Pituitary Tumors Treatment
Standard Treatment Options for Nonfunctioning Pituitary TumorsStandard treatment options for nonfunctioning pituitary tumors include the following:Surgery (preferably with a transsphenoidal approach) followed by close observation with radiation therapy reserved for recurrence.[1,2]Radiation therapy.[1,2,3]Surgery and postoperative radiation therapy.[1,2]The selection of treatment for patients with nonfunctioning (endocrine-inactive) tumors will depend on tumor size, the progressive course of the disease, and anatomical structures affected by the tumor extension. The majority of patients present with suprasellar extension and visual field deficits. In addition, many have hormone deficits prior to treatment. The initial treatment of patients with gonadotroph adenomas is usually by transsphenoidal surgery, particularly if the adenoma presents with neurological symptoms, because the effect of radiation therapy occurs too slowly, and no reliable medical therapy exists.Surgical
Important It is possible that the main title of the report Arachnoid Cysts is not the name you expected. Please check the synonyms listing to find the alternate name(s) and disorder subdivision(s) covered by this report. ...
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This information is produced and provided by the National Cancer Institute (NCI). The information in this topic may have changed since it was written. For the most current information, contact the National Cancer Institute via the Internet web site at http://cancer.gov or call 1-800-4-CANCER.Neuroblastoma Treatment
Recurrent Childhood Brain Stem Glioma
Diffuse Intrinsic Pontine GliomasGiven the dismal prognosis for patients with diffuse intrinsic pontine glioma, progression of the pontine lesion is anticipated generally within 1 year from initial radiation therapy. In most cases, biopsy at the time of clinical or radiologic progression is neither necessary nor recommended. To date, no salvage regimen has been shown to extend survival. Patients should be considered for entry into trials of novel therapeutic approaches because there are no standard agents that have demonstrated a clinically significant activity. Concomitant palliative care should be provided for these patients whether or not disease-directed therapy is administered. Focal or Low-Grade Brain Stem GliomasAt the time of recurrence, a complete evaluation to determine the extent of the relapse may be indicated for selected low-grade lesions. Biopsy or surgical resection should be considered for confirmation of relapse when other entities such as secondary tumor and
Stages of Childhood Brain Stem Glioma
The plan for cancer treatment depends on whether the tumor is in one area of the brain or has spread throughout the brain.Staging is the process used to find out how much cancer there is and if cancer has spread. It is important to know the stage in order to plan treatment. There is no standard staging system for childhood brain stem glioma. Instead, the plan for cancer treatment depends on whether the tumor is diffuse (spread throughout the brain) or focal (in one area of the brain):Diffuse intrinsic pontine glioma is a tumor that has spread widely throughout the brain stem. A biopsy is usually not done for this type of brain stem glioma and it is not removed by surgery. A diffuse intrinsic pontine glioma is usually diagnosed using imaging studies.Focal or low-grade glioma is a tumor that is in one area of the brain stem. A biopsy may be done and the tumor removed during the same surgery.The information from tests and procedures done to detect (find) childhood brain stem glioma is