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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 Subtype

    Tumor TypePathologic SubtypeStaging and Treatment of Newly Diagnosed and Recurrent Disease
    CNS = central nervous system.
    Astrocytomas and Other Tumors of Glial Origin  
    Low-Grade AstrocytomasDiffuse fibrillary astrocytomaChildhood Astrocytomas Treatment
    Gemistocytic astrocytoma
    Pilocytic astrocytoma
    Pilomyxoid astrocytoma
    Pleomorphic xanthoastrocytoma
    Protoplasmic astrocytoma
    Subependymal giant cell astrocytoma
    High-Grade AstrocytomasAnaplastic astrocytomaChildhood Astrocytomas Treatment
    Anaplastic oligoastrocytoma
    Anaplastic oligodendroglioma
    Giant cell glioblastoma
    Gliomatosis cerebri
    Brain Stem Glioma  
     Diffuse intrinsic pontine gliomasChildhood Brain Stem Glioma Treatment
    Focal or low-grade brain stem gliomas
    CNS Embryonal Tumors  
    MedulloblastomaAnaplasticChildhood CNS Embryonal Tumors Treatment
    Large cell
    Medulloblastoma with extensive nodularity
    CNS Primitive Neuroectodermal Tumors (PNETs)CNS ganglioneuroblastoma
    CNS neuroblastoma
    Tumors of the Pineal RegionPineal parenchymal tumor of intermediate differentiation
    Papillary tumor of the pineal region
    CNS Atypical Teratoid/Rhabdoid Tumor Childhood CNS Atypical Teratoid/Rhabdoid Tumor Treatment
    CNS Germ Cell Tumors  
    Germinomas Childhood CNS Germ Cell Tumors Treatment
    TeratomasImmature teratomas
    Mature teratomas
    Teratomas with malignant transformation
    Non-Germinomatous Germ Cell TumorsChoriocarcinoma
    Embryonal carcinoma
    Mixed germ cell tumors
    Yolk sac tumor
    Craniopharyngioma Childhood Craniopharyngioma Treatment
    Ependymoma Childhood Ependymoma Treatment
    Tumors of the Choroid Plexus  

    Recurrence is not uncommon in both low-grade and malignant childhood brain tumors and may occur many years after initial treatment.[1] Disease may occur at the primary tumor site or, especially in malignant tumors, at noncontiguous central nervous system (CNS) sites. Systemic relapse is rare but may occur. At time of recurrence, a complete evaluation for extent of relapse is indicated for all malignant tumors and, at times, for lower-grade lesions. Biopsy or surgical re-resection may be necessary for confirmation of relapse; 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 based on the initial tumor type, the length of time between initial treatment and the reappearance of the lesion, and the clinical picture.

    Early-phase therapeutic trials may be available for selected patients via Children's Oncology Group phase I institutions, the Pediatric Brain Tumor Consortium, or other entities.


    1. Jenkin D, Greenberg M, Hoffman H, et al.: Brain tumors in children: long-term survival after radiation treatment. Int J Radiat Oncol Biol Phys 31 (3): 445-51, 1995.

      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.

      WebMD Public Information from the National Cancer Institute

      Last Updated: February 25, 2014
      This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.

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