How do tumors appear in a child? Brain tumors in children: features, causes, removal operations, treatment. Common symptoms of brain cancer

A brain tumor is a serious condition that requires immediate treatment. Knowing and diagnosing the first signs and symptoms in time early stage development of benign or malignant tumor disease the patient can be cured.

While benign or malignant neoplasms are small in size and detected in the early stages, they can be successfully removed during surgery. The patient can continue to full life. In advanced conditions, unfortunately, the development of a tumor leads to serious consequences and death. The patient can only accept everything as it is - face to face and humbly trust in the Will of the Almighty...

However, well... who said that miracles don’t happen at all? Sometimes healing can come, it seems, due to circumstances completely beyond a person’s control.

Neoplasms formed from blood vessels, tissues and membranes of the brain are, as we have already said, benign and malignant. Both species pose a threat to human life because they gradually compress the brain areas responsible for vital functions. important functions body - breathing, cardiac activity, etc. Depending on the reason for which they formed, neoplasms are distinguished:

1. primary– benign – develop from their own tissues;
2. secondary– malignant – the result of metastases of other organs.

Symptoms of a brain tumor in the early stages are very difficult to determine, but are necessary for correct diagnosis in order to save the patient’s life. Each type of neoplasm requires its own approach to treatment. In oncology, there is a classification of tumors by cell type:

1. neuroepithelial– develop from their own tissues anywhere in the brain and spinal cord;
2. pituitary adenoma– generated from pituitary cells during injuries, neuroinfections, pathologies of childbirth, pregnancy;
3. shell– grow from the membranes of the cerebral cortex;
4. neuromas– neoplasms cranial nerves.

Treatment of tumors has to be removed during surgery with opening of the skull. One of the operation options is the endoscopic method of removing the tumor, without trephination, using special instruments, although the size of the tumor matters here. In addition, methods are used without opening the skull:

1. HIFU therapy– impact on the neoplasm with ultrasonic waves;
2. stereotactic radiosurgery– radioactive irradiation of the source of the disease (name of the instrument – gamma scalpel);
3. spatial scalpel – cyber scalpel– for hard-to-reach tumors.

Benign neoplasms

It is not yet possible to unambiguously identify the cause of the appearance of neoplasms. There are some factors: heredity, radioactive radiation, diseases.

It has been established that a benign tumor develops slowly and does not metastasize. Its danger lies in putting pressure on neighboring areas, which causes severe consequences, there is a risk of it turning into cancer, that is, into a malignant tumor. It is important to have the earliest possible correct diagnosis for timely initiation of treatment.

Symptoms of a benign brain tumor in the early stages are dizziness for no apparent reason, headaches of an increasing nature. This also includes:

1. nausea, vomiting;
2. the appearance of seizures;
3. coordination problems;
4. hallucinations;
5. paralysis of limbs;
6. memory loss;
7. hearing and vision impairment;
8. loss of sensation;
9. speech disorder;
10. loss of concentration.

Malignant tumors

When a tumor grows quickly, does not have clear boundaries, and penetrates (grows) into neighboring tissues, it is malignant. Tissue necrosis and bleeding occur, often inoperable cancer. The patient may die within a few months.

Most primary malignant tumors - gliomas - can have different degrees development. The most rapidly developing and dangerous neoplasm is glioblastoma of the last 4th stage of development.

The first signs of brain cancer at an early stage

Often, at the beginning of the disease, a person does not pay attention to the symptoms, because the main one is headache- may manifest itself by various reasons. They already go to the doctor for more serious manifestations.

What symptoms of a brain tumor should you pay attention to in the early stages?

First of all, these include:

1. dull, bursting pain in the head;
2. morning vomiting;
3. feeling of objects spinning around;
4. poor spatial orientation;
5. epileptic seizures;
6. hearing loss;
7. vision problems - the appearance of floaters, fog.

How does a brain tumor manifest itself?

It is necessary to pay special attention to the signs of a brain tumor at an early stage - sudden headaches. They are long-lasting and appear in a lying position, especially at night and in the morning.

At the same time, headaches with a brain tumor are accompanied by nausea and vomiting.

Neoplasms in the cerebellum, which is responsible for coordinated movement of the body, cause cerebellar, cerebral, and remote symptoms.

They appear:

1. pain in occipital region heads;
2. sitting and standing disorder;
3. paralysis, paresis.

In adults: men and women

Considered a symptom of a brain tumor in the early stages a sharp decline weight, because the neoplasm destroys the metabolic processes in the body. Men and women of different ages are faced with the manifestation of weakness that appears when infected cells enter the blood.

The following symptoms of a brain tumor are also noted:

1. elevated temperature;
2. changes in hair and skin.

It is noted that the disease most often occurs in men after 65 years of age. Representatives of the white race are more susceptible to brain tumors than others.

Provoking factors are:

1. professional – work involving radiation and electromagnetic radiation;
2. radiation therapy to the head;
3. diseases associated with impaired immunity - AIDS, HIV;
4. chemotherapy;
5. organ transplantation.

In children and adolescents

Neoplasms of the brain stem - gliomas - often occur in childhood. This disease is not typical for a mature person. Syndromes of childhood and adolescence show similarities with adults - prolonged headaches and nausea.

Exist special features child brain tumors. These include:

1. development of scoliosis;
2. back pain;
3. early sexual development;
4. strabismus;
5. growth arrest;
6. gait disturbance;
7. problems with coordination;
8. convulsions;
9. palsy of the optic nerves.

Diagnostic methods

When found initial signs brain tumors, you should consult a doctor, he will prescribe biochemical analysis blood.

In the early stages, an ophthalmologist can detect the problem by examining the fundus of the eye.. You can go to several specialists to find out the cause of the disease.

In order to specify the diagnosis, the following is carried out:

1. angiography of cerebral vessels;
2. computed tomography;
3. MRI – magnetic resonance imaging;
4. spinal tap;
5. electroencephalography;
6. PEC-CT – tomography using radioactive contrast.

Prognosis and consequences of the disease

Progress in the field of medicine, the emergence of equipment that makes it possible to perform complex brain operations, has increased the survival time of patients. An important prerequisite for good prognosis remains early diagnosis, which makes possible a survival rate of up to 80% in the next five years.

Positive forecasts are determined by:

1. location of the tumor;
2. age - the younger the better;
3. size of the tumor;
4. the prevalence of the neoplasm;
5. general health;
6. degree of malignancy;
7. type of tumor.

Children who have had the disease before the age of 7 may have problems processing information and visual perception. Since the treatment of the disease is associated with an invasion of parts of the brain that oversee important body functions, there may be associated consequences in adults.

There may be:

1. mental disorders;
2. paralysis;
3. dementia;
4. blindness;
5. speech disorder;
6. death.

Video on the topic

How does a headache with a brain tumor hurt?

You will help your loved ones if you send them for examination by noticing the symptoms of tumors at an early stage. Features tumors of the frontal part – changes in a person’s personal behavior. You need to pay close attention to headaches if their manifestations change, when they are accompanied by nausea and vomiting. Why shouldn't you start a headache? How can a disease be cured, what types exist? modern methods fight against neoplasms? Which specialists will help identify tumor symptoms? Watch the video - you will have the solution to all your questions.

An ophthalmologist can help detect brain cancer at an early stage!!!

What is a brain tumor, and what are the first symptoms of brain cancer and signs of a brain tumor?

On the video channel “Bookimed.com”. Brain tumors can be benign or malignant. Cancer tumor brain can be primary and secondary - metastases to the brain.

Lifestyle: What are the symptoms of a brain tumor

On the Moscow 24 video channel.

We often don’t pay attention to headaches and don’t consider it a serious problem. Sometimes this is true.

One of the most dangerous is a brain tumor. What symptoms should make you see a doctor and how? modern medicine solves this problem, the host of the “Lifestyle” program Ksenia Sokolyanskaya learned at the Research Institute of Neurosurgery named after. N. N. Burdenko.

If your child is bothered and vomits in the morning, this is alarm bell, which makes parents wary. It is possible that trouble has come to your family and its name is a brain tumor. Symptoms in the early stages in children vary depending on where it is located.

As the disease develops, areas that have an impact on the child’s life are affected. The future health and life of the child will depend on the timeliness of contacting a qualified specialist. Knowing the first symptoms of brain cancer in children, you can diagnose the disease in time and begin treatment while it is still developing.

Development and classification of the disease

Brain cancer in children is an uncommon oncological disease accompanied by the appearance malignant tumors both inside the skull and on its surface. The formation of tumors that form inside the skull or spinal canal is caused by uncontrolled cell division.

New growths develop at a rapid pace, increasing in size and spreading to neighboring tissues. A benign brain tumor in children is located directly in the brain tissue, without metastasizing to other organs. Limited by space skull, sooner or later the tumor degenerates into cancer.

Based on the main characteristics, a brain tumor is divided into:

• Primary. It develops initially from the tissues of the membranes of the brain.
• Secondary. The primary cause of tumor development is neoplasms in other organs, which over time metastasize to the brain.

It is customary to distinguish 12 categories of brain tumors, the symptoms of which in children are divided depending on the composition of the cells. There are about 100 types of the disease. The most common are neuroepithelial, pituitary, meningeal, dysembryogenetic and foci not formed in brain tissue.

A neuroepithelial tumor develops from brain tissue cells. This type includes,. The neuroepithelial type accounts for about 60% of all malignant primary tumors.

Meningeal types are provoked by abnormal uncontrolled division of the membrane of the brain, pituitary types are formed during the division of pituitary cells. Incorrect cell division during embryogenesis leads to the formation of dysembryogenetic tumors.

Symptoms of brain cancer in children are differentiated from healthy cells. The high similarity of neoplasms to the structure of healthy tissue facilitates diagnosis. When several levels of differentiation are detected, the development of cancer is detected by infected cells. The offensive and rapid course of the disease is characteristic of cells that are not identical in structure.

Brain cancer in children: stages of development

The patient's life expectancy is influenced by the degree of development of the disease. Distinctive property brain cancer – transformation of tissues in the central nervous system. To determine what stage of development the disease is at, you need to carry out a series of additional methods diagnostics According to the results diagnostic studies and further treatment is determined.

There are 4 stages of brain cancer development, each with specific symptoms:

• First or initial stage. When brain cancer is detected by symptoms in the early stages in children, doctors give a favorable prognosis. With timely treatment it is possible full recovery. The first signs of a brain tumor do not particularly manifest themselves due to their slow growth, so it is almost impossible to detect them.
• Second stage. At this stage of development, the tumor grows, affecting some brain structures. At the second stage, signs of a brain tumor in children appear more pronounced. Nausea, headaches, and increased arterial pressure. In addition, it is difficult for the child to concentrate, his mood changes sharply, and memory lapses occur. If the tumor is not detected at this stage of development, the child’s life is in serious danger.
• Third stage. At this stage, the tumor actively grows, penetrating deeper into the tissues and brain. In progress nervous system are happening serious violations. Signs of a brain tumor in children at the third stage of development are manifested by rapid weight loss, high fatigue, vomiting, and lack of coordination. In addition, hearing, vision, memory and speech deteriorate, numbness of the limbs and anemia are observed.
• Fourth stage. At this stage of development, cancer cannot be treated: . Occur in the body irreversible changes, and they affect not only the central nervous system, but also organs that are part of the area controlled by the part of the brain affected by tumors.

Brain cancer in children, in addition to the symptoms listed above, may be accompanied by complete or partial paralysis and impaired sense of smell. If affected frontal lobe brain, there is a personality defect.

Localization and frequency of tumors

Malignant neoplasms in children can be localized in the hemispheres, midline and posterior cranial fossa.

In the hemisphere, tumors of neuroectodermal origin (gliomas) develop, which are part of a heterogeneous group. They are diagnosed in 37% of patients.

In the midline of the brain, chiasmal gliomas are diagnosed in 4% of cases - tumor formations, formed from glial cells that are located in the area of ​​the optic nerve, in 8% - craniopharyngiomas, in 2% - tumors pineal gland.

In the posterior cranial fossa, brainstem gliomas and cerebellar astrocytomas are diagnosed with equal frequency (15%), medulloblastomas are diagnosed in 14%, and ependyomas are diagnosed in 4%.

Education pathological cells in the tissues of the brain or spinal cord is brain tumor in children. The disease affects areas that control important body functions and affect the functioning of everything. human body. This is one of the most common forms of childhood cancer.

After identifying the main signs and performing diagnostic tests, brain tumor in a child can be classified according to the following general characteristics:

• the benign formation grows slowly and does not penetrate into adjacent tissues. In this case, the tumor becomes dangerous because, as it grows, it compresses nearby areas of the brain, which provokes the appearance of certain symptoms;
• malignant brain lesions include low-grade tumors (not very aggressive) and high-grade tumors that grow quickly and spread to other tissues of the organ;
• primary formations begin in the brain;
• Secondary formations consist of cells that have been released from other parts of the body.

Leading clinics abroad

Brain tumor in a child: the most common types

Astrocytomas- are formed from certain cells in the back of the head. In children they often present with an aggressive form.

Ependiomas– are formed from part of the central nervous system.

Gliomas brain stem() - occur in tissues that connect to the spine ( rear end skull). Typically, they are high-grade, fast-growing lesions. A type - Pontian gliomas.

Medulloblastomas- begin in the posterior cranial fossa at the base of the skull.

Optic nerve gliomas() - affects the tissue that connects the eye to the brain.

Craniopharyngiomas– non-cancerous tumors that arise at the base of the brain (pituitary gland).

Germ cell tumors, as a rule, form in the testes or ovaries, but can form in the brain and central nervous system. They represent both non-malignant and cancerous formations.

Mostly brain tumors in children are gliomas or medulloblastomas (70-80%). Other neoplasms represent craniopharyngiomas or.

Brain tumors in children: symptoms

Signs and brain tumor symptoms in children not the same. They depend on the following factors:

1. The exact location of the tumor (part of the brain or spinal cord).
2. Tumor size and growth rate.
3. Age and general development child.

Leading specialists from clinics abroad

Signs of a brain tumor in children depending on the location of the tumor

Abnormal formations located in different parts of the brain and spinal cord cause symptoms that differ from each other. Based on the occurrence of problems with specific functions, the localization of the tumor can be determined.

Signs of a brain tumor in children according to specific location include:

Tumors in parts of the brain(large and external) – cause loss of control motor function, including weakness and numbness on one side of the body.

Intracranial neoplasms– cause headaches, problems with general health, loss of coordination. Children under 4 years of age may have macrocephaly, frequent nausea, irritable state, lethargy. A brain tumor in a child in the first years of life is usually determined by refusal to eat, poor digestion, increased tearfulness, weakness. Accompanying factors are hyperreflexia (increased reflexes) and cranial nerve palsy.

Central formations of the brain– manifested by unusual eye movements, strabismus and the presence of other general symptoms.

Atypical formations of the anterior part of the brain– responsible for problems with language and thinking (loss of speech or even understanding of words, lack of language skills).

Tumor in the back of the brain or around the pituitary gland– damages optic nerves.

Brain tumor in children, which is localized in the basal ganglia, causes pathological movements and body positions.

Neoplasms in the cerebellum(the back of the brain) cause problems with controlling coordination, walking and even eating.

Tumors within or near other cranial nerves can lead to hearing loss, problems with balance, facial muscles, and swallowing.

Brainstem neoplasms associated with abnormal gait, cranial nerve palsy, headache and strabismus.

In children it causes numbness, weakness, lack of coordination, problems with the intestines and bladder.

Knowing the signs and symptoms listed above that indicate brain tumor in a child, it is possible to recognize brain oncology in a child at an early stage, thereby improving the overall outcome of the disease and preventing a possible critical situation (advanced stage, inoperable form of the tumor). If several conditions of the disease are identified, parents should immediately consult a doctor!

Brain tumors in children are the formation of abnormal cells in the brain tissue. This pathology is considered today one of the most common forms oncological diseases in childhood.

The disease affects areas that control important functions that affect the child’s life, and the prognosis for health and life depends on timely contact with a specialist. Therefore, it is necessary to know the first symptoms and main signs of brain tumors. This will help to diagnose the tumor in time and choose the right treatment tactics.

Manifestations of pathology in childhood

Brain neoplasms in children account for 15 to 20% of all tumors in pediatric oncology, second in prevalence only to leukemia (25 - 30%).

The peculiarity of this pathology in children is the tendency of even benign pathological formations To rapid growth, germination into structures, compression of tissues and disruption or complete cessation of blood flow to certain areas of the child’s brain. This leads to transient or persistent changes, disturbances or loss of important functions of the affected brain structures (stem, cerebellum, ventricles, optic chiasm):

• movement disorders;
• changes in sensitivity;
• coordination problems;
• problems with hearing, vision;
• disturbances in the functioning of certain body systems (respiratory, cardiovascular, swallowing);
• mental changes.

Therefore, early diagnosis of the disease and correctly chosen treatment tactics are the basis for a favorable prognosis for the life and health of the child, as well as the key to his full recovery.

Main symptoms

The clinical picture of the disease in childhood has its own characteristics and is determined, on the one hand, by the immaturity of the nervous system, and on the other, by its high adaptability and plasticity. Therefore, in most cases the disease long time may be asymptomatic, and its signs appear when the tumor reaches a relatively large size.

The first symptoms of a brain tumor in children:

• irritability, change in interest in favorite activities and games;
• capriciousness, causeless crying of a child (in infants and children early age), frequent complaints of headaches;
• nausea, vomiting, more often in the first half of the day and regardless of food intake;
• decreased or impaired vision (double vision, blurriness), hearing;
• problems when walking, changes in gait, coordination of movements;
• changes in speech, memory;
• attacks of convulsions, seizures, short-term loss of consciousness;
• frequent nosebleeds;
• problems breathing, swallowing, urinating, or defecating;
• endocrine disorders.

All these neurological signs associated with compression normal structures brain, germination and infiltration of healthy tissues or delayed outflow cerebrospinal fluid and promotion intracranial pressure.

Signs of the disease and features of their manifestation in children

1. Headache – long-lasting, intense, constant or paroxysmal, does not decrease after taking painkillers medicines, headaches are often accompanied by nausea, vomiting, hearing or vision impairment. In young children, this symptom is manifested by constant or periodic restlessness, crying, sleep disturbance and refusal to eat.
2. Vomiting - occurs without apparent reason, more often in the morning or against the background of increasing intensity of the headache; as the tumor grows, an increase in the manifestation of this symptom of the disease is noted.
3. The child becomes lethargic, capricious, drowsy, gets tired quickly and loses interest in previous games and activities, or, on the contrary, there is increased irritability, hyperactivity, character traits and behavior change.
4. Appear movement disorders which are manifested by changes in gait (limping, lack of coordination of movements).
5. Deterioration in school performance, forgetfulness, memory loss.
6. Changes in speech - slow chanting and fast speech, failure to pronounce individual sounds, words, violation of sentence construction.
7. Symptomatic epilepsy - manifests itself various types epileptic seizures without the formation of a focus of epiactivity (absences, loss of consciousness, attacks of clonic and/or tonic convulsions of varying intensity and duration).
8. Other symptoms (impaired vision, hearing, swallowing, breathing, nosebleeds, urinary and fecal incontinence).

Clinical symptoms of tumor occurrence and growth in young children

It is important to know that the symptoms of a brain tumor in infants and young children differ from clinical manifestations diseases in adolescents and adult patients.

Features of intracerebral neoplasms in young children include the development internal hydrocephalus, which is explained by the midline location of the tumor in the area of ​​the brain stem, optic chiasm and cerebellum with invasion into lateral ventricles. In this case, the outflow of cerebrospinal fluid is disrupted, and the following symptoms appear.

Characteristic first signs of the disease in infants:

• increase in head circumference, which significantly exceeds age standards growth, deformation of the skull bones, asymmetry of the head - increase on the side of the tumor;
• bulging fontanelles, divergence of sutures;
• the network of vessels on the head increases, the veins bulge;
• there is a delay in the physical and psycho-emotional development of the child;
• the baby constantly cries, often the crying is monotonous, which indicates a constant headache;
• frequent and profuse regurgitation, retching, vomiting not associated with food intake;
• movements change eyeballs, appear eye symptoms in the form of twitching, squinting, uneven movements in the form of a “setting sun”;
• convulsions, freezing, chaotic movements of the child’s hands.

Clinical manifestations of the tumor in schoolchildren and adolescents

Symptoms of the presence of a neoplasm in school-age children:

1. Frequent complaints of paroxysmal or constant headaches.
2. Constant lethargy, weakness, drowsiness.
3. Significant decline in school performance and memory.
4. Irritability, changes in the child's behavior.
5. Constant nausea, vomiting not associated with food intake.
6. Persistent loss of appetite.
7. Changes in gait, speech, handwriting.
8. Dizziness.
9. Visual and hearing impairment.
10. Convulsions, loss of consciousness.

Signs of the disease depending on the location of the tumor

The most frequently diagnosed are intracerebral neoplasms (90 - 95%), which are located in the midline relative to the brain structures (tumors of the brainstem, optic chiasm, cerebellum, areas of the third and fourth ventricles of the brain).

These are mainly tumors of neuroepidermal origin. Most often, children are diagnosed with gliomas, which account for 70% of all benign neoplasms brain and meningiomas.

Features of the manifestation of tumors localized in the posterior cranial fossa, cerebellum and ventricles of the brain:

1. Long-term asymptomatic.
2. Initial signs of increased intracranial pressure appear:
   • increase in head circumference;
   • bulging and tension of the fontanelle;
   • regurgitation and vomiting;
   • constant worry and complaints of headaches (in older children);
   • strengthening of the venous network and bulging of the veins of the head;
3. Unsteadiness of gait, hand tremors, dizziness and others vestibular disorders(if the tumor is located in the cerebellum or it grows into its structures from the brain stem).

Brainstem neoplasms

This is the most common location of brain tumors. They are formed from glial cells.

Benign tumors of the trunk grow slowly and may not make themselves felt for years.

There are several types of neoplasms:

1. Primary formations:
   • exophytic stem tumors (growing from the cerebellum or lateral ventricles);
   • neoplasms inside the trunk;
2. Secondary tumors (in most cases these are metastases from other organs or brain structures).

The brain stem contains structures that regulate the main life-supporting functions of the child’s body - the center of breathing and cardiac activity, eye movements, facial expressions, swallowing, hearing and speech.

The main symptoms of the appearance of a brain tumor primarily in the brainstem area include:

• strabismus and impaired eye movement;
• facial asymmetry;
• hearing loss;
• twitching of the eyes, rolling them up or down;
• decreased muscle tone;
• dizziness;
• swallowing problems, choking while eating or drinking;
• changes in breathing (fast, shallow or noisy breathing);
• symptoms of dysfunction of the cardiovascular system (increased or slowed heart rate, interruptions in heart function, decreased or increased blood pressure).

If even one of the symptoms of brain stem damage appears in a child, it is necessary to immediately contact a specialist - a pediatric neurologist.

Malignant brain tumors in children

According to the International Agency for Research on Cancer (IARC), brain cancer in children has been diagnosed much more frequently over the past thirty years and today accounts for 15–16% of all malignant tumors diagnosed in childhood. The most common tumors in children are medulloblastomas, which account for 14% of all malignant neoplasms brain.

The first signs of a malignant brain tumor in a child are the so-called “tumor symptom complex,” which parents should notice in order to promptly seek advice from a specialist:

• fatigue, lethargy, loss of strength, change in activity and drowsiness of the child;
• loss of appetite, vomiting reflex, weight loss.
• pallor skin;
• causeless increase in temperature.

Children also complain of pain in the bones and joints, persistent headaches for several months that do not decrease after taking painkillers, increased lymph nodes in the head and neck area and in armpits, frequent causeless nosebleeds, increased bleeding from minor abrasions and cuts, constant nausea and periodic vomiting.

Focal and “nonspecific” neurological symptoms appear depending on anatomical localization neoplasms similar to the signs of benign tumors.

The most unfavorable course is for sarcomas and malignant tumors localized in the brain stem - in most cases they end fatal– life expectancy depends on the degree of malignancy of the neoplasm.

It is important to remember that early diagnosis and treatment significantly increases the chance of a favorable outcome even with malignant tumors.

According to the Moscow Research Oncological Institute named after P.A. Herzen in 2015 in Russia, 8,896 primary patients with tumors of the central nervous system were identified, including 655 children under the age of 17 years. Currently, more than half of these patients can be cured, and the proportion of patients achieving remission is constantly growing due to improved methods computer diagnostics, surgical treatment, radiation therapy and chemotherapy, as well as innovative methods such as immunotherapy and gene therapy.

What is a tumor?

Tumors are pathological neoplasms in which the growth and differentiation of cells is disrupted due to changes in their genetic apparatus. Neoplasms in the body can arise from any tissue; their growth is carried out exclusively due to own cells. Sometimes the term “secondary tumor” is used to define a tumor that arises after chemoradiation treatment.

Primary tumors consist of cells of the organ or tissue where they begin to develop, i.e. Primary brain tumors arise in brain cells. In addition, there are secondary tumors that originated in other parts of the body but have spread (metastasized) to the brain or spinal cord.

When a tumor grows slowly, often without metastases, it is called benign . On the contrary, cells malignant tumors multiply rapidly and can metastasize to adjacent tissues and other parts of the central nervous system. It is believed that “malignant” in oncology means “bad”, and “benign” means “good”. However, this is not entirely true for CNS tumors.

Even a benign, slow-growing tumor can be life-threatening if it puts pressure on brain structures that regulate vital body functions such as breathing or circulation. IN Lately In neuro-oncology, there are benign tumors that can also metastasize. Therefore, in the complex initial examination all patients, incl. and with benign tumors, MRI of all parts of the central nervous system is included.

The most common brain tumors in children

Depending on the histological variant: 55% - gliomas, with 15% low grade gliom (LGG), 12% - embryonal tumors (usually medulloblastomas)

By localization: 25% supratentorial, 20% infratentorial, 12% brainstem tumors, 8% suprasellar, 7% tumors cranial nerves, 6.4% ventricular tumors, 4.3% spinal cord tumors ( Chiang, Ellison 2016 ).

Infratentorial (or subtentorial) tumors are located in posterior cranial fossa (posterior region of the brain). This area is separated from the cerebral hemispheres by a dense membrane - the so-called tentorium cerebellum, or cerebellar tent. Its Latin name is tentorium, hence the names subtentorial And supratentorial tumors – that is, tumors located respectively under and above the tentorium of the cerebellum.

In the posterior cranial fossa, that is, subtentorially, are the cerebellum, brain stem and fourth ventricle. The following types of tumors are detected in this area: medulloblastomas, cerebellar astrocytomas, brainstem gliomas, ependymomas. Rare types of tumors occur with less frequency in this area - atypical teratoid-rhabdoid tumor and ganglioglioma .

The remaining central nervous system tumors in children are located in the cerebral hemispheres, with the exception of approximately 4% of tumors that occur in the spinal cord. Tumors found in the cerebral hemispheres include astrocytomas, glioblastomas, oligodendrogliomas, craniopharyngiomas, choroid plexus tumors, ependymomas, pineoblastomas and germ cell tumors, rare species tumors.

In the spinal cord, astrocytomas and ependymomas most often occur, as well as metastases of brain tumors.

It's easy to get confused by the complex names of tumors. Let's give a little explanation. Half of brain tumors in children – This gliomas, that is, they develop from glial cells, or “helper” cells of the nervous system. Glial cells include astrocytes, ependymal cells and oligodendrocytes (cells responsible for myelination). The names of some tumors come from the names of these cells. For example, astrocytomas develop from astrocytes, a type of glial cell. Therefore, doctors can call such a tumor a glioma, or maybe an astrocytoma, just the second term will be more specific. The name of the tumor may also reflect its location: for example, brainstem glioma. The use of the grade of malignancy of glioma, low-grade glioma (for example, pilocytic astrocytoma) or glioma can also be more specific. high degree malignancy (eg, glioblastoma or anaplastic astrocytoma).

Below you can see the types and frequency of occurrence of CNS tumors in children aged 0 to 14 years depending on the methylation profile - a relatively new molecular genetic technique for studying CNS tumors (Ostrom et al., Neuro-Oncol 2014).

So, there are many types of brain tumors and many names for them, and often the same tumor can be called by different names. Faced with a flood of new medical terminology, a person may get confused. However, professionals who deal with these problems have long mastered all the necessary terms through many years of study and work. So don't hesitate to ask your child's doctor for clarification.

Below we will describe only the most common types of brain tumors in children, and depending on the location, we will divide them into two large groups.

Glioma– a tumor of glia (cells not related to the nervous tissue) of the nervous system. The term is sometimes also used to refer to all tumors of the central nervous system, including astrocytomas, oligodendrogliomas, medulloblastomas, and ependomas. Benign tumors cause symptoms associated with compression of surrounding tissue, while malignant tumors can quickly affect surrounding tissue, damaging and destroying it.

Posterior fossa tumors

Medulloblastoma – the most common malignant brain tumor in children (20% of all central nervous system tumors childhood). It usually occurs between the ages of four and ten years, most often in boys. This tumor is located in the cerebellum and/or in the fourth ventricle of the brain, interferes with the outflow of cerebrospinal fluid and causes hydrocephalus. The child may have a headache, vomiting, unsteady gait, and sometimes pain in the back of the head. Medulloblastoma can spread (metastasize) to other parts of the central nervous system through the cerebrospinal fluid. Treatment for this tumor usually involves surgical removal of the tumor, followed by radiation to the entire brain and spinal cord and/or chemotherapy.

Astrocytoma cerebellum – benign glial tumor of the cerebellum, the second most common tumor in children (15–20%). It can occur in children and adolescents of any age and has the same Clinical signs, as medulloblastoma. The main treatment for this tumor is surgical removal, and if the tumor can be completely removed, then no other treatment may be required. If the tumor grows into the brain stem and cannot be removed, radiation therapy or chemotherapy is sometimes used, depending on the child's age.

Brain stem gliomas constitute approximately 10–15% of all childhood tumors of the central nervous system (often also called diffuse pontine gliomas). They usually develop in children aged 5-10 years. Because of their location, they can cause the sudden onset of severe neurological symptoms such as double vision, incoordination, difficulty swallowing and weakness. With this type of tumor surgery usually not applicable, only if biopsy and tumor verification are necessary, radiation therapy or radiation therapy in combination with chemotherapy is preferable. However, in a small percentage of cases, slowly growing pontine gliomas, which are characterized by slow progression of neurological symptoms and are represented by nodular formations, can be removed surgically.

Ependymomas make up 8-10% of CNS tumors in children and occur at any age. This type of glioma develops from cells lining the ventricles of the brain. 70% of all ependymomas occur in the posterior fossa. On tomograms, these tumors cannot always be distinguished from medulloblastomas, and clinically they are also similar to medulloblastomas - for example, hydrocephalus often develops with ependymomas. Surgical removal of the tumor, subsequent local irradiation and chemotherapy is the most common treatment strategy for malignant (anaplastic) ependymomas.

Tumors of the cerebral hemispheres

Supratentorial gliomas are located in the cerebral hemispheres and account for about 30% of all brain tumors in children. Treatment and prognosis depend on the location of the tumor and its growth rate. There are several types of such tumors: juvenile pilocytic astrocytoma, optic pathway glioma(opticalglioma) or hypothalamic glioma(see below), oligodendroglioma, hemispheric astrocytoma And ganglioglioma. Many of them cause seizures due to their location in the brain. If such a tumor is not in the area that controls speech, movement, vision or intelligence, then surgical removal is indicated. Sometimes only part of the tumor is removed, after which local radiation therapy and/or chemotherapy are additionally prescribed.

Gliomas visual pathways (optic gliomas). About 5% of tumors in children are gliomas, developing in the area of ​​the optic nerves and hypothalamus. Typically, these tumors are characterized by slow growth and respond well to surgical treatment, radiation therapy or chemotherapy. Because they involve the optic nerves and hypothalamus, children with these tumors often have visual and hormonal disorders.

Craniopharyngiomas – non-glial tumors, accounting for 5% of all CNS tumors in children. Patients with these tumors are characterized by stunted growth because the affected area is near the pituitary gland. Vision problems are also common. The question of their treatment is quite complicated: complete removal of the tumor can lead to a cure, but at the same time it can cause disturbances in memory, vision, behavior and hormonal status. An alternative is partial removal in combination with radiation therapy. After treatment of these tumors, children usually require long-term rehabilitation due to vision problems and/or hormonal disorders.

Germ cell tumors make up a small part of brain tumors - about 4%. They develop in the region of the pineal gland or suprasellar region (i.e. “above the sella turcica”), above the pituitary gland. As a rule, they are diagnosed during puberty and occur in both boys and girls, but are slightly more common in boys. These tumors are often well treated with chemotherapy and radiation therapy given after surgical removal or biopsy, very often these tumors do not even need to be removed and biopsied; for diagnosis it is enough to look at the tumor markers of the blood and cerebrospinal fluid (alphafetoprotein and human chorionic gonadotropin) and see characteristic changes on MRI, in addition, they are highly sensitive to chemotherapy and radiation and respond well even without surgical removal.

Tumors choroid plexus constitute 1-3% of all CNS tumors in children. The choroid plexuses are located in the ventricles of the brain, their main function is the production of cerebrospinal fluid. Tumors of the choroid plexus are benign ( papillomas) and malignant ( choroid carcinoma). These tumors usually occur in young children (under 1 year of age) and often cause hydrocephalus. Typically, they are removed surgically. For malignant tumors, chemotherapy is also prescribed, and in children over 3 years of age, radiation therapy.

Supratentorial PNETs , pineoblastomas previously accounted for about 5% of all brain tumors in children. IN modern classification tumors of the central nervous system, this term has been removed, because Using molecular genetic techniques, it was shown that under the mask of PNET, other tumors are masked, which cannot be distinguished using only a microscope and the eyes of a morphologist. Neurological symptoms depend on the location of the tumor - in particular, on its proximity to the ventricles of the brain. For such tumors, treatment will depend on the diagnosis verified using molecular genetic methods.

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