The formation of abnormal cells is called a brain tumor in a child. This disease affects areas that control the most important functions of the body and affect the vital processes of the whole body. It is one of the most common forms of cancer and benign lesions in children.
Classification
After establishing the main features and performing diagnostic tests, the neoplasm can be classified according to the following general characteristics:
- A benign brain tumor in a child grows slowly and does not penetrate into nearby tissues. In this case, a pathological neoplasm is dangerous because, gradually increasing, it begins to pinch neighboring areas of the brain, which provokes the occurrence of certain symptoms.
- Malignant lesion of the brain includes low-grade formations (with littledegree of aggressiveness) and high-grade tumors that grow rapidly and spread to other tissues of the body.
- Primary formations that originate in the brain.
- Secondary tumors, which consist of cells that metastasize from other parts of the body.
Astrocytoma
This childhood brain tumor is a primary intracerebral neuroepithelial tumor originating from astrocytes (stellate cells). Astrocytoma in children can have a different degree of malignancy. Its symptoms depend on the location and are divided into general (loss of appetite, weakness, headaches) and focal (hemihypesthesia, hemiparesis, coordination disorders, speech disorders, hallucinations, behavioral changes). This neoplasm is diagnosed taking into account clinical data, the results of MRI, CT and histological studies of tumor tissues. Therapy for astrocytoma in children is usually a combination of several methods: surgery or radiosurgery, chemotherapy and radiation.
Can a 10-month-old baby have a brain tumor? Brain astrocytoma can develop at any age, but is most commonly seen in children. This neoplasm is the result of oncological degeneration of star-shaped astrocytes. Until recently, it was believed that these cells perform auxiliary supporting functions in relation to the neurons of the nervous system. However, recent studies in neurophysiology have shown thatthat astrocytes perform a protective function, preventing injury to neurons and suppressing chemicals formed as a result of their vital activity.
There are no exact data on the factors provoking such a pathological transformation of astrocytes yet. Presumably, excess radiation, prolonged exposure to chemicals, and viruses play a role in this process. The hereditary factor plays a significant role, since children with astrocytoma often have genetic disorders in the TP53 gene.
Astrocytoma of the brain is divided into "normal" or "special". The first category includes fibrillar, gemistocytic and protoplasmic astrocytoma of the brain. The "special" category includes pyelocytic, subependymal and cerebellar microcystic astrocytoma of the brain in children.
Astrocytomas are also classified according to their level of malignancy. Pyelocytic astrocytoma belongs to grade I, fibrillar astrocytoma to grade II, anaplastic to grade III, and glioblastoma to grade IV.
Ependymoma
This brain tumor in a child is formed from the ependymal tissue of the ventricular system of the brain. Clinically, it is manifested by signs of high intracranial pressure, ataxia, impaired vision and hearing, seizures, impaired speech, and swallowing reflexes. Diagnosis is carried out mainly with the help of MRI of the brain, EEG, spinal puncture, histological studies. The basis of therapy is radical excision of the ependymoma followed by radiation or chemotherapy.
Ependymoma originates from ependymocytes,which are epithelial-like cells that form a thin lining of the cerebral ventricles and spinal canal. These pathological neoplasms account for up to 7% of all brain tumors in children and are classified as gliomas. Approximately 60% of patients with such a tumor are children under five years of age. In terms of prevalence, ependymoma ranks 3rd among cerebral tumors and its malignant course is most often observed.
Ependymoma of the brain in children is most often formed in the posterior cranial fossa. The tumor is characterized by a slow increase, the absence of germination in neighboring cerebral tissues. However, as such a tumor grows, it can cause compression of the brain. Metastasis of the process occurs mainly along the CSF pathways and does not go beyond the nervous system. The most frequently observed retrograde metastases in the structures of the spinal cord.
Multiple scientific studies have found the SV40 virus, which is in the tumor cells in an active state. But so far, its role in the development of neoplasms is not clear. It is assumed that the formation occurs due to the influence of common oncogenic factors: radioactive radiation, chemical carcinogens, long-term adverse conditions (for example, hyperinsolation), viruses (human papillomavirus, herpes virus, etc.).
In addition, the participation of hereditary factors in the formation of ependymoma should not be excluded. There is a known combination of cerebral tumors in children withRecklinghausen neurofibromatosis, familial colon polyposis, endocrine neoplasia syndrome.
Sun, taking into account the data of the modern classification, there are 4 types of ependymomas, which differ in the degree of benignness and the course of the tumor process. The most benign is myxopapillary ependymoma. Subependymoma is characterized by gradual benign growth, often asymptomatic course and rare recurrence. Classical ependymoma is the most common. It can cause blockage of the cerebrospinal fluid. It often recurs, over time it can degenerate into anaplastic ependymoma, which leaves about 1/4 of all ependymomas. It is characterized by rapid growth and metastasis, as a result of which it received the names: ependymoblastoma, undifferentiated ependymoma, malignant ependymoma.
Medulloblastoma
This neoplasm of the brain in children is a malignant tumor of medulloblasts, which are immature cells and glia, and is localized, as a rule, in the cerebellar worm, located next to the fourth ventricle. Characterized by signs of cancer intoxication in a child, increasing intracranial hypertension and cerebellar ataxia. The diagnosis is made by assessing the clinical picture, the results of the study of cerebrospinal fluid, CT, PET, biopsy. Therapy includes surgical removal of the neoplasm, restoration of spinal fluid circulation, chemotherapy.
Medulloblastoma is an extremely malignant pathology. The tumor develops in the cerebellar vermis, and in children after sixyears is sometimes localized in the hemispheres of the brain. In most cases, it quickly metastasizes through the CSF channels, which distinguishes it from other brain tumors and ranks second among malignant brain tumors in children in terms of incidence. Most often develops in boys.
The age at which medulloblastoma is most commonly detected is 5-10 years. However, it is not exclusively a “childhood” pathology; it can be detected at any age. Typically, cases of medulloblastoma are sporadic. However, there is a hereditary factor in the occurrence of the disease.
Why such a neoplasm of the brain develops in children remains unclear at the moment. Only risk factors for such a pathology are known, they include age less than 10 years, exposure to ionizing radiation, food carcinogens, paints, viral infections (cytomegalovirus, herpes, HPV, infectious mononucleosis), damaging the genome of cells.
Medulloblastoma is a primitive neuroectodermal formation. It is, as a rule, located subtentorially, under the cerebellum, growing into it and filling the entire fourth cerebral ventricle. This leads to blockage of the CSF flow, as the tumor begins to block the fluid circulation paths. Intracranial pressure in a child rises sharply, the bulbar sections are damaged due to the germination of a pathological neoplasm in the brain stem. It is important to recognize the first signs of a brain tumor in a child in a timely manner.
The histological picture is an accumulation of proliferating, small, poorly differentiated, round, embryonic cells with a hyperchromic nucleus and thin cytoplasm. By structure, the following varieties of such a neoplasm are distinguished:
- medullomyoblastoma with muscle fibers;
- melanotic medulloblastoma, consisting of neuroepithelial cells containing melanin;
- lipomatous medulloblastoma with fat cells.
Craniopharyngioma
This benign brain tumor in a child is a cystic-epithelial neoplasm localized in the area of the Turkish saddle and developing from the epithelium of Rathke's pouch. As the neoplasm grows and progresses, the child has an increase in the level of intracranial pressure, developmental delay, visual impairment, hypofunction of the adenohypophysis. The most informative method for diagnosing this pathology is CT, which allows to determine the structure and presence of calcifications in the tumor. Therapy is surgical, after which the patient is prescribed radiation therapy aimed at stopping the subsequent growth of the pathological neoplasm.
Craniopharyngioma is located, as a rule, in the hypothalamic-pituitary zone. As it progresses, cysts can form in the tissues of the tumor, which are filled with fluid with a high level of protein. The incidence of craniopharyngiomas is approximately 3% of all types of brain neoplasms in children. The most common occurrence is neuroepithelialcraniopharyngiomas (about 9% of cases), and the peak of pathology development falls on the age from 5 to 13 years. Another kind of this formation is papillary.
Clinicians consider heredity and various mutations to be the main causes of craniopharyngioma. In addition, some other factors adversely affect the development of pathological formation, especially if their effect took place in the first trimester of pregnancy. The causes of craniopharyngiomas in children include the influence of medications, poisons, toxins, radiation, early toxicosis, diseases of the pregnant woman (diabetes mellitus, kidney failure, etc.). Craniopharyngioma is divided into 2 types: papillary and adamantinomatous.
Symptoms of a brain tumor in children
Signs of brain neoplasm in children are:
- Disturbance of appetite, vomiting (usually in the morning).
- Severe drowsiness, lack of energy or impaired activity, pallor.
- Illness, especially after vomiting, excessive restlessness.
- Irritability and loss of interest in activities (games, etc.).
- Eye disorders - abnormal eye movement, double vision, blurred vision.
- Incoordination, weakness in the legs, gait disturbance (frequent stumbling).
- Seizures are a common symptom of a brain tumor in children.
- Head enlargement.
- Numbness of the body.
- Involuntaryurination, frequent constipation.
- Headaches.
- Hyperreflexia and cranial nerve palsies.
- Developmental delay.
Where to go if you have symptoms of a brain tumor in children?
Diagnosis
Diagnosis of tumors involves a comprehensive examination. Due to the need for diagnostics on modern equipment, the child may require general anesthesia. A neurological examination is carried out, which is aimed at assessing the main functions that indicate the correct functioning of the nervous system or its violation. The visual, auditory and tactile reactions of the child are subjected to research.
Diagnostic methods make it possible to identify the localization and the first signs of a brain tumor in children when studying the parameters: coordination disorders, reflex disorders. Another study is an MRI, in which the necessary area of \u200b\u200bthe brain is well visualized. In this case, a special contrast agent is used.
Should children have a brain tumor removed?
Treatment
Treatment of brain tumors in children should be as effective as possible and avoid possible adverse reactions. Therapy is carried out using three main techniques:
- Surgical removal of the tumor.
- Chemotherapy.
- Radiation therapy.
Treatment of brain tumors in childrensurgically aimed at removing the pathological focus. This method shows the greatest effectiveness in combination with other measures. Surgery for a brain tumor in a child is almost impossible if the main trunk is damaged, since vital areas are located in this zone. The intervention is successful if the child develops a benign neoplasm. In this case, the prognosis for recovery after removal of a brain tumor in children is significantly improved.
Radiation therapy
Radiotherapy is used for contraindications to surgical treatment. The method is not recommended for the treatment of children under 3 years of age, as undesirable consequences may occur due to irradiation - intellectual and physical retardation. Such therapy has a positive effect on neoplasms of a fast-growing nature or small sizes.
The use of chemotherapy is necessary if the patient has a high level of malignancy of the tumor. Treatment is allowed even if the child is less than three years old. What is the prognosis for a tumor of the brain stem in children, it is interesting to many.
Forecast
Modern methods of treatment significantly increase the chances of recovery. The prognosis for a brain tumor in children can be positive, which is mainly determined by whether the tumor is malignant or benign.
The result of therapy depends on many factors:
- varietytumors;
- size and location of the lesion, which affects the prognosis of the success of surgical treatment;
- degree of severity and stage of development of pathology;
- age of patient;
- presence of concomitant tumors.
It has been proven that the prognosis after removal of a pathological formation in childhood is much better than in adults.
