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Written by Kathy Warren, MD, pediatric oncologist, National Cancer Institute
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INTRODUCTION: Although ependymomas are the third most common type of brain tumor in children (following astrocytoma and medulloblastoma), they are relatively rare, with approximately 200 cases diagnosed in the US each year in children and adults less than 25 years of age. Ependymomas account for 6-12% of brain tumors in children less than 18 years of age, but 30% of brain tumors in children less than 3 years of age 1. The average age at diagnosis is 4-6 years 2-4. The underlying cause and basic biology of these tumors is not fully understood, and the optimal staging and treatment of ependymomas in children requires more study.
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Brain Stem Gliomas in Childhood |
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Written by Paul Graham FIsher, M.D., M.H.S. and Michelle Monje, M.D., Ph.D
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Brain stem tumors are perhaps the most dreaded cancers in pediatric oncology, owing to their historically poor prognosis, yet they remain an area of intense research. Brain stem tumors account for about 10 to 15% of childhood brain tumors. Peak incidence for these tumors occurs around age 6 to 9 years. The term brain stem glioma is often used interchangeably with brain stem tumor. More precisely, glioma encompasses tumor pathology types such as ganglioglioma, pilcytic astrocytoma, diffuse astrocytoma, anaplastic astrocytoma, and glioblastoma multiforme.
Rarely, other tumor pathologies such as atypical teratoid/rhabdoid tumor (ATRT), primitive neuroectodermal tumor (PNET)/embryonal tumor, and hemangioblastoma occur at the brain stem. These entities are quite different from brain stem gliomas, and the following comments do not apply.
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Written by Kenneth J. Cohen, M.D., Director, Pediatric Neuro-Oncology, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins and Kaleb Yohay, M.D., Pediatric Neurology, Johns Hopkins University School of Medicine
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Normal brain is made up of several cell types including neurons, the main functional cell of the brain, and glia, which play a supportive role to the neurons. Glia are further subdivided into different types, each type with a different function, including oligodendrocytes which cover the axons of neurons with sheathes of myelin, and astrocytes which serve many functions including taking up excess neurotransmitters and creating the blood-brain barrier. Gliomas are tumors of glial cells, particularly astrocytes and oligodendrocytes. About 2/3 of all childhood brain tumors are gliomas.
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Brain Tumor Types