When diagnosed with a brain and/or spinal cord tumor, your child will benefit from having experts in this specific type of tumor develop a treatment plan that is unique to the child. Our brain and central nervous system (CNS) team is comprised of medical oncologists and pediatric oncology nurse practitioners who work closely with pediatric surgeons and radiation oncologists to determine the best course of treatment for your child. The neuro-oncology nurse coordinator acts as the team’s quarterback, facilitating patient visits and serving as the first point of contact for patients and their families. The brain and CNS team also has a dedicated social worker to help families work through diagnosis and treatment. Though the team is made up of several oncology providers, the team treats malignant and non-malignant tumors alike.
Patients who receive treatment for brain and spinal cord tumors at Cleveland Clinic Children’s typically see members of their core team during each hospital visit so that they can build a relationship with their caregivers. In addition to the individual attention patients receive from their primary oncologists, they benefit from the collective expertise of the entire Department of Pediatric Hematology, Oncology, & Blood and Marrow Transplantation.
Your child’s treatment team remains actively involved in the oversight of every patient’s care, discussing patients’ needs and treatment on a regular basis. Each week, the team of physicians, nurse practitioners, nurse coordinators, research coordinators, and social workers reviews the list of patients currently on therapy and makes plans for the upcoming week and month to ensure well-coordinated care.
What We Treat
The Neuro-Oncology team treats a wide variety of disorders. Some of the more common conditions we treat are:
Astrocytomas are tumors that arise from astrocytes – star-shaped cells that make up the “glue-like” or supportive tissue of the brain. Astrocytomas in children can be low-grade, meaning they are generally localized and slow-growing, or they can be high-grade, meaning they are more aggressive and can spread to other parts of the brain and spinal cord.
Atypical Teratoid/Rhabdoid Tumor
Atypical teratoid/rhabdoid tumor is a very rare, fast-growing tumor of the brain and spinal cord. It usually occurs in children aged three years and younger. About half of these tumors form in the cerebellum (part of the brain that controls movement, balance, and posture) or the brain stem (part of the brain that controls breathing, heart rate, and nerves and muscles used in seeing, hearing, walking, talking, and eating).
Brain Stem Gliomas
Gliomas are tumors formed from glial cells, which hold nerve cells in place, bring food and oxygen to them, and help protect them from disease. The brain stem is the part of the brain connected to the spinal cord that controls breathing, heart rate, and the nerves and muscles used in seeing, hearing, walking, talking, and eating.
Central Nervous System Germ Cell Tumors
Germ cells are a type of cell that form as a fetus (unborn baby) develops. These cells later become sperm in the testicles or eggs in the ovaries. Sometimes while the fetus is forming, germ cells travel to other parts of the body and grow into germ cell tumors. Germ cell tumors that form in the brain or spinal cord are called CNS germ cell tumors.
Central Nervous System Radiation Necrosis
Radiation necrosis, a structural lesion that usually occurs at the original site of a tumor, is a potential long-term CNS complication of radiation therapy. Radiation necrosis can occur when radiation therapy is used to treat primary CNS tumors, metastatic disease, or head and neck malignancies.
Craniopharyngioma develops in the area of the brain called the pituitary gland, which secreted various hormones into the blood stream. This tumor grows from cells that in the developing embryo had helped to form the normal pituitary gland. Craniopharyngiomas can vary in size and may have cysts. The cysts can become very large and occasionally extend into both sides of the brain.
Ependymomas are tumors that form from ependymal cells that line the passageways in the brain and the spinal cord. Ependymal cells make cerebrospinal fluid.
Medulloblastoma is a cancerous brain tumor that starts in the lower back part of the brain, called the cerebellum. The cerebellum is involved in muscle coordination, balance, and movement. Medulloblastoma tends to spread through cerebrospinal fluid to other areas around the brain and spinal cord.
Neurofibromatosis (NF) is a neurocutaneous syndrome that can affect many parts of the body, including the brain, spinal cord, nerves, skin, and other body systems. NF can cause growth of non-cancerous (non-malignant) as well as cancerous (malignant) tumors involving the nerves and brain.
Oligodendroglias are brain tumors that form from the oligodendrocytes in the brain. Oligodendrocyte cells produce a fatty, protective covering (called myelin) of the nerve cells in the brain, which helps nerve signals travel along the nerves more quickly.
Jennifer Weaver, RN
Neuro-Oncology Care Coordinator
Taylor Buss, MSW, LSW
Neuro-Oncology Social Worker
The Children's Oncology Group has nearly 100 active clinical trials open at any given time and more than 90% of children with cancer are cared for at a COG site. These trials include front- line treatment for many types of childhood cancers, studies aimed at determining the underlying biology of these diseases, and trials involving new and emerging treatments, supportive care, and survivorship. In addition to running clinical trials with the Children’s Oncology Group, our team has trials open with pharmaceutical sponsors as well as trials initiated by our own physicians.
Below is a list of open neuro-oncology clinical trials available at Cleveland Clinic Children’s Department of Pediatric Hematology, Oncology, and Blood and Marrow Transplantation. If you are interested in learning more about a COG trial, please contact COG Principal Investigator This list is constantly changing, so please contact COG Principal Investigator, Dr. Aron Flagg at 216.444.3866. If you are interested in Head Start 4, please contact Dr. Tanya Tekautz at 216.444.9532.
- COG ACNS0332: Efficacy of Carboplatin Administered Concomitantly with Radiation and Isotretinoin as a Pro-Apoptic Agent in Other Than Average Risk Medulloblastoma/PNET Patients
- COG ACNS0831: Phase III Randomized Trial of Post-Radiation Chemotherapy in Patients with Newly Diagnosed Ependymoma Ages 1 to 21 years
- COG ACNS1422: A Phase 2 Study of Reduced Therapy for Newly Diagnosed Average-Risk WNT-Driven Medulloblastoma Patients
- Head Start 4: (Nationwide Children’s, Tanya Tekautz, MD) Newly Diagnosed Children (less than 10 years old) with Medulloblastoma and Other Central Nervous System Embryonal Tumors
Choroid plexus tumors in adult and pediatric populations: the Cleveland Clinic and University Hospitals experience.
Bahar M, Hashem H, Tekautz T, Worley S, Tang A, de Blank P, Wolff J. J Neurooncol. 2017 May:132(3):427-432. Doi:10.1007/s11060-017-2384-1. Epub 2017 Mar 13. PMID: 28290001
Lumbar spinal atypical teratoid rhabdoid tumor.
Dhir A, Tekautz T, Recinos V, Murphy E, Prayson RA, Ruggieri P, Wolff J. J Clin Neurosci. 2015 Dec:22(12):1988-9. Doi:10.1016/j.jocn.2015.06.007. Epub 2015 Jul 30. PMID: 26234633
Radiation therapy for choroid plexus carcinoma patients with Li-Fraumeni syndrome: advantageous or detrimental?
Bahar M, Kordes U, Tekautz T, Wolff J. Anticancer Res. 2015 May:35(5):3013-7. PMID: 25964589
Outcome of infants and young children with newly diagnosed ependymoma treated on the “Head Start” III prospective clinical trial.
Venkatramani R, Ji L, Lasky J, Haley K, Judkins A, Zhou S, Sposto R, Olshefski R, Garvin J, Tekautz T, Kennedy G, Rassekh SR, Moore T, Gardner S, Allen J, Shore R, Moertel C, Atlas M, Dhall G, Finlay J. J Neuroncol. 2013 June:13(2):285-91. Doi: 10.1007/s1060-013-1111-9 Epub 2013 Mar 19. PMID: 23508296
Pearls & Oy-sters: Bifocal germinoma of the brain: review of the systems is key to the diagnosis.
Ghosh PS, Tekautz T, Mitra S. Neurology. 2012 Jan 10:78(2):e8-19. doi: 10.1212/WNL.0b013e31823efc5a. No abstract available. PMID: 22232058
Congenital ‘dumbbell’ neuroblastoma presenting as paraplegia.
Ghosh PS, D’Netto MA, Tekautz TM, Ghosh D. J Paediatr Child Health. 2011 Dec:47(12):920, 930. doi:10.1111/j.1440-1754.2011.02389-1.x. No abstract available. PMID: 22171832
Necrotizing granulomatous meningoencephalitis due to Balamuthia in an immunocompetent child.
Ghosh PS, Ghosh D, Loddenkemper T, Prayson RA, Tekautz T, Sriram CD, Danziger-Isakov L. Neurology. 2011 Aug 23:77(8):81-2. doi: 10.1212/WNL.0b013e31822b0100. No abstract available. PMID: 21860010
Phase II trial of ritonavir/lopinavir in patients with progressive or recurrent high-grade gliomas.
Ahluwalia MS, Patton C, Stevens G, Tekautz T, Angelov L, Vogelbaum MA, Weil RJ, Chao S, Elson P, Suh JH, Barnett GH, Peereboom DM. J Neurooncol. 2011 Apr:102(2):317-21. doi:10.1007/11060-010-0325-3. Epub 2010 Aug 4. PMID 20683757
Role of high-dose chemotherapy (HDCT) in treatment of atypical teratoid/rhabdoid tumors (AT/RTs).
Garre ML, Tekautz T. Pediatr Blood Cancer. 2010 Apr:54(4):647-8. doi:10.1002/pbc.22377. Review. PMID: 20146222
Evaluation of IFN-gamma effects on apoptosis and gene expression in neuroblastoma-preclinical studies.
Tekautz TM, Zhu K, Grenet J, Kaushal D, Kidd VJ, Lahti JM. Biochim Biophys Acta. 2006 Oct:1763(10):1000-10. Epub 2006 Aug 9. PMID: 16979248
Diffusion tensor imaging of intraaxial tumors at the cervicomedullary and pontomedullary junctions. Report of two cases.
Phillips NS, Sanford RA, Helton KJ, Boop FA, Zou P, Tekautz T, Gajjar A, Ogg RJ. J Neurosurg. 2005 Dec:103(6 Suppl):557-62. PMID: 16383256
Atypical teratoid/rhabdoid tumors (ATRT): improved survival in children 3 years of age and older with radiation therapy and high-dose alkylator-based chemotherapy.
Tekautz TM, Fuller CE, Blaney S, Fouladi M, Broniscer A, Merchant TE, Krasin M, Dalton J, Hale G, Kun LE, Wallace D, Gilbertson RJ, Gajjar A. J Clin Oncol. 2005 Mar 1:23(7):1491-9. PMID: 15735125
Pediatric extraadrenal paraganglioma.
Tekautz TM, Pratt CB, Jenkins JJ, Spunt SL. J Pediatr Surg. 2003 Sep:38(9):1317-21. PMID: 14523812
Barfield R, Hill DA, Hoffer FA, Tekautz T, Spunt SL. Med Pediatr Oncol. 2002 Aug:39(2):120-. No abstract available. PMID: 12116060
Accuracy of DNA amplification from archival hematological slides for use in genetic biomarker studies.
Boyle EB, Steinbuch M, Tekautz T, Gutman JR, Robison LL, Perentesis JP. Cnacer Epidemiol Biomarkers Prev. 1998 Dec:7(12):1127-31. PMID: 9865432
Members of our Neuro-Oncology Team can be seen at Cleveland Clinic’s Main Campus:
Cleveland Clinic Main Campus
9500 Euclid Ave
Main Clinic Building, 2nd Floor
Cleveland, OH 44195
For information or to make an appointment, please call 216.444.5517.
To speak with the brain and CNS tumor program nurse coordinator, please call 216.444.1216.
To contact the team via email, please send your message to email@example.com.
Referrals & Second Opinions
If you are coming to Cleveland Clinic through a referral or second opinion request from an outside hospital, please send the following medical records in advance of your appointment in our clinic:
- Most recent progress/office notes
- Treatment summary and treatment therapy roadmaps
- Operative report
- Discharge summary
- Pathology specimen/slides and reports
- Recent lab results
- All MRIs on CD
- Radiology reports
- Genetic testing results, if relevant
- Tumor markers, if applicable
The above should be sent to:
Cleveland Clinic Children’s
9500 Euclid Avenue, S20
Cleveland, OH 44195
Attn: Jennifer Weaver, RN
If you have questions about this process, please contact the brain and CNS tumor team at 216.444.1216 or firstname.lastname@example.org.
Note: All patients looking to schedule an appointment must have a Cleveland Clinic Medical Record Number (MRN). If you do not have a Cleveland Clinic MRN, please call the appropriate number below and they will be able to assist you in getting your record created.
- USA: 216.444.5437
- International (including Canada): 216.444.8184