Brain Tumors in Children

There are many types of brain tumors in children. And treatment for each may be different. Brain tumors are one of the most common types of cancer in kids. But it’s important to understand that not every type of brain tumor in children is cancerous. We group and name them by the kind of brain cells, where they form and grow, and if they spread.

Gliomas

About half of all brain tumors in children are cancerous (malignant) gliomas. These start when the glial cells that support and protect your child’s central nervous system grow out of control. This can happen in their brain, spinal cord or both. There are different kinds, like:

• Astrocytomas.
• Oligodendrogliomas.
• Ependymomas.

Embryonal tumors

Embryonic cells are left over in our brains from fetal development. Sometimes, these cells start tumors in the central nervous system. Kids of any age can get these cancerous tumors. But they most often affect babies and younger children. The most common is medulloblastoma. This fast-growing tumor often starts in the back part of the brain (cerebellum). Other types of embryonal tumors are much rarer than medulloblastoma.

Pineal tumors 

The brain has a hormone-producing gland in the middle of it called the pineal gland. And it can develop rare, noncancerous (benign) or malignant pineal tumors. The cancerous pineoblastoma is the most common.

Craniopharyngiomas

Noncancerous craniopharyngiomas grow from embryonic tissue from the hormone-producing pituitary gland. They can be solid, fluid-filled (cystic) or a combination of the two. 

Germ cell tumors

During fetal development, embryonic germ cells move from the brain to form reproductive organs (ovaries or testes). But sometimes these cells stay in the brain — and become cancerous germ cell tumors. 

Choroid plexus tumors

The brain’s fluid-filled cavities (ventricles) are lined with something called choroid plexus. This lining can grow tumors like:

• Noncancerous choroid plexus papilloma.
• Cancerous choroid plexus carcinoma.

Schwannomas

Schwann cells wrap around the peripheral nerves in the brain, protecting and supporting them. If they grow out of control, they become schwannomas — tumors growing near the nerve that controls hearing and balance. They’re almost always noncancerous. Acoustic neuromas (vestibular schwannomas) are common ones.

Meningiomas

Meningiomas grow in the meninges, a layer of tissue around the brain. They’re less common in children but can still develop. They tend to be benign but can grow large enough to be life-threatening.

Diagnosing Brain Tumors in Children at Cleveland Clinic

Brain tumors in children will have a variety of signs and symptoms. Some things to keep an eye out for are:

• Early morning headaches.
• Excessive sleepiness.
• Frequent nausea or vomiting.
• Vision, hearing or speech problems.
• Balance and coordination problems.
• Behavioral changes.
• Weakness in the arms, legs or one side of the body.
• Seizures.

What to expect at your first visit

There’s nothing quite like the stress and worry you feel when your child is seriously ill. That’s why we do everything with compassion. We focus on your child and your family from the first moment you connect with us.

When you come to your child’s first appointment, we’ll take time to get to know you. Your child’s story is an important part of diagnosis and treatment. So, we’ll ask a lot of questions about your child’s health history and their symptoms. 

We’ll also do a physical exam to check out your child’s general health and a neurological exam to see how their brain is working. Your child may also have imaging tests, like an MRI (magnetic resonance imaging),  CT (computed tomography) or PET (positron emission tomography) scans so we can get a better look at their brain and spine. We may also do other tests to learn more about the tumor, like if it’s benign or cancerous. These tests might include: 

• Blood tests to look for signs of cancer (tumor markers).
• Biopsy of a tumor sample to look for cancerous cells.
• Spinal tap (lumbar puncture) to check fluid that flows around their spine and brain for abnormal cells.

Testing can also help our team find out how your child’s tumor is growing and if there’s a chance for it to spread (metastasize) outside of their brain. This is called cancer staging.

Second Opinions for Brain Tumors in Children

Hearing your child may have a brain tumor can turn your world upside down. But one thing is clear. You want the best possible treatment from experienced pediatric healthcare providers you trust. That’s why second opinions can be an important part of your child’s care.

When you get a second opinion, you’ll meet with Cleveland Clinic pediatric specialists highly experienced with treating brain tumors in children. You can learn more about the diagnosis and other treatment options. Getting a second opinion can give you reassurance about your child’s treatment and help you know what to expect as you move forward.

Meet Our Brain Tumors in Children Team

Cleveland Clinic Children’s uses a team-based approach that focuses not just on your child’s healthcare needs but also their emotional and mental well-being. These pediatric specialists work together to plan care and track your child’s progress. Their team could include: 

• Pediatric neurologists.
• Pediatric neurosurgeons.
• Pediatric oncologists (cancer specialists).
• Pediatric radiation oncologists.
• Child life specialists.
• Child psychologists.
• Pediatric social workers.
• Pediatric physical therapists. 
• Pediatric speech-language pathologists (SLPs).
• Pediatric occupational therapists.

For some tumors, our care team may choose to do “watchful waiting” to see if the tumor stays the same or starts to grow. This means your child will have regular check-ins with their providers — and regular tests.

If we decide your child needs to have treatment right away (or after a period of watchful waiting), they may have:

Brain surgery

When possible, our pediatric neurosurgery team will do brain surgery (craniotomy). They’ll remove all or part of the tumor. Or they may place a hollow drainage tube (shunt) in your child’s brain. This can help drain excess fluid and remove the pressure. 

Medications 

We may use medications to kill cancer cells or help relieve symptoms. When we want to destroy tumor cells, we may use systemic therapies, like: 

• Chemotherapy. 
• Targeted therapy. 
• Immunotherapy. 

We may use one of these treatments before surgery to shrink the tumor. Or we may do it after surgery to destroy any remaining cancer cells.

Our team may also prescribe other medications, like corticosteroids, to reduce swelling around the tumor. This can lower painful pressure in your child’s skull.

Radiation therapy

Radiation therapy uses high doses of X-rays before or after surgery to shrink tumors and destroy tumor cells. We may do this outside your child’s body (external beam radiation therapy or EBRT). Or we may use an internal method called brachytherapy.

Radiosurgery

Also known as Gamma Knife^® surgery, radiosurgery combines computer planning and highly focused radiation. This lets us target the brain tumor precisely. Even though the words “knife” and “surgery” are in the name, there are no cuts (incisions) in this treatment. We can also combine it with surgery to help prevent the tumor from coming back (recurrence).

What To Expect After Treatment for Brain Tumors in Children

Once your child finishes treatment, they’ll have regular appointments with their care team. And they’ll get tests often to make sure the tumor isn’t coming back. 

It’s important to keep up with these appointments. They let our care team keep a close eye on your child’s health and quickly start treatment if a tumor regrows. 

We may also recommend physical, occupational or speech-language therapy to help your child with any hearing, speech, balance, coordination or other problems caused by the tumor. 

Your child’s pediatric care team is here for them through young adulthood. If they need continued care past that, we’ll help them move easily to Cleveland Clinic adult providers. 

Taking the Next Step

When your child is diagnosed with a brain tumor, you know life will change. And that can be stressful. But your family doesn’t have to take this journey alone. Cleveland Clinic Children’s experienced, caring pediatric providers will do what it takes to treat their brain tumor. From personalized care plans to rehab and emotional support, you can count on us. Just like you, we want your child to get back to doing what they do best — being a kid.