Brain & Spinal Tumors

A benign tumor does not contain cancer cells and, once removed, typically does not recur (come back). Most benign brain tumors have clear borders, meaning they do not invade surrounding tissue. These tumors can cause symptoms similar to cancerous tumors because of their size and location in the brain.

Malignant brain tumors contain cancer cells. They are usually fast growing and invade surrounding tissue. Malignant brain tumors rarely spread to other areas of the body, but they may recur after treatment.

Brain tumors are the most common solid tumors in children. Approximately 4,000 children and adolescents in the U.S. are diagnosed with primary brain tumors (tumors that originate in the brain) each year. Those that occur in infants and children are different from adult brain tumors, both in terms of the type of cells and the responsiveness to treatment.

There are many types and subtypes of brain and spinal tumors. Some of the more common ones include:

• Gliomas. Gliomas are the most common form of brain and spinal tumor and develop in parts of the brain called glial cells. These cells make up more than half of the brain and help neurons function normally. There are several types of glial cells, and glioma tumors are named for the types of glial cells on which they develop.
• Medulloblastoma.  This relatively common tumor is Grade 4, highly malignant, and often causes rapidly progressive symptoms. Medulloblastomas are treated with a combination of surgery, radiation, and chemotherapy. Most medulloblastomas can be treated effectively, despite the tumor’s aggressive nature.
• Embryonal tumors. These tumors develop in embryonic cells in the central nervous system (CNS) during the gestation period of a fetus. After birth, most CNS embryonal tumors in children become malignant. These malignant tumors are likely to grow quickly and spread into other parts of the brain and spine.
• Mixed neuroglial tumors. This type of brain tumor tends to be small and slow growing. They are rare and mostly benign.
• Tumors arising from non-neuroepithelial tissue. These tumors develop at the base of the brain and are usually benign but not always.
• Choroid plexus papilloma/carcinoma. These tumors generally occur in the ventricles (natural spaces deep inside the brain). They may be benign or malignant.
• Meningeal tumors. These tumors develop in the meninges membrane, which surrounds the brain and spinal cord. Meningeal tumors are often benign but may become malignant. These tumors are rare in children and more common in adults.
• Ependymoma tumors. These tumors form in the cells that line the ventricles of the brain and the center of the spinal cord. 

The exact cause of brain and spinal tumors is not fully understood. Researchers have found that some of the chemical changes that occur in normal brain cells may lead to brain tumors. Most brain tumors involve abnormalities in genes that control the cell cycle (when cells grow, divide and die). These abnormalities cause uncontrolled cell growth.

Spinal tumors can also be caused by tumors that start in tissues that surround the spinal cord and spinal column and push in. They can come from surround muscle or bone and may put pressure on the spinal cord. These types of tumors can include:

• Neuroblastomas begin in primitive nerve cells in young children.
• Sarcomas are tumors that begin in muscle.
• Osteochondromas are tumors that start in bone.

Other than exposure to radiation, there are no known lifestyle-related or environmental causes of childhood brain tumors. If your child has a brain tumor, it is important to remember that there is nothing you or your child could have done to prevent it.

Symptoms of a brain or spinal tumor depend on the tumor’s size, type and location. Symptoms may be caused by a tumor pressing on a nerve or harming a part of the brain. They may also be caused by a tumor blocking the fluid that flows through and around the brain or the brain swelling because of the buildup of fluid.

Some of the most common symptoms of brain and spinal tumors include:

• Balance problems
• Back pain or numbness
• Changes in mood, personality or ability to concentrate
• Changes in speech, vision or hearing
• Headaches (usually worse in the morning)
• Memory problems
• Nausea and vomiting
• Numbness or tingling in the arms or legs
• Seizures or convulsions
• Scoliosis

Many other conditions can cause the same symptoms, so it is important to check with your child’s doctor for an accurate diagnosis. Only a doctor experienced in recognizing the exact combination of symptoms that indicate a brain or spinal tumor can make a firm diagnosis.

Diagnosis of Brain & Spinal Tumors

Diagnosis of a brain tumor starts with a physical exam and medical history. Other procedures and tests may be needed to diagnose a brain tumor, including:

• Angiogram. This is a live X-ray that shows blood flowing in the body.
• Computed tomography (CT). This is a X-ray that shows the inside of the brain from different angles.
• Lumbar puncture/spinal tap. This test checks the fluid that surrounds the brain and spinal cord.
• Magnetic resonance imaging (MRI). A MRI scan uses powerful magnets to create detailed pictures of internal body tissues, including the brain.
• Detailed neurologic exam. This is an assessment of the body’s nervous system, including neurons and motor responses such as reflexes.
• Positron emission tomography (PET) scan. This imaging test uses mild radiation to produce images of processes within the body.
• X-ray. This is a common imaging test that takes pictures of bones and organs inside of the body.
• Biopsy. If a tumor is found, samples of the tumor cells are extracted and studied under a microscope to gain more information about the specific kind of brain or spinal tumor.