Brain and spine tumors are the second most common cancers in children after leukemia. Brain tumors affect nearly 2,500 children in the United States every year, accounting for 20% of childhood cancers.
The brain controls many important facets of everyday life, including emotions, thought, speech, vision, hearing and movement. The brain sends messages throughout the body via the spinal cord and cranial nerves in the head. The network of the brain and spinal cord is called the central nervous system (CNS). Tumors can develop in the spinal cord and cranial nerves.
The hard, bony skull protects the brain, and the bones (vertebrae) of the spine protect the spinal cord. A liquid called cerebrospinal fluid (CSF) surrounds both the brain and the spinal cord.
The brain has four main parts:
Basal ganglia: Found deeper inside the brain, these play a part in muscle movement.
Brain stem: Located at the base of the brain, the brain stem has nerve fibers that carry messages between the cerebrum and the rest of the body. A small but important area, the brain stem plays a part in breathing and heartbeat.
Cerebellum: At the back of the brain, this section helps control and coordinate movement, such as walking and swallowing.
Cerebrum: The outer and largest part of the brain. It has two halves called hemispheres and is responsible for emotions, reasoning, language, movement and the senses of seeing, hearing, smelling and touch; and the perception of pain.
Childhood brain tumor types
Because the brain and spinal cord are made up of many kinds of tissues and cells, many types of tumors ¨C both benign and malignant¨C can develop in these areas. These tumors may require different treatment and have different outlooks.
Even when brain tumors are benign, they can cause serious problems. Although non-cancerous brain tumors usually grow slower than cancerous brain tumors, they may damage and press against normal brain tissue or the spine as they grow.
Childhood brain and spinal cord tumors differ from adult tumors. The location where they develop, the type of cell in which they develop, and their treatment and outlook often are different. Brain tumors are classified by the types of cells they contain. This determines how they grow and what kind of treatment they require. The brain tumors found most often in children are the following.
Medulloblastoma: This is the most common type of malignant brain tumor in children. Learn more about medulloblastoma.
Astrocytoma: These form in the cerebrum in cells called astrocytes. They usually grow slowly, but higher-grade tumors spread more quickly. Since they mix with normal brain tissue, they can be difficult to remove surgically. They may spread along pathways of CSF but seldom spread outside the brain or spinal cord. Glioblastoma is the highest grade astrocytoma and the fastest growing.
Diffuse intrinsic pontine glioma: This dangerous tumor often has a poor prognosis. It grows in a vital area of the brain called the pons, which is in the brain stem.
Ependymomas develop in the brain lining, usually in the posterior fossa or along the spinal cord in glial cells. About five percent of childhood brain tumors are ependymomas. They begin in cells that line the ventricles or central canal of the spine. Ependymomas do not usually spread outside the brain or spinal cord, but they may block CSF, causing hydrocephalus.
Primitive neuroectodermal tumors (PNET): These aggressive tumors can develop anywhere in the brain, but they are usually in the frontal, temporal or parietal lobes.
Pineoblastomas: A type of PNET that develops in pineal gland and can be difficult to treat.
Craniopharyngiomas: These slow-growing tumors start above the pituitary gland but below the brain. They may press on the pituitary gland and hypothalamus, causing hormone problems. Since they start near the optic nerves, they can cause vision problems and be difficult to remove without damaging vision.
Mixed glial and neuronal tumors: Certain tumors that develop in children and young adults (and rarely in older adults) have both glial and neuronal cell components. They tend to have a fairly good prognosis.
- Pleomorphic xanthoastrocytoma (PXA) and dysembryoplastic neuroepithelial tumors (DNETs) look as if they could grow quickly when viewed under the microscope, but these tumors tend to be fairly benign, and most are cured by surgery alone.
- Ganglioglioma is a type of tumor that has both mature neurons and glial cells. Most can be cured by surgery alone or surgery combined with radiation therapy.
Choroid plexus tumors: These rare tumors start in the choroid plexus within the ventricles of the brain. Most are benign and can be removed by surgery.
Other tumors that start in or near the brain
Meningiomas: These tumors begin in the meninges, the tissue around the outer part of the brain and spine. They may press on the brain or spinal cord. Meningiomas are almost always benign and are usually cured by surgery. If they are near vital structures in the brain, they may need additional treatment.
Chordomas start in the bone at the base of the skull or at the lower end of the spine. They can injure the nervous system by pressing on it. They usually do not spread to other areas.
Germ cell tumors: Developing from germ cells, which normally form eggs in women and sperm in men, these are rare tumors. They form in the fetus when germ cells move to abnormal locations, including the brain. Germ cell tumors of the nervous system are usually found in children, most commonly in the pineal gland or above the pituitary gland. Learn more about childhood germ cell tumors.
Brain metastases: Cancers that metastasize (spread) to the brain from other areas of the body are called metastases. These are treated differently than primary brain cancers.
Childhood brain tumors risk factors
Anything that increases your child¡¯s chance of getting a brain tumor is a risk factor. While no definite risk factors have been found for childhood brain tumors, some things may put your child at increased risk, including:
- Radiation exposure, particularly if your child was treated with radiation to the brain for leukemia. This late effect usually is seen between 10 to 15 years after treatment.
- Rare inherited genetic conditions, including:
- Tuberous sclerosis
- Neurofibromatosis types 1 and 2
- Von Hippel-Lindau disease
- Li-Fraumeni syndrome
- Other diseases that run in certain families, including:
- Turcot syndrome
- Rubinstein-Taybi syndrome
- Gorlin syndrome (basal cell nevus syndrome)
Some cases of brain cancer can be passed down from one generation to the next. Genetic counseling may be right for you. Learn more about the risk to you and your family on our genetic testing page.
Learn more about childhood brain tumors:
Learn more about pediatric clinical trials for childhood brain tumors.
Facing a pediatric brain tumor with a cheerful spirit
Audrey Yerian, known to her friends and family as ¡°Audge,¡± is a 10-year-old competitive cheerleader from Tomball, Texas. Her passion for cheer matches her incredible courage. So, when she was diagnosed with a rare and aggressive childhood brain tumor, she faced it with the same perseverance, courage and passion.
For years, Audrey had experienced brain tumor symptoms, including debilitating migraines and what were believed to be moments of daydreaming, later revealed to be focal seizures. Despite persistent advocacy from her parents, early imaging was delayed by her local doctors. A CT scan in October 2024 was read as a sinus infection by a neuro-radiologist, who missed signs of skull deformation.
But when Audrey began having six or more seizures a day, her parents pushed for an MRI. That scan led to a life-changing diagnosis of a Grade 3 anaplastic pleomorphic xanthoastrocytoma (APXA), a rare type of brain cancer.
Perseverance during brain tumor treatment
On Nov. 11, 2024, Audrey underwent a craniotomy at Texas Children¡¯s Hospital. A craniotomy is the most common surgery to treat brain tumors and surgically remove the tumor. With a quick timeline to meet clinical trial requirements, she was immediately referred to MD Anderson Proton Therapy Center, where she began targeted proton therapy treatments under the care of pediatric radiation oncologist , followed by a two-year oral chemotherapy regimen at Texas Children¡¯s Hospital under a clinical trial by the Children¡¯s Oncology Group (COG).
Because protons can be precisely controlled, pediatric proton therapy is ideal for tumors located near growing tissues in the spinal cord, brain, eyes, ears or mouth.
Manzar recalls in their first day meeting that Audrey realized they had something in common ¨C being an avid Taylor Swift fan. ¡°She noticed my Swiftie status on my badge pin and requested that I play ¡®Shake It Off¡¯ on my guitar for her last weekly visit,¡± says Manzar. ¡°It is the first time I ever played guitar for one of my patients as opposed to ukulele, and it was such a magical experience for all of us. The whole family sang along, and we got into the lyrics, which was so encouraging for Audrey.¡±
With the support of child life specialist Ellen Reynolds, Audrey completed six weeks of treatment without the need for sedation. This included an MRI that lasted nearly three hours, during which she had to remain completely still with her head secured in place.
Why come to UT MD Anderson for childhood brain tumor care?
The Children's Cancer Hospital offers comprehensive, personalized care for benign (non-cancerous) and malignant (cancerous) brain tumors in children. Our expert, highly specialized physicians and a dedicated support staff follow your child every step of the way, collaborating and communicating closely.
Advanced diagnosis and treatment
We provide the most advanced diagnostic and treatment approaches, many of which are available at only a few hospitals in the nation. Our surgeons are top in their fields, and their expertise helps target the tumor while saving as much of the surrounding tissue as possible.
In collaboration with Children's Memorial Hermann Hospital, our pediatric brain tumor program brings together expertise from two renowned hospitals. The program ensures that patients receive timely and accurate diagnosis and individualized treatment for all types of childhood brain tumors.
Children's Cancer Hospital offers clinical trials for innovative new treatments for brain tumors in children. And, behind the scenes we are working on groundbreaking basic science research to change the future of pediatric cancer.
Treating the whole child
Children's Cancer Hospital is designed just for children, with a full range of services and amenities that help make the child and family's experience as comfortable as possible. We go beyond medical care to deliver a comprehensive experience that treats the whole child. And at Children's Cancer Hospital, you're surrounded by the strength of one of the nation's top cancer centers.
The one gift cancer gave me is perspective. Now, each day is a new day and is filled with possibilities.
UT?MD?Anderson Children's Cancer Hospital