Solid tumors are the most common type of tumor in children. They account for about 30% of tumors in children. Most develop around the brain and 10% originate in the spinal cord.
CNS tumors are usually classified into tumors known as low grade, which are less aggressive and do not always require treatment, and tumors known as high grade which are more aggressive and have a varied prognosis.
To choose the most appropriate treatment, it is important to identify the type of cell that the tumor derived from: glial cell, embryonal cell, germinal cell, meningeal cell, choroid plexus.
Initial symptoms vary greatly depending on the location, size and speed of growth of the tumor. Some of the most common symptoms are headache, vomiting (often early in the morning) difficulty walking and balancing, and vision problems. The symptoms may be even more non-specific and consist of prolonged pain.
If a brain tumor is suspected, various examinations can help make the diagnosis.
It is important to obtain an image to identify the location and volume of the tumor. Two techniques are available: the brain CT scan can generally be accessed quickly and provides urgent information. Magnetic resonance imaging is typically used as a second step. It provides more accurate information on the size of the lesion and exact location of the tumor. In young children, this technique requires sedation as it is very important that the child does not move for several minutes!
It is also necessary to take a sample of either the whole tumor if the location means this can be done safely (this is called excision), or a small sample of the tumor in order to identify its type (this is called a biopsy).
The treatment strategy is discussed in a multidisciplinary team meeting as this includes numerous parameters aimed at removing the maximum amount of tumoral tissue while minimizing complications and damage to healthy tissue around the tumor.
Chemotherapy is generally always required. Neurosurgical techniques, medical imaging via CT scan and magnetic resonance imaging, as well as radiotherapy, now make it possible to offer more appropriate treatment with fewer side effects than in the past.