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Brain and Spinal Cord Tumors

What is a tumor?

A tumor is an abnormal growth of cells that the body does not need. Tumors can appear almost anywhere in a child’s body, including the brain and spinal cord.

Tumors can be non-cancerous (benign) or cancerous (malignant). Benign tumors grow slowly and do not tend to spread within the central nervous system or to other parts of the body.

Malignant tumors, on the other hand, grow fairly fast. A malignant tumor may spread within the brain or spinal cord but usually does not spread to other parts of the body.

A cross-section view of a malignant tumor called a medulloblastoma (PNET) sitting in the cerebellum. The cerebellum is the back of the brain where balance is coordinated. 'A' is a precontrast MRI image and 'B' is a postcontrast MRI view.
A cross-section view of a malignant tumor called a medulloblastoma (PNET) sitting in the cerebellum. The cerebellum is the back of the brain where balance is coordinated.

Brain tumors

In the past, brain tumors were the second most common cancer in children. Leukemia (cancer of the blood) was the most common. In the last few years brain tumors and leukemia are now equally common in patients at Children’s Hospital. Brain tumors are the most common solid tumor in children.

Brain tumors in children are usually primary tumors meaning that they start in the brain or spinal cord instead of spreading from another area in the body.

Spinal cord tumors

Spinal cord tumors can form on the tough membrane (dura mater) that helps protect the spinal cord.

They can also form in the dura mater itself or inside or outside of the spinal cord.

Who gets brain or spinal cord tumors?

Scientists believe that a tumor happens because of some change in the child’s gene structure.

We don’t know what causes the change. It may be present at birth (congenital) or due to an environmental factor.

Certain types of tumors are more common at certain ages:

  • PNETS or medulloblastomas occur most often in children younger than 9 years old.
  • Astrocytomas occur most often in children between 11 and 14 years.
  • Pilocytic astrosytomas occur most often in teens between 15 and 19 years.

Brain tumors

Brain tumors are fairly common. Each year, about 2,200 children in the United States are diagnosed with a brain tumor.

During the last 20 years, the number has slowly grown. Brain tumors are more common in children younger than 7 years old than in those older than age 7.

Spinal cord tumors

Spinal cord tumors are uncommon and account for only 6 percent of central nervous system tumors. They occur mostly in children 10 to 16 years old.

What is your experience with brain and spinal cord tumors?

Our neurosurgery team has a lot of experience treating brain and spinal cord tumors. We operate on about 70 to 80 children with these tumors each year, using the most up-to-date surgical procedures and equipment.

We work very closely with doctors in the Neuro-oncology Clinic who care for some of our patients and their families after surgery. This partnership continues throughout the child’s tumor treatment.

Our work with other organizations benefits our patients and families at Children’s:

What surgery do you use to treat brain or spinal cord tumors?

Watch the video about Antonia's brain tumor surgery.

Surgery is often the best choice for treating a brain tumor. The primary reason to operate is to cure the child, when possible, by taking out the whole tumor.

Depending on where the tumor is located in the brain or spinal cord, the neurosurgeon may be able to take out only part of it. Even so, taking out part of a tumor can reduce a child’s symptoms.

Sometimes we do surgery to find out what kind of tumor is in the child’s brain or spinal cord. Once we know the type of tumor, we can plan other treatments like chemotherapy and radiation.

Our surgical team uses the most current and well-researched procedures and equipment to operate on and monitor our patients.

Craniotomy

During a craniotomy the neurosurgeon removes a part of the skull (cranium) in order to reach the part of the brain needing surgery.

First the surgeon cuts and removes a piece of bone. He then cuts the tough membrane called the dura mater — the membrane that protects the brain.

Skillfully, using highly technical equipment, he removes as much of the tumor as is safely possible.

The neurosurgeon then closes the dura mater and closes up the skull using the same piece of bone he removed, if possible. Sometimes we use hardware such as micro plates, screws and wires to close the child’s skull.

When a neurosurgeon does a biopsy on a part of the brain, he does a craniotomy or makes a small burr hole in the child’s skull. He takes a small sample of brain tissue or tumor, which is then examined by a pathologist.

A pathologist is a doctor who examines and diagnoses tissue samples in the lab.

Laminectomy

During a laminectomy the surgeon removes one or more sides of the back arches of a few vertebrae, the bones in your child’s spine. This allows the surgeon to reach the spinal cord or spinal nerve roots that need repair.

We usually do this operation using a microscope and other highly technical equipment. Sometimes the surgeon uses an endoscope, a wand-like instrument with a light and camera on the end that allows him to see and remove or operate on the problem.

We do a laminectomy to remove spinal cord tumors.

Gamma knife

Not a knife, this is a radiosurgery procedure we use to treat lesions deep in the brain without opening up a child’s skull. It delivers high doses of radiation to the carefully targeted area where the lesion is.

Embolization

Sometimes a child’s surgeon blocks the blood vessels that feed a tumor so there is less blood loss during surgery. This is called embolization.

Shunt

The open spaces in the brain, called ventricles, contain and circulate cerebrospinal fluid (CSF). Some children with tumors have, or are at risk of developing, hydrocephalus, which involves backed up cerebrospinal fluid in the brain.

In that case, we do surgery to place a small drainage tube into one of the brain’s ventricles. The tube drains extra fluid out of the child’s brain for a few days after surgery and then we attempt to determine if the child no longer needs it.

If your child needs a permanent shunt, we put one in during a separate surgery.

Read more about shunts in the hydrocephalus section.