obsolete childhood brain tumor

Obsolete Childhood Brain Tumors

While advancements in medical science have led to improved understanding and treatment of childhood brain tumors, some types of these cancers were once considered more prevalent or had distinct characteristics that are no longer relevant today.

• Congenital Brain Tumors: These rare tumors were previously thought to be a subgroup of childhood brain tumors, but their definition remains unclear. Molecular characterization of congenital brain tumors is still limited, posing challenges in diagnosis and treatment (6).
• Tumors of the Infancy: This category was once used to describe brain tumors diagnosed in children younger than 1 year old. However, with improved diagnostic techniques, these tumors are now more accurately classified under other categories.

Evolution of Understanding

The classification and understanding of childhood brain tumors have undergone significant changes over time. What were once considered distinct types of tumors are now recognized as part of broader categories or subtypes. This evolution reflects advances in medical research, improved diagnostic tools, and a deeper understanding of the underlying biology of these cancers.

Current Focus

Today's focus is on more common and aggressive forms of childhood brain tumors, such as medulloblastoma, high-grade gliomas, and ependymomas. Research efforts are directed towards improving diagnosis, treatment, and outcomes for these conditions (9, 10, 12).

References: [6] Congenital brain tumors still lack a clear definition in terms of being a subgroup and have been divided by a few authors into "definitely", ... [9] Brain tumors are the most common solid tumor of childhood and the No. 1 cause of death among all childhood cancers. [10] This article will provide a summary of the most common malignant pediatric brain tumors (medulloblastoma, high-grade gliomas and ependymoma) with particular ... [12] by C Thorbinson · 2021 · Cited by 37 — This article will provide a summary of the most common malignant pediatric brain tumors (medulloblastoma, high-grade gliomas and ependymoma) with particular ...

Common Signs and Symptoms of Childhood Brain Tumors

Childhood brain tumors can exhibit a range of symptoms, which may vary depending on the location and type of tumor. Here are some common signs and symptoms:

• Headaches: Frequent or severe headaches are a common symptom in children with brain tumors [10][11].
• Nausea and Vomiting: Children with brain tumors often experience nausea and vomiting, which can be accompanied by other symptoms like double vision [2][12].
• Vision Changes: Double vision, blurred vision, or loss of vision in one eye are common visual symptoms [10][13].
• Weakness or Numbness: Weakness or numbness in a specific part of the body, usually only on one side, can be caused by tumors affecting the cerebrum [15].
• Speech or Comprehension Problems: Tumors in the cerebrum can also cause speech or comprehension problems [15].

Other Symptoms

In addition to these common symptoms, children with brain tumors may experience:

• Dysphagia and Dysarthria: Children with brain tumors can suffer from dysphagia (difficulty swallowing) and dysarthria (speech difficulties) [1].
• Unpredictable and Poorly Controlled Symptoms: Children dying of a brain tumor often experience unpredictable and poorly controlled symptoms, such as vomiting, seizures, anxiety, loss of function, and more [3].
• Abnormal Gait and Coordination Difficulties: The most common clinical presentation of brain stem tumors is with abnormal gait and coordination difficulties (78%) [4].
• Drowsiness or Loss of Consciousness: Drowsiness or loss of consciousness is one of the most frequently reported symptoms in the final weeks of a brain tumor patient's life [5].

Important Note

It's essential to note that these symptoms can also be caused by other conditions, and only a medical professional can accurately diagnose a childhood brain tumor. If you suspect your child may have a brain tumor, seek immediate medical attention.

References:

[1] PH Baenziger (2018) - In addition to the most common symptoms of other childhood cancers (fatigue, pain, dyspnea), children with brain tumors can also suffer dysphagia and dysarthria...

[2] Oct 29, 2021 - The most common symptoms in children with brain tumors are headaches, nausea and vomiting, and double vision [1].

[3] by NK Foreman (cited by 5) - Children dying of a brain tumor often experience unpredictable and poorly controlled symptoms.

[4] by IS Fernández (2017) - The most common clinical presentation of brain stem tumors is with abnormal gait and coordination difficulties (78%).

[5] by SM Chang (cited by 3) - Drowsiness or loss of consciousness is one of the most frequently reported symptoms in the final weeks of a brain tumor patient's life.

[10] Some of the more common signs and symptoms of pediatric brain tumors include: Headaches, which may become more frequent and more severe. In children who don't talk, a parent might notice that the child is more irritable than usual. Nausea and Vomiting...

[11] Here are some common warning signs of a potential brain tumor in children that every parent and caregiver should be aware of.

[12] These subtle indicators can often be the key to early detection and intervention, significantly impacting the child's prognosis.

[13] Childhood brain tumors frequently cause changes in hearing, memory, learning, sight, smell or emotion. Because adults or the child may notice these changes early in the development of a tumor...

[15] In addition to these generalized symptoms, children may exhibit more specific symptoms relating to the location of the tumor within the brain. For instance: Cerebrum (large, outer part of the brain): may cause weakness or numbness in a specific part of the body...

Diagnostic Tests for Obsolete Childhood Brain Tumors

Childhood brain tumors are a significant concern, and diagnostic tests play a crucial role in identifying these tumors. While some diagnostic tests may be considered obsolete due to advancements in medical technology, others remain relevant.

• Histopathological examination: This is one of the most common methods used to diagnose childhood brain tumors (1). However, with the emergence of new tumor types and molecular profiles, histopathological criteria alone are now considered obsolete (4).
• Molecular diagnostics: The 2021 fifth edition of a medical textbook introduces major changes that advance the role of molecular diagnostics in CNS tumor classification (2). This includes testing for specific genetic mutations, such as MYB/MYBL1 and FGFR1, which can be performed in pediatric and young adult patients with diffuse gliomas (7).
• DNA methylation profile: A DNA methylation profile aligned with CNS tumour with BCOR internal tandem duplication can confirm the diagnosis of certain childhood brain tumors (8).

Other Diagnostic Tests

While these tests may not specifically diagnose obsolete childhood brain tumors, they are still relevant in the broader context of pediatric brain tumor diagnosis:

• Brain biopsy: This procedure involves removing a sample of brain tumor tissue for testing in a lab. While it can be used to diagnose various types of brain tumors, its use is limited due to the invasiveness of the procedure (10).
• Imaging studies: CT or MRI scans are commonly used to determine the location and extent of childhood brain tumors (14). These imaging studies can also help identify potential complications or secondary effects of the tumor.
• Neurological exam: A neurological exam can test reflexes, muscle strength, vision, and other functions of the brain and spine. This exam is often performed in conjunction with a physical examination to assess the overall health and well-being of the child (13).

References

1. C Thorbinson (2021) - [1]
2. DN Louis (2021) - [2]
3. PS Páez - Not cited
4. A Tauziède-Espariat (2023) - [4]
5. Not cited
6. AM Halfpenny - Not cited
7. YW Park (2023) - [7]
8. Not cited
9. DR Johnson (2022) - Not cited
10. Not cited
11. Not cited
12. Not cited
13. Not cited
14. Not cited

Obsolete Childhood Brain Tumors: Drug Treatment Options

Childhood brain tumors are a serious concern, and various treatment options have been explored over the years to combat these conditions. While some treatments may be considered obsolete due to advancements in medical science, it's essential to understand what was previously used.

• Valproic Acid: This antiepileptic drug was once used in patients with brain tumors [1]. Although its use has declined, valproic acid remains a relevant medication for managing seizures associated with brain cancer.
• Mebendazole: As of 2023, mebendazole was being researched as a potential treatment for brain tumors due to its efficacy both as monotherapy and in combination therapy [2].
• Dexamethasone: This steroid has been the most common medication prescribed to brain tumor patients to control cerebral edema and manage symptoms [3][4]. While not specifically used for obsolete childhood brain tumors, dexamethasone remains a crucial treatment for managing symptoms associated with various types of brain cancer.
• Temozolomide: This chemotherapy drug was listed as one of the treatments for brain cancer in 2023 [7]. Although its use may have evolved since then, temozolomide remains an essential medication for treating certain types of brain tumors.

Note on FDA Approvals

In recent years, there have been significant advancements in the treatment of childhood brain tumors. The FDA has approved several new drugs for these conditions, including:

• Tovorafenib: This drug was granted accelerated approval by the FDA in April 2024 for the treatment of relapsed or refractory BRAF-altered pLGG [8]. Similarly, tovorafenib received approval on May 22, 2024, for patients 6 months and older with relapsed or refractory pediatric low-grade glioma (pLGG) [9].

While these new treatments offer hope for children suffering from brain tumors, it's essential to understand the historical context of obsolete treatment options. These medications may no longer be considered first-line treatments but can still provide valuable insights into the evolution of medical science.

References:

[1] Alomari, S. (2021). Valproic Acid. [2] Meco, D. (2023). Mebendazole. [3] Chang, SM. (Cited by 3). [4] Chang, SM. (Cited by 3). [7] Chemotherapy drugs for brain cancer. [8] Tovorafenib FDA approval. [9] Tovorafenib FDA approval for pediatric low

The differential diagnosis for an obsolete childhood brain tumor, specifically primitive neuroectodermal tumors (PNETs), has evolved over the years.

Prior to 2016, PNETs were a distinct category of brain tumors in children. However, with the introduction of the 2016 World Health Organization Classification of Tumors of the Central Nervous System, this classification was abandoned and replaced by more specific subtypes such as ETMR (Embryonal Tumor with Multilayered Rosettes), infant-type hemispheric glioma, ZFTA ependymoma, CNS neuroblastoma, FOXR2-activated CNS embryonal tumor, and NOS or NEC (Not Otherwise Specified/Other Neuroepithelial tumors).

According to recent studies [12], the imaging differential diagnosis of a large, bulky, heterogeneous hemispheric mass in an infant or young child includes ETMR, infant-type hemispheric glioma, ZFTA ependymoma, CNS neuroblastoma, FOXR2-activated and CNS embryonal tumor, NOS or NEC. These tumors can be distinguished based on their imaging features and clinical presentation.

It's essential to note that an informed differential diagnosis requires analyzing the imaging features in the context of the clinical presentation of the patient [13]. For instance, a wedge-shaped cortical lesion involving both gray and white-matter presenting with an acute neurologic deficit is likely an ischemic infarction. Multiple cortical/subcortical round nodular enhancing lesions are probably metastatic.

In contrast, large deep white-matter lesions may be indicative of other conditions such as ganglioglioma, pilocytic astrocytoma, DNET, or meningioma [15].

References: [12] Context result 12 [13] Context result 13