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Arthur & Sonia Labatt Brain Tumour Research Centre

Non-gliomas

Craniopharyngioma image

Craniopharyngioma

Craniopharyngioma occur in the region of the optic nerves and the hypothalamus, a structure near the pituitary gland. Like chordomas, they develop from cells left over from early fetal development. They produce problems with vision and hormonal problems, slowing the child's growth and causing poor regulation of water balance. While only a decade ago it was considered inoperable and rarely curable by surgery, it can now be removed with minimal or no brain damage in many cases because of the precision afforded by the surgical microscope and microsurgical techniques. Occasionally, if this tumour continues to grow and cannot be removed surgically, radiation therapy is also necessary.

Medulloblastoma image

Medulloblastoma

Medulloblastomas are the most common primitive neuroectodermal tumour (PNET), representing more than 25% of all childhood brain tumours. Medulloblastoma most often arises in the cerebellum, located in the lower back part of the brain and causes symptoms that include headache, nausea, vomiting and problems with muscle coordination (ataxia). Unlike other primary brain tumours, medulloblastomas has a tendency to spread throughout the nervous system if it remains untreated. 

In unusual cases, medulloblastomas may spread outside the nervous system, to the lymph nodes, bone marrow, lungs or other parts of the body. In many cases, they are treated with surgery and radiation therapy alone. They are fast growing tumours but because they are very sensitive to radiation therapy and chemotherapy they can often be treated effectively.

Ependymoma image

Ependymoma

These tumours arise from the cells lining the ventricles (hollow channels) of the brain (most commonly the fourth ventricle). As these tumours grow and fill the ventricle, they obstruct the flow of cerebrospinal fluid (CSF) through the brain. These tumours appear more commonly among younger children. Symptoms of this tumour include headache, nausea, vomiting, balance problems and visual disturbances. Hydrocephalus, caused by the blocking of the flow of cerebrospinal fluid, may make shunting necessary. Total surgical removal is not always possible, and treatment often involves radiation therapy and/or chemotherapy.

Pineal tumour image

Pineal Tumours

These tumours arise in the region of the pineal gland, a small structure deep within the brain. They account for about 3% to 8% of the intracranial tumours that occur in children. At least 17 different types of tumours may occur in this area, many of which are benign. The three most common types of pineal region tumours are gliomas, germ cell tumours and pineal cell tumours. Surgery is absolutely necessary to obtain a sample of tumour tissue so the pathologist can confirm a precise histological diagnosis, which is essential in planning the appropriate therapy. Benign pineal tumours can be removed surgically. The germinoma, the most common malignant tumour in this area, can be cured in more than 90% of patients. Other malignant germ cell tumours occurring in this region are treated with chemotherapy followed by radiation therapy. Over the past 5 years, the prognosis for children with pineal tumours has improved dramatically.

Pituitary Adenoma image

Pituitary Adenoma Pituitary Adenoma

The pituitary gland is a small oval structure located at the base of the brain in the centre of the head, behind the eyes and optic nerve. It is about the size of a pea but is very important because it secretes several chemical messengers known as hormones, which help control the body's other glands and regulate growth, metabolism, maturation and other essential body processes. A tiny tumour located just next to the gland, pituitary adenomas account for about 10% of brain tumours.

Doctors classify pituitary tumours into two groups secreting and non-secreting. Secreting tumours release unusually high levels of pituitary hormones, triggering a constellation of symptoms. They are usually much smaller than the gland when they begin to cause symptoms and the symptoms depend on the tumour's size and the kind of hormone the tumour secretes.

Prolactin secreting adenomas affect sexual characteristics and cause impotence in men. Adenomas secreting growth hormone cause acromegaly (abnormal body growth, enlarged facial features, hands and feet) and gigantism (excessive size and stature). The less common adrenocorticotropic hormone secreting adenoma causes Cushing's disease. Some adenomas secrete a combination of these or other hormones and some secrete none.

Almost all adenomas are benign, but their slow expansion compresses normal structures that surround it, suppressing normal pituitary function and sometimes causing headaches or problems with vision. Pituitary adenomas rarely metastasize or spread to other areas of the body. They are removed in an operation using microsurgical techniques, a very successful form of treatment for the majority of patients.

Primitive Neuroectodermal tumours

Primitive Neuroectodermal tumours (PNETs) are thought to spring from primitive cells left over from early development of the nervous system. PNETs are usually very malignant, growing rapidly and spreading easily within the brain and spinal cord. In rare cases, they cause cancer outside the central nervous system. Medulloblastomas are the most common PNET. Other more rare PNETs include neuroblastomas, pineoblastomas, medulloepitheliomas, ependymoblastomas and polar spongioblastomas. Because their malignant cells often spread in a scattered, patchy pattern, PNETs are difficult to remove totally through surgery. Doctors usually remove as much tumour as possible with surgery then prescribe high doses of radiation and, in some cases, chemotherapy.