Oligodendroglioma in Children
What is an oligodendroglioma in children?
The brain is part of the central nervous system (CNS). The CNS also includes the spinal cord. A tumor is an abnormal growth of tissue. An oligodendroglioma is a type of CNS tumor called a glioma. These are tumors of the glial cells, the supporting cells of the brain. There are several types of glioma, depending on the type of cells involved and the location in the brain. Oligodendroglioma is a rare tumor that starts in the oligodendrocytes. These are the cells that help form the fatty covering (myelin) of nerve cells.
- Are more common in adults than in children
- May start out growing slowly (low-grade), but change and grow quickly (high-grade)
- Often grow into the brain tissue, making surgery difficult
- May be mixed with other types of cells that also support the brain
What causes an oligodendroglioma in a child?Researchers don't fully know what causes brain tumors. CNS tumors are usually from changes (mutations) in the genes (DNA) inside cells. This may be passed on from parents to children (inherited) or it may happen without a known reason.
What are the symptoms of an oligodendroglioma in a child?
Symptoms of brain tumors depend on their size and where they are in the brain. For example, if a tumor develops in the region that controls speech, your child's speech may be affected.
Symptoms of an oligodendroglioma may include:
- Trouble with thinking, memory, or concentration
- Nausea and vomiting
- Problems with vision or speech
- Weakness or numbness, often just on one side of the body
The symptoms of oligodendroglioma can be like other health conditions. Make sure your child sees a healthcare provider for a diagnosis.
How is an oligodendroglioma diagnosed in a child?
Your child's healthcare provider will ask about your child's health history and symptoms. He or she will examine your child. This will include a neurological exam. The exam tests reflexes, muscle strength, eye and mouth movement, and coordination. Your child's healthcare provider may refer your child to a cancer specialist (oncologist). Your child may have tests such as:
- CT scan. A CT scan uses a series of X-rays and a computer to make detailed pictures of the body.
- MRI. An MRI uses large magnets, radio waves, and a computer to make detailed pictures of the body. Contrast dye may be injected into your child's vein. It helps cancer cells be seen more clearly.
- Biopsy. Tumor cells are removed and sent to a lab for testing. This is done to find out the type of tumor and how quickly it is likely to grow. This may be done with surgery.
- Blood tests. Blood tests may be done to check for substances that are released by some tumors. These are called tumor markers.
Part of diagnosing cancer and deciding on treatment is called grading. Grading describes how much cancer cells are different from normal cells. Most tumors are graded on a scale from I to IV. Grade I means that the cancer cells have only just started to grow. They look a lot like normal cells and are likely to grow slowly. They are called low-grade. Grade IV means that it is advanced in its growth and is likely to grow quickly. They are called high-grade. Grade 4 tumors are also called anaplastic oligodendrogliomas. Grades 2 and 3 are in between. They are called intermediate-grade.
How is an oligodendroglioma treated in a child?
If your child has been diagnosed with a brain tumor and time allows, you may want your child to see a different oncologist (get a second opinion) before beginning treatment. In fact, your insurance company might require a second opinion.
Treatment may include one or more of the below:
- Surgery. This is done to remove part or all of the tumor. More surgery may be needed over time, if the tumor grows back. Surgery may be followed by chemotherapy or radiation therapy.
- Chemotherapy. These are medicines that kill cancer cells. One or more medicines may be given. Oligodendroglioma tumors respond better to chemotherapy.
- Radiation therapy. These are high-energy X-rays or other types of radiation. They are used to kill cancer cells or stop them from growing.
Other parts of treatment may include:
- Steroids. These are medicines help prevent or reduce the swelling in the brain.
- Anticonvulsant medicines. These help to prevent or control any seizures.
- Shunt placement. A shunt is a small tube. It’s put into the skull to drain any fluid that has built up in or around the brain.
With any cancer, how well a child is expected to recover (prognosis) varies. Keep in mind:
- Getting medical treatment right away is important for the best prognosis.
- Ongoing follow-up care during and after treatment is needed.
- New treatments are being tested to improve outcome and to lessen side effects.
What are the possible complications of an oligodendroglioma in a child?
A child may have complications from the tumor or from treatment, such as:
- Damage to the brain or nervous system that causes problems with coordination, muscle strength, speech, or eyesight
- Problems after surgery, such as infection, bleeding, and problems with general anesthesia
- Infection and bleeding from chemotherapy
- Delayed growth and development
- Learning problems
- Problems with reproduction (infertility)
- Return of the cancer
- Growth of other cancers
How can I help my child live with an oligodendroglioma?
A child with a brain tumor needs ongoing care. Your child will be seen by oncologists and other healthcare providers to treat any late effects of treatment and to watch for signs or symptoms of the tumor returning. Your child will be checked with imaging tests and other tests. And your child may see other healthcare providers for problems from the tumor or from treatment. For example, your child may see an eye doctor (ophthalmologist) for vision problems.
Your child may need therapy to help with movement and muscle strength. This may be done by physical and occupational therapists. If your child's speech is affected, he or she may need help from a speech therapist. Your child may also need the help of other therapists for learning or emotional problems.
You can help your child manage his or her treatment in many ways. For example:
- Your child may have trouble eating. A dietitian may be able to help.
- Your child may be very tired. He or she will need to balance rest and activity. Encourage your child to get some exercise. This is good for overall health. And it may help to lessen tiredness.
- If your child smokes, help him or her quit. If your child doesn’t smoke, make sure he or she knows the danger of smoking.
- Get emotional support for your child. Find a counselor or child support group can help.
- Make sure your child attends all follow-up appointments.
When should I call my child’s healthcare provider?
Call the healthcare provider if your child has:
- Symptoms that get worse
- New symptoms
- Side effects from treatment
Key points about an oligodendroglioma in children
- Oligodendroglioma is a type of brain tumor. It’s a rare tumor that grows in the cells that make up the fatty covering of nerve cells.
- They are rare in children.
- Symptoms may include seizures, headaches, trouble with thinking, memory, or concentration, and nausea and vomiting.
- They may be diagnosed with MRI and CT tests.
- Treatment is usually done with surgery. It’s then followed by chemotherapy, radiation therapy, or both.
- Ongoing care is important.
Tips to help you get the most from a visit to your child’s healthcare provider:
- Know the reason for the visit and what you want to happen.
- Before your visit, write down questions you want answered.
- At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
- Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
- Ask if your child’s condition can be treated in other ways.
- Know why a test or procedure is recommended and what the results could mean.
- Know what to expect if your child does not take the medicine or have the test or procedure.
- If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
- Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.
April 21, 2017
Alteri, Rick, MD,MMI board-certified, academically affiliated clinician