Medulloblastoma – Childhood

Overview

What is a medulloblastoma?

Medulloblastoma is the most common malignant central nervous system tumor of childhood. It accounts for 15-20 percent of pediatric brain tumors. These tumors are located in the cerebellum, the part of the brain that controls balance and other complex motor functions. Within the cerebellum, medulloblastomas are most often seen in the region of the fourth ventricle/vermis, or the central part of the cerebellum, and less frequently they arise within the cerebellar hemispheres.

What causes a medulloblastoma?

There are no identified predisposing factors that lead to the development of medulloblastomas. Current research is focusing on understanding some of the possible genetic pathways that may be involved in the development of medulloblastomas, because there are rare genetic conditions in which medulloblastomas may arise with a slightly increased frequency

What are the symptoms of a medulloblastoma?

• The following are the most common symptoms of a medulloblastoma, however each child may experience symptoms differently. Medulloblastomas have a peak incidence between the ages of 3 and 8 but can be seen anywhere from the newborn/infant up into adulthood. Common symptoms may include: increased pressure within the brain. These symptoms include:
• headache (generally upon awakening in the morning)
• vomiting
• fatigue
• lethargy

There are three different forms of Hodgkin lymphoma:

• A childhood form (in children 14 years or younger)
• A young adult form (in people 15 to 34 years old)
• An older adult form (in people 55 to 74 years old)

Risk Factors

A risk factor is anything that increases a person’s chance of developing cancer. Some risk factors can be controlled, such as smoking, and some cannot be controlled, such as age and family history. Although risk factors can influence the development of cancer, most do not directly cause cancer. Some people with several risk factors never develop cancer, while others with no known risk factors do.
The cause of Hodgkin lymphoma is unknown, although infection with the Epstein-Barr virus may trigger the development of the cancer in approximately 30% of children and teens. People with immune system problems also have a higher risk of developing Hodgkin lymphoma. This group includes:

• Children born with the hereditary condition of ataxia telangiectasia, which causes immune system problems
• Children with HIV/AIDS

Symptoms

Children with Hodgkin lymphoma may experience the following symptoms:

• Painless swelling of lymph nodes in the neck, underarm, or groin that doesn’t go away in a few weeks
• Unexplained fever (without other signs of infection) that doesn’t go away
• Itching
• Fatigue
• Unexplained weight loss
• Night sweats (usually drenching)

Treatment overview

Treatment of Hodgkin lymphoma consists of chemotherapy and/or radiation therapy. Surgery is not commonly used as a treatment, although it may sometimes be used for localized lymphocyte predominant Hodgkin disease (LPHD).
The amount and type of treatment used to treat Hodgkin lymphoma depends on how many lymph node areas are involved and how large the lymph nodes have grown. Children with more widespread (advanced) or “bulky” disease may have more cycles of chemotherapy and radiation therapy than children with early-stage disease. New studies of childhood Hodgkin lymphoma are trying to further reduce the amount of treatment to avoid long-term side effects.
Descriptions of the most common treatment options for childhood Hodgkin lymphoma are listed below.

Chemotherapy

Chemotherapy is the use of drugs to kill cancer cells. Systemic chemotherapy uses drugs to target cancer cells throughout the body. Chemotherapy for childhood Hodgkin lymphoma is given by a pediatric oncologist. Some people may receive chemotherapy in their doctor’s office; others may go to the hospital. A chemotherapy regimen (schedule) usually consists of a specific number of cycles given over a specific time.