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About Childhood Tectal Glioma

  • Tectal glioma is a slow-growing brain tumor in the tectum (or roof of the brain stem), which controls vital body functions such as breathing, heart rate, and blood pressure.

    • Tectal glioma is a low-grade glioma.
    • Despite originating in a critical part of the body, tectal glioma has a very high cure rate. The long-term prognosis is usually excellent.
    • Most children with tectal glioma develop these brain tumors between the ages of three and sixteen.
    • Tectal glioma tends to develop spontaneously, which means that no known environmental or genetic factor that doctors suspect could have caused the tumor to grow.

    At Dana-Farber/Boston Children's Cancer and Blood Disorders Center, our pediatric brain tumor specialists have extensive expertise in treating all types of gliomas, including tectal glioma. Your child will receive care from a team of pediatric neuro-oncologists, surgeons, pathologists, and radiation oncologists through our Childhood Glioma Program, part of our comprehensive Brain Tumor Center.

    Symptoms of Childhood Tectal Glioma

    Tectal glioma symptoms might mimic those of other, more common ailments. Since these tumors grow relatively slowly, your child may see the doctor with problems that have been occurring for many months. Or symptoms may come on rapidly.

    While symptoms vary from child to child, the most common include:

    • Indications of increased pressure in the brain, including headache (usually upon awakening in the morning), vomiting, and fatigue
    • Abnormal eye movements
    • Difficulty walking

    Because many of these symptoms can also point to other conditions, it's important to have your child evaluated by a qualified medical professional as soon as possible.

    How We Diagnose Childhood Tectal Glioma

    The first step in effective treatment is an accurate diagnosis. We use a combination of diagnostic tools, including a medical history review, physical and neurological examinations, imaging studies, and a biopsy to confirm the diagnosis.

    Your child’s doctor will discuss the results and outline the most effective treatment options with you as quickly as possible.

    How We Treat Childhood Tectal Glioma

    Treatment generally focuses on relieving symptoms caused by increased pressure within the brain and monitoring the tumor for growth or complications. Relieving cranial pressure is usually all a patient needs for a good prognosis.

    Our experts address intracranial pressure by:

    • Shunt: We surgically insert a device to drain excess fluid from your child's body.
    • Endoscopic third ventriculostomy: It’s an alternative to a shunt in which the surgeon creates a pathway to drain fluid into the brain's third ventricle.
    • Oral steroid: We may use a steroid called dexamethasone to relieve pressure.

    We may recommend chemotherapy as a follow-up treatment in some situations. We typically avoid radiation therapy for the majority of children with tectal gliomas.

    We will continue to follow your child to monitor progressive disease using MRI scans (about every three months to start). Spinal fluid diversion has a high cure rate and is sufficient therapy for the majority of patients.

    Ongoing care and support are also available through our extensive pediatric cancer survivorship programs, including the Stop & Shop Family Pediatric Neuro-Oncology Outcomes Clinic for pediatric brain tumor survivors. These services address health and social issues, ranging from motor function evaluation and physical therapy to return-to-school and learning programs.

    Research and Clinical Trials for Childhood Tectal Glioma

    Research is a top priority at Dana-Farber/Boston Children's. Our physicians work continuously to translate laboratory findings into clinical therapies and find ways to improve survival while reducing the toxicity and long-term impact of treatment.

    One of our primary research efforts is the Pediatric Low-Grade Astrocytoma (PLGA) Program. The clinical and research program is dedicated to looking for more effective, less toxic treatments and a cure for children battling brain tumors. Our pediatric neuro-oncologists, including Mariella Filbin, MD, PhD, and Pratiti (Mimi) Bandopadhayay, MBBS, PhD, are actively contributing to these efforts. Our program has contributed to international research efforts that have identified genomic drivers that contribute to growth of low-grade glioma. Specifically, we have identified genes that are commonly mutated in low-grade glioma. These findings are guiding clinical trials examining the activity of new drugs specifically for children with low-grade glioma.

    In addition to launching our own clinical trials, we also offer trials available through collaborative groups such as the Children's Oncology Group (COG) and the Pacific Pediatric Neuro-Oncology Consortium (PNOC). We are also the New England Phase I Center of the Children's Oncology Group. If your child has progressive or recurrent tumor, she may be eligible for a number of experimental therapies available through these groups, or from one of our independent clinical investigators.

    We continue to test new types of low-grade glioma treatment through clinical trials. If you’re interested in learning more, your child’s doctor will be able to provide you with more information.

    Long-term Outcomes for Children with Tectal Glioma

    Tectal gliomas are associated with a high cure rate. Over time, many children will demonstrate an increase in tumor size; however, most will remain asymptomatic and not require further treatment other than ongoing MRI scans.

    Childhood Tectal Glioma Treatment Team

    Children who come to Dana-Farber/Boston Children’s receive care from some of the most skilled and experienced pediatric brain tumor doctors in the world. See a complete list of the specialists in our Childhood Brain Tumor Center.