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Astrocytoma in children
Last reviewed: 09.06.2022
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Probably, there is nothing worse for parents than to learn that your child has cancer or even a benign tumor in the brain that needs to be removed promptly, and this carries a certain risk. Brain tumors are not as common as gastritis or bronchial asthma, however, the likelihood of such a disease in a child really exists, and preventive measures cannot be developed until scientists accurately determine the cause of brain tumors.
Epidemiology
Today, primary brain tumors are the leading cause of cancer mortality in children and adolescents aged 20 years and younger, currently exceeding leukemia, and the third leading cause of cancer death in young people aged 20 to 39 years. Gliomas are the most common primary tumors of the central nervous system in both children and adults. The World Health Organization (WHO) classifies this heterogeneous group of tumors into four main groups: astrocytomas; oligodendroglio; mixed oligoastrocytomas; and ependymal tumors.[1], [2]
Causes and risk factors
When it comes to a child, the number of factors that are supposed to cause the development of a tumor process, including astrocytomas in a child, is even more narrowed. Radiation and exposure to chemicals are associated more with professional activities, so they are not relevant in childhood.
As for viruses, it takes time for the active tumor process provoked by them. And we know that babies most often have tumors with slow growth. Therefore, the influence of viruses is difficult to explain the tumor in children.
As a more likely factor, hereditary predisposition remains, but it does not explain why brain astrocytomas are not diagnosed in the prenatal and early postnatal period. One gets the impression that this is an acquired pathology, but what, in that case, starts the process?
There is a possibility that the disease may actually be congenital, but it is not possible to identify its symptoms at an early age. A rare malignant tumor is already detected posthumously at the autopsy, and benign ones develop slowly, so their symptoms are detected later when the child has grown up.
Many doctors today are inclined to believe that negative intrauterine factors during embryogenesis can provoke the formation of a tumor to the same extent as mutagenic ones, especially when it comes to their combined effect.
Astrocytoma symptoms in a child
The first signs of the disease may go unnoticed or be attributed to other diseases due to their non-specificity. Reduced activity of the baby, fatigue, poor appetite, and hence low weight, dyspepsia symptoms do not always indicate a brain tumor. There are many childhood diseases with a similar clinical picture.
Another thing, if we are talking about a lag in psychomotor development, which is controlled by the brain. But here, tumors are not among the first reasons. There are many other factors that can affect brain development in the prenatal period and after childbirth, leading to impaired psychophysical development. So the child can still be observed for a long time, unaware of the true picture of the disorder.
Hypertensive-hydrocephalic syndrome (HGS) is considered a more specific manifestation of the disease. Although he is not always associated with tumors. The suspicion should be caused by: a large head not of age, pronounced cranial sutures that do not stiffen for a long time, a large eminating tight spring. Bad symptoms include sleep disturbances in a small child, a monotonous cry with the head tilted back, an expansion of the venous network in the forehead, temples, and nose.
Doctors also identify some specific manifestations of HGS: a Graefe symptom (a symptom of the setting sun or a wide white stripe between the iris and the upper eyelid when the child lowers his eyes) and a symptom of the rising sun (overlapping almost half of the iris by the lower eyelid).
By itself, the symptom Gref does not always indicate pathology. It is often observed in infants up to 6 months. It is worthwhile to suspect that something is wrong if this symptom is accompanied by other abnormalities: abundant regurgitation, severe excitability, tremor, deviation of the visual axes, which can be easily noticed by the asymmetric arrangement of the corneas (squint). These are all manifestations of hydrocephalic syndrome associated with increased intracranial pressure.
In newborns who still cannot complain of a headache, the pathology can be suspected by the behavior of the baby: it takes the breast poorly, cries for no reason, groans, weak severity of prehensile and swallowing reflexes, reduced muscle tone (“seal paws”), significant head growth ( from 1 cm per month).
Older children may be capricious or talk about pains in the head, nausea, they may often appear vomiting, dizziness, decreased visual acuity [3]. There are frequent complaints that there are difficulties with lowering the eyes or raising the head.
The appearance of headaches can be noticed by the paleness of the skin, weakness and apathy, and at the same time loud sounds, bright light, noise, etc. Start to irritate the child. Sometimes kids start to tiptoe, some have epileptic seizures. Almost always, a brain tumor leaves its mark on the mental development of the child. If a tumor appears early, the baby will initially lag behind in development, with a later development of the process, memory and cognitive abilities will deteriorate, some skills will be lost.[4]
Treatment
It is clear that such symptoms can not be ignored, even if they are not associated with the tumor process. In children, benign tumors are most often identified, so parents have a difficult choice: leave it as it is, because it is not cancer, or venture on risky neurosurgical surgery or chemotherapy.[5]
While relatives decide, the tumor is gradually growing, influences the development of the child and can make him disabled, affecting both the intellectual, emotional and motor areas, depending on the location. A child may go blind or lose his hearing, with a large tumor, he will fall into a coma and die. Doctors consider it necessary to remove malignant and benign tumors that are rare at an early age, and the sooner the better.