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Childhood Central Nervous System Embryonal Tumors Treatment (PDQ®)

Patient Version

Staging Childhood Central Nervous System Embryonal Tumors

Treatment of childhood central nervous system (CNS) embryonal tumors and pineoblastomas depends on the type of tumor and the child's age.

Staging is the process used to find out how much cancer there is and if cancer has spread. It is important to know the stage in order to plan treatment.

There is no standard staging system for childhood central nervous system (CNS) embryonal tumors and pineoblastomas. Instead, treatment depends on the type of tumor and the child's age (3 years and younger or older than 3 years).

Treatment of medulloblastoma in children older than 3 years also depends on whether the tumor is average risk or high risk.

Average risk (child is older than 3 years of age)

Medulloblastomas are called average risk when all of the following are true:

  • The tumor was completely removed by surgery or there was only a very small amount remaining.
  • The cancer has not spread to other parts of the body.

High risk (child is older than 3 years of age)

Medulloblastomas are called high risk if any of the following are true:

In general, cancer is more likely to recur (come back) in patients with a high-risk tumor.

The information from tests and procedures done to detect (find) childhood CNS embryonal tumors or pineoblastomas is used to plan cancer treatment.

Some of the tests used to detect childhood CNS embryonal tumors or pineoblastomas are repeated after surgery to remove the tumor. (See the General Information section.) This is to find out how much tumor remains after surgery.

Other tests and procedures may be done to find out if the cancer has spread:

  • Bone marrow aspiration and biopsy : The removal of bone marrow, blood, and a small piece of bone by inserting a hollow needle into the hipbone or breastbone. A pathologist views the bone marrow, blood, and bone under a microscope to look for signs of cancer. A bone marrow aspiration and biopsy is only done when there are signs the cancer has spread to the bone marrow.
    Bone marrow aspiration and biopsy; drawing shows a patient lying face down on a table and a Jamshidi needle (a long, hollow needle) being inserted into the hip bone. Inset shows the Jamshidi needle being inserted through the skin into the bone marrow of the hip bone.
    Bone marrow aspiration and biopsy. After a small area of skin is numbed, a Jamshidi needle (a long, hollow needle) is inserted into the patient’s hip bone. Samples of blood, bone, and bone marrow are removed for examination under a microscope.
  • Bone scan : A procedure to check if there are rapidly dividing cells, such as cancer cells, in the bone. A very small amount of radioactive material is injected into a vein and travels through the bloodstream. The radioactive material collects in the bones and is detected by a scanner. A bone scan is only done when there are signs or symptoms that the cancer has spread to the bone.
  • Lumbar puncture : A procedure used to collect cerebrospinal fluid (CSF) from the spinal column. This is done by placing a needle into the spinal column. A pathologist views the CSF under a microscope to look for cancer cells. This procedure is also called an LP or spinal tap.
  • Updated: December 11, 2014