Staging Childhood Central Nervous System Embryonal Tumors
Key Points for This Section
- Treatment of childhood CNS embryonal tumors and pineoblastomas depends on the type of tumor and the child's age.
- Treatment of medulloblastoma in children older than 3 years also depends on whether the tumor is average risk or high risk.
- The information from tests and procedures done to detect (find) childhood CNS embryonal tumors or pineoblastomas is used to plan cancer 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).
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.
Medulloblastomas are called high risk if any of the following are true:
- Some of the tumor was not removed by surgery.
- The cancer has spread to other parts of the brain or spinal cord or to other parts of the body.
In general, cancer is more likely to recur (come back) in patients with a high-risk tumor.
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 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.