Oligodendroglioma in Children

What is an oligodendroglioma in children?

The brain is part of the central nervous system (CNS). The CNS also includes the spinal cord. A tumor is an abnormal growth of tissue. An oligodendroglioma is a type of CNS tumor called a glioma. These are tumors that start in the glial cells. The glial cells act as supports for other brain cells. There are many types of gliomas.

Oligodendroglioma is a rare tumor that starts in cells called oligodendrocytes. These are the cells that help form the fatty covering (myelin) of nerve cells. Oligodendrogliomas:

  • Are more common in adults than in children
  • May start out growing slowly (low-grade), but tend to change over time and then grow quickly (high-grade)
  • Often grow into the brain tissue, making them hard to remove with surgery
  • May be mixed with other types of cells that also support the brain
  • Rarely spread beyond the CNS to other parts of the body

What causes an oligodendroglioma in a child?

Researchers don't know what causes brain tumors. Changes (mutations) in the genes (DNA) likely cause normal cells to turn into cancer. These may be passed on from parents to children (inherited). Or may happen without a known reason.

What are the symptoms of an oligodendroglioma in a child?

Symptoms of brain tumors depend on their size and where they are in the brain. For example, if a tumor develops in the region that controls speech, your child's speech may be affected.

 Symptoms of an oligodendroglioma may include:

  • Seizures
  • Headaches, especially when first waking up
  • Trouble with thinking, memory, or concentration
  • Nausea and vomiting
  • Problems with vision or speech
  • Weakness or numbness, often just on one side of the face or body
  • Balance problems

The symptoms of oligodendroglioma can be like other health conditions. Make sure your child sees a healthcare provider for a diagnosis.

How is an oligodendroglioma diagnosed in a child?

Your child's healthcare provider will ask about your child's health history and symptoms. The provider will do a physical exam that includes a neurological exam. The exam tests reflexes, muscle strength, eye and mouth movement, and coordination. Your child's healthcare provider may refer your child to a cancer specialist (oncologist). Your child may need tests such as:

  • CT scan. A CT scan uses a series of X-rays and a computer to make detailed pictures of the body. Your child may drink a contrast dye or it may be injected into a vein. The dye helps show more details.
  • MRI.  An MRI uses large magnets, radio waves, and a computer to make detailed pictures of the body. Contrast dye may be injected into your child's vein. It helps show clearly.
  • Biopsy. Tumor cells are removed and sent to a lab for testing. This is done to find out the type of tumor and how quickly it' s likely to grow. This may be done during surgery.

Part of diagnosing oligodendroglioma and deciding on treatment is called grading. Grading describes how much the cancer cells look like normal cells. Most tumors are graded on a scale of I (1) to IV (4). Grade I means that the cancer cells look a lot like normal cells and are likely to grow slowly. They' re called low-grade. Grade IV means that the cancer cells look very different and are likely to grow quickly. They' re called high-grade. Grade IV tumors are also called anaplastic oligodendrogliomas. Grades II and III  are in between. They are called intermediate-grade. Talk with the doctor about the grade of your child's cancer and what it means.

How is an oligodendroglioma treated in a child?

If your child has been diagnosed with a brain tumor and time allows, you may want your child to see a different oncologist to get a second opinion. This may help you better understand the treatment options and feel good about the treatment choices you make.

It's important for your child to be treated at a center that specializes in treating cancer in children. Most children are treated in a clinical trial. These are studies that compare the best treatments available now with treatments that are thought to be even better. Your doctor may talk to you about this option.

Treatment may include one or more of the below:

  • Surgery.  This is done to remove part or all of the tumor. More surgery may be needed over time, if the tumor grows back. Surgery may be followed by chemotherapy or radiation therapy.
  • Chemotherapy.  These are medicines that kill cancer cells. One or more medicines may be given.
  • Radiation therapy.  These are high-energy X-rays or other types of radiation. They' re used to kill cancer cells or stop them from growing. 
  • Clinical trials. A clinical trial is a way to test new treatments for cancer. Ask your child's healthcare provider if there are any treatments being tested that may work well for your child. Many new treatments are only available in clinical trials.
  • Supportive care. Treatment can cause side effects. Medicines and other treatments can be used for pain, fever, infection, and nausea and vomiting. This an important part of cancer care.

Other parts of treatment may include:

  • Steroids. These are medicines help prevent or reduce swelling in the brain.
  • Anticonvulsant medicines.  These help to prevent or control any seizures.
  • Shunt placement. A shunt is a small plastic tube. It’s put into the skull to drain any fluid that has built up in or around the brain.

With any cancer, how well a child is expected to recover (prognosis) varies. Keep in mind:                                             

  • Getting medical treatment right away is important for the best prognosis. Cancer that has spread is harder to treat.
  • Ongoing follow-up care during and after treatment is needed.
  • Talk with the doctor about any concerns you have or problems you notice. Your child's treatment team wants to know as much as they can about how your child is doing.

What are the possible complications of an oligodendroglioma in a child?

A child may have short- and long-term problems from the tumor or from treatment. They may include things such as:

  • Damage to the brain or nervous system that causes problems with coordination, muscle strength, speech, or eyesight
  • Problems after surgery, such as infection, bleeding, and problems with general anesthesia
  • Infection and bleeding from chemotherapy
  • Delayed growth and development
  • Learning problems
  • Problems with reproduction (infertility)
  • Return of the cancer (recurrence)
  • Increased risk for other cancers later in life

Talk with the doctor about what you should watch for and what can be done to help prevent complications.

How can I help my child live with an oligodendroglioma?

A child with a brain tumor needs special care for the rest of his or her life . Your child will be seen by oncologists and other healthcare providers to treat any late effects of treatment and to watch for symptoms of the tumor returning. Your child will be checked with imaging tests and other tests. And your child may see other healthcare providers for problems from the tumor or from treatment. For example, your child may see an eye doctor (ophthalmologist) for vision problems.

Your child may need therapy to help with movement and muscle strength. This may be done by physical and occupational therapists. If your child's speech is affected, he or she may need help from a speech therapist. Your child may also need the help of other therapists for learning or emotional problems. 

You can help your child manage his or her treatment in many ways. For example:

  • Your child may have trouble eating. A dietitian may be able to help.
  • Your child may be very tired. He or she will need to balance rest and activity. Encourage your child to get some exercise. This is good for overall health. And it may help to lessen tiredness.
  • Get emotional support for your child. Find a counselor or child support group can help.
  • Make sure your child attends all follow-up appointments.

When should I call my child’s healthcare provider?

Call the healthcare provider if your child has:

  • Symptoms that get worse
  • New symptoms
  • Side effects from treatment

Key points about an oligodendroglioma in children

  • Oligodendroglioma is a type of brain tumor. It’s a rare tumor that grows in the cells that make up the fatty covering of nerve cells. 
  • They' re rare in children.
  • Symptoms may include seizures, headaches, trouble with thinking, memory, or concentration, and nausea and vomiting.
  • They may be diagnosed with MRI, CT scan, or both.
  • Treatment is usually surgery. It may be followed by chemotherapy, radiation therapy, or both. 
  • Ongoing care is important.
  • Because the cancer is so rare, it's important for your child to be treated at a center that specializes in the disease.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

  • Know the reason for the visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
  • Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
  • Ask if your child’s condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if your child does not take the medicine or have the test or procedure.
  • If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your child’s provider after office hours. This is important if and you have questions or need advice.
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