Specialized Benign or Malignant Pediatric Tumor Care

At Penn State Health Children’s Hospital, our dedicated care team treats all types of brain, spinal cord and peripheral nerve tumors. Brain tumors and spinal cord tumors can be benign (non-cancerous) or malignant (cancerous) – and unfortunately, both can be life-threatening.

At Penn State Health Children’s Hospital, we offer comprehensive, multidisciplinary care for your child. We also have an extensive experimental therapeutics program, providing innovative treatments for recurrent and difficult to treat tumors. Our pediatric subspecialties work together to create a customized treatment program to achieve the best possible outcome for your child.  

Examples of pediatric brain and spinal cord tumors our team treats include:  

• Astrocytomas and oligodendrogliomas
• Atypical terato-rhabdoid tumors (ATRT)
• Benign and malignant choroid plexus tumors
• Dysembryoplastic neuroepithelial tumors (DNET) and gangliogliomas
• Ependymomas
• Germinomas and other germ cell tumors
• Medulloblastomas and other primitive neuroectodermal tumors (PNET)

When your child comes to Penn State Health Children’s Hospital for brain, spine or peripheral nerve tumor treatment, you can rest assured that our dedicated team will use every option available to help treat your child. Our goal is to treat your child while preserving neurological function and quality of life. Patients referred to our pediatric oncology program will be seen within 24 hours and possibly order additional neuroimaging tests. Once we have all of the imaging results, our entire team will work together to determine the best treatment plan for your child.

Symptoms, Diagnosis and Outlook

Pediatric Brain Tumors

A brain tumor is a group (mass) of abnormal cells that start in the brain. Pediatric brain tumor symptoms may be subtle and gradually become worse – or they may occur quickly. Headaches are often the most common symptom. But only very rarely do children with headaches have a brain tumor.

Headache patterns that may occur with brain tumors include:

• Headaches that are worse when waking up in the morning and go away within a few hours
• Headaches that get worse with coughing or exercise, or with a change in body position
• Headaches that occur while sleeping and with at least one other symptom such as vomiting or confusion

Sometimes, the only symptoms of brain tumors are mental changes, which may include:

• Changes in personality and behavior
• Increased sleep
• Memory loss
• Problems with reasoning
• Unable to concentrate

Additional brain tumor symptoms can include:

• Gradual loss of movement or feeling in an arm or leg
• Hearing loss with or without dizziness
• Problems with balance
• Speech difficulty
• Unexpected vision problem (especially if it occurs with a headache), including vision loss (usually of peripheral vision) in one or both eyes, or double vision
• Weakness or numbness

Infants may have the following signs of a brain tumor:

• Bulging fontanelle
• Enlarged eyes
• No red reflex in the eye
• Positive Babinski reflex

The following diagnostic tests may be used to detect a brain tumor in your child, as well as identify the tumor’s location:

• CT scan of the head
• MRI of the brain
• Examination of the cerebral spinal fluid (CSF)

Outlook for pediatric brain tumors depends on the tumor’s location and how quickly the tumor is diagnosed.

Pediatric Spinal Cord Tumors

A spinal cord tumor is a growth of cells (mass) in or surrounding the spinal cord. Symptoms depend on the location, type of tumor and your child’s general health. Tumors that have spread to the spine from another site (metastatic tumors) often progress quickly. Primary tumors often progress slowly over weeks to years.

Pediatric spinal tumors usually cause symptoms, sometimes over large portions of the body. Tumors outside the spinal cord may grow for a long time before causing nerve damage.

Symptoms may include:

• Abnormal sensations or loss of sensation, especially in the legs
• Back pain that gets worse over time, gets worse when lying down or straining (such as during a cough or sneeze)
• Cold sensation of the legs or cool fingers or hands
• Fecal incontinence
• Inability to keep from leaking urine (urinary incontinence)
• Muscle contractions, twitches or spasms (fasciculations)
• Muscle function loss
• Muscle weakness (decreased muscle strength) in the legs that causes falls, makes walking difficult and may get worse

A nervous system (neurological) examination may help pinpoint the location of a spinal cord tumor. Your child’s physician might also notice the following:

• Abnormal reflexes
• Increased muscle tone
• Loss of pain and temperature sensation
• Muscle weakness
• Tenderness in the spine

The following diagnostic tests may confirm a spinal tumor in your child:

• Cerebrospinal fluid (CSF) examination
• Cytology (cell studies) of CSF
• Myelogram
• Spinal CT
• Spine MRI
• Spine X-ray

Outlook for pediatric spinal tumors depends on the location of the tumor and how quickly the tumor is diagnosed.

Why Choose Penn State Health for Care

Expert Pediatric Subspecialists

Complex brain and spine tumors require the combined expertise of several pediatric subspecialties to provide the most comprehensive care for your child. We are the only hospital in central Pennsylvania to offer patients a full complement of pediatric subspecialists, including:

• Pediatric neurosurgeons
• Medical oncologists
• Radiation oncologists
• Neuropathologists
• Neurologists
• Psychologists
• Physical therapists
• Rehabilitation specialists

Children’s Oncology Group (COG) Partner

Penn State Health Children’s Hospital is a member of the Children’s Oncology Group (COG), a National Cancer Institute supported clinical trials group. As part of this group, we follow treatment plans developed by cancer experts from across North America. Children treated at COG-affiliated institutions tend to have better results than children who receive care at other hospitals. Through this network, we also have access to brain tumor specialists at other institutions if we want additional opinions about the best treatment for your child.

Surgical Expertise

In most cases with brain and spine tumors, surgery is the first step – both to obtain a diagnosis and remove as much of the tumor as possible. For malignant tumors, we may use chemotherapy and/or radiation therapy after surgery. Our team avoids radiation therapy whenever possible because of the negative effect it can have on developing brains. If possible, we use highly focused radiation treatments such as intensity-modulated radiation therapy (IMRT) or Gamma Knife stereotactic radiosurgery to avoid injuring adjacent brain structures.

We treat benign tumors as a chronic condition, aiming to completely remove symptomatic tumors if possible while preserving neurological function and quality of life. For residual or re-growing tumors, we aim to halt tumor growth with repeat surgery or other therapies.

Brain Tumor Surgery

We offer the latest techniques for brain tumor surgery including microsurgery. Our dedicated team is committed to making tumor removal safer and more effective than ever before. Surgical innovations we offer at Penn State Health Children’s Hospital include:

• Frameless stereotaxis: provides image guidance during surgery, mapping the surgical instruments to MRI or CT scans performed before surgery
• Intraoperative monitoring: we routinely monitor a variety of brain functions in “real time” during tumor removal so we can choose the safest path for tumor removal and avoid injuring adjacent areas of the brain.
• Minimally invasive endoscopic surgery: we use endoscopic technologies in conjunction with tiny microinstruments such as the Myriad for tumor removal through an endoscope, and techniques such as corridor surgery, whenever possible that result in smaller incisions and faster recoveries
• Sonopet: an ultrasonic surgical system that can core tumors from the inside out with less damage to the surrounding brain
• Laser Interstitial Thermal Therapy: laser interstitial thermal therapy (LiTT) is a minimally invasive surgery for patients with brain tumor
• Gamma Knife radiosurgery: is a type of radiation therapy used to treat tumors, and other abnormalities in the brain. Gamma Knife radiosurgery, is minimally invasive and does not require open surgery.

Four Diamonds Fund

To make sure that all children get the care they need, the Four Diamonds Fund pays for treatment costs not covered by insurance - including both benign and malignant tumors of the brain and spinal cord. The Four Diamonds Fund has helped more than 4,000 families and assisted 100% of the childhood cancer patients at Penn State Health Children’s Hospital. The program also helps to fund a diverse platform for childhood cancer research.