Low-grade gliomas

Causes

A glioma develops during normal cell division in a precursor cell of the brain’s supporting cells. During this process, changes occur in the DNA of that cell. In some children, this happens because of neurofibromatosis, a condition in which tumors can develop in the nervous system. In most children, it happens by chance during normal brain development.

Symptoms

The symptoms depend on where the glioma is located.

Is the glioma in the cerebellum? Your child may have difficulty maintaining balance. You may notice unsteady walking. Your child may also develop crossed eyes or double vision.

Is the glioma in the brainstem? Your child may experience unusual or tingling sensations in the arms or legs. Swallowing and speaking can become more difficult. Some children have trouble writing.

Is the glioma in the cerebrum? Your child may develop epilepsy. This can happen, for example, if the tumor is located in the temporal lobe.

A glioma can also develop in the optic nerve. In that case, your child may have reduced vision. Hormone problems can also occur, depending on the location of the tumor. For example, your child may have difficulty regulating body temperature or may experience changes in weight.

The brain is surrounded by cerebrospinal fluid, which protects it. The body produces new cerebrospinal fluid every day and also absorbs it into the bloodstream. Sometimes the tumor blocks the flow of this fluid. This can increase pressure inside the head. Your child may develop headaches. Nausea and vomiting can also occur.

How are low-grade gliomas diagnosed?

An MRI scan of the head and spinal cord is performed.

Treatment

Children with a low-grade glioma are treated according to a protocol developed by national and international experts. Treatment may include surgery, chemotherapy, targeted therapy, and/or radiation therapy.

Most children first undergo surgery. If the glioma can be completely removed, your child will not need further treatment. We will monitor your child with follow-up MRI scans.

If the glioma cannot be removed or can only be partially removed, we often choose to monitor the tumor closely. This is possible if the tumor is not causing harm or symptoms, such as reduced vision, movement problems, or hormone changes. Your child will have regular checkups with the doctor. We will also perform MRI scans. Sometimes additional monitoring by other health care professionals is needed, such as an ophthalmologist, endocrinologist, neurologist, or rehabilitation specialist. We always look at what your child needs. Together, we focus on the best possible quality of life.

Chance of recovery

The chance of cure for a low-grade glioma is high. Children rarely die from this tumor. The chance is highest when the glioma can be completely removed. Sometimes this is not possible because it would damage important parts of the brain. Even then, the chance that a child will die from the glioma is very small.

Every child and every situation is unique. That is why we discuss each treatment plan in a large multidisciplinary team, called a tumor board. Together, we decide what is best for your child at that moment: starting treatment or monitoring first.

We work closely with other hospitals in Europe and beyond. This allows us to share knowledge and experience. We follow the latest developments and actively contribute to research. In this way, we aim for the best possible cure and quality of life for your child.

Questions?

Children and adolescents with a low-grade glioma are treated in the neuro-oncology department.