Diagnosis of Childhood Brain stem glioma

Executive Summary

Brainstem Glioma- Childhood is diagnosis based on signs and symptoms. The diagnosis of bone cancer relies on the type of tumor, such as benign and malignant. There are different types of tests for the diagnosis of childhood brainstem glioma. A biopsy is the most common diagnostic approach. Imaging tests such as magnetic resonance imaging (MRI) are conducted to diagnose diffusion in brain stem glioma. Along with the physical examination, the neurological examination test is done to diagnose the brainstem glioma. Also, computed tomography (CT) scan is used as an imaging test for diagnosis.

Diagnostic Approach of Brainstem Glioma- Childhood

Many tests are performed to find the Diagnosis of Brain stem glioma cancer. Also, tests are done to learn if cancer has spread to parts other than where it started. 

biopsy is a sure way to know if you have cancer in a particular part or organ of the body for most types of cancer. 

Diffuse brain stem glioma is different from most other cancers. Brain stem glioma can be diagnosed with MRI (Magnetic resonance imaging) only ​1​.

Usually, the biopsy is avoided in children with diffuse brainstem glioma because it does not alter the treatment option and can have some serious risks. However, a biopsy can be used in clinical trials and brainstem glioma with unusual features ​2​.

By testing the part of the tumor removed during a biopsy, doctors may find certain molecular features to help plan treatment. As advanced treatments based on this molecular information increase and the risk of a biopsy decreases, these procedures may be done more often.

A biopsy and removal of the tumor by surgery can be considered for focal brainstem glioma. If a biopsy is not feasible, the doctor may suggest other tests to help diagnose.

The different tests can be used for a person depending upon the following factors – 

  • Your signs and symptoms
  • The age and general health status
  • The type of cancer suspected
  • The result of earlier medical tests

In addition to a physical examination, the given tests can be used to diagnose a brain stem glioma:

Also Read: Integrative cancer treatment

Neurological Exam

A sequence of questionnaires and tests to inspect the brain, spinal cord, and nerve function is included in this test. The exam checks a person’s mental status, ability to walk normally, coordination, muscles, senses, and reflexes work ​3​. It is called a neuro exam or a neurologic exam.

Magnetic resonance imaging (MRI)

Magnetic resonance imaging (MRI) uses magnetic fields, not x-rays, to produce detailed body images. A special dye known as contrast medium is given before the scan to create a better picture. 

Computed tomography (CT or CAT) scan

A Computed tomography(CT or CAT) scan clicks pictures of the body from the inside using x-rays taken from different angles. A computer combines photos into a detailed, 3-dimensional image that shows abnormalities or tumors. A CT scan can measure the size of the tumor and recognize enlarged lymph nodes, which may indicate the spread of cancer. A contrast medium dye is given before the scan to deliver better detail on the image. This dye can be injected intravenously into the patient or given as a liquid to swallow. In the case of brain stem glioma, this usually does not provide a definite diagnosis; hence Magnetic resonance imaging (MRI) is still needed.

Biopsy

A biopsy removes a small part of tissue to examine under a microscope. For diffuse brainstem glioma, a biopsy is generally not done. However, focal glioma is typically used to find the type of tumor ​4​. A neurosurgeon will remove a small piece of tissue from the brain if possible. A neurosurgeon specializes in treating a CNS tumor using surgery. A pathologist then analyzes the sample. A pathologist specializes in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose disease. 

These results usually help the doctor describe the tumor if brain stem glioma is diagnosed.

References

  1. 1.
    Stroink AR, Hoffman HJ, Hendrick EB, Humphreys RP. Diagnosis and management of pediatric brain-stem gliomas. Journal of Neurosurgery. Published online December 1986:745-750. doi:10.3171/jns.1986.65.6.0745
  2. 2.
    Ramos A, Hilario A, Lagares A, Salvador E, Perez-Nuñez A, Sepulveda J. Brainstem Gliomas. Seminars in Ultrasound, CT and MRI. Published online April 2013:104-112. doi:10.1053/j.sult.2013.01.001
  3. 3.
    Maria BL, Rehder K, Eskin TA, et al. Topical Review Article: Brainstem Glioma: I. Pathology, Clinical Features, and Therapy. J Child Neurol. Published online April 1993:112-128. doi:10.1177/088307389300800203
  4. 4.
    Mohanty A. Biopsy of brain stem gliomas: Changing trends? Journal of Neurosciences in Rural Practice. Published online April 2014:116-117. doi:10.4103/0976-3147.131648