Grades and Stages of Childhood Brain Stem Glioma

Executive Summary

The staging system of childhood brainstem glioma depends upon the size of the tumor, and its metastasis (diffuse involving spread across the body or focal that in a part of the brain). The grading system in cancer determines the similarity of the cancer cells with the healthy cells. The low-grade tumor and high-grade tumor are the two grouping systems in grading. The grading helps the doctor in determining the level of metastasis of cancer. Diffuse brain stem glioma is the most common stage of brainstem glioma, high-grade tumors that spread throughout the pons and reach the midbrain, the medulla, or nearby parts of the brain. Focal brain stem glioma covers up the 1/5th of brain stem gliomas and mainly occurs in one aspect or remains confined to its original location. Recurrent brainstem glioma is observed among the patients even after completing their treatment.

Staging System of Brainstem Glioma- Childhood

Under Stages of Brain Stem Glioma – Childhood, Staging is the procedure of determining where the tumor is located, whether it has spread, and how it grows. While assessing the cancer stage, many factors are taken into account.

Doctors use diagnostic tests to discover cancer’s stage, so staging may not be complete until all tests are finished. 

There is no typical staging system for childhood brain stem glioma. Instead, the treatment is selected based on whether the tumor is diffuse (spread across the body) or focal (in a part of the brain) ​1​

Grades Or Stages

The grade tells how much cancer cells look like healthy cells when viewed under a microscope. Cancer resembles healthy tissue and has different cell groupings; it is called ‘well-differentiated or a ‘low-grade tumor.’ It is called ‘poorly differentiated’ or a ‘high-grade tumor’ if the cancerous tissue does not resemble healthy tissue”.

The tumor’s grade may help the doctor predict how quickly it will spread. In general, the lower the tumor’s grade, the better the prognosis.

Below are given the general classification of Brain stem glioma : 

Diffuse brain stem glioma

It is one of the most common Stages of Brain Stem Glioma. The type of tumor spreads throughout the pons and reaches the midbrain, the medulla, or nearby brain parts. These are high-grade tumors. They contain abnormal-looking cells and are aggressive. If a biopsy is done, a diffuse brain stem glioma might be further classified by a specific genetic change in the tumor cells called H3 K27M ​2​.

Also Read: Symptoms based on Cancer types

Focal brain stem glioma

About 1/5th of brain stem gliomas are focal, occurring in one part or remaining confined to their original location. They usually occur in the midbrain or the medulla rather than the pons. They are benign or low-grade tumors ​3​. The tumor cells look like normal healthy cells and are less aggressive.

Recurrent brain stem glioma

The brain stem glioma is the tumor that returns after the treatment. The doctor performs another round of tests to know the extent of the recurrence. These tests and scans are usually similar to those done at the time of the original diagnosis. 


  1. 1.
  2. 3.
    Upadhyaya SA, Koschmann C, Muraszko K, et al. Brainstem Low-Grade Gliomas in Children—Excellent Outcomes With Multimodality Therapy. J Child Neurol. Published online November 3, 2016:194-203. doi:10.1177/0883073816675547