Does your little one suddenly have seizures? Or does he/she always complain that his/her head hurts when he/she wakes up in the morning? It is normal for you as a parent to feel very scared when you see things like this. Sometimes these can be signs of a small tumor in the brain. That is why today we thought of talking about this rare type of brain tumor called Ganglioglioma . Don't worry, we will talk about this in detail and simply.
What is this Ganglioglioma?
Simply put, Ganglioglioma is a very rare type of brain tumor. It is made up of a combination of two types of cells: neuronal cells and glial cells .
Think about it, our brain is like a very complex machine.
- Neuronal cells are like the wires that carry information back and forth in this machine. These cells are responsible for carrying information throughout our bodies.
- Glial cells are like the support staff that help keep those wires in place. They form the structure of our central nervous system , and they work together with neurons to help them function.
Gangliogliomas are also called mixed neuronal-glial tumors because they form from a combination of both cell types. They are most commonly seen in children and young adults .
The good news is that most of the time, these gangliogliomas are small, grow slowly, and are not cancerous (benign) . This means that they do not spread to other parts of the body. However, even if they are not cancerous, they can cause problems because they are in the brain, so treatment is necessary.
Most gangliogliomas are classified as low-grade gliomas . Gliomas are tumors that develop in the brain or spinal cord due to the uncontrolled growth of glial cells. Because they are low-grade, they are not cancerous and have a low risk of recurrence.
However, very rarely, these Gangliogliomas can be high-grade . In that case, they can be malignant . They are more aggressive, spread quickly, and are more likely to recur after treatment.
Are there different types of gangliogliomas? Where do they form?
Gangliogliomas are most commonly found in the parts of your brain near your ears, called the temporal lobes . However, they can develop anywhere in the brain. For example:
- Cerebrum - The largest part of our brain.
- Brainstem - The area where the brain and spinal cord connect.
- Cerebellum - the part that controls balance.
- Thalamus
- Hypothalamus
Not only this, sometimes these tumors can also form in the spinal cord .
There is another very rare type, called Desmoplastic Infantile Ganglioglioma . This usually develops in the upper part of the brain in young children under the age of 2 .
How common is this disease?
Ganglioglioma is actually a very rare condition. For example, in the United States, about 4,000 children under the age of 19 are diagnosed with a brain or spinal cord tumor each year. However, only about 1% to 2% of those children have gangliogliomas. So, this is not that uncommon.
What are the symptoms of this?
As I mentioned before, since these tumors most often develop in the temporal lobes, there is a high chance of epilepsy . So, seizures are probably the first sign you notice in your child.
Other symptoms usually develop gradually. These symptoms may vary depending on where the tumor is in the brain:
- Headaches , especially when getting up in the morning.
- Nausea and vomiting .
- Difficulty swallowing .
- Double vision .
- Unsteady gait .
- Feeling tired (Fatigue) .
- Dizziness .
- Weakness on one side of your body .
If your child has one or more of these symptoms, it's best to see a doctor immediately for an examination.
Why does this Ganglioglioma develop?
In most cases, it is difficult to find a specific cause for the development of these Gangliogliomas. This means that they develop almost randomly.
However, researchers have found that a genetic mutation in the BRAF gene is found in between 10% and 60% of these gangliogliomas. However, this genetic mutation can also be found in other types of tumors, so it is not possible to say for sure that this is a specific cause for gangliogliomas.
What are the risk factors for this condition?
Children with certain genetic conditions are at slightly higher risk of developing glial tumors, including ganglioglioma. Some of these conditions include:
- Neurofibromatosis type 1 (NF1)
- Tuberous sclerosis
- Turcot syndrome
- Li-Fraumeni syndrome
- Von Hippel-Lindau syndrome
In addition, data shows that boys are generally more likely to develop brain and spinal tumors than girls, and that white children develop these tumors more often than children of other races.
How do you recognize this exactly?
If your child has these symptoms, a doctor will first do a thorough physical exam . Then they will ask you about your child's symptoms and medical history.
Next, a neurological exam is performed. This tests the child's reflexes, muscle strength, mouth and eye movements, consciousness, and coordination.
After these initial tests, the doctor will recommend several more tests to confirm the diagnosis:
- CT scan (Computed tomography - CT scan) : This uses a series of X-rays and a computer to take cross-sectional images of the child's brain.
- MRI scan (Brain magnetic resonance imaging - MRI scan) : This uses a powerful magnet, radio waves, and a computer to produce very detailed images of the brain. This is very important for determining the exact location and size of the tumor.
- EEG (Electroencephalogram - EEG) : This test measures the electrical signals and activity of the child's brain. This can help determine the cause of a seizure, especially if it's a seizure.
- Biopsy : Sometimes, depending on the child's condition, a neurosurgeon may perform a biopsy. This involves removing a very small piece of tissue from the tumor, either through surgery or through a small incision, and having it examined under a microscope by a pathologist . In addition, this tissue sample may be sent for other specialized tests, such as genomic testing . This can help identify the exact type of tumor.
How is Ganglioglioma treated?
To ensure your child receives the best treatment, it is best to refer them to a pediatric medical center . You should see a board-certified pediatric oncologist or a pediatric neuro-oncologist who has experience treating gangliogliomas.
The treatment given to the child depends on several factors:
- The child's overall health, age, and pre-existing medical conditions.
- The type of tumor, its location in the brain, and its size.
- The severity of the tumor.
- How well the child can tolerate certain treatments, surgeries, or medications.
- How the tumor will progress as the doctors expect.
The first line of treatment is usually surgery to remove the tumor. The doctor will try to remove as much of the tumor as possible. However, sometimes if the tumor is in a very sensitive part of the brain, it can be difficult to completely remove it.
Imagine, if the tumor cannot be completely removed, and if it is high-grade, doctors may next resort to radiation therapy .
- Radiation therapy : This uses high-energy X-rays or other types of radiation to kill cancer cells or stop them from growing or dividing. This treatment can target the exact location of the tumor and deliver radiation. This treatment may be recommended if the tumor is growing slowly (progressive) or if it has come back after surgery (recurrent).
- Chemotherapy : This involves giving drug treatments that kill or shrink cancer cells.
- Targeted therapy : This is also a treatment with drugs. However, this uses drugs that target only a specific marker in the tumor. Many gangliogliomas have specific markers, such as the BRAF gene mutation we talked about earlier. These targeted therapies can destroy those markers.
Sometimes, doctors may recommend that children with recurring tumors that are not responding to other treatments be referred to clinical trials , which are studies that test new treatments.
What is the prognosis?
This is what many parents want to know. The overall five-year survival rate for a child with a ganglioglioma is over 90% . This means that the child has a very good chance of surviving five years after diagnosis.
However, this chance of recovery depends on several factors, such as the tumor grade, the child's age, and the location of the tumor in the brain.
Is there a chance of relapse? (Relapse)
More than 95% of gangliogliomas are low-grade , meaning they are unlikely to recur after the tumor is completely removed.
However, higher-grade tumors, such as grade 3 Ganglioglioma, have a slightly higher chance of reoccurring after surgery.
Can this be prevented from happening?
Unfortunately, researchers still don't know exactly why some children develop gangliogliomas and others don't. Therefore, there is currently no way to prevent this condition from developing .
When should I take my child to the doctor ?
If your child suddenly has a seizure, or if they are showing one or more of the other symptoms I mentioned earlier in this article (such as morning headaches, nausea, difficulty walking), it is essential to take your child to a doctor immediately for an examination .
The symptoms of Ganglioglioma can be similar to those of other health conditions, so it's important to see a doctor for a proper diagnosis to know exactly what's going on.
What questions should you ask the doctor?
When you find out that your child has a ganglioglioma, it's normal to have a lot of questions on your mind. Here are some questions you can ask the doctor:
- What type of Ganglioglioma does my child have?
- Is it cancerous?
- How will this tumor affect my child's brain and health?
- What are the treatment options?
- Can you recommend support groups that help families of children with ganglioglioma?
Finally, things to remember...
"Your child has a brain tumor." Hearing those words can feel like a moment frozen in time. In one shocking moment, your life can feel like it's changed forever.
But, don't give up hope. As shocking and frightening as these words may be, remember that most gangliogliomas are noncancerous, low-grade tumors.
It's natural to be scared when your child is told they have a tumor, and treatment is definitely needed. However, your child is more likely to get rid of the tumor soon . Talk to your child's doctor about his condition and prognosis. They will give you all the information you need.
` Ganglioglioma, brain tumors, pediatrics, seizures, epilepsy, brain surgery, cancer
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