Embryonal tumors

Diagnosis

Your healthcare team reviews your child's medical history and symptoms. Tests and procedures used to diagnose embryonal tumors include:

• Neurological exam. During this procedure, vision, hearing, balance, strength, coordination and reflexes are tested. This helps find out which part of the brain might be affected by the tumor.
• Imaging tests. Imaging tests make pictures of the brain. The pictures can show the size and location of the tumor. The pictures may show pressure or blockages of the fluid in the brain. CT and MRI are often used to diagnose brain tumors. Advanced techniques, such as perfusion MRI and magnetic resonance spectroscopy, also may be used.
• Removal of tissue for testing. A biopsy is a procedure to remove a sample of tissue from the tumor for testing. The sample is often taken during surgery to remove the tumor. Your child's healthcare team may want to remove tissue before surgery if the imaging tests show features that aren't typical of embryonal tumors. The tissue is looked at in a lab to determine the types of cells.
• Removal of cerebrospinal fluid for testing. A spinal tap, also called a lumbar puncture, involves inserting a needle between two bones in the lower spine. The needle draws out the fluid from around the spinal cord. The fluid, called cerebrospinal fluid, is tested to look for tumor cells or other things that aren't typical. This test is only done after managing the pressure in the brain or removing the tumor.

Treatment

Treatment for embryonal tumors usually involves surgery. Other treatments might be used after surgery to reduce the risk that the tumor may come back. Which treatments are best for your child depends on your child's age. Your child's healthcare team also considers the type of embryonal tumor and its location.

Embryonal tumor treatment options may include:

• Surgery to relieve fluid buildup in the brain. Some embryonal tumors may block the flow of fluid in the brain. This can cause a buildup of fluid that puts pressure on the brain, called hydrocephalus. To reduce the pressure, a brain surgeon, also called a neurosurgeon, can create a pathway for the fluid to flow out of the brain. Sometimes this procedure can be combined with surgery to remove the tumor.
• Surgery to remove the tumor. A brain surgeon removes as much of the tumor as possible. The surgeon takes care not to harm nearby tissue. Typically, children with embryonal tumors receive additional treatments after surgery to target any remaining cancer cells.
• Radiation therapy. Radiation therapy uses powerful energy beams to kill tumor cells. The energy can come from X-rays, protons and other sources. During radiation therapy, a machine directs beams of energy to specific points on the body. Standard radiation uses X-rays. A newer form of radiation uses proton beams. Proton beam radiation can be carefully targeted to deliver the radiation to the area of the tumor or other areas at risk. This lowers the risk of hurting nearby healthy tissue. Proton beam therapy is available at a limited number of healthcare centers in the United States.
• Chemotherapy. Chemotherapy uses strong medicines to kill tumor cells. Many chemotherapy medicines are given through a vein, but some are taken in pill form. Chemotherapy may be recommended after surgery or radiation therapy. Sometimes it's done at the same time as radiation therapy.
• Clinical trials. Clinical trials are studies of new treatments. These studies give your child a chance to try the latest treatment options. The risk of side effects for these treatments may not be known. Ask a member of the healthcare team whether your child can participate in a clinical trial.

Preparing for your appointment

Make an appointment with a doctor or other healthcare professional if your child has any symptoms that worry you. If your health professional thinks your child may have an embryonal tumor, that person may refer you to a specialist. Often, this is a doctor who specializes in cancer that affects children, called a pediatric oncologist.

Appointments can be short, and being prepared can help. Here's some information that may help you get ready for your child's visit.

What you can do

When you make the appointment, ask if there's anything you need to do for your child in advance, such as fasting before having a specific test. Make a list of:

• Your child's symptoms, including any that seem unrelated to the reason for the appointment.
• Key personal information, including recent life changes and family medical history.
• All medicines, vitamins or other supplements your child takes, including the doses.
• Questions to ask your child's healthcare professional.

For embryonal tumors, some basic questions to ask your child's healthcare professional include:

• Does my child have cancer?
• Does my child need more tests?
• What are my child's treatment options?
• What are the potential risks for these treatment options?
• Do any of the treatments cure the cancer?
• Can I have a copy of the pathology report?
• How much time can I take to consider the treatment options?
• Are there brochures or other printed materials that I can take with me? What websites do you recommend?

Don't hesitate to ask other questions.

What to expect from your child's doctor

Your healthcare professional is likely to ask you several questions, such as:

• When did your child's symptoms begin?
• Have your child's symptoms been continuous or occasional?
• How severe are your child's symptoms?
• What, if anything, seems to improve your child's symptoms?
• What, if anything, appears to worsen your child's symptoms?

Living with embryonal tumors?

Connect with others like you for support and answers to your questions in the Adolescent & Young Adult (AYA) Cancer support group on Mayo Clinic Connect, a patient community.

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