诊断

医疗护理团队会查看您孩子的病史和症状。用于诊断胚胎性肿瘤的检查和医疗程序包括:

  • 神经系统检查。在这个医疗程序中,会检测您的视力、听力、平衡、力量、协调和反应能力。这有助于确定大脑的哪个部分可能受到肿瘤的影响。
  • 影像学检查。影像学检查可捕获大脑图像。图像可显示出肿瘤的大小及位置。图像还可显示脑内液体的压力或阻塞情况。CTMRI 常被用来诊断脑肿瘤。可能还要用到灌注 MRI 和磁共振波谱分析等先进技术。
  • 取出组织进行检查。活检是一种取出肿瘤的组织样本并进行检查的医疗程序。通常在切除肿瘤的手术过程中采集样本。如果影像学检查显示的特征并非胚胎性肿瘤的典型特征,您孩子的医疗护理团队可能希望在手术前采集组织。将在实验室对组织进行分析,以确定细胞类型。
  • 采集脑脊液用于检测。这种医疗程序也称为腰椎穿刺,需要在下脊柱的两块骨头之间插入针头。针头从脊髓周围抽取液体。抽取的液体称为“脑脊液”,将对此液体进行检测,以寻找肿瘤细胞或其他异常情况。此项检查只有在控制脑部压力或切除肿瘤后才能完成。

治疗

胚胎性肿瘤的治疗通常需要手术。手术后可能需要其他治疗以降低肿瘤复发的风险。哪些治疗最适合取决于孩子的年龄。孩子的医疗护理团队在决策时也会考虑到胚胎性肿瘤的类型和所在部位。

胚胎性肿瘤的治疗方案可能包括:

  • 缓解脑部积液的外科手术。一些胚胎性肿瘤可能会阻断脑内液体的流动。这会导致液体积聚,对大脑造成压力,称为脑积水。为降低压力,脑外科医生(也称为神经外科医生)可能建立一个使液体流出大脑的通道。有时会在进行这个医疗程序的同时行外科手术来切除肿瘤。
  • 切除肿瘤的外科手术。脑外科医生会切除尽可能多的肿瘤。同时,外科医生会小心避免伤害附近的组织。通常来说,患有胚胎性肿瘤的儿童都会在外科手术后接受靶向任何残留癌症细胞的额外治疗。
  • 放射疗法。放射疗法利用强大的能量束来杀死肿瘤细胞。能量可能来自 X 线、质子和其他来源。在放射疗法过程中,机器将能量束照向患者身体的特定位置。标准放射疗法使用的是 X 线。新型放射疗法则使用质子束。质子束放疗可以精确瞄准,将放疗能量引至肿瘤区域或其他有风险的区域。这种方法可以降低伤害附近健康组织的风险。美国只有少数几个医疗中心能够提供质子束疗法。
  • 化疗。化疗使用强效药物杀死肿瘤细胞。许多化疗药物是通过静脉给药,但有的是以片剂形式。外科手术或放射疗法治疗后可能会再推荐化疗。有时化疗会与放疗同时进行。
  • 临床试验。临床试验是对新疗法进行研究。这些研究让孩子有机会尝试最新的治疗方法。但这些治疗方法的副作用风险可能尚不清楚。您可以咨询医疗护理团队成员,了解孩子是否可以参加临床试验。

准备您的预约

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?
Dec. 19, 2024

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  1. Childhood medulloblastoma and other central nervous system embryonal tumors treatment (PDQ) — Patient version. National Cancer Institute: https://www.cancer.gov/types/brain/patient/child-cns-embryonal-treatment-pdq. Accessed Jan. 29, 2023.
  2. Chheda MG, et al. Uncommon brain tumors. https://www.uptodate.com/contents/search. Accessed Jan. 29, 2023.
  3. Winn HR, ed. Central nervous system embryonal tumors. In: Youmans and Winn Neurological Surgery. 8th ed. Elsevier; 2023. https://www.clinicalkey.com. Accessed Sept. 26, 2022.
  4. Louis DN, et al. The 2021 WHO Classification of Tumors of the Central Nervous System: A summary. Acta Neuro-Oncology. 2021; doi:10.1093/neuonc/noab106.