Clinical Review

Identifying brain tumours in children and young adults

BMJ 2013; 347 doi: http://dx.doi.org/10.1136/bmj.f5844 (Published 09 October 2013) Cite this as: BMJ 2013;347:f5844
  1. S H Wilne, consultant paediatric oncologist1,
  2. R A Dineen, clinical associate professor2,
  3. R M Dommett, National Institute for Health Research clinical lecturer3,
  4. T P C Chu, research fellow in epidemiology2,
  5. D A Walker, professor of paediatric oncology2
  1. 1Department of Paediatric Oncology, Nottingham University Hospitals NHS Trust, Queens Medical Centre, Nottingham NG7 2UH, UK
  2. 2Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
  3. 3School of Clinical Sciences, University of Bristol, Bristol, UK
  1. Correspondence to: S H Wilne sophie.wilne{at}nuh.nhs.uk
  • Accepted 24 September 2013

Summary points

  • Each week in the United Kingdom, 10 children and young people are diagnosed with a brain tumour

  • An average general practice sees a new childhood cancer every six years; a quarter of these will be brain tumours

  • Earlier diagnosis of brain tumours in children and young adults improves long term outcomes

  • Diagnosis requires recognition of the specific combinations of symptoms and signs seen with tumours in different areas of the brain and with raised intracranial pressure, followed by brain imaging

  • The developmental stage of the child affects tumour presentation; young children may not be able to describe visual abnormalities and headache

  • Include a focused history (looking for corroborative symptoms and risk factors) and assessment of vision, motor skills, growth, and puberty in children or young people who present with symptoms or signs suggestive of a brain tumour

Healthcare professionals caring for children need to promptly identify the child or young person with a serious underlying condition from the majority who present with minor self limiting illness. Recognising when a child might have cancer can be particularly difficult. Despite the perception that cancer is rare in children, an average general practice will see a child or young person with a new cancer every six years, and a quarter of the tumours will be brain tumours (personal communication, Patricia O’Hare, 2013).1 Early diagnosis can be crucial—evidence from cohort studies shows that it can improve short term and long term outcomes.2 3 4 5 This review summarises current evidence on the presentation and recognition of brain tumours in children and young adults and provides an overview of the treatment and long term care strategies for this population.

Sources and selection criteria

We searched Medline, Embase, and the Cochrane Library for review articles. Key words were brain tumour(s), brain tumor(s), and diagnosis. Articles were restricted to …

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