Brain/Pituitary Tumors Community
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Course of action 7 year old with brain tumor

I am trying to understand the course of action for situation described below.My son is 7. NOt over weight, no diabetes, no abnormal growth, no disabilities. Not a pituitary adenoma but a possible dermoid/epidermoid tumor complicated with precocious puberty. My son was 5 when we noticed pubic hair growth. Per ped brought to pedi endo. Ran every test in the book , plus bone ages every 6 months. All blood work including tumor markers normal, bone ages slightly advanced but nothign impressive. ie last bone age he was exactly 7 and 1 month and came back bone age of 7.6. Pedi endo suggested mri to rule out pituitary adenoma. Though would be unexpected since nothing in blood work over course of 1 1/2 years. Also had normal ultrasound of adrenal glands. MRI came back not a pituitary adenoma. The tumor is 1.4 X.6 X.6 cm.Fat containing heterogeneous lesion anterior to the interpenduncular fossa and inferior to the hypothalmaus. This is likely to be a tumor of germ cell origin such as a dermoid, epidermoid, verusus unusual apearance of lipoma. We met with a neurosurgeon at CHOP who said would not touch this tumor if not bothering him, felt the precocious hair growth is unrelated, and pretty much said I would not touch this and said not cancer/nothing to worry about. We went on our happy way. We had an appt with a pedi endo at chop who also wanted us to meet with neuroonc at chop on the same day. The appt was mon dec 15.  The pedi endo said tumor unrelated to pubic hair growth can attribute it to nothing else. Neuro once said tumor to be concerned about mainly because close to main artery that goes through the brain. (surgeon never told us this). Said she spoke with neurosurgeon and where located in the brain to remove the tumor would have a high degree of morbitity and mortality.  She is recommending another mri at chop as well as a spinal tap.
Is this the normal course of action for somthing like this? I am assuming they want to try to better type the tumor to come up with a course of action? The onc said she is leaning towards a teratoma but i am unsure how this is different from a dermoid/epidermoid tumor? (i think they are all the same but want to find out) What is the best MRI machine to further investigate this problem? We had one (cost a mini fortune) but apparently not top of the line at the hospital we went to. I want o make sure if we go to CHOP i do not have to pay another 1,500 for mri and sedation just to be instructed to have another one somewhere else. Any direction with this confusing situation would be greatly appreciated.
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Avatar universal
   It sounds like your son is getting good care.  I am not familiar with the type of lesion your son may have, but annual mri's will probably be recommended, to monitor any growth or changes. If your son has no uncomfortable symptoms associated with this, I don't see any reason to expect a recommendation for surgery. I have read that many people probably have brain lesions their whole lives, and never know, unless they have an mri for some reason. I believe lesions such as dermoid cysts can sometimes disappear on their own.
The "wait and see" approach can be frustrating, but it is a common course of action (inaction!).
Precocious puberty can be caused by hormonal disruptions from many sources. For example, soy foods are notorious for causing thyroid disorders, precocious puberty, and other endocrine disorders. Unfortunately, it's a rare doctor who looks for the primary cause of the lesions they treat, in my experience.
Keep up with the diagnostic tests (serum,urine etc.). Something may show up outside the normal range within the next year.

I wish you and your son the best,


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