Newly Diagnosed

About pediatric-type diffuse high-grade brainstem gliomas

DIPG (Diffuse Intrinsic Pontine Glioma) and DMG (Diffuse Midline Glioma) make up about 10% – 20% of all brain tumors.

DIPGs are found in the pons or middle area of the brainstem. They are highly aggressive and can grow into other areas of the brainstem.  The diagnosis of DIPG can be based on an MRI alone, because they have a distinctive appearance.

Most DIPG patients survive less than one year. Because this type of tumor is located within the brainstem and cannot be removed, patients are often treated with radiation therapy to help extend their life. A surgical biopsy may be recommended to learn more about the molecular characteristics of the tumor. A surgical needle biopsy is recommended when it can be done safely by a pediatric brain surgeon who has experience performing biopsies in this part of the brain.  Molecular information about the tumor is increasingly important for matching a patient to the clinical trial best suited for their tumor.

DMGs are high-grade gliomas that invade the midline structures of the brain, including the pons, midbrain, thalamus, and spinal cord. These types of tumors also have a poor chance of recovery and no known cure.

Resection is often inadvisable in midline gliomas due to the delicate nature of midline structures and little evidence showing that this extends the life or improves quality of life for patients. Finding ways to help chemotherapy cross the blood-brain barrier and reach the tumor, along with new treatments like immunotherapy (such as CAR-T cells) and targeted therapies, gives hope for improving outcomes for children with DIPG and DMG in the future.

About low-grade brainstem gliomas

Low-grade, or focal brainstem gliomas, are contained to one area of the brainstem and are very rare. They grow more slowly and are unlikely to spread. If surgery can remove it completely, then usually there is no further treatment needed.