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Diffuse Intrinsic Pontine Glioma (DIPG)

What Is DIPG?

Diffuse intrinsic pontine glioma (DIPG) is a type of brain tumor that comes from glial cells. Normally, glial cells surround, protect, and support other cells in the brain. But in a tumor, they continue to grow without stopping and eventually compress and hurt other parts of the brain.

DIPG occurs in a delicate area known as the pons, located in the brainstem. This part of the brain controls vital functions such as swallowing and eye movements, and it passes information from the brain to the rest of body, controlling movements in the arms and legs.

DIPG occurs most often in elementary school-age children, but it can affect children of any age. About 250 to 300 children in the U.S. are diagnosed with DIPG each year.

DIPG Symptoms

DIPG tends to grow quickly, so most children are diagnosed soon after their symptoms start. The most common symptoms are:

  • Problems with eye or face movements (crossed eyes or a droop in parts of the face)
  • Hearing problems
  • Headaches and vomiting
  • Trouble swallowing
  • Problems with walking or standing
  • Trouble with speech

DIPG Diagnosis

DIPG is often diagnosed by a child’s symptoms along with a picture of their brain using magnetic resonance imaging (MRI). The location, appearance and symptoms of the tumor usually identify it as DIPG. A biopsy, or surgery to remove a piece of the tumor, may be performed if a child’s symptoms and the MRI images are not clear-cut. The doctor may also use a small section of the tumor to help them plan the most effective treatment.

DIPG Treatment

Treatment options for DIPG are limited. The tumors cannot be entirely removed because they grow alongside and in between normal cells in the brainstem that control essential functions. Radiation helps shrink the tumor, but it cannot make the tumor go away permanently.

Researchers continue to look for medicines that will help stop or slow DIPG.  So far, because it is hard to get the medicine across the blood-brain barrier, none of them has worked very well.

Our Treatment Team

Cincinnati Children’s has long been one of the nation’s leading pediatric centers for brain tumor treatment and research. Research into finding the most effective treatments for high-grade gliomas and DIPG is a high priority. Our physician-scientists do their utmost to ensure that valid scientific discoveries move quickly and safely from the laboratory to the bedside to benefit our patients. 

Because the diagnosis of DIPG affects patients and families in so many ways, our treatment team includes a range of specialists who support families during and after treatment, including:

  • Psychiatrists and psychologists
  • Social workers
  • Nutritionists
  • Specialists who work with a child’s school

Outlook

One of the significant barriers to learning more about DIPG has been a lack of tumor tissue for study. Recently, Cincinnati Children’s helped lead a group of hospitals and research organizations known as the DIPG Collaborative in creating an international DIPG registry. This collaborative effort among physicians and researchers from North America, Canada, Europe and Australia collects health information and tumor samples donated by families of DIPG patients around the world, 

Because of this, researchers are learning more about the biology and genetic makeup of the disease. This can help them design treatments that are more effective. Scientists have had some success developing new medicines in laboratory models of DIPG, and are better ways to deliver those medicines to the tumor. Researchers at Cincinnati Children’s are currently studying a drug that could target a pathway activated by DIPG.

Last Updated 02/2018

Who treats this.

Children and young adults with tumors of the brain and spine receive advanced, comprehensive care at the Brain Tumor Center.

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