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Alternative NamesGlioblastoma multiforme - adults; Ependymoma - adults; Glioma - adults; Astrocytoma - adults; Medulloblastoma - adults; Neuroglioma - adults; Oligodendroglioma - adults; Meningioma - adults; Cancer - brain tumor (adults)
Definition Return to top
A primary brain tumor is a group (mass) of abnormal cells that start in the brain. This article focuses on primary brain tumors in adults.
Causes Return to top
Primary brain tumors include any tumor that starts in the brain. Tumors may be confined to a small area, invasive (spread to nearby areas), benign (not cancerous), or malignant (cancerous).
Tumors can directly destroy brain cells. They can also indirectly damage cells by producing inflammation, compressing other parts of the brain as the tumor grows, causing swelling in the brain, and increasing pressure within the skull.
Brain tumors are classified depending on the exact site of the tumor, the type of tissue involved, benign or malignant tendencies of the tumor, and other factors. Primary brain tumors can arise from the brain cells, the meninges (membranes around the brain), nerves, or glands.
The cause of primary brain tumors is unknown. This is because they are rare, there are many types, and there are many possible risk factors that could play a role. Exposure to some types of radiation, head injuries, and hormone replacement therapy may be risk factors, as well as many others. The risk of using cell phones is hotly debated.
Some inherited conditions increase the risk of brain tumors, including neurofibromatosis, Von Hippel-Lindau syndrome, Li-Fraumeni syndrome, and Turcot syndrome.
Tumors may occur at any age, but many specific tumors have a particular age group in which they are most common. In adults, gliomas and meningiomas are most common.
SPECIFIC TUMOR TYPESGliomas are thought to be derived from glial cells such as astrocytes, oligodendrocytes, and ependymal cells. The gliomas are subdivided into three types:
Meningiomas are another type of brain tumor. These tumors:
Other primary brain tumors in adults are rare and include ependymomas, craniopharyngiomas, pituitary tumors, primary lymphoma of the brain, pineal gland tumors, and primary germ cell tumors of the brain.
Symptoms Return to top
The specific symptoms depend on the tumor's size, location, degree of invasion, and related swelling. Headaches, seizures, weakness in one part of the body, and changes in the person's mental functions are most common.
Symptoms may include:
Exams and Tests Return to top
A doctor can often identify signs and symptoms that are specific to the location of the tumor. Some tumors may not show symptoms until they are very large and cause a rapid decline in the person's mental functions. Other tumors have symptoms that develop slowly.
Most brain tumors increase pressure within the skull and compress brain tissue because of their size and weight.
The following tests may confirm the presence of a brain tumor and identify its location:
Treatment Return to top
Treatment can involve surgery, radiation therapy, and chemotherapy. Brain tumors are best treated by a team involving a neurosurgeon, radiation oncologist, oncologist, or neuro-oncologist, and other health care providers, such as neurologists and social workers.
Early treatment often improves the chance of a good outcome. Treatment, however, depends on the size and type of tumor and the general health of the patient. The goals of treatment may be to cure the tumor, relieve symptoms, and improve brain function or the person's comfort.
Surgery is often necessary for most primary brain tumors. Some tumors may be completely removed. Those that are deep inside the brain or that enter brain tissue may be debulked instead of entirely removed. Debulking is a procedure to reduce the tumor's size.
Tumors can be difficult to remove completely by surgery alone, because the tumor invades surrounding brain tissue much like roots from a plant spread through soil. When the tumor cannot be removed, surgery may still help reduce pressure and relieve symptoms.
Radiation therapy is used for certain tumors.
Chemotherapy may be used along with surgery or radiation treatment.
Other medications used to treat primary brain tumors in children may include:
Comfort measures, safety measures, physical therapy, occupational therapy, and other such steps may be required to improve quality of life. Counseling, support groups, and similar measures may be needed to help in coping with the disorder.
Patients may also consider enrolling in a clinical trial after talking with their treatment team.
Legal advice may be helpful in creating advanced directives such as a power of attorney.
Support Groups Return to top
For additional information, see cancer resources.
Possible Complications Return to top
When to Contact a Medical Professional Return to top
Call your health care provider if you develop any new, persistent headaches or other symptoms suggestive of a brain tumor.
Call your provider or go to the emergency room if you have seizures that are new, or suddenly develop stupor (reduced alertness), vision changes, or speech changes.
References Return to top
Buckner JC, Brown PD, O'Neill BP, Meyer FB, Wetmore CJ, Uhm JH. Central nervous system tumors. Mayo Clin Proc. 2007;82(10):1271-1286.Update Date: 6/10/2008 Updated by: James R. Mason, MD, Oncologist, Director, Blood and Marrow Transplantation Program and Stem Cell Processing Lab, Scripps Clinic, Torrey Pines, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.