Glioblastoma multiforme; ependymoma; glioma; astrocytoma; brain tumor - primary; medulloblastoma; neuroglioma; oligodendroglioma; meningioma
A mass created by growth of abnormal cells or uncontrolled proliferation of cells in the brain.
Primary brain tumor includes any tumor that originates in the brain. Tumors may be localized to a small area, invasive (spread to nearby areas), benign (noncancerous), or malignant (cancerous). Tumors can directly destroy brain cells. They also can cause indirect damage to cells from inflammation, compression from growth of the tumor, cerebral edema (brain swelling), and increased intracranial pressure (the pressure within the skull).
Classification of brain tumors depends on the exact site of the tumor, type of tissue involved, benign or malignant tendencies of the tumor, and other factors. Childhood nervous system tumors are classified as infratentorial (located below the tentorium cerebelli) meaning they are in the posterior third of the brain, or as supratentorial meaning they are within the anterior two-thirds of the brain. Central nervous system tumors account for about 20% of all childhood cancers. They are 2nd in incidence, only surpassed by leukemias. Two-thirds of brain tumors in children are infratentorial with peak ages of 5 to 9 years. The annual incidence in children less than 15 years old is 2.4 per 100,000. More than 1,200 new cases occur each year.
The cause of primary brain tumor is unknown. Some tumors (retinoblastoma, for example) tend to be hereditary. Others tumors (craniopharyngioma) are congenital. Tumors may occur at any age, but many have a particular age group in which they are more common. The most common childhood brain tumors are astrocytoma, medulloblastoma, ependymoma, and brain stem glioma. Gliomas account for 75% of brain tumors in pediatrics, but only 45% in adults. Outside of retinoblastomas, most brain tumors are rare in the first year of life.
Specific symptoms, treatment, and prognosis (probable outcome) vary according to the site and type of the tumor and the age and general health of the person.
Note*: Specific symptoms vary.
Examination often shows focal (isolated location) or general neurologic changes that are specific to the location of the tumor. Some tumors may not show symptoms until they are very large and cause rapid neurologic decline, others are characterized by slowly progressive symptoms. Most brain tumors will include signs typical of space-occupying masses (aggregations of cells) which cause increased intracranial pressure and compression of brain tissue.
A primary brain tumor should have prompt treatment. Early treatment improves the chance of a good outcome for many tumors.
Treatment varies with the size and type of the tumor and the general health of the person. The goals of treatment may be cure of the disorder, relief of symptoms and improvement of function, or comfort.
Surgery is indicated for most primary brain tumors. Some may be completely excised (removed). Tumors that are deep, or that infiltrate brain tissue, may be debulked (removal of much of the mass of the tumor to reduce its size). Surgery may reduce intracranial pressure and relieve symptoms in cases when the tumor cannot be removed. Stereotactic (CT scan-guided) surgery may be helpful in removing deep tumors.
Radiation therapy may be advised for tumors that are sensitive to this treatment. Anticancer medications (chemotherapy) may be recommended.
Other medications 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.
Legal advice may be helpful in formulating advanced directives, such as power of attorney, in cases where continued physical or intellectual decline is likely.
The stress of illness can often be helped by joining a support group where members share common experiences and problems.
Prognosis and outcome vary.
Call for an appointment with your health care provider if new, persistent headaches or other symptoms of primary brain tumor occur.
Call your health care provider or go to the emergency room if seizures develop or if there is the sudden development of stupor,vision changes, or speech changes.
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