Brain tumor - primary - adults

Alternative Names

Glioblastoma multiforme - adults; Ependymoma - adults; Glioma - adults; Astrocytoma - adults; Medulloblastoma - adults; Neuroglioma - adults; Oligodendroglioma - adults; Lymphoma - adults; Vestibular schwannoma (acoustic neuroma) - adults; Meningioma - adults; Cancer - brain tumor (adults)

Definition

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

Primary brain tumors include any tumor that starts in the brain. Primary brain tumors can start from brain cells, the membranes around the brain (meninges), nerves, or glands.

Tumors can directly destroy brain cells. They can also damage cells by producing inflammation, placing pressure on other parts of the brain, and increasing pressure within the skull.

The cause of primary brain tumors is unknown. There are many possible risk factors that could play a role.

SPECIFIC TUMOR TYPES

Brain tumors are classified depending on:

Sometimes, tumors that start out less aggressive can become more aggrssive.

Tumors may occur at any age, but many types of tumors are most common in a certain age group. In adults, gliomas and meningiomas are most common.

Gliomas come from glial cells such as astrocytes, oligodendrocytes, and ependymal cells. The gliomas are divided into three types:

Meningiomas and schwannomas are two other types of brain tumor. These tumors:

Meningiomas are much more common in women. Schwannomas affect both genders equally.

Other primary brain tumors in adults are rare. These include:

Symptoms

Some tumors may not cause symptoms until they are very large. Then they can quickly damage a person's health. Other tumors have symptoms that develop slowly.

The symptoms depend on the tumor's size, location, how far it has spread, and whether there is swelling. The most common symptoms are:

Headaches caused by brain tumors may:

Other symptoms may include:

Other symptoms that may occur with a pituitary tumor:

Exams and Tests

Most brain tumors increase pressure in the skull and press on brain tissue because of their size and weight.

The following tests may confirm the presence of a brain tumor and find its location:

Treatment

Treatment can involve surgery, radiation therapy, and chemotherapy. Brain tumors are best treated by a team that includes: 

Early treatment often improves the chance of a good outcome. How you are treated depends on the size and type of tumor and your general health. The goals of treatment may be to cure the tumor, relieve symptoms, and improve brain function or comfort.

Surgery is often needed 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 removed. Debulking is a procedure to reduce the tumor's size.

Tumors can be hard 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 with surgery or radiation treatment.

Other medications used to treat primary brain tumors in children may include:

Comfort measures, safety measures, physical therapy, and occupational therapy may be needed to improve quality of life. Counseling, support groups, and similar measures can help people cope with the disorder.

You may consider enrolling in a clinical trial after talking with your treatment team.

Legal advice may be helpful for creating advanced directives such as a power of attorney.

Possible Complications

When to Contact a Medical Professional

Call your health care provider if you develop any new, persistent headaches or other symptoms of a brain tumor.

Call your provider or go to the emergency room if you start having seizures, or suddenly develop stupor (reduced alertness), vision changes, or speech changes.

References

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.

Stupp R, Roila F; ESMO Guidelines Working Group. Malignant glioma: ESMO clinical recommendations for diagnosis, treatment, and follow-up. Ann Oncol. 2009;20 Suppl 4:126-128.

National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Central nervous system cancers. V.2.2009.

Wen PY, Kesari S. Malignant gliomas in adults. N Engl J Med. 2008 Jul 31;359(5):492-507.


Review Date: 11/2/2012
Reviewed By: Luc Jasmin, MD, PhD, Department of Neurosurgery, Cedars Sinai Medical Center, Los Angeles and Department of Anatomy, University of California, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, and Stephanie Slon.
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