brain tumour


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brain tumour

A neoplasm affecting the brain, which may be primary (arising in the brain or meninges) or secondary (i.e., metastatic to the brain).

Epidemiology
Brain tumours are the 3rd most common malignancy in ages 15–34; 35,000 occur annually in the US. 1st-degree relatives of children with brain tumours have a 5-fold increased risk of CNS tumours, leukaemia and other childhood tumours in the affected family.

Clinical findings
Seizures, vision or hearing loss, hemiparesis, double vision, headache, bizarre behaviour, nausea, vomiting, memory loss.
 
Imaging
Mass lesion by all modalities—CT, MRI, PET, ultrasound.

Management
Surgery, gamma knife radiotherapy may be effective; chemotherapy and immunotherapy are less so.

Prognosis
Generally poor, but depends on histological grading; malignant gliomas account for 2.5% of all cancer-related deaths.

Brain tumours/masses 
Primary
• Non-neoplastic—craniopharyngioma, colloid cysts. 
• Primary, benign—meningioma, pituitary adenoma, acoustic neuroma, epidermoid tumours, choroid plexus papilloma. 
• Primary, low grade—pilocytic astrocytoma, astrocytoma, hemangioblastoma, oligodendroglioma, ganglioglioma. 
• Primary, malignant—anaplastic astrocytoma, glioblastoma multiforme, ependymoma, lymphoma, medulloblastoma, primitive neuroectodermal tumour, germ cell tumour, pineal cell tumour, chordoma, choroid plexus carcinoma.
 
Metastatic
Carcinoma, meningeal carcinomatosis.
 
Location-specific symptoms of brain cancer 
• Brainstem—vomiting, incoordination, difficulty with swallowing and speech, unilateral facial muscle weakness (e.g., crooked smile, drooping eyelid), crossed eyes, poor vision, morning headache, drowsiness, hearing loss, head tilt, hemiparesis, personality changes.
• Frontal lobe—seizures, impaired judgment and memory, changed personality or mental capacity, hemiparalysis, loss of sense of smell, impaired vision, swollen optic nerve or papilledema; if both hemispheres are involved, changed mental state or personality, uncoordinated gait.
• Parietal lobe—loss of ability to write; if tumour is in the left hemisphere, speech disturbances and seizures, loss of recognition of body parts, spatial disorders.
• Occipital lobe—directional blindness, seizures.
• Temporal lobe—may be asymptomatic; occasionally speech defects, seizures.
• Ependyma—hydrocephalus, ± neck stiffness, head tilt, multiple cranial nerve palsies.
• Meninges—symptoms specific to the region being compressed; metastatic brain tumours cause oedema resulting in headache, vomiting and nausea, as well as location-specific symptoms.

brain tumour

Secondary spread of cancer to the brain, from a primary tumour elsewhere in the body is common. Primary tumour, originating in the skull is less common. Primary tumours arise from the brain coverings (MENINGIOMAS), the neurological supportive tissue (GLIOMAS), the blood vessels (HAEMANGIOMAS), the bone (OSTEOMAS) or the pituitary gland (PITUITARY ADENOMAS). Some are of congenital origin (CRANIOPHARYNGIOMAS, TERATOMAS) and are due to abnormal development.
References in periodicals archive ?
ALAW firm organised a family fun day to raise much-needed funds and awareness for The Brain Tumour Charity.
Sarah Lindsell, chief executive of The Brain Tumour Charity, said: "We are hugely grateful to everyone who took part and we hope people had some fun, at the same time as raising awareness of brain tumours and the devastation they cause.
Mel has got local schools involved in the charity event and many people are keen to get on board with raising funds and awareness into brain tumour research, after hearing about the plight of little Ruby Hodgson, pictured inset.
The loss of his two best friends hasn't eased for Mark, but it has galvanised him and his wife to support The Brain Tumour Charity.
John Bishop, Tommy Tiernan, Aisling Bea, Jason Byrne and Charlie Baker are amongst those taking part in Underbelly's Big Brain Benefit on Wednesday to raise money to fight brain tumours, the biggest cancer killer for children and adults under 40.
Rebecca Headland, customer service specialist, explained: "A member of ours, Peter Realf, asked if we would support the Brain Tumour Research Wear A Hat Day in memory of his son Stephen, who was also a member of the Coventry and sadly passed away from a brain tumour at the age of 26.
But after medication failed to help, Cameron was eventually diagnosed after an appointment for an unrelated issue with a consultant who recognised the warning signs of a brain tumour.
Sarah Lindsell, chief executive of The Brain Tumour Charity, which is running the HeadSmart campaign to raise awareness of childhood brain tumour symptoms, explains that brain tumours aren't just about having a headache - it's the persistence and variety of a combination of symptoms which indicate the possibility of a tumour.
Sue Farrington Smith, of Brain Tumour Research, said: "We are calling for the national investment in research to be increased to PS30-PS35 million per year.
According to figures from The Brain Tumour Charity, just 19% of adults survive for five years following a brain tumour diagnosis.
Georgia said: "I am only 12 but I already know about three people who have been diagnosed with a brain tumour and the devastating effect it has had on the person and family around them.
THE NUMBERS AROUND 16,000 people are diagnosed with a brain tumour every year in the UK - high profile examples include singer Russell Watson and actor Martin Kemp.