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 ?
Joanne was first diagnosed with a brain tumour back in 2006, when she began having a seizure and was rushed to A&E.
"Demand for our services is constantly growing and we urgently need to help more brain tumour patients and their families.
There are currently more than 100,000 people in the UK living with a brain tumour.
Corinne had been enjoying retirement when she suffered a bleed on the brain and was diagnosed with an aggressive type of brain tumour.
The charity's young adult meet-ups aim to provide a safe and relaxing environment for those diagnosed with a brain tumour to get to know new people with similar experiences.
"Dad was originally diagnosed with a low-grade astrocytoma brain tumour after having experienced a heightened sense of smell and deja vu.
Brain tumour can cause different adverse effects on human body depending on its types.
Matthew Price, community fundraising manager at Brain Tumour Research, said: "Brain tumours kill more children and adults under the age of 40 than any other cancer, yet historically just 1% of the national spend on cancer research has been allocated to this devastating disease.
"It is really upsetting for parents and carers, so please can you donate money to Brain Tumour Research, not just for my life but for the other 16,000 people who have brain tumours, too."