or pressure-areas, hyperintense on T2-weighted MRI, they might indicate the presence a diffuse neoplasm (unclear outline)This is because these tumors disrupt the normal functioning of the blood-brain barrier and lead to an increase in its permeability.
Survival rates in primary brain tumors depend on the type of tumor, age, functional status of the patient, the extent of surgical tumor removal and other factors specific to each case.
Several current research studies aim to improve the surgical removal of brain tumors by labeling tumor cells with 5-aminolevulinic acid that causes them to fluoresce. Postoperative radiotherapy and chemotherapy are integral parts of the therapeutic standard for malignant tumors. Radiotherapy may also be administered in cases of "low-grade" gliomas, when a significant tumor burden reduction could not be achieved surgically.
Multiple metastatic tumors are generally treated with radiotherapy and chemotherapy rather than surgery and the prognosis in such cases is determined by the primary tumor, but is generally poor.
Radiotherapy may be used following, or in some cases in place of, resection of the tumor. Forms of radiotherapy used for brain cancer include external beam radiation therapy, brachytherapy, and in more difficult cases, stereotactic radiosurgery, such as Gamma knife, Cyberknife or NovalisTx radiosurgery.
In 2008 a study published by the University of Texas M. D. Anderson Cancer Center indicated that cancer patients who receive stereotactic radiosurgery (SRS) and whole brain radiation therapy (WBRT) for the treatment of metastatic brain tumors have more than twice the risk of developing learning and memory problems than those treated with SRS alone.
1- Consequences of intracranial hypertension:• are the most common symptom in braintumor patients.• present at the initialencounter with at least 40% of patients.• must be distinguished from seizure.•
3-Irritation• 25% to 50% of all patients with brain tumors experience seizures at some point in their disease course.•••
Brain tumors can be benign or malignant: •• Benign brain tumors do not contain cancer cells: Usually, benign tumors can be removed, and they seldom grow back. The border or edge of a benign brain tumor can be clearly seen. Cells from benign tumors do not invade tissues around them or spread to other parts of the body. However, benign tumors can press on sensitive areas of the brain and cause serious health problems. Unlike benign tumors in most other parts of the body, benign brain tumors are sometimes life threatening.
Malignant brain tumors contain cancer cells:Malignant brain tumors are generally more serious and often are lifethreatening.They are likely to grow rapidly and crowd or invade the surroundinghealthy brain tissue.Very rarely, cancer cells may break away from a malignant braintumor and spread to other parts of the brain, to the spinal cord, oreven to other parts of the body. The spread of cancer iscalled metastasis.Sometimes, a malignant tumor does not extend into healthy tissue.The tumor may be contained within a layer of tissue. Or the bones ofthe skull or another structure in the head may confine it. This kind oftumor is called encapsulated.
Grade I: The tissue is benign. The cells look nearlylike normal brain cells, and cell growth is slow.Grade II: The tissue is malignant. The cells look lesslike normal cells than do the cells in a grade I tumor.Grade III: The malignant tissue has cells that lookvery different from normal cells. The abnormal cells areactively growing. These abnormal-appearing cells aretermed anaplastic.Grade IV: The malignant tissue has cells that lookmost abnormal and tend to grow very fast.
Tumor type :1. Primary brain tumor:Tumors that begin in brain tissue are known as primarytumors of the brain.Primary brain tumors are named according to the type of cellsor the part of the brain in which they begin.The most common primary brain tumors are gliomas. Theybegin in glial cells. There are many types of gliomas:
Astrocytoma - The tumor arises from star-shapedglial cells called astrocytes. In adults, astrocytomasmost often arise in the cerebrum. In children, theyoccur in the brain stem, the cerebrum and thecerebellum. A grade III astrocytoma is sometimescalled an anaplastic astrocytoma. A grade IVastrocytoma is usually called a glioblastomamultiforme.Brain stem glioma - The tumor occurs in thelowest part of the brain. Brain stem gliomas mostoften are diagnosed in young children and middle-aged adults.
Ependymoma - The tumor arises from cells that line the ventricles or the central canal of the spinal cord. They are most commonly found in children and young adults.Oligodendroglioma - This rare tumor arises from cells that make the fatty substance that covers and protects nerves. These tumors usually occur in the cerebrum. They grow slowly and usually do not spread into surrounding brain tissue. They are most common in middle-aged adults.
Some types of brain tumors do not begin in glial cells. The most common of these are: Medulloblastoma - This tumor usually arises in the cerebellum. It is the most common brain tumor in children. It is sometimes called aprimitive neuroectodermal tumor. Meningioma - This tumor arises in the meninges. It usually grows slowly. Schwannoma - A tumor that arises from a Schwann cell. These cells line the nerve that controls balance and hearing. This nerve is in the inner ear. The tumor is also called an acoustic neuroma. It occurs most often in adults.
Craniopharyngioma - The tumor grows at the base of the brain, near the pituitary gland. This type of tumor most often occurs in children. Germ cell tumor of the brain - The tumor arises from a germ cell. Most germ cell tumors that arise in the brain occur in people younger than 30. The most common type of germ cell tumor of the brain is agerminoma. Pineal region tumor - This rare brain tumor arises in or near the pineal gland. The pineal gland is located between the cerebrum and the cerebellum.
2. Secondary brain tumor (metastatic) : Metastatic brain tumors are made of cancerous cells that spread through the bloodstream from a tumor located elsewhere in the body (e.g. lung, breast and kidney). Metastatic brain tumors are the most common type of tumor found in the brain and are much more common than primary brain tumors. Metastatic tumors are usually named after the type of tissue from which the original cancer cells arose (for example, metastatic lung or metastatic breast cancer).
No one knows the exact causes of brain tumors.Research has shown that people with certain risk factors are more likely than others to develop a brain tumor.The following risk factors are associated with an increased chance of developing a primary brain tumor:
I. Being male - In general, brain tumors are more common in males than females. However, meningiomas are more common in females.II. Race - Brain tumors occur more often among white people than among people of other races.III. Age - Most brain tumors are detected in people who are 70 years old or older. However, brain tumors are the second most common cancer in children. Brain tumors are more common in children younger than 8 years old than in older children.IV. Family history - People with family members who have gliomas may be more likely to develop this disease.V. Being exposed to radiation or certain chemicals at work (e.g. Formaldehyde, Vinyl chloride)reference : http://www.medicinenet.com/brain_tumor/
• The Common Brain Tumor in Child : 1- Astrocytoma 2-neuroblastoma 3-Medulloblastoma 4-ependymoma• Which one of this tumor is not a gliomas : 1- Ependymoma 2- Germ cell tumor 3- Astrocytoma 4-Brain stem
1-Diagnosis2- Treatment3- Prognosis Seif el eslam Wael Bedir
Increase Intracranial pressure Neurological symptoms History examination Investigation meningitis vitals EECSpace occupying fundoscope Spinal fluid analysis lesion Complete Radiological work up neurological examination
• computed tomography (CT)-scans• magnetic resonance imaging (MRI).• Neoplasms will often show as differently colored masses (also referred to as processes) in CT or MRI results.
Benign brain tumors oftenshow up as hypodense (darkerthan brain tissue) mass lesionson cranial CT-scans. On MRI, they appear eitherhypo- (darker than braintissue) or isointense (sameintensity as brain tissue) on T1-weighted scans, orhyperintense (brighter thanbrain tissue) on T2-weightedMRI, although the appearanceis variable.
• Contrast agent uptake, sometimes in characteristic patterns, can be demonstrated on either CT or MRI- scans in most malignant primary and metastatic brain tumors.• Perifocal edema
• histological examination of tumor tissue samples obtained either by means of brain biopsy or open surgery.• This examination, performed by a pathologist, typically has three stages:• interoperative examination of fresh tissue,• preliminary microscopic examination of prepared tissues,• Follow up examination of prepared tissues after immuno histochemical staining or genetic analysis.
OverviewThese various types of treatment are available depending on neoplasm type and location and may be combined to give the best chances of survival:• surgery: complete or partial ressection of the tumor with the objective of removing as many tumor cells as possible• radiotherapy• Chemotherapy: with the aim of killing as many as possible of cancerous cells left behind after surgery and of putting remaining tumor cells into a non dividing, sleeping state for as long as possible
A)Surgery• The primary and most desired course of action described in medical literature is surgical removal (resection) via craniotomy.• The prime remediating objective of surgery is to remove as many tumor cells as possible, with complete removal being the best outcome and cytoreduction ("debulking") of the tumor otherwise.• In some cases access to the tumor is impossible and impedes or prohibits surgery.
• Any person undergoing brain surgery may suffer from epileptic seizures. Medication is prescribed and administered to minimize or eliminate the occurrence of seizures.
B) Radiation therapy• The goal of radiation therapy is to selectively kill tumor cells while leaving normal brain tissue unharmed.• Radiotherapy is the most common treatment for secondary brain tumors.• The amount of radiotherapy depends on the size of the area of the brain affected by cancer.
• Conventional external beam1-whole brain radiotherapy treatment (WBRT) or whole brain irradiation‘ may be suggested if there is a risk that other secondary tumors will develop in the future2- Stereotactic radiotherapy is usually recommended in cases involving fewer than three small secondary brain tumors.
C) Chemotherapy• Patients undergoing chemotherapy are administered drugs designed to kill tumor cells. Although chemotherapy may improve overall survival in patients with the most malignant primary brain tumors, it does so in only about 20 percent of patients.• Chemotherapy is often used in young children instead of radiation, as radiation may have negative effects on the developing brain.• The decision to prescribe this treatment is based on a patient’s overall health, type of tumor, and extent of the cancer. The toxicity and many side effects of the drugs, and the uncertain outcome of chemotherapy in brain tumors puts this treatment further down the line of treatment options with surgery and radiation therapy preferred.
Type Treatment prognosisGlioma Surgical debulking 90% deis with treatment radiationmeningioma Preoperative embolisation & surgical resectionCerebellar astrocytoma Surgical resection 90% exceed 5 years survival rateMedulloblastoma Surgical removal 50% exceed 5 years Radio survival rate Chemotherapy
Other• A shunt is used not as a cure but to relieve symptoms by reducing hydrocephalus caused by blockage of cerebrospinal fluid.• Researchers are presently investigating a number of promising new treatments including gene therapy, highly focused radiation therapy, immunotherapy and novel chemotherapies.
• The prognosis of brain cancer varies based on the type of cancer.• Medulloblastomahas a good prognosis with chemotherapy, radiotherapy, and surgical resection while• glioblastoma multiforme has a median survival of only 12 months even with aggressive chemoradiotherapy and surgery.• Brainstem gliomas have the poorest prognosis of any form of brain cancer, with most patients dying within one year, even with therapy that typically consists of radiation to the tumor along with corticosteroids.However, one type of brainstem glioma, a focal seems open to exceptional prognosis and long-term survival has frequently been reported.