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A primary brain tumor is a group (mass) of abnormal cells that start in the brain.
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)
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 risk factors that could play a role:
These have not proven to be risk factors:
SPECIFIC TUMOR TYPES
Brain tumors are classified depending on:
Sometimes, tumors that start out less aggressive can change their biologic behavior and become more aggressive.
Tumors can occur at any age, but many types are most common in a certain age group. In adults, gliomas and meningiomas are the most common.
Gliomas come from glial cells such as astrocytes, oligodendrocytes, and ependymal cells. Gliomas are divided into three types:
Meningiomas and schwannomas are two other types of brain tumors. These tumors:
Other primary brain tumors in adults are rare. These include:
Some tumors do not cause symptoms until they are very large. Other tumors have symptoms that develop slowly.
Symptoms depend on the tumor's size, location, how far it has spread, and whether there is brain swelling. The most common symptoms are:
Headaches caused by brain tumors may:
Other symptoms can include:
Other symptoms that may occur with a pituitary tumor:
The following tests may confirm the presence of a brain tumor and find its location:
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. Treatment depends on the size and type of tumor and your general health. 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. This is 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 medicines 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 advance directives such as a power of attorney.
Complications that may result from brain tumors include:
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.
Dorsey JF, Hollander AB, Alonso-Basanta M, et al. Cancer of the central nervous system. In: Niederhuber JE, Armitage JO, Doroshow JH, et al, eds. Abeloff's Clinical Oncology. 5th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2014:chap 66.
Michaud DS. Epidemiology of brain tumors. In: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SK, eds. Bradley's Neurology in Clinical Practice. 7th ed. Philadelphia, PA: Elsevier; 2016:chap 71.
National Cancer Institute. PDQ Adult Central Nervous System Tumors Treatment. Bethesda, MD: National Cancer Institute. Date last modified January 15, 2016. Available at: www.cancer.gov/types/brain/hp/adult-brain-treatment-pdq. Accessed January 18, 2016.
National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines): Central nervous system cancers. Version 1.2015. Available at: www.nccn.org/professionals/physician_gls/pdf/cns.pdf. Accessed January 18, 2016.
Reviewed By: Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.