Brain Tumour.jpg
MRI of a Brain Tumour

Definition

[1]
A brain tumour (also brain cancer or intracranial neoplasm) is an uncontrolled, abnormal growth of tissue within the skull that includes neural tissue, meninges, pituitary tissue, the skull or the pituitary gland (see also pituitary tumour)

Types

[2]
  • Glioma (52%)
    • Astrocytoma (44%)
    • Ependymoma
    • Oligodendroglioma
    • Medulloblastoma
  • Meningioma (15%)
  • Pituitary Adenoma (see pituitary tumour) (8%)
  • Acoustic neuroma (8%)
  • Metastases from other cancers

Incidence

[3]
28 per 100 000 people/ year

Age

Increasing risk with age

Gender

Overall, slightly higher risk in women

Risk Factors

[4]
  • Radiation (including Electromagnetic radiation from high-voltage electricity)
  • Head trauma
  • Family History of brain tumours

Signs and Symptoms

[5] [6]

Pathophysiology

[7]
Brain Tumours can be either benign or malignant and may be primary tumours or secondaries from a metastatic source. The presentation of the tumour varies depending on its location inside the cranium; however it is common ffor patients to have signs of raised intracranial pressure, namely, headache, altered conscious status, nausea and vomiting.

Investigations

[8]

Imaging

  • CT
  • MRI

Other

  • Biopsy may be required

Diagnosis

[9]
Diagnosis is usually made based on imaging. The diagnosis of the exact type of tumour may require biopsy.

Differentials to rule out

Treatment

[10]

Non-Pharmacological

  • Radiotherapy

Pharmacological

  • Chemotherapy
  • Dexamethasone (for cerebral oedema and anti-emetic)
  • Mannitol (for cerebral oedema)
  • Seizure prophylaxis

Surgical

  • Resection

Management

[11]
Follow up depends on the stage of the tumour, the type of tumour and the extent of resection.

Complications

[12]

Prognosis

[13]
Prognosis is usually poor with 5-year survival of <50%.

See Also

Oxford Handbook of Clinical Medicine - 9th edition p502
BMJ Best Practice - Astrocytic Brain Tumours
BMJ Best Practice - Overview of Brain Tumours

Citation

MRI Brain Tumour image: "Hirnmetastase MRT-T1 KM" by The original uploader was Marvin 101 at German Wikipedia(Original text: benutzer:marvin_101) - selbst. Licensed under CC BY-SA 2.0 de via Commons - https://commons.wikimedia.org/wiki/File:Hirnmetastase_MRT-T1_KM.jpg#/media/File:Hirnmetastase_MRT-T1_KM.jpg
  1. ^ http://bestpractice.bmj.com.ezp.lib.unimelb.edu.au/best-practice/monograph/262.html
  2. ^ Lecture - Brain Tumours by Mr Leon Lai at Western Health, Melbourne (2015)
  3. ^ http://www.uptodate.com/contents/incidence-of-primary-brain-tumors?source=search_result&search=brain+tumor&selectedTitle=3~150
  4. ^ http://www.uptodate.com/contents/risk-factors-for-brain-tumors?source=search_result&search=brain+tumor&selectedTitle=7~150#H17
  5. ^ Oxford Handbook of Clinical Medicine - 9th edition p502
  6. ^ http://bestpractice.bmj.com.ezp.lib.unimelb.edu.au/best-practice/monograph/729.html
  7. ^ http://bestpractice.bmj.com.ezp.lib.unimelb.edu.au/best-practice/monograph/262.html
  8. ^ Oxford Handbook of Clinical Medicine - 9th edition p502
  9. ^ Oxford Handbook of Clinical Medicine - 9th edition p502
  10. ^ Oxford Handbook of Clinical Medicine - 9th edition p502
  11. ^ http://bestpractice.bmj.com.ezp.lib.unimelb.edu.au/best-practice/monograph/729.html
  12. ^ http://bestpractice.bmj.com.ezp.lib.unimelb.edu.au/best-practice/monograph/729.html
  13. ^ Oxford Handbook of Clinical Medicine - 9th edition p502