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Brain TumorAka: Brain Tumor in Adults

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  1. See Also
    1. Brain Lesion
    2. Pediatric Brain Tumor
    3. HIV related Brain Lesion
  2. Epidemiology
    1. Primary malignant brain tumors account for only 2% of all cancers
    2. Incidence: 6.4 cases per 100,000 person-years
    3. Age at peak Incidence for adults: 65-79 years old
    4. Lifetime Prevalence in U.S.
      1. Men: 0.65%
      2. Women: 0.5%
  3. Risk Factors: Environmental (most uproven)
    1. High Dose Ionizing Radiation (Only proven risk factor)
    2. Electromagnetic field exposure (e.g. cellular phones, unproven)
    3. Head Injury (unproven)
    4. Infections (e.g. Toxoplasmosis gondii, unproven)
    5. Chemical exposures (unproven)
      1. Air pollution from car exhaust
      2. Alcohol Abuse
      3. Hair dyes
      4. Nitrate, nitrite and nitrosamine intake
      5. Pesticides
      6. Petroleum products
      7. Solvents
      8. Tobacco abuse
      9. Vinyl Chloride
  4. Risk Factors: Hereditary Condition Associations
    1. Li-Fraumeni Syndrome
    2. Multiple Endocrine Neoplasia Type I
    3. Neurofibromatosis
    4. Nevoid Basal Cell Carcinoma Syndrome
    5. Tuberous Sclerosis
    6. Turcot's Syndrome
    7. Von Hippel-Lindau Disease
  5. Symptoms: Presenting
    1. Headache (70%)
      1. Often occurs in the morning
    2. Seizures (54%)
      1. Most often focal Seizures (e.g. Partial Motor Seizures)
      2. Seizures may progress to Generalized Tonic-Clonic Seizures (e.g. Jacksonian Seizure)
    3. Cognitive or Personality Changes (52%)
      1. Memory loss and decreased alertness
    4. Focal Weakness (43%)
    5. Nausea or Vomiting (31%)
    6. Speech altered (27%)
    7. Altered Level of Consiousness (25%)
    8. Visual Changes (22%)
  6. Signs: Focal findings suggestive of lesion
    1. Eye exam (observe for signs of increased Intracranial Pressure)
      1. Papilledema (present in only 5% of cases at primary tumor presentation)
      2. Cranial Nerve 6 palsy
    2. Motor Exam
      1. Focal motor weakness
    3. Coordination
      1. Gait disturbance
  7. Types: Primary Brain Tumors in Adults
    1. See Pediatric Brain Tumor for Types in Children
    2. Benign
      1. Meningioma (17%)
        1. Grade 1: Meningioma
        2. Grade 2: Atypical Meningioma
        3. Grade 3: Anaplastic Meningioma (malignant)
      2. Pituitary adenoma (5%)
      3. Schwannoma (3-5%)
      4. Craniopharyngioma (<2%)
    3. Malignant
      1. Gliomas
        1. Astrocytoma (18-20%)
          1. Grade 1: Pilocytic Astrocytoma
          2. Grade 2: Diffuse Astrocytoma
          3. Grade 3: Anaplastic Astrocytoma
        2. Glioblastoma (35-40%)
          1. Grade 4: Glioblastoma
      2. Oligodendroglial Tumor
      3. Pineal Tumor (2%)
      4. Medulloblastoma (<1%)
    4. References
      1. Mahaley (1989) J Neurosurg 71:826
  8. Types: Metastatic Cancer to Brain
    1. Common
      1. Lung Cancer
      2. Breast Cancer
    2. Less common
      1. Hypernephroma
      2. Melanoma
      3. Prostate Cancer
  9. Prognosis: Better prognostic factors
    1. Age under 60 years
    2. Seizure at presentation
    3. Cancer characteristics
      1. Low grade brain tumors
      2. Frontal Lobe tumors
      3. Tumor cells with low proliferative activity and tumor necrosis is absent
      4. MGMT gene promotor hypermethylation present
    4. Treatment response
      1. Minimal residual tumor post-resection
  10. References
    1. Behin (2003) Lancet 361(9354):323
    2. Buckner (2007) Mayo Clin Proc 82(10):1271
    3. Chandana (2008) Am Fam Physician 77:1423

Brain Neoplasms (C0006118)

Definition (MSH)Neoplasms of the intracranial components of the central nervous system, including the cerebral hemispheres, basal ganglia, hypothalamus, thalamus, brain stem, and cerebellum. Brain neoplasms are subdivided into primary (originating from brain tissue) and secondary (i.e., metastatic) forms. Primary neoplasms are subdivided into benign and malignant forms. In general, brain tumors may also be classified by age of onset, histologic type, or presenting location in the brain.
Definition (CSP)neoplasms of the intracranial components of the central nervous system, including the cerebral hemispheres, basal ganglia, hypothalamus, thalamus, brain stem, and cerebellum; subdivided into primary (originating from brain tissue) and secondary (metastatic) forms; primary neoplasms are subdivided into benign and malignant forms; brain tumors may also be classified by age of onset, histologic type, or presenting location in the brain.
Definition (NCI)Benign and malignant neoplasms that arise from or metastasize to structures within the cranium. This includes meningeal and other tumors that occur in the spaces that surround the brain, and neoplasms of the brain.
ConceptsNeoplastic Process (T191)
ICD9239.6
MSHD001932
EnglishBRAIN NEOPL, BRAIN NEOPLASM, Brain Neoplasms, BRAIN TUMOR, Brain tumors, Brain tumour, BT - Brain tumor, BT - Brain tumour, NEOPL BRAIN, Neoplasm of brain, Neoplasm of the Brain, Neoplasm of unspecified nature of brain, Tumor of Brain, Tumor of the Brain
Spanishneoplasia de cerebro de naturaleza no especificada, neoplasia del encefalo, tumor cerebral
Parent ConceptsBrain Diseases (C0006111), Central Nervous System Neoplasms (C0085136), Neoplasms (C0027651), Neoplasms, Intracranial (C1527390), Malignant neoplasm of central nervous system (C0348374)
SourcesCOSTAR, CSP, CST, ICD9CM, MSH, MTH, NCI, NDFRT, OMIM, PDQ, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)


adult brain tumor (C0220624)

Definition (NCI)An abnormal growth of the cells that comprise the tissues of the brain. This term does not specify whether the growth is benign or malignant nor does it specify location. It is limited to persons aged greater than twenty one years.
ConceptsNeoplastic Process (T191)
EnglishAdult Brain Neoplasm, adult brain tumor, Neoplasm of Adult Brain, Neoplasm of the Adult Brain, Tumor of Adult Brain, Tumor of the Adult Brain
Parent ConceptsBrain Neoplasms (C0006118), Adult Intracranial Neoplasm (C1332203), adult solid tumor (C0280099)
SourcesNCI, PDQ
Derived from the NIH UMLS (Unified Medical Language System)



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