Brain Tumors & Skull Base Tumors

OVERVIEW:

The term Brain Tumor encompasses growths that are both benign (non-cancerous) and malignant (cancerous). Brain tumors are usually classified into primary brain tumors (which include skull base tumors and pituitary tumors) and secondary (metastatic) brain tumors. Metastatic brain tumors arise from a cancer from elsewhere in the body. Skull Base Tumors arise in the bony structures and coverings of the brain and may be primary (arising in that specific location) or metastatic in origin (arising from a cancer elsewhere).

Primary brain tumors comprise a wide spectrum of benign and malignant neoplasms that may arise from the brain itself (gliomas, astrocytomas, oligodendrogliomas, pineal tumors, lymphoma), the nerves that exit the brain (schwannomas, neurofibromas), the pituitary gland and related structures (pituitary adenomas, craniopharyngiomas, Rathke’s cleft cysts), the coverings of the brain (meningiomas, epidermoid and arachnoid cysts), and the skull base (meningiomas, chordomas, schwannomas, olfactory neuroblastomas, sinus tumors). It is estimated that there are at least 40,000 primary brain tumors diagnosed annually in the United States.

Secondary Brain Tumors or Metastatic brain tumors that arise from cancers elsewhere in the body are unfortunately common. They most often are seen in patients with cancers of the lung, breast, melanoma, colon, kidney and thyroid. It is estimated that at least 10-30% of cancer patients develop brain metastases. In total, 100,000 to 300,000 patients per year are diagnosed with metastatic brain tumors in the United States.

SYMPTOMS:

Given their location, brain tumors and skull base tumors may produce a variety of symptoms including headache, seizures, visual loss, double vision, weakness, fatigue, numbness, difficulty walking, in-coordination, confusion and personality changes.

DIAGNOSIS:

Brain tumors and tumors of the skull base are best diagnosed by imaging studies, typically a magnetic resonance imaging (MRI) of the brain with gadolinium or a computer tomography (CT) scan of the brain. Sometimes focused MRIs of the pituitary region, temporal bones, internal auditory canals or orbits may be needed to obtain better anatomical detail of a tumor. Other tests may also be needed such as angiography (typically now performed as a CT angiogram or an MR angiogram), magnetic resonance spectroscopy, positron emission tomography (PET), visual field tests, an audiogram or hormonal tests.

TREATMENT:

The optimal treatment of patients with brain tumors is dependent upon several factors including the tumor type, location, symptoms and overall health status of the patient. Therapy may include surgical removal, radiation therapy, chemotherapy and hormonal therapies.