Diagnosis

Brain tumor

Tumor in the central nervous system (cerebrum, cerebellum, medulla spinalis).

Also known as: Brain cancer, Brain Neoplasm

Etiology

Cause

  1. Primary brain tumors (<50%):

    • Astrocytoma

    • Oligodendroglioma

    • Ependymoma

    • Meningioma

    • Pituitary Adenoma

    • Acoustic Neuroma

    • Craniopharyngioma

    • Hemangioblastoma

    • Glomus Tumors

  2. Metastatic (>50%):

    • Lung cancer (40%)

    • Breast cancer (19%)

    • Melanoma (10%)

    • Colon adenocarcinoma (7%)

Pathophysiology [k7p]

  1. DNA mutations in cellular growth pathways --> tumor formation

  2. Location and size lays a major role in the pathophysiology:

    • Epileptogenic regions --> development of seizures

    • Increased intracranial pressure --> Headache, nausea, vomiting, papilledema,

    • Obstruction of CSF --> hydrocephalus

  3. Cerebellar dysfunction, and focal neurological deficit

Epidemiology

Incidence per 100.000 [e85][q1n][r6a][gfn][s4i][uif][8qk]

Epidemiology chart for Incidence

Symptoms & findings

Symptoms

Anopsia, Aphasia, Ataxia, Bradycardia, Cheyne-Stokes respiration, Cushing's triad, Diplopia, Headache, Hearing loss, Irregular respiration, Nausea, Nystagmus, Paralysis, Paresis, Scotoma, Seizure, Sunset eye sign, Tinnitus, Vertigo, Vomiting, Wide pulse pressure

Clinical findings

Elevated Intracranial Pressure, Papilledema

Anamneses

None listed.

Localized findings

Pain
Radiates
Caput
Onset
Gradual (days)
Pattern
Constant
Severity
Mild (1-3)Moderate (4-7)

Approach

Treatment

Treatment depends on acute symptoms, size and tumor type: [8qk][k7p]

  1. Intubation if impending herniation

  2. Corticosteroids --> reduce cerebral edema

  3. Hyperventilation --> vasoconstriction --> reduce ICP

  4. Mannitol --> transiently lower ICP (rebound increases in ICP --> problematic)

  5. Surgical resection

  6. Radiation treatment

  7. Chemotherapy

Differential diagnoses

Arteriovenous malformation, Brain abscess, Cerebral aneurysm, Ependymoma, Epidural hematoma, Hydrocephalus, Intracerebral hemorrhage, Lymphoma, Meningioma, Multiple sclerosis, Stroke, Subarachnoid hemorrhage, Subdural hematoma, Toxoplasmosis

References

[1] Mezzacappa FM, Thorell W. Neuronal Brain Tumors. [Updated 2022 Nov 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK576406/

[2] Bondy et al. Brain Tumor Epidemiology Consortium. Brain tumor epidemiology: consensus from the Brain Tumor Epidemiology Consortium. Cancer. 2008 Oct 1;113(7 Suppl):1953-68.

[3] Irena Ilic, Milena Ilic. International patterns and trends in the brain cancer incidence and mortality: An observational study based on the global burden of disease. Heliyon, Volume 9, Issue 7, 2023, e18222. ISSN 2405-8440.

[4] Hiba A Wanis et al. The incidence of major subtypes of primary brain tumors in adults in England 1995-2017, Neuro-Oncology, Volume 23, Issue 8, August 2021, Pages 1371–1382

[5] https://cbtrus.org/cbtrus-fact-sheet/

[6] Arora et al. Age-incidence patterns of primary CNS tumors in children, adolescents, and adults in England. Neuro Oncol. 2009 Aug;11(4):403-13.

[7] Etxeberria et al. Brain and central nervous system cancer incidence in navarre (Spain), 1973-2008 and projections for 2014. J Cancer. 2015 Jan 5;6(2):177-83.

[8] http://emedicine.medscape.com/article/779664 (2014-01-02); [Medscape]

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