Brain Tumor | Dr. Tamer Tekin
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Brain Tumors

When patients first learn about the tumor diagnosis, they naturally panic. However, thanks to current research; It is useful to know that there are serious developments in the treatment of brain tumors with each passing year. In addition, brain tumors have a higher chance of being cured than tumors seen in other organs.

A brain tumor is an abnormal growth of tissue in the brain. The tumor occurs either from brain cells or from another part of the body, spreading to the brain through the blood.  Brain tumor is called benign or malignant according to its behavior.  Benign brain tumor is well circumscribed, grows slowly, and does not spread and damage the surrounding tissues. It usually does not recur after surgical removal. malignant brain tumor  on the other hand, it grows rapidly, spreads to the surrounding tissues, its borders are not clear. It is very rare for tumors originating from brain cells to spread to other organs, such as tumors in other parts of the body. Lung, breast, and colon tumors are the most common tumors that spread to the brain.

Types of Benign Brain Tumors

  • Chordomas are benign, slow-growing tumors that are most common in people aged 50 to 60 years. The most common locations are the base of the skull and the lower part of the spine. Although these tumors are benign, they can invade adjacent bone and press on nearby neural tissue. These are rare tumors that contribute to only 0.2 percent of all primary brain tumors.

  • Craniopharyngiomas are typically benign, but difficult to remove because they are located near critical structures deep in the brain. They usually originate from a part of the pituitary gland (the structure in the body that regulates many hormones), so almost all patients will need some form of hormone replacement therapy.

  • Gangliocytomas, gangliomas, and anaplastic gangliogliomas are rare tumors containing relatively well-differentiated neoplastic nerve cells that occur primarily in young adults.

  • Glomus jugulare tumors are most often benign and typically located at the apex of the jugular vein, just below the skull base. It is the most common form of glomus tumor. Overall, however, glomus tumors contribute only 0.6 percent of head and neck neoplasms.

  • Meningiomas are the most common benign intracranial tumors, accounting for 10 to 15 percent of all brain neoplasms, although a very small percentage are malignant. These tumors originate in the meninges, which are membrane-like structures that surround the brain and spinal cord.

  • Pineocytomas are usually  from pineal cells  These are benign lesions that occur predominantly in adults. They are mostly well-defined, non-invasive, homogeneous and slow growing.

  • Pituitary adenomas  Gliomas are the most common intracranial tumors after meningiomas and schwannomas. The vast majority of pituitary adenomas are benign and grow very slowly. Even malignant pituitary tumors rarely spread to other parts of the body. Adenomas are by far the most common disease affecting the pituitary. They usually affect people in their 30s or 40s, although they can also be diagnosed in children. Most of these tumors can be successfully treated.

  • Schwannomas are common benign brain tumors in adults. They occur along nerves that normally consist of cells that provide "electrical insulation" for nerve cells. Schwannomas often displace rather than invade the rest of the normal nerve. Acoustic neuromas are the most common schwannoma arising from the eighth cranial nerve or the vestibularcochlear nerve that runs from the brain to the ear. Although these tumors are benign, they can cause serious complications and even death if they grow and put pressure on nerves and eventually the brain. Other locations include the spine and, more rarely, the nerves to the limbs.

Types of Malignant Brain Tumors

Gliomas are the most common type of adult brain tumor, accounting for 78 percent of malignant brain tumors. It arises from the brain's support cells called glia. These cells are divided into astrocytes, ependymal cells, and oligodendroglial cells. Glial tumors include:

  • Astrocytomas are the most common glioma, accounting for about half of all primary brain and spinal cord tumors. Astrocytomas develop from star-shaped glial cells called astrocytes, which are part of the supporting tissue of the brain. People of any age can develop astrocytoma, but it is more common in adults, especially middle-aged men. Astrocytomas at the base of the brain are more common in children or young people and make up the majority of children's brain tumors. In children, most of these tumors are considered low-grade, while in adults, most are high-grade.

  • Ependymomas are derived from neoplastic transformation of ependymal cells lining the ventricular system and account for two to three percent of all brain tumors.  

  • Glioblastoma multiforme (GBM) is the most invasive type of glial tumors. These tumors tend to grow rapidly, spread to other tissues, and have a poor prognosis. They can consist of several different types of cells, such as astrocytes and oligodendrocytes. GBM is more common in people aged 50 to 70 and is more common in men than women.

  • Medulloblastomas usually occur in the cerebellum, most commonly in children. They are high-grade tumors, but often sensitive to radiation and chemotherapy.

  • Oligodendrogliomas are derived from cells that make myelin, the insulation for the brain's wiring.

Other Brain Tumor Types

  • Hemangioblastomas are slow growing tumors usually located in the cerebellum. They originate from blood vessels, can be large, and are often associated with a cyst. These tumors are most common in people between the ages of 40 and 60, and are more common in men than women.

  • Rhabdoid tumors are rare, highly aggressive tumors that tend to spread throughout the central nervous system. They usually occur in more than one area of the body, especially the kidneys. It is more common in young children, but can occur in adults as well.

Pediatric Brain Tumors

Brain tumors in children typically come from different tissues than those that affect adults. Treatments (such as radiation therapy) that are well tolerated by the adult brain can interfere with the normal development of a child's brain, especially in children younger than five years old.

According to the Pediatric Brain Tumor Foundation, approximately 4,200 children are diagnosed with brain tumors in the United States. Seventy-two percent of children diagnosed with brain tumors are younger than 15 years old. Most of these brain tumors grow in the posterior fossa (or back). Children often develop hydrocephalus (fluid buildup in the brain) or may develop paralysis of the face, arms, and legs.

Some types of brain tumors are more common in children than adults. The most common types of pediatric tumors are medulloblastomas, low-grade astrocytomas (pilocytic), ependymomas, craniopharyngiomas, and  brain stem gliomas .

How Does a Brain Tumor Occur?

 

Studies show that the abnormality in the genes that control the cell cycle causes uncontrolled cell proliferation.  The risk of developing central nervous system tumor is high in genetic diseases such as neurofibromatosis, von Hippel-Lindau disease, Li-Fraumeni syndrome, retinoblastoma. In studies, it has been observed that families whose children have brain tumors have been exposed to chemicals in the past. Some chemicals can alter gene structures that protect against cancer. Oil refineries, tire production workers, and chemists have reported a high incidence of some types of tumors. However, the relationship of chemical toxins with these tumors has not been proven yet.

 

Brain Tumor Symptoms  

 

Although symptoms vary from person to person, most symptoms are due to increased pressure in or around the brain. The most common brain tumor symptoms are listed below:

  • Headache

  • Vomiting (especially in the morning)

  • Nausea

  • personality changes

  • Depression

  • drowsiness, drowsiness  

  • Epilepsy (Sara) seizures

  • vision losses

  • speech disorder

  • loss of balance

  • Hearing loss

  • Weakness in arm and leg

 

Brain Tumor Diagnosis

 

The medical history can be easily taken with high-tech devices such as CT , MR, PET after the neurological examination.

 

Brain Tumor Treatment

 

Treatment of brain tumor It is usually surgery in the first place. The aim of surgery is to remove the tumor as much as possible while preserving neurological functions. The type of tumor cells is determined by taking a biopsy. Depending on the type of this tumor, radiotherapy or chemotherapy is added to the treatment. 

Steroids are given, especially in the presence of cerebral edema. Antiepileptics are given to prevent epilepsy.

 

New Treatment Methods

 

Stereotactic radiosurgery: A high-dose radiation beam is focused on the tumor site. Cobalt rays or photon rays emanating from linear accelerator are used.

Gene therapy: A special gene attached to the virus is injected into the brain tumor. Cancer cells infected with this virus are then killed with an antiviral drug.  

 

Prognosis

 

  • Type of tumor

  • the duration of the disease

  • The localization and size of the tumor

  • Whether there is metastasis

  • Tumor response to therapy

  • The age of the patient, whether there is any additional disease

may vary accordingly. Life spans vary greatly from person to person.

Dr. Tamer Tekin

Beyin Tümörü Tedavisi
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