Brain Tumors
Brain tumors constitute an important group of diseases in Neurosurgery. In its simplest terms, a brain tumor is the proliferation and mass formation of abnormal cells in the brain. Brain tumor grows in the skull irregularly or regularly according to its character and puts pressure on the brain; and enlargement gives symptoms according to the region in the skull that does not have the opportunity to grow and the brain area that it presses; but primarily, it shows symptoms related to the increase in intracranial pressure by disrupting the fluidity of the cerebrospinal fluid or completely stopping the flow. In general, we can classify brain tumors as malignant and benign.
Malicious Brain Tumor:
Glial Tumors: These are the most common brain tumors, that is, they cause most of the brain cancers. They contain cells capable of uncontrolled proliferation. They grow rapidly and extend into the healthy tissue around them, although very rarely, they can spread to the spinal cord and even to other organs of the body. To understand how these will progress in the clinic, staging is done in four groups: Stages I and Stage II are called “low stage”, while Stage III (anaplastic astrocytoma) and Stage IV (glioblastoma multiforme) are considered “high stage”. Some other tumors in this group; ependymoma, medulloblastoma, oligodendroglioma. Survival times are related to pathological staging (ie, examination of abnormal tissue under the microscope with some special staining and production techniques), radiotherapy, chemotherapy, response to treatment, and age. The survival time for low-grade glial tumor is longer, while it is much shorter for high-grade glial tumor. In addition, low-grade tumors can transform into high-grade tumors.
Metastatic brain tumor: These are tumors that develop as a result of the spread of a tumor elsewhere in the body to the brain. Metastatic brain tumors spread through the blood and are most commonly caused by cancers of the lung, breast, large intestine, stomach, skin or prostate. In some patients, metastatic focus can be detected in more than one area of the brain. Brain metastases are seen in 20-40% of patients diagnosed in oncology clinics and hospitalized for treatment. This rate constitutes 10% of all brain tumors. Metastatic brain tumors are 4 times more common than other brain tumors. The risk of metastatic brain tumor increases between the ages of 45 and 65, and reaches the highest rate after the age of 65. Making a definitive diagnosis by biopsy with stereotaxic surgery, which can be performed under local anesthesia, facilitates the choice of treatment. Some types of cancer metastasize to the brain years after the primary cancer located in another organ is detected. However, most brain metastases are located in brain tissue before the primary tumor is detected. In some patients, although metastases are detected in the brain, a primary tumor located in another organ cannot be found. Malignant brain tumor treatment options; surgical intervention, radiation therapy, drug therapy, that is, chemotherapy and radio-surgery. Response to treatment is related to factors such as the focus of origin of the tumor, the number of organs to which it has spread, the number of metastatic lesions, the age of the patient, and the presence of additional disease.
Benign Brain Tumor:
These are tumors that usually develop inside the skull but outside of the brain tissue. Meningioma (comprising a significant part of this group), pituitary adenoma, craniopharyngioma, dermoid and epidermoid tumors, hemangioblastoma, colloid cyst, subependymal giant cell astrocytoma, neuroma are the most common lesions of this group. They grow slowly, often have clear borders, rarely spread, but unlike benign tumors in other organs; Since benign brain tumors are located in an organ such as the brain, they can sometimes cause life-threatening situations. Some, although rare, can turn into malignant tumors.
Benign tumors usually do not spread to the surrounding brain tissue, so they have a high chance of being completely removed by surgery. However, they may reappear, albeit to a lesser extent.
Childhood Brain Tumor:
Brain tumors in children develop from different cell groups and in different parts of the brain compared to adults. Childhood brain tumors can be diagnosed earlier than adults. In children, a low-grade malignant tumor can progress to a high-grade one, but this is less common. Brain tumors constitute 21% of all pediatric cancers. Although brain tumors can be seen in children of all ages, it is a more risky period under 7 years old. The most common pediatric brain tumor is “glioma”. When these tumors are located in the cerebellum, they are called medulloblastomas and they grow rapidly and cause an increase in intracranial pressure by preventing the flow of cerebrospinal fluid. Medulloblastoma can also spread to other parts of the brain and spinal cord.
