Types of brain tumors Diagnosis, symptoms, treatment
What are brain tumors
Brain tumors are clarified as any growth that growsunnormally cells in the brain. There are two types of brain tumors
- Benign tumors: they are those that grow in a specific area only and do not spread to neighboring tissues
- Malignant tumors: they are growing and multifocal tumors that spread rapidly to other neighboring tissue areas.
Meningioma (Meningioma) is one of the benign tumors and the most common among infected patients in the brain.
It also accounts for one-third of all primary brain and central nervous system tumors.
Meningiomas originate from the meninges. They are usually small tumors that do not cause symptoms and are detected at autopsy.
Larger meningiomas cause patients symptoms of ocular focal seizures, progressive spastic weakness of the legs, urinary incontinence, motor, sensory, neurological symptoms, convulsive seizures depending on the location of the tumor.
There are two types of malignant brain tumors: primary malignant brain tumors, which are the source of the tumor or originate in the brain from nerve cells or glial Cells, and secondary malignant brain tumors that arise as a result of the spread of cancers that originate elsewhere in the body.
Malignant brain tumors that spread from other areas to the central nervous system of the brain are more common in infected patients in adults and are the source of the spread of tumors that spread to the brain, namely lung cancer, breast cancer, melanoma and kidney cancer.
Primary brain tumors
Primary brain tumors are classified based on tissue and location. The main difference is in the form of tumors arising from nerve cells and glial cells.
What are brain tumors arising from central nerve cells:
Central Neurocytoma
- Cerebellar Liponeurocytoma
- Gangliocytoma
- Gliomas
Gliomas are primary malignant tumors of the brain and central nervous system that originate from glial cells and developusually in the frontal, temporal, parietal, and occipital lobes of the cerebral cortex.
In general there are four types of gliomas:
1– Astrocytic tumors: They arise from astrocytes. The most common type of glial cell, arteriovenous malformations are a form of astrocytoma.
2- Oligodendroglial tumors : They arise from oligodendrocytes. It is less common and less aggressive than astrocytomas.
It is characterized by the presence of chromosomal abnormalities that make these tumors insensitive to chemotherapy. It can spread to the brain, which further complicates the surgical removal.
3- Ependymal tumors: They arise from nerve endothelial cells. They are relatively rare tumors of the central nervous system, they are more common in children than in adults. It can lead to significant swellingby blocking the flow of cerebrospinal fluid inside the brain.
4– Mixed glioblastomas
Astrocytomas: astrocytomas are the most common type of glioma. Of the many different types of gliomas, the most common is astrocytomas, accounting for about 3/4 of all gliomas to date.
Gliomas arise from glial cells, the most common are astrocytes. It usually does not spread beyond the brain, distant metastases to organs are rare.
Glioblastoma multiforme (GBM) is a term used to describe grade IV astrocytomas.
(GBM) Glioblastoma multiforme
Glioblastoma multiforme (GBM): it is a Grade IV astrocytoma. It is the most malignant type of glioma. It rarely spreads.
Local growth is usually observed. The spread to the surrounding tissues occurs by diffuse infiltration.
They usually cross the midline of the brain to include the opposite hemisphere of the brain.
It most often affects the frontal and temporal lobes of the brain, but it can affect any part of the central nervous system. On examination with the naked eye, GBM appears as an inconspicuous lump with a polymorphic appearance due to vascular proliferation and/or necrosis.
GBM) Glioblastoma multiforme has different distinctive features and shapes
- High vascularization: the cells are densely trapped inside the tumor.
- Atypical: abnormal or irregular appearance of cells
- Cellular differentiation: cells have lost their normal structural and functional differentiation, which often leads to an increase in size and a large or abnormally shaped nucleus.
- High mitosis index: high level of cell division
Glioblastoma multiforme is divided into two main categories: those that occur spontaneously (primary glioblastoma multiforme) and those that develop from pre-existing low-grade astrocytomas (secondary glioblastoma multiforme).
The majority (>90%) of glioblastoma multiforme are primary tumors. Secondary polymorphic glioblastomas occur much less frequently (<10%).
Primary glioblastoma multiforme is spontaneous and grows very quickly. Secondary polymorphic glioblastoma develops as a result of the development of low-grade astrocytomas such as diffuse low-grade astrocytoma (who Grade II) or anaplastic astrocytoma (who Grade III).
They usually occur in younger patients and the average age at diagnosis is 45 years. The incidence of glioblastoma multiforme is about 3-4 / 100, 000 people per year. It differs somewhat in different geographical areas. It is observed more frequently in developed countries than in developing ones.
Factors determining the prognosis in glioblastoma multiforme
- Age: the prognosis is better in patients under 50 years of age.
- Performance status:a good performance status is the best. A relatively young age and good general fitness affect PS and contribute to a better overall prognosis by increasing the likelihood of tolerating optimal therapy.
- Total or semi-total excision of the tumor has better results.
- Patients with good neurological function have a better prognosis.
Signs and symptoms of glioblastoma multiforme
Mild signs or symptoms that last for a short time have a better prognosis. Methylation of the gene promoter O6-methylguanine methyl transferase (MGMT): patients with methylation have a better prognosis than patients in the unmethylated state, regardless of treatment.
Mass Effects of a tumor exerting local pressure on neighboring brain areas due to a tumor or edema, bleeding that causes local damage, destruction of normal central nervous system tissues due to direct infiltration of a growing tumor, increased intracranial pressure are the main causes of signs and symptoms of the disease.
Other symptoms can be classified as focal or generalized. Focal signs and symptoms reflect the location of the tumor within the brain and its effects on certain brain functions such as paraparesis and aphasia.
General signs and symptoms reflect the effects of high intracranial pressure and may manifest as headache, nausea, vomiting, stroke.
Symptoms of brain tumors
Symptoms of brain tumors may vary depending on their type, size and location. Common symptoms include the following:
- Severe headaches
- Nausea or vomiting
- Epilepsy-fainting
- Problems with sleep, fatigue and drowsiness
- Tingling or numbness in the arm or leg
- Forgetfulness, memory loss
- Speech or personality dysfunction
- Problems with walking and balance
- Visual disturbances
Headache
The most common symptom of brain tumors is headache. The tumor takes up space and presses inside the skull. This causes increased headaches, visual disturbances or double vision.
Nausea and vomiting
In the early stages of a brain tumor, symptoms such as nausea and vomiting may occur. Because the tumor can cause an imbalance of hormones.
Seizures
Brain tumors put pressure on nerve cells in the brain, which can lead to seizures.
Fainting spells are more common in the early stages of a brain tumor and may increase as the disease progresses.
Fatigue and weakness
The fatigue we are talking about goes far beyond the fatigue that you sometimes feel.
If you feel lethargic most of the time or all the time, fall asleep a lot in the middle of the day, have difficulty concentrating, feel irritated or upset, you may need to see your doctor.
Memory loss
Memory problems may be caused by tumors in the frontal or temporal lobes. In addition, problems with concentration, confusion, inability to do two things at the same time, or short-term memory loss may also occur.
Loss of balance
Symptoms of brain tumors may include personality or behavior disorders and sudden emotional changes.
Numbness in the arm or leg
Some types of tumors can cause numbness or tingling in the hands and legs. This tingling or numbness sensation occurs only in one place on the body.
Types of brain tumors
We can classify the types of brain tumors under two headings: primary and secondary. Primary brain tumors can be benign or malignant.
Secondary brain tumors occur due to the spread of cancer cells from other parts of the body to the brain.
Benign brain tumors
These cells mostly occur outside the brain tissue. They multiply slowly and are easily separated from brain tissue. All or some benign tumors can be removed by surgery.
Benign tumors include colloid cysts, pituitary tumors, meningiomas, craniopharyngeal tumors, cutaneous/epidermoid tumor, hemangioblastoma, subendothelial tumor, giant cell astrocytoma, and neuroblastomas.
Malignant brain tumors
Malignant brain tumors grow abnormally fast and can damage nearby brain tissue. Treatment of malignant brain tumors may vary depending on the location of the tumor and the extent of its spread. Therefore, it is very difficult to completely remove these cells.
Diagnosis of brain tumors
In diagnostics, contrast magnetic resonance imaging is the gold standard for scanning the brain due to its high accuracy and pronounced tissue differentiation.
In a contrast-enhanced MRI examination, glioblastoma multiforme usually acts as an enhanced lesion of the loop. A tumor biopsy also helps in the diagnosis.
Since complete resection is associated with the best survival chances for patients with glioblastoma multiforme, most patients with suspected glioblastoma multiforme will undergo surgery to remove as much of the tumor as possible.
At the same time, a tumor biopsy will be performed to provide suitable tumor tissue for pathological examination.
Histological analysis of biopsies is necessary for accurate identification and grading of the tumor, providing a definitive diagnosis.
In a small group of patients where lumpectomy is not possible, a biopsy is performed to obtain tumor tissue for pathological examination.
No predictive biomarkers have been identified for glioblastoma multiforme. The condition of glioblastoma multiforme is an alarm, but there are no current treatment options that require the patient to be selected based on the condition of glioblastoma multiforme.
The glioblastoma multiforme enzyme is a DNA repair enzyme that quickly reverses damage caused by alkylating agents and ionizing radiation, thereby preventing cell death.
Treatment of brain tumors
Treatment of brain tumors depends on the type, location and size of the tumor; it may vary depending on the patient’s age and general state of Health.
Surgery, radiation therapy and chemotherapy are among the treatment options for brain tumors. Surgery is performed on all benign tumors.
Laser treatment of brain tumors
Tumors or other lesions can be removed using this method called a Gamma Knife. The radioactive rays used in laser therapy make it possible to remove diseased tissue without damaging normal brain tissue.
Laser treatment of brain tumors is mostly preferred in cases where surgery is not possible or the patient is at high risk.
Brain tumor surgery
Surgery is most often preferred to remove benign tumors. While all benign tumors can be removed by surgery, in malignant tumors the situation may be different.
If it was not possible to remove all malignant tumors, radiation therapy and postoperative chemotherapy can be applied.
