Brain tumor

Brain tumor
Other names	Intracranial neoplasm, brain tumour
Brain metastasis in the right cerebral hemisphere from lung cancer, shown on magnetic resonance imaging
Specialty	Neurosurgery, Neuro-oncology
Symptoms	Vary depending on the part of the brain involved, headaches, seizures, problem with vision, vomiting, mental changes[1][2]
Types	Malignant, benign[2]
Causes	Usually unknown[2]
Risk factors	Neurofibromatosis, exposure to vinyl chloride, Epstein–Barr virus, ionizing radiation[1][2][3]
Diagnostic method	Computed tomography, magnetic resonance imaging, tissue biopsy[1][2]
Treatment	Surgery, radiation therapy, chemotherapy[1]
Medication	Anticonvulsants, dexamethasone, furosemide[1]
Prognosis	Average five-year survival rate 33% (US)[4]
Frequency	1.2 million nervous system cancers (2015)[5]
Deaths	228,800 (worldwide, 2015)[6]

A brain tumor occurs when abnormal cells form within the brain.^[2] There are two main types of tumors: malignant (cancerous) tumors and benign (non-cancerous) tumors.^[2] These can be further classified as primary tumors, which start within the brain, and secondary tumors, which most commonly have spread from tumors located outside the brain, known as brain metastasis tumors.^[1] All types of brain tumors may produce symptoms that vary depending on the size of the tumor and the part of the brain that is involved.^[2] Where symptoms exist, they may include headaches, seizures, problems with vision, vomiting and mental changes.^[1][2][7] Other symptoms may include difficulty walking, speaking, with sensations, or unconsciousness.^[1][3]

The cause of most brain tumors is unknown, though up to 4% of brain cancers may be caused by CT scan radiation.^[2][8] Uncommon risk factors include exposure to vinyl chloride, Epstein–Barr virus, ionizing radiation, and inherited syndromes such as neurofibromatosis, tuberous sclerosis, and von Hippel-Lindau Disease.^[1][2][3] Studies on mobile phone exposure have not shown a clear risk.^[3] The most common types of primary tumors in adults are meningiomas (usually benign) and astrocytomas such as glioblastomas.^[1] In children, the most common type is a malignant medulloblastoma.^[3] Diagnosis is usually by medical examination along with computed tomography (CT) or magnetic resonance imaging (MRI).^[2] The result is then often confirmed by a biopsy. Based on the findings, the tumors are divided into different grades of severity.^[1]

Treatment may include some combination of surgery, radiation therapy and chemotherapy.^[1] If seizures occur, anticonvulsant medication may be needed.^[1] Dexamethasone and furosemide are medications that may be used to decrease swelling around the tumor.^[1] Some tumors grow gradually, requiring only monitoring and possibly needing no further intervention.^[1] Treatments that use a person's immune system are being studied.^[2] Outcomes for malignant tumors vary considerably depending on the type of tumor and how far it has spread at diagnosis.^[3] Although benign tumors only grow in one area, they may still be life-threatening depending on their size and location.^[9] Malignant glioblastomas usually have very poor outcomes, while benign meningiomas usually have good outcomes.^[3] The average five-year survival rate for all (malignant) brain cancers in the United States is 33%.^[4]

Secondary, or metastatic, brain tumors are about four times as common as primary brain tumors,^[2][10] with about half of metastases coming from lung cancer.^[2] Primary brain tumors occur in around 250,000 people a year globally, and make up less than 2% of cancers.^[3] In children younger than 15, brain tumors are second only to acute lymphoblastic leukemia as the most common form of cancer.^[11] In NSW Australia in 2005, the average lifetime economic cost of a case of brain cancer was AU$1.9 million, the greatest of any type of cancer.^[12]