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Brain tumors

Last updated: May 25, 2021

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Brain tumors are masses of abnormal cells within the brain. They can be primary or metastatic, benign or malignant. Common tumors in children are pilocytic astrocytomas, medulloblastomas, ependymomas, and craniopharyngiomas. Adults most often develop glioblastoma multiforme, meningiomas, hemangioblastomas, schwannomas, oligodendrogliomas, and pituitary adenomas. Clinical features and radiological findings vary according to the type, location, and onset of the tumor. Magnetic resonance imaging (MRI) is the primary diagnostic method. Removal of the entire tumor is a prerequisite for remission. The histological grade of the tumor, which is determined postoperatively, is an important factor in determining the prognosis. Malignant tumors usually require additional treatment with radiotherapy and/or chemotherapy.

Astrocytomas (e.g., pilocytic astrocytoma, glioblastoma multiforme), meningiomas, pituitary adenomas, and schwannomas are discussed in separate articles.

Pediatric primary brain tumors [22]

  • Most pediatric brain tumors are primary.
  • Brain tumors are the second most common cause of pediatric cancer; after leukemia, accounting for approx. 20% of all cases of pediatric cancer and the primary cause of pediatric cancer deaths in the US.
Overview of pediatric primary brain tumors [8][23]
Tumor Precursor Typical location [6] Typical histology [10]
Pilocytic astrocytoma
  • Rosenthal fibers: eosinophilic fibers with corkscrew-like configuration
  • GFAP positive
Medulloblastoma
Ependymoma [24]
  • Perivascular pseudorosettes: tumor cells that are arranged in a papillary structure around a central blood vessel
Craniopharyngioma [15]
Pinealoma

In children, most primary brain tumors arise infratentorial, craniopharyngiomas being an important exception.

Adult primary brain tumors [22]

Overview of adult primary brain tumors [8][23]
Tumor Precursor Typical locations [6] Typical histology [10]
Glioblastoma multiforme (WHO grade IV astrocytoma)
Meningioma
  • Arachnoid cap cells
Hemangioblastoma
  • Vascular system origin
Schwannoma
  • Spindle cells in palisades (Antoni A tissue) alternating with myxoid areas (Antoni B tissue)
  • S-100 positive
Oligodendroglioma
Pituitary adenoma [25]
  • Monomorphic, acidophilic or basophilic, polygonal cells arranged in sheets or cords

In adults, most primary brain tumors arise supratentorially, hemangioblastomas and schwannomas being important exceptions.

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