Brain tumors encompass a diverse array of neoplasms, each with unique characteristics and clinical implications. This summary offers insight into the characteristics, clinical presentations, and treatment modalities associated with these distinctive brain tumors.
Germ cell tumors (GCTs)
GCTs are a type of cancer that can occur in different parts of the body, including the central nervous system (CNS). When GCTs arise in the CNS, they are similar to germ cell tumors found in the gonads and other areas. These tumors are most commonly located in the brain's midline, specifically in the suprasellar and pineal regions. All intracranial GCTs, except for benign teratomas, are malignant and can spread systemically through the cerebrospinal fluid. Types of GCTs include germinomas, which are malignant tumors of primitive germ cells, and nongerminomatous germ cell tumors (NGGCTs), which include embryonal carcinoma, choriocarcinoma, endodermal sinus tumor, and teratoma. Tumor markers in the CSF, such as beta-human chorionic gonadotropin (β-hCG), alpha-fetoprotein (AFP), and placental alkaline phosphatase (PLAP), can be used to monitor treatment response and detect recurrence. Still, they are not always reliable for diagnosing pineal region tumors. GCTs primarily affect children and adolescents.
Hemangiopericytoma
This is a rare type of tumor that can occur in various parts of the body, including the central nervous system (CNS). In recent years, the term "hemangiopericytoma" has been combined with another tumor called solitary fibrous tumor, now known as solitary fibrous tumor/hemangiopericytoma (SFT/HP).
The treatment for hemangiopericytoma is typically surgery, but depending on the grade of the tumor, adjuvant radiation therapy and chemotherapy may also be recommended. Early diagnosis and treatment can improve outcomes.
Chondrosarcomas
Chondosarcomas comprise a rare type of malignant bone tumor that mainly affects cartilage. This cancer can develop in different parts of the body, including the thighbone, arm, pelvis, knee, spine, and even the face bones or skull base. It usually affects people between the ages of 40 and 60.
Chondrosarcoma tumors can be aggressive, but this can vary from case to case. Symptoms of chondrosarcoma can include pain, swelling, and a lump in the affected area. Treatment for chondrosarcoma typically involves surgery to remove the tumor, and sometimes, radiation therapy. With early diagnosis and proper treatment, many people with chondrosarcoma can achieve good outcomes and lead normal lives.
Olfactory neuroblastoma
Also known as esthesioneuroblastoma, this is an extremely rare type of cancer that usually starts in the upper part of the nasal cavity. It is named after the stem cell of the olfactory epithelium from which it arises.
This type of cancer can invade nearby tissues and may even spread to the brain.
The most common symptoms are nosebleeds, nasal congestion, and watery eyes, but it can also cause double vision, pain, and loss of smell.
Treatment usually involves surgery to remove the tumor, followed by radiation therapy and sometimes chemotherapy.
Brain lymphomas
These lymphomas are rare malignant brain tumors that can either be primary or secondary. Primary CNS lymphoma is a type of non-Hodgkin lymphoma that makes up less than 2% of all primary brain tumors. They are more common in patients over the age of 60 but can occur in younger people who are immunocompromised.
The symptoms of brain lymphoma are non-specific and may include mental status changes, headaches, nausea, vomiting, seizures, and multiple cranial-nerve palsies. The diagnosis is highly likely if a tumor is seen in conjunction with uveitis, and treatment usually involves radiation therapy with or without chemotherapy.
Although surgery does not alter the patient's prognosis, it is necessary to obtain a tissue biopsy to confirm the diagnosis and determine the type of lymphoma.
Brain lymphomas are responsive to steroid treatment, which can cause the tumor to disappear temporarily. However, the tumor usually returns after steroid treatment is stopped. The standard treatment for brain lymphomas is radiation therapy, with chemotherapy added for non-AIDS cases.
Rhabdomyosarcoma
This is a rare type of cancer that affects muscles and tendons. It's most commonly found in children, and it can occur in various parts of the body, such as the head and neck, bladder, and reproductive organs. The exact cause of rhabdomyosarcoma is unknown, but certain genetic conditions increase the risk of developing this cancer.
Symptoms may include swelling or a lump in the affected area, pain, and difficulty moving. Treatment options depend on the size and location of the tumor, as well as the extent of the disease. Surgery, chemotherapy, and radiation therapy are standard treatment options.
Atypical teratoid/rhabdoid tumors (AT/RT)
AT/RT are rare and aggressive types of brain tumors that primarily affect infants and young children, with more than 90% of cases occurring in children under the age of 5. These tumors comprise poorly differentiated cells and are classified as WHO-grade IV embryonal tumors of the central nervous system (CNS). These tumors may present with cerebrospinal fluid spread at diagnosis, and while the prognosis is generally poor, different molecular classes have been identified that may affect behavior.
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Sylvester is an NCI-designated cancer center. The National Cancer Institute has recognized Sylvester for its outstanding work conducting research in its laboratories, treating patients in its clinics and hospitals, and reaching out to medically underserved communities with innovative prevention strategies.
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