Brain Tumour - Gleneagles Global Hospitals Group
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Tumours arising from brain cannot be classified strictly into benign or malignant.
Even 'Benign' tumours account for significant morbidity and mortality, as they can continue to grow and cause the adverse effects of any space-occupying lesion.
The preferred terms are 'high-grade tumour' (a tumour that grows rapidly and is aggressive) and 'low-grade tumour' (a tumour that grows slowly but which may or may not be successfully treated).
Also cancers from other sites can spread (metastasize) to brain and cause symptoms- Brain metastasis
Risk factors for Primary Brain tumours
Immunosuppression (eg.as a result of AIDS) may cause cerebral lymphoma.
Anyone presenting with new, unexplained headaches or neurological symptoms needs a thorough neurological study of history and examination.
The presentation will depend on location and rate of growth but includes features of a space-occupying lesion and raised intracranial pressure (ICP)
Progressive focal neurological deficits – eg. diplopia associated with a cranial nerve defect, visual field defect, neurological deficits affecting the upper and/or lower limb.
Symptoms relating to location of mass – eg. frontal lobe lesions associated with personality changes, disinhibition and parietal lobe lesions might be associated with dysarthria.
Diagnosis largely rests on brain imaging – eg. CT scan and/or MRI scan (with or without contrast). MRI is more sensitive.
The spine may also need to be imaged, especially in CNS tumours that spread to the spine – eg. germ cell tumours and lymphoma
Blood tests may be useful in determining any complications of the tumour (eg. bleeding disorders, hypercalcaemia or inappropriate antidiuretic hormone secretion) or in the initial assessment of other possible causes of headache
Technetium brain scan: is useful in the diagnosis of skull vault (eg, metastases) and skull base lesions.
Magnetic resonance angiography (MRA) and magnetic resonance spectroscopy (MRS) are occasionally used to define changing size or blood supply.
Positron emission tomography (PET) is helpful in grading gliomas or locating an occult primary.
Biopsy and tumour removal: stereotactic biopsy via a skull burr-hole to obtain histology of a suspected malignancy.
Open exploration (craniotomy) may be required – eg. for a symptomatic meningioma.
Lumbar puncture or CSF analysis is done in assessment of certain brain tumours
For some types of tumours, it is the treatment of choice – eg. metastatic brain tumours, leptomeningeal metastases.
Whole brain radiation is used with some tumours – eg. medulloblastomas, primary CNS lymphomas. An alternative technique is 'involved-field radiation', which means that normal brain tissue is exposed to less radiation.
Commonly used agents include those that can cross the blood brain barrier - eg, temozolomide in glioblastoma multiforme, nitrosureas in oligodendrogliomas, platinum agents in medulloblastomas
Treatment of brain metastasis
For metastases that are larger in size, stereotactic radiosurgery may be an option.
What we offer in our centre?
All advanced neurological treatments including-
Awake craniotomy for brain tumours
Surgery for skull base tumours
Surgery for CP angle tumours
Lobectomy for localised tumours
Radiotherapy for brain tumours (conventional/ 3D CRT/IMRT/ Stereotactic radiosurgery)
Chemotherapy based on stage of cancers
Metastatectomy for solitary brain oligometastasis