Brain & Spine Tumor Diagnosis

What are gliomas?

Gliomas are a family of primary brain and spine tumors that are born in the brain and spine. They are different than secondary brain tumors. Secondary brain tumors spread or metastasize to the brain from another part of the body. Gliomas are characterized by invasive growth - the tumor cells form roots into the normal brain around the tumor. Consequently, even when the entire visible tumor is removed by the neurosurgeon, the roots are left behind. As such, other treatments are needed after surgery to manage what remains. Although gliomas can spread in the brain and spine, they usually do not spread into the rest of the body.

Unlike other cancers, gliomas are not staged. Instead they are graded. The grade of the tumor is determined by how abnormal the tumor looks under the microscope when examined by the neuropathologist. Generally speaking, the higher the grade, the more abnormal the tumor appears and the more aggressive the tumor behaves. The grade of the tumor cannot be established by imaging.

Subtypes of gliomas include:

• Glioblastoma
• Astrocytoma
• Oligodendroglioma
• Ependymoma

How are gliomas diagnosed?

Imaging is essential to diagnosing and treating brain tumors. The most common imaging methods include CT scan and MRI. While these tests provide valuable information that helps in establishing your treatment plan, surgery is generally necessary to diagnose the tumor. Other tests frequently performed during treatment include blood work to measure blood counts and other body functions.

What are metastatic brain tumors?

Metastasis refers to when a tumor spreads to other parts of the body away from its original site. Cancers frequently metastasize (spread) to brain, occurring in about 10 to 30% of patients. Tumors in the brain can cause a variety of neurological symptoms such as seizures, arm or leg weakness or numbness, difficulty speaking, dizziness or balance problems that result in difficulty walking, changes in vision, or headaches. Tumors can be seen on CT scan or MRI. Usually multiple tumors are present in the brain, although occasionally just one tumor is present. In addition to visible tumors, seeds (small deposits of cancer) that cannot be detected on CT or MRI are present that can give rise to tumors in the future.

What are Meningiomas?

Meningiomas are the most common tumor that originates in the head. Although commonly referred to as brain tumors, they do not grow from the substance of the brain itself. Rather, they come from the dura, a layer of tissue that wraps around the brain.

What is neoplastic or carcinomatosis meningitis?

Spinal fluid is constantly being made by the brain. It flows through and around the brain and spinal cord. Occasionally, cancers can shed or dissolve tumor cells in the spinal fluid, a condition called neoplastic or carcinomatosis meningitis. This is similar to dissolving sugar in water in that you cannot see the dissolved cells in the fluid.

Neoplastic meningitis is uncommon, affecting approximately 5% of patients with solid tumors (i.e., lung cancer or breast cancer). It is more common in leukemia and lymphoma.

What is metastatic epidural spinal cord compression?

Spinal cord compression from epidural metastases, also called epidural spinal cord compression, ESCC or MESCC, occurs after cancer metastasizes to the spine, epidural space or brain. MESCC is the most common and dreaded neurological complications of cancer as a result of brain metastasis because it can have irreversible effects, including paralysis, sensory loss and lack of sphincter control.

What are pituitary tumors?

As the name suggests, pituitary tumors are abnormal growths that begin in the pituitary gland. Your pituitary gland is a pea-sized gland located at the bottom of the brain, just above the nasal passages. Sometimes called the “master gland,” your pituitary gland controls most of the hormones released within your body.

Pituitary tumors are common and may not cause noticeable symptoms. However, these types of tumors can disrupt the balance of hormones in your body and lead to endocrine disease, like Cushing’s syndrome or hyperthyroidism. The pituitary gland is also next to the optic While these tumors are typically noncancerous (meaning will not spread to other areas), they can cause serious health concerns as they are so close to the brain and may affect surrounding tissue. Pituitary carcinomas (cancers) are very rare.

What are acoustic neuromas?

Acoustic neuromas, or vestibular schwannomas, develop from the overproduction of Schwann cells, which cover the vestibular nerve. The vestibular nerve connects the inner ear to the brain and is associated with balance and hearing. Because of their location, pressure from acoustic neuromas can cause hearing loss, a ringing sound and unsteadiness or dizziness.

While acoustic neuromas are not malignant and tend to grow slowly, if at all, these tumors can still cause severe issues and can be fatal if left untreated.

What are medulloblastomas?

Medulloblastomas are fast-growing, high-grade cancerous tumors. These tumors form in the cerebellum, which is located in the bottom part of the brain and the back of the skull.

While medulloblastomas can occur at any age, they most often occur in children. Medulloblastomas are rare, but are the most common form of pediatric brain tumor. Although medulloblastomas grow quickly and may spread, they generally respond well to treatment.

What is neurofibromatosis?

Neurofibromatosis is a rare genetic disorder that affects the growth and development of nerve cells. Primarily, neurofibromatosis causes tumors to grow on nerve tissue. As a nervous system disorder, these tumors can form on your brain, spinal cord and nerves. Tumors are usually not cancerous, but can become so, meaning they can spread to other areas of the Because neurofibromatosis is genetic, the disease can be inherited by parents or form due to a gene mutation.

Neurofibromatosis is divided into three types:

• Type 1 (NF1): Most typically appears in childhood. NF1 is characterized by multiple light-brown skin spots (in the groin and underarms) and deformed bones.
• Type 2 (NF2): Often manifests during teen or adolescent years. NF2 primarily affects nerves that transmit sound and balance, causing hearing loss, ringing in the ears and unsteadiness.
• Schwannomatosis: Typically diagnosed in adults older than 30. This form of neurofibromatosis is the rarest type and can cause severe pain, numbness, tingling and weakness in the fingers and toes.

What is primary central nervous system lymphoma?

Primary central nervous system (CNS) lymphoma is a rare form of non-Hodgkin’s lymphoma. This cancer develops in the lymph tissue of the primary central nervous system, which consists of the brain, its surrounding membranes and spinal cord. CNS lymphoma may develop in the brain, spinal cord, leptomeninges membranes or even the eye (called ocular lymphoma).