BRAIN TUMOURS

( By JASCAP )

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Types of primary brain tumours

There are many different types of brain tumours. They are usually named after the type of brain cells from which they have developed.

This section gives brief details about the main types of malignant and benign brain tumours. You may find it helpful to look at the diagrams on the brain page when reading this section.

If you have any questions about the type and position of your tumour, your doctor can give you more information. Our cancer support specialists can also give you further information about the different types of brain tumours.

Gliomas

Most tumours develop from the supporting cells of the brain known as the glial cells. They may be named after the type of cell that they are made up of, or after the part of the brain in which they are found, such as a brain stem glioma. More than half of all primary brain tumours are gliomas.

Grading of gliomas

Grading is a term that refers to how the tumour cells look under the microscope. A pathologist will examine the cells and look at whether there are signs they are dividing, how abnormal they look and if there are any abnormal blood vessels.

The grade gives an idea of how quickly the tumour may develop. There are four grades: grade 1 tumours are benign and grow very slowly, whereas grade 4 tumours are malignant (cancerous) and grow faster. Sometimes grade 1 and 2 gliomas are called low-grade gliomas and grades 3 and 4 are called high-grade gliomas. Knowing the type and grade of your tumour will help your doctors plan the best treatment.

Types of gliomas

Astrocytic tumours - This is the most common type of glioma and develops from star-shaped cells called astrocytes. They are graded 1-4. Grade 4 astrocytic gliomas (sometimes called glioblastoma) is the commonest brain tumour found in adults. Grade 3 astrocytic glioma is also known as anaplastic astrocytoma.

Oligodendroglioma − These are tumours that are made up of cells known as oligodendrocytes, which produce the covering of nerve cells - the myelin sheath. They are usually slower-growing than astrocytic tumours.

Mixed glioma − Mixed gliomas are made up of a mixture of more than one type of cell. Oligo-astrocytomas are a type of mixed glioma and are made up of cells called astrocytes and oligodendrocytes.

Ependymoma − A rare type of glioma, ependymomas develop from the ependymal cells, which line the ventricles of the brain and the central canal of the spinal cord. These tumours can spread to other parts of the brain and spinal cord.

Medulloblastoma

Medulloblastomas are one of the most common malignant brain tumours in children, but rare in adults. They usually develop in the cerebellum at the back of the brain but may spread to other parts of the brain. Very occasionally, these tumours spread outside the brain to the lymph nodes or lungs.

Medullablastoma is a type of primitive neuroectodermal tumour (PNET). PNETs develop from cells which are left over from the earliest stages of a baby's development in the womb.

Central nervous system (CNS) lymphoma

A lymphoma is a malignant tumour of the lymphatic system, which is part of the body's immune system. In rare cases, these tumours only affect the brain. They are then called primary CNS lymphomas.

Pineal region tumours

The pineal gland is just below the area where the two cerebral hemispheres join. Tumours in this part of the brain are extremely rare. They can be made up of different types of cells.

The most common tumours found in the pineal gland are germinomas; others include teratomas, pineocytomas and pineoblastomas.

Meningioma

Meningiomas arise from the meninges, the covering of the brain. They can occur in any part of the meninges over the brain or spinal cord and usually grow very slowly. Most meningiomas are benign and do not spread from the area where they started. Malignant meningiomas are very rare.

Acoustic neuroma

Acoustic neuromas, (also called vestibular schwannoma or neurilemmoma) are benign tumours that develop in the acoustic or auditory nerve, which controls hearing and balance. The nerve is covered by schwann cells. The tumour arises from these cells, so it is also known as a schwannoma.

Acoustic neuromas are usually found only in adults and are more common in people who have a genetic condition called neurofibromatosis type 2 (NF2).

Haemangioblastoma

This is a rare type of tumour that develops from the cells that line the blood vessels. Haemangioblastomas are benign and grow slowly. It may take several years for symptoms to appear.

Pituitary tumours

The pituitary gland produces hormones that control and regulate the other hormone-producing glands of the body. Pituitary tumours are benign and are also called pituitary adenomas. Symptoms often occur due to disturbances in vision or hormone levels.

Spinal tumours

Spinal tumours often cause symptoms by pressing on the spinal nerves. These symptoms may include numbness, tingling, leg or arm weakness and pain in the back, neck and limbs.

Sometimes a tumour in the lower part of the spinal cord can lead to loss of control of the bladder or bowel.

** JASCAP has separate factsheets in more details on each of these particular types of Brain Tumours.

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