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Johns Hopkins Hospital Neuro-Oncology Program: Adult Brain Tumors

Johns Hopkins Hospital Neuro-Oncology Program: Adult Brain Tumors . Adult Brain Tumors. 2 types Primary Metastatic (secondary) Patient outcome affected by: Aggressiveness of tumor Tumor location Early detection Patient age and general health Degree of surgical resection

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Johns Hopkins Hospital Neuro-Oncology Program: Adult Brain Tumors

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  1. Johns Hopkins HospitalNeuro-Oncology Program:Adult Brain Tumors

  2. Adult Brain Tumors • 2 types • Primary • Metastatic (secondary) • Patient outcome affected by: • Aggressiveness of tumor • Tumor location • Early detection • Patient age and general health • Degree of surgical resection • Additional non-surgical treatments

  3. Primary Brain Tumors

  4. Primary Adult Brain Tumors • Originate within the brain • Can be benign or malignant • About 40,000 new cases each year • World Health Organization: 7 major classifications • 4 tumor types make up > 85% of all brain tumors: glioma; meningioma; schwannoma; pituitary adenoma

  5. Most Common Primary Brain Tumors

  6. Gliomas - 1 • World Health Organization uses a grading system: • Low Grade: slow growing • High Grade: make up the majority of gliomas and are very aggressive

  7. Gliomas - 2 • Most common primary brain tumor • Astrocytoma, Oligodendroglioma, Mixed glioma • Astrocytoma (Grades I-IV) • Grade I • Pilocytic; more often seen in children and young adults; does not infiltrate the brain; surgery can cure this tumor

  8. Gliomas - 3 • Grade II • Diffuse Astrocytoma; infiltrates the brain; surgery +/- radiation; may become high grade • Grade III • Anaplastic Astrocytoma; more infiltrative and causes more swelling; surgery, radiation, and chemotherapy • Grade IV • Glioblastoma Multiforme; highly infiltrative; requires aggressive treatment including surgery, radiation, chemotherapy and experimental protocols

  9. Gliomas - 4 • Oligodendroglioma (Grades II-IV) • 10-15% of gliomas • Most are grade II • Somewhat less aggressive than astrocytomas • Mixed glioma • “oligoastrocytoma” • Features of both astrocytoma and oligodendroglioma

  10. Meningiomas • Slow growing • Usually benign • Originate from covering of the brain (meninges) • Because they grow slowly, they may become quite large before causing symptoms • May be cured with surgery • Radiation can be used for residual or recurrent tumor

  11. Acoustic Neuroma(Schwannoma) • Benign • Encapsulated • Patients may complain of hearing loss or ringing in the ears • Curable with surgery • Focused radiation (radiosurgery; FSR) may be used instead of surgery, depending on tumor size and patient preference

  12. Pituitary Adenoma • Benign • May secrete hormones or may be non-secreting • Classified by size • Microadenoma < 1 cm • Macroadenoma > 1 cm • Can cause visual field problems by pushing up on the optic nerves • Some tumors can be treated with medicine (prolactinomas, for example) • Surgery: transsphenoidal (95%) or craniotomy • Radiation can be used for residual or recurrent tumor

  13. Metastatic (Secondary) Brain Tumor

  14. Metastatic Brain Tumors • Originate in other part of the body and travel to brain through the blood • Always malignant • About 160,000 new cases each year • Occur in 10-15% of cancer patients • May have solitary or multiple metastases • Surgery, radiation, +/- chemotherapy

  15. Most Common Metastatic Brain Tumors

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