Brain tumours

1. Brain tumours are either malignant or benign in nature 

2. Brain tumours can be Primary Brain tumours or Secondary to Metastasis from primary elsewhere

3. Brain tumors are the most common solid malignancy and the leading cause of cancer death in children and adolescents up to the age of 19

Risk Factors :

1. Radiation 

2.   Diet containing N-nitroso compounds and possibly dietary fat 

3. Tobacco

4. Alcohol

5. Trauma

6. Infections 

7. Genetic: Neurofibromatosis, von Hippel-Lindau syndrome, Li-Fraumeni syndrome, Familial Adenomatosis polyposis, Familial Gliomas, Basal Cell Nevus Syndrome

8. Malignancies: Cancer of the Breast, 

Lung, Gastrointestinal, Cervix, melanoma

In general, young age, high performance status, and lower pathologic grade are favorable prognostic factors for primary brain tumors. 

Names of the common brain tumours :

1. Gliomas: Low grade And High grade 

2. Astrocytomas, Anaplastic variant 

3. Oligodendrogliomas 

4. Medulloblastomas

5. Ependymomas 

6. Meningioma 

7. Primary CNS lymphoma 

Diagnosis : Requires Multidisciplinary team with Specialist like Neurosurgeon,Oncologist and radiotherapy specialist. 

1. History and physical examination

2. MRI of the brain and Spine

3. Tissue Biopsy 

4. Genetic Mutational Studies : IDH1, ATRX,,1p/19q deletion.

5. Performance status assessment 

Treatment : In Brain tumours,the following modalities are used to treat the cancer 

1. Surgery : Main line of treatment 

2. Radiation Therapy 

3. Chemotherapy 

4. Targeted therapy 

Brain tumours like primary CNS lymphomas are highly chemosensitive cancers and Can be cured by Chemotherapy and radiation therapy.

Prognosis:

1. Complete excision of the tumour surgically carries good prognosis.

2. Large tumours which are inoperable are treated with radiation and chemotherapy after debunking the tumours.This increases the overall survival.

3. Prognositication by mutational studies 

4.High grade tumours have poor prognosis with high risk of recurrence.