Central nervous system (CNS) tumours treatment and diagnosis

Malignant brain tumours are rare in adults with around 5,000 new cases a year diagnosed in the UK, accounting for approximately 2% of all new cancer cases (Other brain tumours may be confirmed as benign and some are undiagnosed due to their position preventing a biopsy).

Higher incidence in men, male to female ratio is 1.5:1. Adult brain tumours can occur at any age, the incidence rises from the age of 30 with the highest incidence being between 50 and 70 years of age. Most of these arise in the frontal, temporal and parietal lobes of the cerebrum, 86% are gliomas (includes astrocytomas, ependymomas, oligodendroblastomas and mixed gliomas).

Risk factors and causes are not well understood but radiation is recognised as a cause and radiotherapy for primary brain tumours is associated with a 55% increased risk of further brain tumours.Risk factors include some genetic conditions such as neurofibromatosis, Li-Fraumeni syndrome and a family history of CNS tumours, diabetes in females, Parkinson’s disease and HIV infection or AIDS. (Secondary brain tumours have spread from tumours elsewhere in the body e.g. lung).

• The cerebrum (two halves with four lobes on each side- frontal, temporal, parietal and occipital)
• The cerebellum
• The brain stem
• The pituitary gland

• Headaches
• Nausea and vomiting
• Drowsiness
• Seizures

Other symptoms may be related to the functions of the area of the brain where the tumour has developed.

• Physical examination (will include neurological test, checking muscle strength, reflexes, sensation, eye tests and hearing tests)
• Blood tests
• CT scans
• Brain MRI scan
• PET/SPECT scan
• Surgical biopsy (surgery may be to remove a sample of brain tissue to enable analysis followed by further surgery or in some cases the intention of the initial surgery may be to remove part or all of the tumour)
• Lumbar puncture
• Neuroendoscopy

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