Assessment and Resection of Brain Tumors

1.5% of all newly diagnosed cancers in the United States are brain tumors. A brain tumor is a mass of unnecessary and abnormal cells growing in the brain (Figure 1).

Figure 1 - A brain tumor is a mass of abnormal cells growing in the brain:
Figure 1

Brain tumors can be classified into two main types: primary or metastatic. Primary brain tumors originate from the cells of the brain tissue and usually remain within the brain itself. Primary tumors may be either benign (e.g.-slow-growing) or cancerous (e.g.-fast-growing). Primary brain tumors that are cancerous require prompt treatment.

Metastatic (or secondary) brain tumors are tumors that start somewhere else in the body, such as the breast or the lung, and spread to the brain through the bloodstream. Metastatic tumors are considered cancerous and need prompt treatment.

Brain tumors vary widely in terms of their location, the type of brain tissue involved, and the degree of aggressiveness. Depending on these factors, brain tumors may be asymptomatic or may cause pressure on or irritation of the brain, resulting in headaches, seizures, loss of function, or decreased cognitive ability.

The most common type of benign primary brain tumor is a meningioma, which arises from the covering (e.g.-the meninges) of the brain. This “wart-like” mass is typically a slow-growing tumor that, if small and asymptomatic, can be observed with repeated brain scans over time. If a meningioma is large and/or causing symptoms like seizures or brain swelling, then surgery for tumor removal may be recommended.

Another type of benign brain tumor is a pituitary adenoma, which is a mass that arises near the pituitary gland in an area of the brain just behind the nose called the “sella.” This tumor may be slow-growing and, if small and asymptomatic, can be observed with repeated brain scans over time. However, this type of tumor may also cause visual loss if it grows large enough to cause pressure against the eye nerves. This type of tumor may also cause hormonal disturbances. If a patient has visual loss or hormonal abnormalities that are not treatable with medication, then surgery for tumor removal may be recommended.

Other types of primary brain tumors include glioblastomas, astrocytomas, oligodendrogliomas, and hemangiomas, among others. Many of these tumors will require surgical treatment, followed by long-term observation with repeated brain scans over time. In addition, more aggressive tumors may require radiation and chemotherapy after surgery, which is typically coordinated our physician colleagues at the Willis-Knighton Cancer Center.

Visualase laser therapy now offers a less invasive option than open brain surgery for treatment of certain brain tumors. Please see our Visualase section for more information.