Brain Cancer Types

There are over 20 different kinds of brain tumors and the treatment depends on the specific type and grade.   Below is a table that depicts most of the major types, the characteristics, and the typical treatment that is offered.   If you are curious as to whether your “aggressive” brain cancer or your child’s “high grade” brain cancer was improperly diagnosed take the quiz.

Pilocytic Astrocytoma (Grade I)
Low Grade Astrocytoma (Grade II)
Anaplastic Astrocytoma (Grade III)
Glioblastoma Multiforme (GBM)
Brain Stem Glioma
Ependymoma
Mixed Glioma
Oligodendroglioma
Optic Nerve Glioma
Acoustic Neuroma
Chordoma
CNS Lymphoma
Craniopharyngioma
Hemangioblastoma
Medulloblastoma
Meningioma
Pineal Tumor
Pituitary Tumor
Primitive Neuroectodermal Tumors (PNET)
Rhabdoid Tumor

Schwannoma

Name

Characteristics

Treatment

Pilocytic Astrocytoma
(Grade I)

Derived from astrocytes star-shaped glial cells that support nerve cells.

This tumor is also known as a juvenile pilocytic astrocytoma, or by the initials JPA.

- Slow growing, with relatively well-defined borders
- Grows in the cerebrum, optic nerve pathways, brain stem and cerebellum
- Occurs most often in children and teens
Surgery

Low Grade Astrocytoma
(Grade II)

Derived from astrocytes star-shaped glial cells that support nerve cells.
- Slow growing
- Rarely spreads to other parts of the CNS
- Borders not well defined
- More common among men and women in their 20s–50s
Treatment depends on the size and location of the tumor.

Anaplastic Astrocytoma
(Grade III)

Derived from astocytes star-shaped glial cells (astrocytes) that support nerve cells.
- Grows faster and more aggressively than grade II astrocytomas
- Tumor cells are not uniform in appearance
- Invades neighboring tissue
- Common among men and women in their 30s–50s
- More common in men than women
Surgery and radiation therapy, with chemotherapy during or following radiation, are the standard treatments.

Glioblastoma Multiforme (GBM) (Grade IV Astrocytoma)

Derived from astocytes star-shaped glial cells (astrocytes) that support nerve cells and other brain cell types (astroblasts, spongioblasts).
- Most invasive type of glial tumor
- Commonly spreads to nearby tissue
- Grows rapidly
- May have evolved from a low-grade astrocytoma or oligodendroglioma
- Common among men and women in their 50s–70s
- More common in men than women
- Accounts for 23 percent of all primary brain tumors
Standard treatment of surgery, radiation therapy and chemotherapy are palliative (not curative).

Brain Stem Glioma

- Named for its location at the base of the brain
- Can range from low grade to high grade
- Occurs most often in children between three and ten years of age, but can occur in adults
Surgery may not be an option because the brain stem controls vital life functions and can easily be damaged.

Ependymoma

Derived from ependymocytes
- Usually localized to one area of the brain
- Develops from cells that line the hollow cavities at the bottom of the brain and the canal containing the spinal cord
- Can be slow growing or fast growing
- Sometimes extends to the spinal cord
- Common among men and women in their 40s and 50s, and in children
- Occurrence peaks at age five and again at age 34
Surgery followed by radiation therapy is the usual course of treatment. A shunt may be needed to treat hydrocephalus caused by blockage of the ventricles.

Mixed Glioma

A mixed glioma is often a combination of an astrocytoma and an oligodendroglioma
- Composed of two or more types of glioma cells
- Graded according to the most aggressive type of tumor cells
- Common among men and women in their 20s–50s
Mixed gliomas are generally treated for the most anaplastic (cancerous) type of cell found in the tumor.

Oligodendroglioma

Derived from glial cells called oligodendrocytes.
- Occurs frequently in the frontal or temporal lobes
- Can be classified as low grade or high grade
- Common among men and women in their 20s–40s, but can occur in children
- More common in men than women
Treatment options depend on the grade of the tumor. Low grade may require surgery only. High grade such as anaplastic oligodendroglioma or mixed malignant astrocyto-maoligodendroglioma (oligoastrocytoma) may require surgery followed by radiation therapy and/or chemotherapy. Both low and high-grade oligodendrogliomas can recur.

Optic Nerve Glioma

- Named for its location on or near the nerve pathways between the eyes and the brain
- Can range from low grade to high grade
- Occurs most often in infants and children, but can occur in adults
Surgery is standard treatment, usually followed by radiation therapy or chemotherapy.

Acoustic Neuroma

Also known as a vestibular schwannoma or neurilemmoma.

- Grows on the sheath surrounding the eighth cranial nerve in the inner ear
- More common in women than men
The tumor may be monitored or surgery may be performed. The goal of surgery is the complete removal of the tumor without harming the seventh cranial nerve (which controls facial movement) or causing hearing loss. Radio-surgery may also be an option.

Chordoma

- Rare and low grade
- Occurs at the sacrum, near the lower tip of the spine, or at the base of the skull
- Thought to originates from cells left over from fetal development
Surgery and radiation therapy are the common forms of treatment.

CNS Lymphoma

A type of cancer that develops in the lymphatic system.
- Can metastasize (spread) or recur
- Very aggressive
- Usually involves multiple tumors throughout the CNS
- More common in people whose immune systems are compromised
- Can be primary (originating in the brain) or secondary (originating outside the brain)
- Most common among men and women in their 60s–80s, but incidence is increasing in young adults
- Twice as common in men as in women
Radiation therapy, chemotherapy, and steroids are the most common forms of treatment. Surgery is rarely an option because there are usually multiple lesions.

Craniopharyngioma

- Most common in the parasellar region, an area at the base of the brain and near the optic nerves
- Also grows in the regions of the optic nerves and the hypothalamus, near the pituitary gland
- Tends to be low grade
- Often accompanied by a cyst
- Occurs in children and men and women in their 50s and 60s
Surgery is the most common treatment. Radiation therapy may also be used.

Hemangioblastoma

- Commonly located in the cerebellum
- Slow growing
- Originates from blood vessels
- Can be large in size
- Often includes a cyst
- Common among men and women in their 40s–60s
- More common in men than women
Surgery is the standard treatment. Radiosurgery may be given to destroy multiple inoperable lesions.

Medulloblastoma

Derived from primitive neural cells
- A type of primitive neuroectodermal tumor (PNET)
- Often located in the cerebellum or near the brain stem
- Can spread to the spinal cord through the CSF
- May obstruct the fourth ventricle, causing hydrocephalus
- Occurs most often in children under the age of ten, but may occur in adults
- Slightly more common in males than females
Surgery is the standard treatment when possible. Radiation of the brain and spine is often recommended in adults and children over three years of age.

Meningioma

These tumors grow from the meninges, the layers of tissue covering the brain and spinal cord.
- May arise after previous treatment from ionizing radiation or excessive x-ray exposure
- Common among women and men in their 40s–50s, but can occur at any age
- Twice as common in women as in men
- Accounts for 27 percent of all primary brain tumors
- In very rare cases, can invade the skull or metastasize to the skin or lungs
- Women with meningiomas can experience tumor growth during pregnancy
Surgery is the standard treatment. But, if the patient is asymptomatic, only monitoring may be used. If the tumor cannot be completely resected radiation may be prescribed. Scans are needed indefinitely, because meningiomas can recur years or even decades after treatment.

Pineal Tumor

A malignant form of pineal tumor is called pineoblastoma.
- Named for its location in or around the pineal gland (near the center of the brain)
- Can range from low grade to high grade
- Can produce an excess of melatonin, a hormone that controls the sleep/wake cycle
- Can block the ventricles, causing hydrocephalus
- High-grade pineal tumors can spread to the spinal cord through the CSF
- Common types include germ cell tumors, pineal parenchymal tumors, and gliomas
- Occurs most often in children and young adults
Surgery is standard treatment when possible. Radiation therapy may be used as primary treatment in adults and children over three. Treatment for highgrade (malignant) pineal tumors such as a pineoblastoma may involve radiation to the brain and spine to control spread through the CSF.

Pituitary Tumor

The pituitary gland produces hormones that affect growth and the functions of other glands in the body.
- Named for its location on or near the pituitary gland, located at the center of the brain behind and above the nose
- Can range from low grade to high grade
- May cause excessive secretion of hormones
- Common among men and women in their 50s–80s
If the tumor is large or compressing the optic nerve, standard treatment is surgery. This can be transphenoidal surgery, which gets access to the tumor by entering through the nasal passage. Radiation therapy may also be used. Some pituitary tumors may be treated with medication, and/or observed with MRI scans.

Primitive Neuroectodermal Tumors (PNET)

Derived from primitive neural cells.

There are several tumor types in this category. Names of specific PNETs may be based on the tumor location. Examples include pineoblastoma (located in the pineal region), medulloblastoma (located in the cerebellum), and cerebral cortex PNET (located in the cerebral cortex).

- Very aggressive and tend to spread throughout the CNS
- Commonly include cysts and calcification (calcium deposits)
- Tend to be large
- Occur most often in young children
Surgery is the standard treatment when possible. In adults and children over three years of age, surgery may be followed by radiation therapy to the whole brain and spinal cord.

Rhabdoid Tumor

- Rare
- Highly aggressive and tends to spread throughout the CNS
- Often appears in multiple sites in the body, especially the kidneys
- Difficult to classify
Whenever possible, surgery is performed to remove as much of the tumor as possible. This is usually followed by chemotherapy and radiation therapy.

Schwannoma

Derived from the Schwann cell. Also known as vestibular schwannoma and acoustic neuroma.
- Arises from cells that form a protective sheath around nerve fibers
- Typically grows around the eighth cranial nerve, but can be found around other cranial or spinal nerves
Surgery and radiotherapy are the most common forms of treatment. If the tumor is not completely removed, recurrence is likely.

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