BENIGN TUMORS

Most benign brain tumors arise from the coverings of the brain or from the nerves immediately outside the brain. Benign tumors differ from malignant brain tumors in that they grow slowly and may be present for many years before the patient develops any symptoms.

A brain tumor is a mass of tissue formed by cells that multiply without restraint and don’t follow the control mechanisms of normal cells. The reference to the tumors as “benign” refers to their appearance under a microscope. But in effect, even tumors thought to be benign may cause neurological injury or death because of their expansion and the resulting compression of the brain inside the skull.

Specific types of benign tumors include:

Meningiomas - The most common type of benign brain tumor, account for about 15% of all brain tumors. They arise from the meninges (the membrane that covers the brain) and can grow in all areas of the brain. The majority of meningiomas are benign, but occasionally meningiomas grow very rapidly or may become malignant. Most commonly seen in women, meningiomas are usually diagnosed in patients who are in their 40s.

Acoustic neuromas - Also referred to as vestibular schwannomas, arise from the vestibular part of the cranial nerve. The most common symptom of acoustic neuromas is loss of hearing. Very large acoustic neuromas may produce pressure on the brain stem and cause balance difficulty, paralysis, or numbness of the face. An audiogram and an MRI scan can determine whether hearing loss is related to an acoustic neuroma or to some other condition.

Schwannomas - Schwannomas are benign tumors that arise from cells called Schwann cells that cover the cranial nerves. The acoustic neuroma is a particular form of schwannoma. The most common other schwannoma arises from the trigeminal nerve that supplies feeling to the face.

Pituitary adenomas - Pituitary adenomas, arising from the pituitary gland located beneath the brain, account for about 10% of all brain tumors. Pituitary tumors may be either non-secreting or secreting. The pituitary gland produces hormones that regulate the thyroid gland, body and bone growth, adrenal gland, and male and female sexual organs. Non-secreting pituitary tumors tend to reduce the production of normal hormones that may result in tiredness and/or lack of sex drive. Secreting tumors produce high levels of one or more of the pituitary hormones that can result in a variety of symptoms including the cessation of menstruation in women and impotence in men; abnormal body growth; and an increase in cortisone circulating in the blood. Almost all pituitary tumors are benign, but those that secrete excess amounts of hormone may cause serious symptoms, such as high blood pressure and blood vessel changes leading to early death.

SYMPTOMS

Symptoms of benign brain tumors vary, depending upon type of tumor, its location, and how it grows. Although not exclusive, the following are some symptoms caused by benign brain tumors:

		Headache
		Loss of vision
		Double vision
		Facial numbness
		Loss of hearing
		Balance problems
		Seizures and convulsions
		Abnormal sense of smell
		Lightheadedness
		Nausea
		Lapses in attention

Many of the symptoms of benign brain tumors are also signs of other diseases.

TREATMENT

The usual methods of treating benign brain tumors include traditional invasive open brain surgery (craniotomy) and traditional radiation therapy, or the new forms of non-invasive treatment such as stereotactic radiosurgery (Gamma Knife, linear accelerator, or proton bean generator). Chemotherapy is generally not employed in treating benign brain tumors. However, in certain instances of unusually rapid growth or malignant meningiomas, some forms of drug treatment may be helpful.

In some cases, either radiosurgery or traditional radiation therapy may follow an operation that is not able to completely remove a benign tumor. Steroids, used in conjunction with other treatments, may be helpful to patients who develop swelling of the brain following open surgery, radiosurgery, radiotherapy, or from the tumor itself.

Decisions about treatment are based on the patient’s age, the location and size of the tumor, and the patient’s general overall medical condition. Your physician will discuss the appropriate treatments and possible side effects with you.

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