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Brain Tumors

What is a brain tumor?


Brain tumors constitute an important group of diseases in neurosurgery. In general, we can classify brain tumors as malignant (malignant) and benign (benign). Tumors that are not cancerous are called “benign”. They do not spread to other parts of the body and are rarely life-threatening. They are usually surgically removed and do not recur. Cancerous cells are called "malignant". They progress and destroy the surrounding healthy tissues and organs. At the same time, they spread through the bloodstream and lymphatic system to form new tumors (metastasize) in other parts of the body.


What are the causes of brain tumors and who gets it?


The cause of brain tumors is unknown. Brain tumors can occur at any age, but are more common in two age groups. It is most common in the 3-12 age group and the 40-70 age group. As risk factors leading to brain tumor; working in the refining-rubber-paint industry, virus infections and heredity can be mentioned. In some families, brain tumors can occur in different members of the family. Generally, no clear risk factor has been found in patients with brain tumors. This is perhaps due to a combination of many factors. A brain tumor occurs when abnormal cells in the brain grow and become massive. Brain tumors classified as primary or secondary are tumors that originate in the brain or, more commonly, start in another organ and metastasize to the brain. This disorder, which is common in men and white people, is more common in people over 60 years of age and children under 8 years of age, according to statistics. Signs and symptoms of brain tumors may begin and disappear, making diagnosis difficult.


What is the classification of brain tumors?


1) Malignant Tumors A-Glial Tumors


They are the most common tumors of the brain. These cause most brain cancers. It contains cells with uncontrolled proliferation. They grow rapidly and extend into the healthy tissue around them, although very rarely, they can spread to the spinal cord and even to other organs of the body. Staging is done in four groups. Stages I and II are called "low stage", while Stage III (anaplastic astrocytoma) and Stage IV (glioblastoma multiforme) are considered "high stage." Some other tumors in this group; ependymoma, medulloblastoma, oligodendroglioma. Survival times, pathological staging, radiotherapy, chemotherapy or not are related with age. Low-grade glial tumors have a long survival time. Low-grade tumors can transform into high-grade tumors. The average chance of survival for high-grade gliomas is much shorter. B-Metastatic brain tumors: They are tumors that result from the spread of a tumor elsewhere in the body to the brain. They most commonly originate from the lung, breast, large intestine, stomach, skin or prostate. However, sometimes the organ of origin cannot be determined. Brain metastases are seen in 20-40% of patients diagnosed in oncology clinics and hospitalized for treatment. This rate constitutes 10% of all brain tumors. If possible, a definitive diagnosis by biopsy with stereotaxic surgery, which can be performed under local anesthesia, facilitates the choice of treatment. Treatment options in malignant brain tumors; surgical intervention, biopsy, radiation therapy, drug therapy and radiosurgery. Response to treatment is related to factors such as the focus of tumor origin, the number of organs to which it has spread, the number of metastatic lesions, the age of the patient, and the presence of additional disease. Therefore, the survival times are different.


2) Benign Tumors


These are tumors that usually develop inside the skull but outside the brain tissue. Meningiomas, pituitary adenomas, craniopharyngiomas, dermoid and epidermoid tumors, hemangioblastoma, colloid cyst, subependymal giant cell astrocytoma, neuromas are the most common lesions of this group. Meningiomas form an important part of this group. Unlike benign tumors in other organs, benign brain tumors can sometimes cause life-threatening conditions. Some (for example, meningiomas) can transform into malignant tumors, although they are rare. Since they generally do not spread to the surrounding brain tissue, they have a high chance of being completely removed by surgery. However, they may reappear, albeit to a lesser extent. It is known that even in the case of complete removal of meningiomas, 20% of them can recur in 10 years, and post-surgical complications may occur, especially in those that adhere to important areas.


What are the Treatment Methods in Brain Tumor?


Generally, surgical removal of the tumor is considered the first choice for almost all brain tumors. In a minority, partial removal or radiotherapy and follow-up are recommended due to the high complication rate. Especially in high-grade glial tumors, after the diagnosis is confirmed by biopsy, radiosurgery or chemotherapy (drug therapy) can be applied instead of tumor removal. Some of the benign lesions located in the brain stem can be surgically removed, while radiosurgery can be applied in some. In short, the degree of malignancy and location of the tumor, the age, general condition of the patient, and the presence of additional systemic problems determine the surgical decision making and the limits of surgical tumor removal.

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