Brain Cancer

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Questions to Ask Your Doctor About Your Cancer
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Types

The World Health Organization (WHO) has nine categories of primary brain tumors, which are based on the types of cells in which the tumors originate. Gliomas are primary brain tumors that are made up of glial cells—cells that provide important structural support for the nerve cells in the brain.

Infiltrative astrocytoma and glioblastoma multiforme (GBM) account for nearly 85% of all brain tumors, with the remainder spread among the other seven types.

Tumor Type	Cell Origin
Infiltrative astrocytoma	Astrocytes
Pilocytic astrocytoma	Astrocytes
Oligodendroglioma	Oligodendrocytes
Mixed oligoastrocytoma	Oligodendocytes and astrocytes
Glioblastoma multiforme (GBM)	Astrocytes and other brain cell types (astroblasts, spongioblasts)
Ependymoma	Ependymocytes
Medulloblastoma	Primitive neural cell
Meningioma	Meninges
Other

Tumor grade: All gliomas, except GBM, range from well-differentiated tumors (low grade) to anaplastic, that is, completely chaotic, undifferentiated (high grade). High-grade tumors are more aggressive and are associated with lower survival rates. In terms of surviving the disease, the grade of the tumor is the most important feature.

Primary Tumors

A primary brain tumor usually develops through a complex series of molecular and cellular mutations and may take years to acquire enough mass to cause symptoms that bring the disease to a person's and/or a physician's attention.

• astrocytoma–most common type of brain tumor in children; originates in the brainstem, cerebellum, white matter of the cerebrum, or spinal cord
  
• brainstem glioma–originates in the medulla, pons, or midbrain
  
• choroid plexus papilloma–originates in the ventricles
  
• ependymoma–originates in the membrane that lines the bentricles and central canal of the spine
  
• glioblastoma multiforme–most common types in adults; originates in glial cells in the berebrum
  
• medulloblastoma–second most common type in children; originates in the fourth cerebral ventricle and the cerebellum; often invades the meninges
  

Other types of primary brain cancer include the following:

• acoustic neuroma–originates in the vestibulocochlear nerve
  
• lymphoma–originates in lymphocytes; common in HIV/AIDS patients
  
• meningioma–originates in the meninges
  
• pineal gland tumor–rare; originates in the pineal gland
  
• pituitary adenoma–originates in surface cells of the pituitary gland
  
• schwannoma–originates in cells of the myelin sheath that covers neurons
  

Secondary (Metastatic) Brain Tumors

In adults, the most common types of cancer that spread to the brain are the following:

• melanoma
  
• breast cancer
  
• renal cell carcinoma
  
• colorectal cancer
  

The prognosis for people who develop brain metastases is generally poor.

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