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Overview of the clinical features and diagnosis of brain tumors in adults

Authors
Eric T Wong, MD
Julian K Wu, MD
Section Editors
Jay S Loeffler, MD
Patrick Y Wen, MD
Deputy Editor
April F Eichler, MD, MPH

INTRODUCTION

Brain tumors are a diverse group of neoplasms arising from different cells within the central nervous system (CNS) or from systemic cancers that have metastasized to the CNS. Systemic cancers most likely to metastasize to the CNS include lung cancer, melanoma, and breast cancer. Primary brain tumors include a number of histologic types with markedly different tumor growth rates (table 1A-G). (See "Classification and pathologic diagnosis of gliomas" and "Epidemiology, clinical manifestations, and diagnosis of brain metastases".)

Brain tumors can produce symptoms and signs by local brain invasion, compression of adjacent structures, and increased intracranial pressure (ICP). In addition to the histology of the tumor, the clinical manifestations are determined by the function of the involved areas of the brain. The proper evaluation of the patient with a suspected brain tumor requires a detailed history, comprehensive neurologic examination, and appropriate diagnostic neuroimaging studies.

An overview of the clinical manifestations and diagnosis of primary and secondary brain tumors in adults will be reviewed here. The evaluation of brain masses in patients with human immunodeficiency virus (HIV) is presented separately. (See "Approach to HIV-infected patients with central nervous system lesions".)

EPIDEMIOLOGY

The incidence rate of primary brain and nervous system tumors in adults in the United States is approximately 29 per 100,000 persons [1]. Meningiomas and glial tumors (eg, glioblastoma, astrocytoma, oligodendroglioma) account for about two-thirds of all primary brain tumors in adults (table 2). (See "Incidence of primary brain tumors" and "Epidemiology, pathology, clinical features, and diagnosis of meningioma".)

The frequency of various tumor types and grades varies by age group. In adolescents and young adults, primary brain tumors are more common than metastatic tumors, and among primary brain tumors, low-grade gliomas predominate (figure 1). In adults above the age of 30 to 40 years, metastatic brain tumors become increasingly prevalent, accounting for more than half of all brain tumors. Glioblastoma is the most common malignant primary brain tumor in adults, with a median age at diagnosis of 64 years.

                                 

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Literature review current through: Jul 2017. | This topic last updated: Jul 19, 2017.
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