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Intracranial tumors (summary)

Dr Derek Smith ◉ et al.

This is a basic article for medical students and other non-radiologists

Intracranial tumors comprise a heterogeneous group of tumors. In adult patients, the majority represent metastatic disease with a smaller proportion being primary brain tumors. Metastasis to the brain occurs, most commonly, from lung, breast, melanoma, renal cell, and colorectal cancers.

On this page:

Article:

Reference article
Summary
Imaging
Related articles
References

Images:

Cases and figures

Reference article

This is a summary article; read more in our article on intracranial tumors.

Summary

epidemiology
- incidence increases with age
- equivocal gender distribution
- risk factors
  - malignancy elsewhere
presentation
- headache
- features of raised intracranial pressure
  - nausea & vomiting worse in the morning or positional
- altered mental state
- focal neurology may occur as the tumor grows
- adult-onset seizures
- incidental finding
  - some tumors may not cause symptoms
  - patients may be imaged for another reason, e.g. trauma
pathophysiology
- heterogeneous group of tumors
  - metastases, e.g. lung, breast, renal
  - meningiomas
  - primary parenchymal tumors
  - pituitary or pineal tumors
  - cranial nerve schwannomas
- tumors are graded using the WHO grade
investigation
- CT is often the first test performed to assess presenting symptoms
- MRI may be used with symptoms of headaches or seizures
- MRI is the investigation of choice to characterize the tumor
treatment
- parenchymal brain tumors generally have a poor prognosis
- treatment should be in specialist centers
  - steroids may alleviate symptoms caused by edema
  - anti-epileptic agents may help for those with seizures
  - a biopsy may be performed neurosurgically
  - some tumors may be removed, e.g. pituitary tumors
  - stereotactic radiotherapy can be used for small lesions

Imaging

role of imaging
- confirm intracranial abnormality and prioritise MRI
- tumor characterization
- help to determine the grade, and make a decision about biopsy
- follow up
radiographic features
- CT
  - often the first line test
  - variety of appearances depending on the tumor
  - hypo- or hyperdense, irregular, well-defined, peripheral or deep
  - useful to determine edema and mass effect
  - contrast may make lesions more conspicuous
  - CT is especially helpful for determining bony involvement
- MRI
  - investigation of choice
  - fantastic contrast and spatial resolution
  - origin of tumors can be determined
  - different sequences are used to determine the likely diagnosis
  - specialized sequences can be useful to look at tumor metabolites

Quiz questions

References

Medical student radiology curriculum

radiology for students
neuroradiology
- imaging
- key findings
- conditions
- presentations
chest radiology
- imaging
  - chest x-ray
    - chest x-ray - an approach
  - CT chest
- key findings
- conditions
  - pneumonia
  - lobar collapse
  - pulmonary edema
  - heart failure
  - symptomatic pneumothorax
  - tension pneumothorax
  - pleural effusion
  - COPD
  - asthma
  - pulmonary embolism
  - lung cancer
  - mesothelioma
  - bronchiectasis (and CF)
  - tuberculosis
- presentations
abdominal radiology
- imaging
- key findings
- conditions
  - upper GI
  - lower GI
  - hepatopancreatobiliary
  - genitourinary
    - renal tract calculi
    - prostate cancer
  - vascular
    - aortic aneurysm
    - peripheral arterial disease
  - breast
    - breast cancer
- presentations
musculoskeletal radiology
- imaging
  - tests and when to use them
    - upper limb
    - lower limb
- key findings
  - fracture description
- interpretation
  - approach to trauma films
- conditions
  - upper limb
  - lower limb
    - pelvic fractures
    - proximal femoral fractures
    - distal fibula fracture
    - 5th metatarsal fracture
  - pediatrics
  - spine
  - major trauma
  - joint pain/arthritis
- presentations
  - upper limb
    - shoulder injury
    - fall onto an outstretched hand
  - lower limb
    - hip trauma
    - lower limb injury
    - foot and ankle injury
  - joint pain/arthritis
obstetrics and gynecology imaging
- imaging
- key findings
- conditions
- presentations
pediatric radiology
- imaging
- key findings
- conditions
- presentations

Article information

rID: 34338

System: Central Nervous System

Tag: neuro, medical student, teaching, tumour, tumor, brain, cns, gbm, meningioma, summary

Synonyms or Alternate Spellings:

Brain tumors (summary)

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Cases and figures

Case 1: metastatic malignant melanomaCase 1: metastatic malignant melanoma

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Case 2: glioblastomaCase 2: glioblastoma

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Case 3: hemorrhagic brain metastasesCase 3: hemorrhagic brain metastases

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Case 4: pituitary macroadenomaCase 4: pituitary macroadenoma

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