Benign brain tumor

التشخيص

If your healthcare professional thinks you might have a brain tumor, you may need tests and procedures to get a diagnosis. These might include:

• Neurological exam. A neurological exam tests different parts of the brain and nervous system. It may include checking vision, hearing, balance, coordination, strength and reflexes. The exam does not detect a brain tumor. But it can help your healthcare professional understand which part of the brain or nervous system may be causing symptoms.
• Head CT. A CT scan uses X-rays to make pictures. CT may be used when quick imaging is needed, when MRI is not available or when MRI cannot be done. CT also may help show bleeding, fluid buildup or calcium deposits in a tumor. If a CT scan shows a possible brain tumor, a brain MRI may be needed.
• Brain MRI. MRI uses strong magnets to make detailed pictures of the brain. MRI often is used to look for brain tumors because it shows brain structures clearly. Contrast material may be given through a vein before an MRI. Contrast can make some tumors easier to see and can help show how the tumor relates to nearby tissue.
• Special MRI scans. Some people need special types of MRI. Functional MRI can show areas of the brain involved in speech, movement and other important tasks. This may help the healthcare team plan surgery or other treatments. Magnetic resonance spectroscopy uses MRI to measure certain chemicals in tissue. Magnetic resonance perfusion uses MRI to measure blood flow in different parts of a tumor. These tests may help the healthcare team learn more about the tumor and plan treatment.
• PET scan. A positron emission tomography (PET) scan uses a radioactive tracer to make pictures of the brain. PET scans are not needed for everyone with a benign brain tumor. These scans may be used as an added test when MRI or CT results need clarification. PET is more likely to help identify high-grade tumors than low-grade tumors.
• Angiography. Angiography is a test that shows blood vessels and blood flow. It is not needed for everyone with a benign brain tumor. In some cases, it may help the healthcare team understand how a tumor affects nearby blood vessels and plan treatment, such as surgery.
• Hormone testing. Blood tests may be used if a pituitary tumor is suspected. These tests can show whether the pituitary gland is making too much or too little of certain hormones.
• Vision testing. A visual field test may be used if a tumor is near the optic nerves or optic chiasm. The optic chiasm is the place at the base of the brain where the two optic nerves cross.
• Hearing testing. Hearing tests may be used if a vestibular schwannoma, also called an acoustic neuroma, is suspected. These tests can help show whether the tumor is affecting hearing.

• Biopsy or surgery to get a tissue sample. A sample of tumor tissue may be needed to confirm the diagnosis. Often, the tissue sample is taken during surgery to remove the tumor. If surgery is not possible or the tumor is in a hard-to-reach area, a needle biopsy may be used. A biopsy removes a small piece of tissue for testing. Imaging tests may help guide the biopsy.

  The tissue sample is studied under a microscope. Tests can show whether the cells are cancer or not. The tests also can help identify the tumor type and, for some tumors, the tumor grade. Tumor grade describes how the tumor cells look and how they are likely to behave. Some tumors also may be tested for molecular changes. Molecular changes are changes in the tumor's genes or other cell features. These test results can help guide treatment and follow-up.

العلاج

Treatment for a benign brain tumor depends on the tumor type, size, location and growth rate. It also depends on symptoms, test results, molecular features, a person's age and overall health, and whether the tumor is affecting important brain functions.

Some benign brain tumors can be checked with regular imaging. Others may need surgery, radiation therapy, radiosurgery, medicines, rehabilitation or supportive care.

Monitoring

Some benign brain tumors do not need treatment right away. The approach to these tumors may be called observation, watchful waiting or active monitoring. Monitoring means your healthcare team checks the tumor over time with imaging tests, such as MRI, and watches for new symptoms or tumor growth.

Monitoring may be an option when a tumor is small, is not causing symptoms or is not pressing on important brain structures. This approach also may be used when the risks of treatment are greater than the likely benefit. If the tumor grows or symptoms develop, treatment may be recommended.

Surgery

Surgery may be recommended if a benign brain tumor is causing symptoms, growing, pressing on important structures or needs to be removed to confirm the diagnosis. The goal is to remove as much of the tumor as safely possible while protecting brain and nerve function.

Surgery also can provide tissue for lab testing. Testing the tissue can confirm the tumor type and show molecular changes that may help guide treatment and follow-up. Molecular changes are changes in the tumor's genes or other cell features.

Surgical approaches and techniques may include:

• Craniotomy. A craniotomy is surgery that removes a section of skull bone so the surgeon can reach the brain tumor. The tumor is removed with special tools. Sometimes lasers are used to destroy tumor tissue. In some cases, awake brain surgery is used to help lower the risk of affecting important parts of the brain. When the tumor removal is done, the skull bone is put back in place.
• Endoscopic transnasal transsphenoidal surgery. This surgery uses a long, thin tube with a camera, called an endoscope. The endoscope and special surgical tools are passed through the nose and sinuses to reach the pituitary area. This approach may be used for some pituitary tumors.

Sometimes the whole tumor cannot be removed safely. This can happen when the tumor is close to areas that control movement, speech, vision, hearing or other important functions. In these cases, the surgeon may remove part of the tumor to lower pressure, improve symptoms or get tissue for diagnosis. If the tumor is in a hard-to-reach area, a biopsy may be done to get tissue for testing and to help plan treatment.

Some benign brain tumors need no further treatment after they are removed. Others need ongoing imaging or more treatment if part of the tumor remains, the tumor grows or the tumor comes back.

Radiation therapy

Radiation therapy uses high-energy beams to damage tumor cells. It may be used when surgery is not possible, when part of the tumor remains after surgery or when a tumor comes back. Radiation therapy also may be considered when surgery could cause too much risk to important brain or nerve functions. Radiation therapy may be given in multiple treatments over time.

Radiosurgery

Stereotactic radiosurgery for brain tumors is an intense form of radiation treatment. It doesn't involve making a cut in the skin. It aims beams of radiation from many angles at the brain tumor. Each beam isn't very powerful. But the point where the beams meet gets a very large dose of radiation that kills the tumor cells.

Radiosurgery may be used for some benign brain tumors, including some meningiomas and vestibular schwannomas. It may be an option for small tumors, tumors that are hard to reach with surgery, tumors that remain after surgery or tumors that come back.

Types of radiosurgery technology may include:

• Gamma Knife radiosurgery. This treatment uses many small beams of gamma radiation aimed at the tumor.
• Linear accelerator radiosurgery. This treatment uses carefully shaped X-ray beams aimed at the tumor from different angles.
• Proton beam therapy. This treatment uses proton beams. It may be considered in some situations to limit radiation to nearby tissue. Proton beam therapy is the newest type of radiosurgery. It's becoming more common but isn't available at all hospitals.

Medicines

Medicines may be used to treat symptoms caused by the tumor or hormone issues related to the tumor.

Medicines may include:

• Antiseizure medicines. These medicines may be used for people who have seizures. The medicines are not typically used to prevent seizures in people who have never had one.
• Hormone-related medicines. Some pituitary tumors called prolactin-secreting pituitary tumors or prolactinomas can be treated with medicines called dopamine agonists. These medicines lower prolactin levels and may shrink prolactinomas. Other pituitary tumors may need monitoring, surgery or other treatments.

Chemotherapy and targeted therapy

Chemotherapy and targeted therapy may be considered for some low-grade gliomas. These treatments also may be used for some tumors with specific molecular changes, such as papillary craniopharyngioma. Treatment decisions depend on the tumor type, grade and molecular features, along with age and how much tumor remains after surgery.

Targeted therapy uses medicines that act on specific changes in tumor cells, called mutations. Treatment decisions for tumors with molecular changes depend on the full diagnosis and the person's situation.

Rehabilitation and supportive care

Some people need help recovering after treatment or managing symptoms caused by the tumor. Rehabilitation and supportive care may include:

• Physical therapy for strength, movement or balance.
• Occupational therapy for help with daily activities.
• Speech therapy for speech, language or swallowing concerns.
• Vision support.
• Hearing support.
• Help with memory, thinking or learning changes.
• School or workplace support for children or adults if the tumor or treatment affects learning, memory or development.

For some vestibular schwannomas, vestibular rehabilitation before surgery may help with movement and balance after surgery.

Recovery after surgery

Recovery after surgery depends on the tumor type, size and location. It also depends on the type of surgery, whether the whole tumor could be removed and whether the tumor affected important brain functions before surgery.

After surgery, the healthcare team watches for changes in brain and nervous system function. Imaging may be done to see how much of the tumor was removed and to help plan follow-up care. Some people go home after a short hospital stay. Others need more time in the hospital or need rehabilitation before going home.

Enhanced recovery programs help people prepare for surgery and recover afterward. For people having planned craniotomy for a brain tumor, these programs may help shorten the hospital stay and lower costs without increasing surgery-related complications.

Follow-up care is important after surgery. Some tumors need regular imaging to watch for tumor growth or recurrence. Follow-up schedules depend on the tumor type, how much tumor was removed and whether the tumor changes over time.

التجارب السريرية

استكشِف دراسات مايو كلينك حول التطورات الجديدة في مجال العلاجات والتدخلات الطبية والاختبارات المستخدمة للوقاية من هذه الحالة الصحية وعلاجها وإدارتها.

الطب البديل

Little research has been done on complementary and alternative brain tumor treatments. No alternative treatments have been proven to cure brain tumors. However, complementary treatments may help you cope with the stress of a brain tumor diagnosis.

Some complementary treatments that may help you cope include:

• Art therapy.
• Exercise.
• Meditation.
• Music therapy.
• Relaxation exercises.

Talk with your healthcare team about your options.

التأقلم والدعم

Some people say a brain tumor diagnosis feels overwhelming and frightening. It might make you feel like you have little control over your health. It may help to take steps to understand your condition and talk about your feelings. Consider trying to:

• Learn enough about brain tumors to make decisions about your care. Ask your healthcare professional about your specific type of brain tumor. Ask about your treatment options and, if you like, your prognosis. As you learn more about brain tumors, you may feel better about making treatment decisions.
• Keep friends and family close. Keeping your close relationships strong can help you deal with your brain tumor. Friends and family can provide the practical support you'll need, such as helping to take care of your home if you're in the hospital.
• Find someone to talk with. Find a good listener who is willing to hear you talk about your hopes and fears. This may be a friend, family member or clergy member. Ask your healthcare team to suggest a counselor or medical social worker you can talk with.

Ask your healthcare team about brain tumor support groups in your area. It can be helpful to learn how others in the same situation are coping with complicated medical conditions.

الاستعداد لموعدك

Make an appointment with a healthcare professional if you have symptoms that are new, don't go away or get worse over time. You may be referred to a specialist who diagnoses and treats brain and nervous system conditions. This specialist is called a neurologist. You also may see a neurosurgeon, radiation oncologist, endocrinologist, vision specialist, hearing specialist or rehabilitation specialist, depending on the tumor type and symptoms.

What you can do

Before the appointment, it may help to gather:

• A list of your symptoms, including when they started and whether they have changed.
• A list of all medicines, vitamins and supplements you take.
• Your personal and family medical history, including any known genetic conditions.
• Copies of imaging tests or test reports, if you have them.

It also may help to:

• Bring a family member or friend to help remember the information you receive.
• Write down questions to ask your healthcare team.

Your time with your healthcare professional is limited. Prepare a list of questions to help you make the most of your time together. For a benign brain tumor, some basic questions to ask include:

• What type of brain tumor do I have?
• Is the tumor benign?
• Where is the tumor located?
• Is the tumor growing or pressing on nearby brain structures?
• What tests do I need?
• Do I need to meet with other specialists?

Questions about treatment and follow-up may include:

• Do I need treatment now, or can the tumor be watched with imaging?
• What are my treatment options?
• What are the risks and benefits of each option?
• How often will I need follow-up imaging?
• What symptoms should lead me to seek care right away?
• Are genetic counseling or clinical trials options for me?

What to expect from your doctor

Your healthcare professional may ask about symptoms, such as:

• Headaches.
• Seizures.
• Vision changes.
• Hearing changes.
• Balance problems.
• Changes in memory, thinking, mood, speech or movement.

Your healthcare professional also may ask:

• When did the symptoms start?
• Have the symptoms changed over time?
• Have you had imaging tests, such as MRI or CT?
• Have you been treated for a brain tumor before?
• Do you have a family history of brain tumors or inherited genetic conditions?
• Have you had radiation treatment to the head?