Types of Brain Tumors

An acoustic neuroma is a tumor that forms from the covering of the eighth cranial nerve. This tumor is benign, is generally slow-growing and does not spread to other parts of the body. Acoustic neuromas affect about 10 people in one million. More women than men are affected; they are usually diagnosed between the ages of 30 and 60 years.

The most common first symptom is hearing loss in the affected ear, which may often go unrecognized or mistaken as a normal aging-related development. As an acoustic neuroma enlarges, it may cause additional symptoms such as loss of balance, headache, unsteadiness, facial weakness, facial numbness and/or double vision.

The cause is unknown. Acoustic neuromas can be sporadic or caused by an inherited condition called neurofibromatosis, a rare disease characterized by multiple tumors in various sites, especially the skin, which can cause bilateral acoustic tumors.

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Glioblastoma multiforme is a malignant tumor that accounts for 30 percent of all primary brain tumors and is the most common primary brain tumor in adults. It can grow very rapidly in the brain in a period of three to six months. The tumor presents special problems because it is not solid and cannot be removed in one clean piece. The tumor is diffuse, and individual cells tend to escape removal. As a result, the tumor often grows back near the site of the initial mass. The cause of these tumors is unknown.

Headaches, memory loss, seizures and behavioral changes are the most common symptoms, resulting from increased pressure caused by the tumor’s rapid growth. As the tumor grows, loss of certain bodily functions may also occur.

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A glioma (glee-OH-mah) is a tumor arising from the glial cells in the brain or spinal cord. Glial cells support nerve cells with energy and nutrients and help maintain the blood-brain barrier, which protects the brain. Gliomas vary in their aggressiveness, or malignancy. Some are slow-growing and are highly curable. Others, like glioblastoma multiforme, are extremely difficult to treat and are likely to recur. The actual cause of gliomas is unknown. Men are more likely than women to develop glioma, and different gliomas are more likely to occur at different ages across the lifespan.

Headaches, memory loss, seizures and behavioral changes are the most common symptoms, resulting from increased pressure caused by the tumor’s growth. As the tumor grows, loss of certain bodily functions may also occur. These could include arm or leg weakness or difficulties with speech.

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Otolaryngologists (ENT Surgeons) at our center treat all tumors of the head and neck. These tumors, or neoplasms, are abnormal growths of tissue. They can appear on or in the ear, throat, jaw or mouth, tongue, tonsils, salivary glands, sinuses, thyroid, lips or scalp. Symptoms can include difficulty or pain with swallowing, voice change or persistent hoarseness, weight loss, ear pain, coughing up blood, a firm lump on the side of the face or in the mouth, or a non-healing ulcer on the scalp, ears or lips.

Upper Aerodigestive Tract Tumors

The upper aerodigestive tract is subdivided into the oral cavity, throat (pharynx) and voice box (larynx). A variety of benign and malignant tumors may occur in various parts of the throat, causing symptoms such as difficulty or pain with swallowing, voice change, weight loss, ear pain or coughing up blood. The risk factors for cancer in these areas are long-term tobacco and alcohol use. People with these risk factors who experience cancer symptoms should seek a complete head and neck evaluation.

Salivary Gland Tumors

The salivary glands include the parotid, submandibular, and sublingual glands, as well as numerous minor glands located throughout the upper aerodigestive tract (the throat). A salivary-gland tumor may be malignant or benign. This type of tumor typically presents as a slow-growing, non-tender lump on the side of the face in front of the ear, at the angle of the jaw, or in the oral cavity.

Skin Cancers

Skin cancer frequently occurs in the head and neck. These growths often appear as non-healing ulcers on the scalp, ears or lips. Generally, larger lesions or lesions that involve the nose or ear are managed by head and neck surgical oncologists, particularly when skin reconstruction is necessary. The three most common types of skin cancer are basal cell carcinoma, squamous cell carcinoma and malignant melanoma. Each type has its own unique pattern of spread and behavior and requires tailored treatment.

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A meningioma is a brain tumor that grows in the meninges, a thin layer of tissue covering the brain and spinal cord. Some meningiomas contain cysts or calcified mineral deposits, and others contain hundreds of tiny blood vessels. Because meningiomas tend to grow inward, they commonly cause pressure on the brain or spinal cord. Infrequently meningiomas will grow outward, causing the skull to thicken. Meningiomas grow very slowly and may not produce symptoms for many years. Radiation and genetics are known causes of meningiomas. Most meningiomas occur in adults between the ages of 40 and 60 years.

Symptoms vary by location and size of the tumor. They often first appear as headaches and seizures, the result of increased pressure imposed by the growing tumor. Weakness in the arms or legs, or loss of sensation, may occur with spinal cord meningiomas.

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Metastatic brain tumors have spread to the brain from a cancer that has originated elsewhere in the body. Metastatic brain tumors most often have spread from the breast or lung. As patients live longer with their primary cancer, they have a higher likelihood of developing metastatic tumors to the brain. Patients with existing cancer are at risk of developing a metastatic brain tumor. Tumors most likely to spread to the brain are those originating in the lung and breast. Melanoma, renal, gastrointestinal and pelvic cancer also metastasize to the brain. About 170,000 cases are diagnosed each year.

Headaches, memory loss, seizures and behavioral changes are the most common symptoms, resulting from increased pressure caused by the tumor’s rapid growth. As the tumor grows, loss of certain bodily functions may also occur.

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Nerve sheath tumors develop from Schwann cells, which produce the insulating myelin sheath that covers peripheral nerves. Nerve sheath tumors include schwannomas and neurofibromas. They can develop along any nerve of the head and neck or central nervous system. Some arise on nerves before they exit the skull, and as they grow they can compress normal brain structure. Others arise along the length of the nerve outside the skull, usually causing dysfunction of that specific nerve of origin.

Schwannomas and most neurofibromas grow slowly and are almost always benign. Those that become malignant (less than 1 percent) are known as malignant peripheral nerve sheath tumor, malignant schwannoma or neurofibrosarcoma. A vestibular schwannoma, which originates within the myelin-forming cells of the vestibulocochlear nerve (the hearing and balance nerve), is more commonly known as an acoustic neuroma.

The cause of most nerve sheath tumors is unknown. However, people with a hereditary disorder known as neurofibromatosis are susceptible to developing benign and malignant lesions of the nerve sheath. A genetic disorder known as schwannomatosis can lead to the development of schwannomas.  Nerve sheath tumors affect men and women equally. Most patients are diagnosed between the ages of 30 and 50, although children and elderly patients also can be affected.

Symptoms can include dysfunction of any of the nerves that course through the head and neck. Symptoms also can include the presence of an oral or facial mass, which is often accompanied by pain, loss of hearing, and muscle weakness.

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A pituitary tumor is an abnormal growth in the pituitary gland. The pituitary is a small gland in the brain. It is located behind the back of the nose. It makes hormones that affect many other glands and many functions in your body. Most pituitary tumors are not cancerous (benign). They don’t spread to other parts of your body. But they can cause the pituitary to make too few or too many hormones, causing problems in the body.

Pituitary tumors that make too many hormones will cause other glands to make more hormones which in turn will cause symptoms related to each of the specific hormones. Many pituitary tumors will also press against the nearby optic nerves. This can cause vision problems.

Most pituitary tumors don’t cause symptoms. As a result, they are not diagnosed. Or they are found only during a routine brain imaging test. About 25% of people may have small pituitary tumors without knowing it.

Below are the main types of pituitary tumors:

Nonfunctional adenomas

These tumors are the most common type; they don’t make extra hormones. You may not have any symptoms until the tumor is a certain size. When the tumor is big enough, it may cause headaches and vision problems. Large pituitary tumors can crush normal pituitary cells. This leads to symptoms caused by the pituitary not producing enough hormones.

Prolactin-producing tumors

These benign tumors are also common. They make too much prolactin. If you are a woman, high prolactin levels can make your menstrual period irregular, or even stop your period. These tumors can also cause you to make breastmilk, even if you are not pregnant or nursing. If you are a man, you may have erectile dysfunction or a lack of interest in sex. You may also have enlarged breasts, a low sperm count, or less body hair. In time, you may have headaches and vision problems.

ACTH-producing tumors

ACTH (adrenocorticotropic hormone) stimulates the adrenal gland to make steroids that affect metabolism. Too much ACTH can cause Cushing’s disease. This disease causes fat buildup in your face, neck, back, belly (abdomen), and chest. Also your arms and legs tend to become thin. You may also have purple stretch marks and high blood pressure. These tumors can also weaken your bones.

Growth hormone-producing tumors

These tumors make too much growth hormone. In children, too much growth hormone stimulates the growth of almost all the bones in the body. When that occurs, the result is called gigantism. Gigantism can include increased height (over 7 feet), very quick growth, joint pain, and heavy sweating. In adults, too much growth hormone causes a condition called acromegaly. It may include:

• Extra growth in the skull, hands, and feet
• Deepened voice
• A change in the facial appearance because of extra growth in the facial bones
• A wide spacing of teeth because of the growth of facial bone
• Joint pain
• Snoring or sleep apnea
• Diabetes or impaired glucose tolerance

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Skull base lesions include pituitary tumors, tumors of the sino-nasal tract, tumors of the clivus (including chondromas and chordomas), lesions of the petrous apex, neuromas, meningiomas, cholesteatomas, keratomas and paragangliomas (glomus tumors). The UC Gardner Neuroscience Institute offers patients with skull base tumors optimal care that minimizes the risk of neurological deficits. Our physicians were the first to propose selective use of cytoreductive surgery, which is the minimization of tumor removal, when possible, and maximization of quality of life.

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Spinal tumors account for a small percentage of all tumors of the central nervous system. Symptoms of spinal tumors include:

• Neck or back pain
• Neurological problems (such as weakness/numbness of the arms or legs, or a change in bodily functions)
• Severe pain when there is direct manipulation or compression of the affected area of the spine
• Pain that does not diminish with rest
• Pain that may be worse at night than during the day
• Back pain along with constitutional symptoms, such as loss of appetite, unplanned weight loss, nausea, vomiting, fever, chills and shakes.

They appear in three forms:

Primary Spinal Bony Tumors

These tumors, which are quite rare, occur in the vertebral column and grow either from the bone or disc elements of the spine. They typically occur in younger adults, and they usually grow slowly. Osteogenic sarcoma (osteosarcoma) is the most common malignant bone tumor.

Metastatic Spinal Tumors

Most spinal tumors have metastasized (spread) from cancer in another area of the body.

Intradural-Extramedullary Tumors (Primary Spinal Chord Tumors)

Intradural-extramedullary tumors grow within the spinal canal, under the membrane that covers the spinal cord but outside of the nerves. These tumors usually are benign and slow growing.

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