Tumour Classification 2 - Types of Brain Tumours

What kinds of Brainstem tumours are there?

1. Diffuse: These are unfortunately the most common type and are often malignant. Surgery is not indicated, except to treat the secondary hydrocephalus. Symptoms and signs are multiple and occur with rapid onset.
   
   
2. Focal: These can occur anywhere in the brainstem and may have a cystic component (fluid). The symptoms have often been present for years and may be very specific e.g. choking on one's food. Most of these tumours are low grade and not malignant like the diffuse variety. Surgery, although high risk, may be curative or at the least prolong life significantly. A subset of these focal tumours are the tectal gliomas which carry a particularly good prognosis.
   
   
3. Exophytic: These are rare, comprising no more than 17% of all brainstem tumours. They arise from the brainstem but do not invade it. Instead they grow out of the brainstem into the fourth ventricle. They have symptoms that have often been present for more than a year. The prognosis is generally excellent with total surgical removal.
   
   
4. Cervicomedullary: These are also rare and may have primarily brainstem symptoms or spinal cord symptoms. Either way, the onset of problems spans over many years and many of these patients have been investigated by many physicians. More than 80% of these tumours are low grade and are therefore amenable to radical surgical resection. Once again, the risks are high but there is certainly potential for cure with complete macroscopic resection.
   
   

What is an Optic Glioma?
These are most commonly found in patients with neurofibromatosis, a rare condition characterised by multiple tumours under the skin, in the brain and in the spinal cord. The optic glioma is often very slow growing and may never cause symptoms or signs.