Brain tumor surgery

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Brain tumor Microchapters
Patient Information
Overview
Classification Adult brain tumors Glioblastoma multiforme Oligodendroglioma Meningioma Hemangioblastoma Pituitary adenoma Schwannoma Primary CNS lymphoma Childhood brain tumors Pilocytic astrocytoma Medulloblastoma Ependymoma Craniopharyngioma Pinealoma Metastasis Lung cancer Breast cancer Melanoma Gastrointestinal tract cancer Renal cell carcinoma Osteoblastoma Head and neck cancer Neuroblastoma Lymphoma Prostate cancer
Causes
Differentiating Brain Tumor from other Diseases

Overview

Meningiomas, with the exception of some tumors located at the skull base, can be successfully removed surgically, but the chances are less than 50%. In more difficult cases, stereotactic radiosurgery, such as Gamma Knife radiosurgery, remains a viable option. Most pituitary adenomas can be removed surgically, often using a minimally invasive approach through the nasal cavity and skull base (trans-nasal, trans-sphenoidal approach). Large pituitary adenomas require a craniotomy (opening of the skull) for their removal. Radiotherapy, including stereotactic approaches, is reserved for the inoperable cases.

Surgery

Surgery is usually done on primary brain tumors to help pinpoint the diagnosis and to take as much as the tumor as possible. There are two main types of surgery commonly used on brain tumors: Open and stereotactic.

• If the tumor is accessible and the patient is in good health, an open operation is done to take the tumor as much as possible.
• If the tumor is deep and the patient's health does not allow an open operation, a stereotactic biopsy can be performed.
  • Using a small needle under CAT scan or MRI guidance, a small piece of the tumor can be taken out. In the open operation a piece of the skull is taken out, the brain is entered and the tumor is taken out. The piece of the skull is then replaced and the skin is closed. Sometimes it is possible to take the whole tumor out especially in the case of malignant gliomas. In some cases, if the whole tumor is taken out, the surrounding brain can be damaged or deficiencies in the brain can result. Depending on the location of the tumor, the neurosurgeon may have to decide during the operation exactly how much of the tumor can be removed. Surgery on metastatic brain tumors may be done to help diagnose the disease and may be needed to save the life of the patient. If the original tumor is under control, removal of the metastatic tumor may help to extend the patient's life.