Principal Director & HOD, Neuro and Spine Surgery, Fortis Hospital, Shalimar Bagh, New Delhi
Part 2 of 9 in Diagnosis and Management of Brain Tumour
How Brain Tumours Are Classified: Benign, Malignant, Primary and Secondary
June 9, 2024
A brain tumour is an abnormal growth of cells within the brain, and understanding how it is classified is the first step in understanding treatment options.
Benign versus malignant, and where tumours arise from
Tumours are classified as benign (non-cancerous) or malignant (cancerous). They can arise from the skull bone, the brain's covering membrane (the meninges), or the brain tissue itself. Of tumours arising from brain tissue, roughly 40% are malignant (astrocytomas and glioblastomas) and 40% are benign (meningiomas, pituitary tumours and nerve sheath tumours); the remaining 20% are metastases, meaning cancer that has spread from elsewhere in the body.
Primary versus secondary tumours
Primary tumours arise from the skull or brain itself and can be benign or malignant. Benign tumours never spread and are usually completely removable by surgery. Malignant primary tumours can spread to the spine and usually cannot be removed completely. Secondary tumours, or metastases, occur in about 25% of cancer patients; surgery for a metastasis is generally only advised if there is a single large tumour, or if one tumour among several is life-threatening due to its size.
This article is based on a Jivo Masterclass session conducted by Dr. Sonal Gupta, Principal Director & HOD, Neuro and Spine Surgery, Fortis Hospital, Shalimar Bagh, New Delhi. The article has been summarised with the assistance of an AI tool from the original masterclass recording. Watch the full Masterclass recording
Looking for a neurosurgery or brain tumour consultation? Get in touch with the Jivo team
This guide is based on a live Jivo Masterclass: Dr. Sonal Gupta taught doctors across Africa on June 9, 2024.
FROM THE LIVE Q&A
Moderator
How can epilepsy surgery be made practical and accessible for African patients?
Dr. Sonal Gupta
Not every epilepsy patient needs surgery - only intractable epilepsy (uncontrolled despite adequate medication) or epilepsy caused by a visible lesion on MRI warrants it. To make this accessible, an online epilepsy clinic can review a patient's medication history and MRI findings remotely, and only call the patient to India for a surgical workup once epilepsy is confirmed to be intractable.
Frequently Asked Questions
If an adult has a first-time seizure, is it correct to suspect a brain tumour as the cause?▼
Every patient presenting with a seizure should have an MRI under the epilepsy protocol with contrast, since a CT scan can miss small lesions responsible for epilepsy. However, not all seizure disorders are caused by a brain tumour.
How are childhood brain tumours identified and managed differently from adult ones?▼
Identification is the same as in adults. The surgical approach is also the same, but radiotherapy and chemotherapy protocols must be modified according to the child's age.
Can a brain tumour be detected in a newborn?▼
Yes. An ultrasound of the skull can be used as a screening test to check for excess fluid or a tumour, but an MRI is required for a definitive diagnosis even in a newborn.
What are the post-operative complications of brain tumour surgery?▼
Complications have come down to under 5% of cases. They include epilepsy, a haematoma (clot) at the surgical site, infection from open surgery, and, if the tumour is very large, the possibility that a portion has to be left behind.
Will children benefit from epilepsy surgery at an early age?▼
Yes. If a child is dependent on multiple anti-epileptic medications, surgery helps by reducing both the number of medications needed and their side effects.
How are brain tumours classified?▼
As benign (non-cancerous) or malignant (cancerous), and as primary (arising from the skull or brain) or secondary/metastatic (spread from cancer elsewhere in the body).
When is surgery advised for a brain metastasis?▼
Generally only if there is a single large tumour, or if one tumour among multiple is life-threatening due to its size.
In This Series: Diagnosis and Management of Brain Tumour
- 1.Brain Tumour
- 2.How Brain Tumours Are Classified: Benign, Malignant, Primary and Secondary
- 3.Brain Tumour Symptoms and Which Headaches Are Red Flags
- 4.Diagnosing Brain Tumours: CT, MRI and Beyond
- 5.Brain Tumour Surgery and Radiosurgery: Treatment Options Explained
- 6.Brain Tumour Surgery: Realistic Complication Rates and Recovery
- 7.Epilepsy Surgery: Who Needs It and How It Helps
- 8.Brain Tumours in Children and Newborns: Diagnosis and Management
- 9.Real Brain Tumour Cases: Weighing Surgery Against Radiosurgery