Summary
Definition
History and exam
Key diagnostic factors
- headache
- neurologic deficit
- seizure
- history of radiation exposure
Other diagnostic factors
- family history of brain tumor or neurofibromatosis 2 (NF2)
- history of breast cancer
- history of exogenous hormone exposure
- cognitive deficit
- vertigo/dizziness
Risk factors
- ionizing radiation
- genetic predisposition
- hormones: endogenous and exogenous
- head trauma
Diagnostic tests
1st tests to order
- MRI brain or spine with and without contrast
Tests to consider
- CT brain or spine
- somatostatin receptor PET/CT
- cerebral angiography
- histopathology of surgical resection
Treatment algorithm
good surgical candidate
poor surgical candidate
recurrent or progressive tumor following initial treatment
Contributors
Authors
Stephen T. Magill, MD, PhD
Assistant Professor
Lou and Jean Malnati Brain Tumor Institute
Robert Lurie Comprehensive Cancer Center
Department of Neurological Surgery
Northwestern University Feinberg School of Medicine
Chicago
IL
Disclosures
STM has authored several articles cited in this topic.
Acknowledgements
Dr Stephen T. Magill would like to gratefully acknowledge Professor William T. Couldwell and Dr Jayson A. Neil, previous contributors to this topic.
Disclosures
WTC is an author of several references cited in this topic. JAN declares that he has no competing interests.
Peer reviewers
Marc Chamberlain, MD
Professor of Neurology
Moffitt Cancer Center and Research Institute
University of Washington
Seattle
WA
Disclosures
MC is an author of several references cited in this topic.
Ian McCutcheon, MD
Professor of Neurosurgery
The University of Texas M. D. Anderson Cancer Center
Houston
TX
Disclosures
IM declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
World Health Organization Classification of Tumours Editorial Board. WHO classification of tumours of the central nervous system. 5th Edition. France: IARC; 2021.
Louis DN, Perry A, Wesseling P, et al. The 2021 WHO Classification of Tumors of the Central Nervous System: a summary. Neuro Oncol. 2021 Aug 2;23(8):1231-51.Full text Abstract
National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: central nervous system cancers [internet publication].Full text
Goldbrunner R, Stavrinou P, Jenkinson MD, et al. EANO guideline on the diagnosis and management of meningiomas. Neuro Oncol. 2021 Nov 2;23(11):1821-34.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Dural metastasis
- Granuloma
- IgG4-related disease
More DifferentialsGuidelines
- NCCN guidelines: central nervous system cancers
- American College of Radiology (ACR) appropriateness criteria: brain tumors
More Guidelines
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