Neurological and Spinal Oncology

Click on the condition for more information.

Adenoma

An adenoma is a benign tumor of adrenal glands, pituitary gland and thyroid. Adenomas have the potential to cause serious health complications by compressing adjacent structures and by producing hormonal imbalance.

You may experience signs and symptoms such as:

● Headache
● Dizziness
● Moodiness
● Nausea
● Double Vision
● Fluctuation in weight
● Joint pain or weakness

Anaplastic Astrocytoma

An astrocytoma is a type of tumor that develops within the brain or spinal cord. These tumors are most common among men and women in the 30-50 age range. Astrocytomas demonstrate variable rates of growth depending on the “grade” of the tumor. Malignant astrocytomas (grade IV) are otherwise known as glioblastoma multiforme.

You may experience signs and symptoms such as:
● Headaches
● Depression
● Neurological deficits
● Seizures

Astrocytoma

Astrocytoma tumors are a form of brain or spinal tumor with star-shaped cells. These tumors are often slow growing or can remain unchanged for long periods of time. Once this condition is identified it is important to monitor the Astrocytoma growth closely.

Symptoms are often a result of increased pressure within the skull or spinal canal. In young children, the growing pressure of an Astrocytoma tumor inside the skull may cause enlargement of the skull.

Those with Astrocytoma tumors may experience signs and symptoms such as:

● Headache
● Seizures
● Vomiting
● Drowsiness
● Decreased energy
● Mood swings
● Impaired mental focus

Brain Tumors

A brain tumor is a mass or growth of abnormal cells within the brain. Many different types of brain tumors exist. Some brain tumors are noncancerous (benign), and some brain tumors are cancerous (malignant). Primary brain tumors originate in the brain or the surrounding tissue, such as in the membranes that cover the brain (meninges), cranial nerves and pituitary gland. These tumors originate when normal brain cells undergo mutations in their DNA that allow cells to grow and divide at increased rates and to continue living when healthy cells would die. This results in a mass of mutated cells known as a tumor.

Secondary, or metastatic brain tumors, spread to the brain from an anatomically distinct tumor located elsewhere in the body .

Those with Primary or Metastatic Brain Tumors may experience signs and symptoms such as:
● Sudden onset of headaches
● Seizures
● Headaches that gradually become more frequent and more severe
● Nausea or vomiting
● Blurred vision or double vision
● Loss of peripheral vision
● Loss of sensation or mobility in the arms or legs
● Difficulty with balance
● Speech difficulties
● Confusion
● Mood swings
● Hearing impairment

Chordoma

Chordoma is a malignant primary cancer that manifests as a tumor most typically arising in the sacrum (base of the lower spine) or in the base of the skull. These life threatening tumors can occur at any age but are most often seen in adults.

Chordomas are the result of small remnants of the notochord, a coil of cells in the embryo that develops into the spinal cord. In some cases, a leftover cell (notochord remnant) can develop into a Chordoma. Symptoms depend on the site of the tumor. Symptoms can vary depending upon the size of the tumor.

In many instances, surgery is needed to excise the tumor. Long term follow up is needed to prevent metastasis of these tumors.

Those with Chordoma of the skull may experience signs and symptoms such as:
● Neck pain
● Headache
● Blurred or double vision
● Facial numbness
● Facial twitching
● Difficulty swallowing
● Impaired speech
 
Those with Chordoma of the sacral spine may experience signs and symptoms such as:
● Lower back pain
● Pain in the legs (Sciatica)
● Weakness in the legs
● Bowel or bladder incontinence

Craniopharyngioma

Craniopharyngioma is a type of brain tumor derived from embryonic tissue within the pituitary gland. This tumor is usually slow growing but behaves aggressively as it affects surrounding structures. These benign tumors occur most often in children but are also common in adults in their 50’s and 60’s

 

Those with Craniopharyngioma may experience signs and symptoms such as:

 

● Headaches
● Nausea / vomitting
● Dizziness
● Difficulty balancing
● Increased fatigue
● Mood swings
● Visual impairment
● Excessive thirst
● Increased urination
● Excessive weight gain

Cushing’s Disease

Cushing Disease (hypercortisolism) is a result of the overproduction of a hormone known as Cortisol . One of the most common causes of Cushing Disease is the use of oral corticosteroid medication. Another common cause of Cushing’s Disease is an adenoma (tumor) of the pituitary gland. This tumor forces the pituitary gland to produce increased levels of ACTH (adrenocorticotropic hormone). In response, the adrenal glands produces increased levels of Cortisol, causing a variety of physical and psychological symptoms.

 
Those with Cushing’s Disease can experience signs and symptoms such as:
 
● Weight gain
● Lumps of fatty tissue deposits around the midsection, upper back, face and between the shoulders
● Stretch marks on the abdomen, arms, thighs or breasts
● Skin that bruises easily and appears to be thinning
● Delayed healing of cuts, abrasions and insect bites
● Acne
● Fatigue
● Headache
● Mood Swings
● Weakness
● Depression or anxiety
● Cognitive deficiencies
 
Women with Cushing syndrome can also experience signs and symptoms such as:
 
● Thicker or more visible hair on the face and body
● Missed or irregular menstrual cycles
 
Men with Cushing syndrome can experience signs and symptoms such as:
 
● Decreased libido
● Sexual dysfunction

Dysembryoplastic Neuroepithelial Tumors

Dysembryoplastic Neuroepithelial Tumors (DNETs) are benign tumors of the Central Nervous System. These tumors are most often identified and diagnosed in patients under 20 years old. DNETs, which usually arise in the frontal or temporal lobes of the brain, generally consist of multiple lumps, cysts, or fluid-filled sacs. They arise from the supporting cells of the brain (oligodendrocytes).

 
Signs and symptoms can vary depending upon the severity and location of the tumor.
 
Those with Dysembryoplastic Neuroepithelial Tumors can experience signs and symptoms including:
 
● Seizures
● Headache
● Nausea
● Loss of sensation in extremities
● Impaired motor skills
● Cognitive Impairment

Esthesioneuroblastoma

Esthesioneuroblastoma is a type of cancer that begins in the olfactory bulb. The olfactory bulb is the area of the brain that controls our sense of smell. Esthesioneuroblastoma is also called Olfactory Neuroblastoma. Esthesioneuroblastoma can occur at any age and often manifests as a tumor at the base of the brain behind the nose.

 
Those with Esthesioneuroblastoma can experience signs and symptoms such as:
 
● Loss of sense of smell
● Loss of sense of taste
● Visual impairment
● Frequent nosebleeds
● Difficulty breathing through the nose

Ependymoma

Ependymal tumors begin in the cells that line the passageways in the brain where cerebrospinal fluid (CSF) is produced and stored (ependyma). Ependymomas may occur in the brain or spinal cord, and can be either slow or fast growing.

 

This condition is most common in children and men and women in their 40’s or 50’s. These tumors may obstruct normal CSF flow, leading to Hydrocephalus.

 
Those with Ependymal tumors can experience signs and symptoms such as:
 
● Headaches
● Nausea and vomiting
● Difficulty walking
● Fatigue or sleepiness
● Problems with motor skills
● Coordination Issues
● Neck pain or stiffness in the neck
● Visual impairment

Fibrillary Astrocytoma

Fibrillary astrocytomas (also known as diffuse astrocytomas), are primary brain tumors. They typically occur in adults between the ages of 20 and 50. Fibrillary astrocytomas arise from neoplastic astrocytes, which are a type of glial cell found within the central nervous system. Although these tumors can be found anywhere within the brain or spinal cord they are most often found in the cerebral hemispheres.

These tumors tend to project small microscopic fibrillary tentacles that penetrate the surrounding brain or spinal cord tissue.

Those with Fibrillary Astrocytoma can experience signs and symptoms such as:

● Seizures
● Mood swings
● Headache
● Physical weakness on one side of the body

Foot Drop Injury

Foot drop is the inability to lift the front part of the foot when walking, causing the toe and front foot to drag while walking. Foot drop can affect one or both feet simultaneously and can arise at any age.

Foot drop stems from weakness or paralysis of the muscles that control the lifting of the foot. .

Although there are many causes of foot drop, the most common is a nerve injury resulting from:

● Disc herniation
● Sports Injuries
● Damage during knee or hip replacement surgery
● Child birth
● Diabetes
● Long hours spent in the squatting position
● Stroke
● Multiple Sclerosis
● Cerebral Palsy
● Muscular Dystrophy
● ALS (Lou Gehrig’s Disease)

Those experiencing a Foot Drop Injury can experience signs and symptoms such as:

● Difficulty walking
● Difficulty raising the foot or toes
● Inability to control toes when walking
● Pain or numbness in one or both legs
● Exaggerated gait when walking or climbing stairs

Giant Cell Tumor

Giant cell tumor of bone (GCT) is a benign, but aggressive tumor that typically develops in adults between the ages of 20 and 40 years. Giant cell tumor of bone is very rarely seen in children or in adults older than 65 years of age.

Giant cell tumors derive their name from their appearance under a microscope. These tumors are formed when several single cells fuse into “giant cells”. These tumors occur spontaneously and are not generally associated with trauma, environmental factors, or diet. They are also not a result of genetics or genetic predisposition.

Those with Giant Cell Tumors can experience signs and symptoms such as:

● Progressive pain in the area of the tumor
● Decreased bone density in the area of tumor
● Swelling in the area of the tumor
● Sudden fracture in the area of tumor

Gliomas

A Glioma is a type of tumor that starts in the brain or spinal cord. Its name derives from the cell of origin, the glial cell. Glial cells are surround and protect the neurons of the brain. Gliomas are also referred to as intrinsic brain tumors because they reside within the brain and are known to intermix with normal brain tissue. These tumors arise from three different types of cells that are naturally occuring in the brain: astrocytes, oligodendrocytes, and ependymal cells.

About half of all brain tumors that begin in the brain are a result of gliomas. These generally occur in the upper hemispheres of the brain, but can also grow near the optic nerve, cerebellum and brain stem. Gliomas can affect all age groups, but are seen more more commonly in adults. Also, Gliomas are slightly more common in men than in women.

Those suffering from Gliomas can experience signs and symptoms such as:

● Headache
● Seizure
● Memory loss
● Cognitive impairment
● Mood swings
● Visual impairment
● Coordination Loss
● Physical Weakness
● Pain in the extremities

Glioblastoma Multiforme (GBM)

Glioblastoma Multiforme (GBM) is a malignant glioma (Grade IV) that has the potential to grow quickly and infiltrate the brain.

GBM’s are the most invasive type of glial tumors. In adults, GBM occurs most often in the cerebral hemispheres. Because of the aggressiveness of these tumors it is important to seek treatment immediately. These tumors have a high mortality rate if not addressed quickly.
Glioblastoma Multiforme accounts for about 15% of brain based tumors and generally occur in adults between the ages of 45 and 70.

Those suffering with Glioblastoma Multiforme can experience signs and symptoms such as:

● Chronic headaches
● Seizures
● Double or blurred vision
● Vomiting
● Nausea
● Decreased appetite
● Mood swings
● Cognitive Impairment
● Difficulty in speech

Hemangiopericytoma

Hemangiopericytoma is a rare malignant tumor that occasionally develops in the spine or brain. Hemangiopericytomas are identified by MRI or CT, but often are histologically diagnosed only at the time of surgery. Symptoms are referable to the location of the tumor.

Juvenile Pilocytic Astrocytoma

Juvenile Pilocytic Astrocytoma (JPA) is a brain tumor that occurs in juveniles. In most instances, the tumor is a benign and slow growing tumor and typically does not spread to the surrounding brain tissue. JPA develops from star-shaped brain cells (astrocytes) and other similar cells that form the tissue that surrounds and protects the nerve cells in and around the brain and spinal cord. These tumors increase pressure in the brain or spine and can have a variety of symptoms whose severity depends on the size and location of the tumor.

JPA are considered Grade I Tumors and rarely develop into malignant tumors.

Those suffering from Juvenile Pilocytic Astrocytoma can experience signs and symptoms including:
● Headache
● Seizures
● Nausea
● Vomiting
● Visual impairment
● Balance issues
● Mood swings
● Memory loss
● Cognitive Impairment

Malignant Nerve Sheath Tumors

A Malignant Peripheral Nerve Sheath Tumor (MPNST) is tumor that forms from the soft tissue that covers the nerves in the brain and peripheral nervous system. Involved nerves can derive from the brain, spinal cord, or nerves in the periphery of the central nervous system.

These tumors are generally fast growing although they can produce very few symptoms at their earliest stages. As the tumor progresses the symptoms may become more severe.

Those suffering with Malignant Nerve Sheath Tumors can experience signs and symptoms including:

● Severe pain at the site of the tumor
● Muscle weakness
● A mass within the muscle fibers
● Numbness or tingling in the extremities
● Dizziness
● Balance issues

Medulloblastoma

Medulloblastoma is a malignant brain tumor that most commonly develop in or near the cerebellum. The cerebellum is the area of the brain that controls movement and coordination.

This tumor affects the central nervous system (CNS) and can cause impairment in thought, speech, and body strength. Obstruction of normal CSF flow by these tumors can also lead to Hydrocephalus. Medulloblastoma most often occurs in children but can also be seen in adults.

Symptoms can vary depending upon the severity and location of the tumor.

Those suffering Medulloblastoma can experience signs and symptoms such as:

● Headache
● Problems with coordination
● Cognitive impairment
● Balance issues
● Visual hallucination

Meningioma

Meningioma is a tumor that arises from the meninges (the membranes that surround the brain and spinal cord). Meningiomas will present with symptoms based on its location where it is pushing on the brain, spinal cord, or nerves.
 
Those with Convexity Meningioma may experience signs and symptoms such as:
 
● Headaches
● Seizures
● Difficulty with memory or concentration
● Impaired motor skills
● Fatigue
● Muscle ache
● Mood changes
● Trouble speaking
● Weakness
● Paralysis

Metastatic Brain Tumor

Metastases are the most common brain tumor. A Metastatic Brain tumor (also called a Secondary Brain Tumor) is a tumor that arises from a cancer in another area of the body and secondarily spreads to and infiltrates the brain. Certain types of cancers are more likely to spread to the brain than others, with lung and breast cancers being the most common.

These tumors are most often found in the cerebellum. About 50% of those with one Metastatic Brain Tumors will have multiple tumors in the brain.

Signs and symptoms can vary depending on the size, location and number of tumors.

Those suffering with Metastatic Brain Tumors can experience signs and symptoms including:
● Seizures
● Headaches
● Mood Swings
● Coordination impairment

Neurofibromatosis

Neurofibromatosis is a result of a genetic disorder that disturbs the healthy growth of cells in the central nervous system (CNS). This disturbance can cause tumors to form on nerve tissue. These tumors may develop anywhere in the nervous system but are most often found in the brain, spinal cord and peripheral nerves. The tumors are generally benign, however in some cases these tumors develop into malignant tumors.
Based on the severity of these tumors they are categorized into two groups – NF1 and NF2.

Neurofibromatosis 1 (NF1) usually appears in childhood. Indications of NF1 in children include:
● Flat, light brown spots on the skin.
● Freckling in the groin or armpits
● Soft bumps on or under the skin
● Small bumps on the iris
● Cognitive impairment or learning disabilities
● Deformities of the bones
● Large head size
● Stunted growth
● Underweight

Neurofibromatosis 2 (NF2) occurs much less frequently than NF1 and is hallmarked by the development of Vestibular Schwannomas (Acoustic Neuromas) in both ears.
 
These benign tumors grow on the eighth cranial nerve, the nerve that is responsible for carrying sound and balance information from the inner ear to the brain.
 
Signs and symptoms most often appear in the adolescent and early adult years and can include:
 
● Progressive hearing loss
● Tinnitus (ringing in the ears)
● Poor balance
● Facial drooping or sagging
● Numbness and weakness in the arms
● Numbness and weakness in the arms

Spinal Neurofibromas

Spinal neurofibromas are tumors that grow along the nerves that derive from the spinal cord. Symptoms develop depending on the size and location of the tumors.
Those suffering with Spinal Neurofibromas can experience signs and symptoms including:
● Back Pain
● Neck Pain
● Numbness or tingling in the arms
● Numbness or tingling in the legs

Oligodendroglioma

Oligodendrogliomas are tumors that derive from oligodendrocytes (a form of glial cells). These tumors can be found throughout the brain.

Oligodendrogliomas typical contain calcifications (mineral deposits), and/or multiple cysts. These tumors can grow at variable rates, and are graded from II to IV. The grade reflects how rapidly the tumor cells may reproduce as well as how aggressive the tumor may be.

Depending on the size, location and grade of the tumor, signs and symptoms may vary.

Those suffering from Oligodendroglioma can experience signs and symptoms including:

● Seizure
● Headache
● Mood swings
● Paralysis or weakness on one side of the body
● Short term memory difficulty
● Speech or language impairment

Optic Nerve Glioma

Optic Nerve Gliomas are a type of brain tumor (glioma) that is present in the optic chiasm or optic nerve. These tumors affect the optic nerve which is responsible for sending visual data to the brain. These tumors are more frequently found in people with neurofibromatosis.

These tumors are most often found in children but can be found in adults as well.

Those with Optic Nerve Gliomas can experience signs and symptoms including:

● Blurred or double vision
● Hormonal changes
● Headaches
● Progressive loss of vision

Osteoma

An osteoma is a benign bone tumor that is most often found in the skull or spine. New and extra bone formation are the hallmark of this type of tumor.

Those with Osteoma can experience signs and symptoms including:

● Headache
● Facial Pain
● Swelling
● Sinus infection
● Visual impairments

Petrous Apex Lesion

Petrous Apex Lesions are tumors or cysts that most commonly occur at the end of the bone in the skull adjacent to the middle ear.

Petrous Apex Lesions can be congenital or acquired. With Congenital Petrous Apex Cholesteatomas small amounts of skin cells can be left behind in the embryonic stage and these cells then form a skin cyst (cholesteatoma) in that area. As these cysts develop they will grow and will invade surrounding structures. The majority of Petrous Apex Lesions are benign. However, patients with other forms of cancer in the body can develop Metastatic Petrous Apex Lesions.

Those with Petrous Apex Lesions can experience signs and symptoms including:

● Headache
● Ear Pain
● Pain behind the eye
● Pus drainage in the ear
● Facial weakness
● Double vision
● Hearing loss

Pituitary Tumors

Pituitary Tumors are abnormal growths that arise within the pituitary gland and may cause excessive production of hormones that regulate important functions of your body. Some other Pituitary Tumors can restrict normal functions of the pituitary gland and cause reduced production of certain hormones.

The majority of pituitary tumors are benign and remain in the pituitary gland region. Pituitary Tumors less than 1cm are referred to as Microadenomas. Pituitary Tumors that are larger than 1 centimeter are referred to as Macroadenomas. These larger tumors can increase pressure on the rest of the pituitary gland and nearby structures.

Those with Pituitary Tumors can experience signs and symptoms including:

● Headache
● Peripheral vision loss
● Nausea
● Vomiting
● Hormone deficiency
● Weakness
● Less frequent or missed menstrual cycles
● Loss of body hair
● Sexual dysfunction
● Increased frequency and amount of urination
● Fluctuation in body weight

Rhabdomyosarcoma

Rhabdomyosarcoma is a malignant tumor of the muscles, soft tissue or tendons that are attached to bones throughout the body. One of the most common locations for these tumors is the skull and cervical spine.

Rhabdomyosarcoma is the most common soft tissue tumor in children. Some children with certain birth defects are at an increased risk. Also, families with genetic mutations can increase the risk of Rhabdomyosarcoma. However, the great majority of children with rhabdomyosarcoma do not have any known risk factors.

Those suffering from Rhabdomyosarcoma can experience signs and symptoms such as:

● Bleeding in the nose or throat
● Persistent congestion
● Swallowing problems
● Neurological deficits.
● Bulging of the eyes
● Visual impairment
● Pain in the eyes
● Pain or swelling of the ears