Primary Neoplasms of the Brain in Adults

Abstract

Overview In 2021, it is expected that at least 700,000 people in the United States will be living with a primary brain tumor. Primary brain tumors are a heterogeneous group of neoplasms arising from nervous system tissue and the surrounding meninges. Unique to these cancers is a presentation of neurologic symptoms such as seizures, worsened headaches, weakness, personality changes, impaired cognition, and speech difficulty. It is estimated that 70% of brain tumors are benign (most commonly meningiomas), while 30% are malignant (most commonly gliomas). Malignant brain tumors are among the most challenging cancers to treat, due to limited effective therapies and difficulty of drug delivery across the blood–brain barrier. Despite the challenges, there has been a tremendous amount of knowledge gained about these neoplasms over the past decade. The 2016 World Health Organization (WHO) classification of central nervous system tumors (CNS) introduced the integration of histologic evaluation and molecular alterations to make a more informed diagnosis of these alterations, which have prognostic implications. This article will review the most encountered primary brain neoplasms and their management approaches.