Psychosis in patients with brain tumors

Summary of findings Introduction Primary brain tumors are a diverse group of neoplasms arising from the brain parenchyma (primarily from astrocytes, oligodendrocytes, and less frequently ependymal cells), meninges, pituitary region, pineal region, and skull base. To this date, over 120 types of brain tumors have been identified. The incidence of primary brain tumors varies by gender and geographic location, and has risen over the past decades. The most common histologic tumor types are meningiomas (27%), glioblastomas (21%), other astrocytomas (11%), neuromas (8%), and oligodendrogliomas (4%). Histologic tumor types affecting children are different from those in adults. For gliomas and meningiomas, the incidence increases with age, reaching a peak in late adulthood. Primary CNS lymphoma is rare, representing about 1% of all primary brain tumors; its incidence has dramatically increased in the past decades, in part due to the AIDS epidemic (Batchelor, Dorfman, & Hunter, 2005; DeAngelis, 2001). Most brain tumors in adults are supratentorial. Primary brain tumors are most commonly located in the posterior fossa (30%), frontal and temporal area (22%), and less commonly in the parietal area (12%), pituitary (10%), and the occipital lobes (4%). In children, primary brain tumors are primarily infratentorial. Brain metastases typically arise in mid-to-late adulthood, are common, and affect up to 25% of cancer patients. They most commonly originate from primary cancers of lung, breast, gastrointestinal tract, kidney, and skin. Testicular and thyroid cancer, though uncommon, also frequently metastasize to the brain (Batchelor et al., 2005; DeAngelis, 2001).