Brain Mass
A brain mass is an abnormal growth or lesion within the brain that occupies space and may cause symptoms by pressing on surrounding tissue. Brain masses can be benign (non-cancerous) or malignant (cancerous), and include tumors, cysts, abscesses, hematomas, and other abnormal tissue collections requiring careful evaluation to determine their nature and appropriate treatment.
What is it?
A brain mass is a general term describing any abnormal tissue growth or collection within the brain. Brain masses encompass a wide spectrum of conditions with different causes, characteristics, and prognoses. They can be classified as neoplastic (tumors, either primary brain tumors or metastases from cancers elsewhere), infectious (abscesses), vascular (hematomas, vascular malformations), inflammatory (demyelinating lesions), or developmental (cysts). Each type has distinct imaging characteristics, clinical presentations, and treatment approaches.
Primary brain tumors occur at a rate of approximately 24 per 100,000 people annually in the United States. Common benign masses include meningiomas (arising from the meninges), pituitary adenomas, and acoustic schwannomas, while malignant primary tumors include glioblastoma, astrocytomas, and oligodendrogliomas. Metastatic brain tumors (spread from cancers elsewhere in the body) are actually more common than primary brain tumors, affecting 10-30% of cancer patients. Brain masses can cause symptoms through several mechanisms: direct compression of brain tissue (mass effect), obstruction of cerebrospinal fluid flow causing hydrocephalus, seizures from irritation of brain tissue, or disruption of specific brain functions depending on location.
Important to Know
Discovery of a brain mass requires comprehensive evaluation to determine its nature and optimal treatment. MRI with contrast is the gold standard for characterization, often supplemented by advanced imaging techniques like MR spectroscopy, perfusion imaging, or PET scans. Not all brain masses are cancerous—many are benign and some require only monitoring. Symptoms vary widely based on location and may include persistent headaches (especially morning headaches that improve through the day), new-onset seizures, progressive weakness or numbness, vision or hearing changes, personality or cognitive changes, balance problems, or nausea and vomiting. Treatment depends on the mass type, location, size, and patient factors. Options include surgical resection, stereotactic radiosurgery, conventional radiation therapy, chemotherapy, or watchful waiting for small, asymptomatic benign masses. Early detection and accurate diagnosis are crucial for optimal outcomes.