Expert: Claes-Gustaf Nordquist, M.D. - 4/5/2010

Question
I know you have said that there are no known genetic causes of maligant brain tumors. However some studies I have read indicate a increase of non optic gliomas in NF 1 patients. I know benign tumors like schwanomas, neurofibromas and low grade astrocytomas are more common, but what about grades III and IV? Digging deep into the internet all I can find are three published cases of a GBM in NF patients and as NF is very common (in terms of genetic disorders) and GBMs are the most common primary brain tumor it would stand to reason that a coincidental occurence would be common. Is it that NF patients are more prone to have lower grade gliomas transform into higher grade ones? As the studies I have read seem to indicate in adult NF patients brain tumors are rare and most adults with NF who have brain tumors have had them since childhood?

I ask because I have NF and have been having some headaches lately and am worried? My MRI in September of 07 was clear with the exception of a subarachnoid cyst and an MRI of my C-spine last month showed a T-2 intensity in the dentate nucleus.  I am scheduled for a brain MRI this friday.

with just a minor headache and no other neurological signs along with negative tests ( I did a self test for Hoffman, Rombergs and Babinsky's signs) what would the risk of a tumor be? Thank You

Answer
Yes there are often clear genetic links in the case of neurofibromatosis (von Recklinghausen). BUT while that condition has an increased risk of tumors of the cranial nerves (like acusticusneuromas of the 8th cranial nerve, the hearing & balance nerve) and other schwannomas these are NOT real brain tumors and there is no known links at present to real high grade malignant brain tumors. Even so I do agree that an MRI brain scan should be done soonest in order to find any schwannomas etc. Good luck!



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