Brain tumors can develop in virtually any part of the brain, but they cluster in predictable locations depending on the type of tumor, whether the tumor started in the brain or spread from elsewhere, and the age of the patient. In adults, most primary brain tumors grow in the upper portion of the brain (the cerebrum), while in children, tumors more commonly form in the lower back portion near the cerebellum and brainstem.
The Cerebral Lobes
The cerebrum, the large upper portion of the brain divided into left and right hemispheres, is the most common territory for brain tumors in adults. Each hemisphere contains four lobes, and tumors don’t affect them equally. According to the most recent U.S. national registry data covering 2018 to 2022, the frontal lobe accounts for 7.2% of all brain and central nervous system tumors, the temporal lobe 5.2%, the parietal lobe 3.0%, and the occipital lobe just 0.7%. When looking only at malignant (cancerous) tumors, those numbers shift dramatically: the frontal lobe accounts for 25.2%, the temporal lobe 17.8%, the parietal lobe 10.5%, and the occipital lobe 2.4%.
The location within the cerebrum matters because each lobe controls different functions. Tumors in the frontal lobe, which manages thinking, personality, and voluntary movement, can cause balance problems, trouble walking, forgetfulness, and personality changes like loss of interest in usual activities. The parietal lobe processes touch, temperature, and spatial awareness. The temporal lobe handles memory and language. The occipital lobe at the very back of the brain controls vision, so tumors there can cause visual disturbances.
The Cerebellum and Brainstem
The lower back portion of the brain, sitting beneath the cerebrum and behind the brainstem, is the cerebellum. This region is especially important in children’s brain tumors. About 70% of a common childhood tumor called pilocytic astrocytoma develops in the cerebellum, compared with only 35 to 40% in adults. Medulloblastoma, one of the most common malignant brain tumors in children, typically grows in the midline of the cerebellum and can block the normal flow of fluid through the brain, causing dangerous pressure buildup.
The brainstem, a narrow stalk connecting the cerebrum to the spinal cord, is another critical location. Most brainstem tumors are gliomas, including a particularly aggressive type called diffuse midline glioma (previously known in children as DIPG). Because the brainstem controls so many basic functions, tumors here produce a wide range of symptoms: balance and coordination problems, double vision or difficulty moving the eyes, slurred speech, trouble swallowing, weakness on one side of the body, facial drooping, and headaches that are often worse in the morning. Even small tumors in this area can cause significant problems because the brainstem is densely packed with nerve pathways.
The Meninges and Brain Surface
Meningiomas, the most common primary brain tumor overall, don’t grow from brain tissue itself. They develop from the membranes (meninges) that wrap around the brain and spinal cord. The most frequent locations include the convexity (the curved outer surface of the brain), along the falx (the membrane between the two hemispheres), near the sphenoid bone and middle cranial fossa at the base of the skull, and in the posterior fossa behind the brainstem. Because they grow on the surface rather than inside the brain, meningiomas often push on brain tissue rather than infiltrating it, which generally makes them easier to remove surgically.
The Pituitary and Pineal Regions
Two small glands deep inside the brain are common sites for specific tumor types. The pituitary gland, a pea-sized structure at the base of the brain just behind the eyes, gives rise to pituitary adenomas. These tumors sit in a bony pocket called the sella turcica and can grow upward to press on the optic nerves, causing vision problems, particularly loss of peripheral vision. They can also disrupt hormone production, leading to a wide range of symptoms from irregular periods to abnormal growth.
The pineal gland sits deep in the center of the brain. Pineal region tumors arise from stem cells near this gland. Because of their central position, they can block the flow of cerebrospinal fluid and compress surrounding structures. Craniopharyngiomas, another midline tumor type, grow near the pituitary and can press on the optic nerve, the hypothalamus (which regulates hunger, sleep, and body temperature), and the third ventricle.
Inside the Ventricles
The brain contains a connected system of fluid-filled cavities called ventricles: two lateral ventricles (one in each hemisphere), a third ventricle in the center, and a fourth ventricle near the brainstem. Several tumor types grow directly inside these spaces. Ependymomas, which arise from the cells lining the ventricles, occur in the fourth ventricle about 58% of the time, with the remaining cases in the lateral and third ventricles. Central neurocytomas typically fill the lateral ventricle near a narrow passageway called the foramen of Monro.
Choroid plexus tumors develop from the tissue that produces cerebrospinal fluid. In children, they tend to appear in the lateral ventricles, while in adults, the fourth ventricle is more common. These tumors represent 10 to 20% of brain tumors arising in the first year of life. Meningiomas can also occur inside the ventricles and are among the most common tumors found in the lateral ventricles of adults. Any tumor growing inside a ventricle can block the normal circulation of cerebrospinal fluid, causing the ventricles to enlarge (hydrocephalus) and increasing pressure inside the skull.
Where Metastatic Tumors Land
Tumors that spread to the brain from cancers elsewhere in the body, called metastatic or secondary brain tumors, follow a different pattern than tumors that originate in the brain. They travel through the bloodstream and most commonly lodge at the junction between the brain’s gray matter (the outer layer of nerve cell bodies) and white matter (the deeper layer of nerve fibers). This gray-white matter junction is a common landing zone because blood vessels narrow at this boundary, trapping clusters of cancer cells. The most frequent sources are lung, breast, melanoma, colon, and kidney cancers.
Metastatic tumors can appear anywhere in the brain, but they tend to follow the distribution of blood flow, which means the cerebrum receives the majority. On imaging, they typically appear as distinct masses at the gray-white junction surrounded by a halo of swelling that, unlike the swelling around primary brain tumors, spares the surrounding gray matter. Multiple metastases are common, so finding one often prompts a search for others.
Why Location Shapes Treatment
Where a brain tumor sits determines not just the symptoms it causes but how aggressively it can be treated. Neurosurgeons categorize certain brain regions as “eloquent,” meaning they control clearly identifiable functions like speech, movement, or vision. Tumors in or near these areas require a careful balance between removing as much tumor as possible and preserving the patient’s neurological function. A tumor in the frontal pole (the very front of the frontal lobe) might be removed aggressively with minimal risk, while an identical tumor near the brain’s language or motor areas demands more cautious, often awake, surgery with real-time brain mapping.
Deep-seated tumors in the brainstem, thalamus, or pineal region pose additional challenges simply because of how much healthy tissue a surgeon must navigate to reach them. Tumors inside the ventricles can sometimes be accessed through natural corridors in the brain, but their proximity to critical structures still demands precision. In all cases, the tumor’s address in the brain is one of the most important factors in deciding whether surgery, radiation, chemotherapy, or some combination offers the best outcome.