Downloaded 300 times
Uploaded byMed Study
CNS Tumors
Primary CNS tumors can be classified based on their cell of origin and include gliomas, neuronal and glioneuronal tumors, and meningiomas. Gliomas are the most common and include astrocytomas, oligodendrogliomas, and ependymomas. Astrocytomas are graded from I-IV based on malignancy. Childhood CNS tumors often occur in the posterior fossa while adult tumors are more commonly supratentorial. Metastatic tumors account for about a quarter of CNS tumors with the most common primary sites being the lung, breast, skin, and kidney.
More Related Content
CNS Tumors
- 1.
- 2. LEARNING OBJECTIVES • ClassifyCNS tumors • Describe general characteristics of CNS tumors • Identify tumor type in relation to age and site of tumor • Describe primary peripheral nerve sheath neoplasms with clinical relevance
- 5. FACTS • Tumors inadults are more commonly based in anterior fossa/ supratentorial location whereas childhood tumors are more commonly posterior fossa/ infratentorial in location • CNS tumors do not metastasize outside the brain and spinal cord. • Even benign tumors can be sinister according to location.
- 6.
- 7. Tumor origin • Neuronal •Glial • Nerve sheath • Meningeal • Others • Metastatic
- 9. CNS TUMOR CLASSIFICATION •Primary tumors- 1/2 --3/4th • Metastatic tumors- 1/4 – ½ • In primary tumors,WHO grading is done according to biologic behaviour into grade I to IV (depending on risk of recurrence) Under current classification scheme, lesions of different grades are given distinct names
- 10. CNS TUMOR CLASSIFICATION •PRIMARY TUMORS – Gliomas – Neuronal and glioneuronal tumors – Poorly differentiated tumors – Other parenchymal tumors Primary lymphomas 1% of intracranial tumors Germ cell tumors 0.2-1% Pineal tumors Tumors of meninges Meningiomas Nerve sheath tumors Schwannomas Neurofibromas
- 11. PRIMARY TUMORS 1-Gliomas Astrocytomas (80%adult primary tumors) Oligodendrogliomas Ependymomas and other paraventricular lesions Grading Astrocytomas Pilocytic astrocytoma(Non infiltrating)Grade I Diffuse astrocytoma- Grade II Anaplastic astrocytoma- Grade III Glioblastoma multiforme- Grade IV Oligodendrogliomas Most Grade II Anaplastic Grade III Ependymomas Most Grade II Anaplastic Grade III
- 12. Gliomas • SITES andAGE group – Astrocytoma • Pilocytic (Children , posterior fossa) • Infiltrating (Adults, Cerebral hemispheres) – Oligodendroglioma • Adults 4th -5th decade, cerebral hemispheres – Ependymoma (2 groups) • 4th ventricle, children • Intraspinal, adults
- 13. Low grade vsHigh grade glioma
- 14.
- 15. Cystic/ Pilocytic astrocytoma •Gliomas in children,are most common in the posterior fossa. Most childhood brain tumors arise below the tentorium, which is the reverse of the adult.
- 16.
- 17. Ependymoma • Ependymoma arisingfrom the ependymal lining of the fourth ventricle above the brainstem and bulging toward the cerebellum. Ependymomas are benign histologically.
- 18. Ependymoma • This horizontal sectionof the brain reveals a large ependymoma of the fourth ventricle.
- 19.
- 20. Undifferentiated tumors • Medulloblastoma –Predominantly in children (20% of brain tumors in children) – Posterior fossa/ cerebellum – Highly malignant but radiosensitive • Atypical teratoid/ rhabdoid tumor – Children less than 5 yrs – Dismal prognosis
- 21. Medulloblastoma • irregular posterior fossa massnear the midline of the cerebellum and extending into the fourth ventricle in a child.
- 22. CNS TUMOR CLASSIFICATION •METASTATIC TUMORS ¼ to ½ of brain tumors Mainly mtastatic carcinomas 5 common primaries accounting for 80% mets – Breast – Lung – Skin (melanoma) – Kidney – GIT
- 23. Metastasis from alung carcinoma. Metastases most often appear at the border of the grey and white matter in the distribution of the middle cerebral artery,
- 24. MENINGEAL TUMORS •Meningiomas-Grade I •Atypical meningiomas-Grade II •Anaplastic meningiomas-Grade III
- 25.
- 26. Peripheral nerve sheathtumors • Schwaanomas • Neurofibromas • Malignant peripheral nerve sheath tumors/ MPNST
- 27. Schwaanomas/ Acoustic neuroma The mass lesionhere is arising in the acoustic (eighth cranial) nerve at the cerebellopontine angle. This is a schwannoma. Patients may present with hearing loss. These benign neoplasms can be removed.
- 28. SUMMARY (Common tumors) •Childhood tumors – Medulloblastomas, high grade – Pilocytic astrocytomas, Grade I – Ependymomas, posterior fossa(4th ventricle) – Choroid plexus papillomas, lateral ventricles • Adult tumors • Gliomas • Spinal ependymomas, oligodendrogliomas
- 29. TUMORS of PNS •Neurofibroma Cutaneous Plexiform • Schwaanoma • Malignant peripheral nerve sheath tumors
- 30.
- 31.
- 32.