1) Brain tumors are the 20th most common malignancy worldwide and their incidence varies based on factors like age, sex, and race.
2) Diagnostic workup involves imaging like MRI and CT scans, cerebrospinal fluid examination, and biopsy when needed. Molecular testing helps classify tumors.
3) Treatment depends on tumor type and grade but generally involves surgery, radiation, chemotherapy, and targeted therapies. Management of symptoms is also important.
4) Prognosis depends on tumor specific factors and can range from months to over 10 years depending on the tumor characteristics.
Medulloblastoma- A primitive neuroectodermal tumors (PNETs) is the most common malignant brain tumor of childhood (WHO IV)
arising from the vermis in the inferior medullary velum.
It comprises up to 18% of all pediatric brain tumors.
WNT and Shh pathway plays major role in its pathogenesis.
c-erbB-2 (HER2/neu) oncogene expression has prognostic value. Norcantharidin, Vismodegib, Sonidegib are the future in medulloblastoma.
Gliomas are the commonest tumor of brain arising from the supportive cells of the brain with diverse form and presentation the treatment of which is surgical and demands adjuvant therapy for most of circumstances.
Dr Vandana, cranio spinal irradiation, radiotherapy, medulloblastoma, cancer, radiation, treatment, diagnosis, management, natural history of medulloblastoma, signs & symptoms of medulloblastoma,
current approach, future advancements
General Basic knowledge of Brain tumour explained in brief of classification, pathogenesis, clinical features, CT, MRI, management, Radiotherapy. Best for MBBS and PG preparation student.
Medulloblastoma- A primitive neuroectodermal tumors (PNETs) is the most common malignant brain tumor of childhood (WHO IV)
arising from the vermis in the inferior medullary velum.
It comprises up to 18% of all pediatric brain tumors.
WNT and Shh pathway plays major role in its pathogenesis.
c-erbB-2 (HER2/neu) oncogene expression has prognostic value. Norcantharidin, Vismodegib, Sonidegib are the future in medulloblastoma.
Gliomas are the commonest tumor of brain arising from the supportive cells of the brain with diverse form and presentation the treatment of which is surgical and demands adjuvant therapy for most of circumstances.
Dr Vandana, cranio spinal irradiation, radiotherapy, medulloblastoma, cancer, radiation, treatment, diagnosis, management, natural history of medulloblastoma, signs & symptoms of medulloblastoma,
current approach, future advancements
General Basic knowledge of Brain tumour explained in brief of classification, pathogenesis, clinical features, CT, MRI, management, Radiotherapy. Best for MBBS and PG preparation student.
Brain metastasis is an advance diseases with poor overall prognosis management of which is full of controversies. This slide aims to make metastasis simplified.
Brain metastasis is an advance diseases with poor overall prognosis management of which is full of controversies. This slide aims to make metastasis simplified.
Giant Glioblastoma in a Patient with Previous Prostate Adenocarcinoma_Crimson...CrimsonPublishersAICS
Giant Glioblastoma in a Patient with Previous Prostate Adenocarcinoma by Anna Aldea Parés, Adrián Téllez Santoyo, Pedro Castro Rebollo and Ramón Estruch Riba* in Advancements in Case Studies
Primary brain tumours are a diverse group of neoplasm arising from different cells of the central nervous system.
It accounts for about 2% of all cancers with an overall annual incidence of 22 per 1,00,000 population.
Most common brain tumour in adults is Brain Metastasis.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
4. EPIDEMIOLOGY
It is the 20th most common malignancy worldwide and 14th most common in India according to
GLOBOCAN 2020 data.
whites males (except meningiomas and schwannomas) .
High mortality upto 75%
Dramatic improvement in children and young adult, mortality by 50% between 1975 to 2010
Tumors that have a propensity for CSF spread include
◦ Medulloblastomas
◦ Germ cell tumors
◦ CNS lymphoma
5. Neuro Oncol, Volume 22, Issue Supplement_1, October 2020, Pages iv1–iv96, https://doi.org/10.1093/neuonc/noaa200
The content of this slide may be subject to copyright: please see the slide notes for details.
Distribution of All Primary Brain and Other CNS Tumors
(Malignant and Non-Malignant Combined)
Site Histology
CBTRUS 2020
Glioblastoma
14.5%
Pituitary
16.9%
Nerve sheath
tumor 8.6%
Meningioma 38.3%
6. Neuro Oncol, Volume 22, Issue Supplement_1, October 2020, Pages iv1–iv96, https://doi.org/10.1093/neuonc/noaa200
The content of this slide may be subject to copyright: please see the slide notes for details.
CBTRUS 2020
Distributionof All Primary Brain and Other CNS Gliomas
Site Histology
Out of all
gliomas
GBM: 57.7%
7. Neuro Oncol, Volume 22, Issue Supplement_1, October 2020, Pages iv1–iv96, https://doi.org/10.1093/neuonc/noaa200
The content of this slide may be subject to copyright: please see the slide notes for details.
CBTRUS 2020
Age adjusted incidence rates of Brain and Other CNS
Tumors
8. ETIOLOGY
Occupational & Environmental factors
Prior exposure to ionizing and non-ionizing radiation (2.3% incidence of
primary brain tumors in children treated with PCI for acute leukemia, a
22 fold increase expected)
Farmers and petrochemical workers
Chemical exposures (formaldehyde, vinyl chloride, acrylonitrile, etc.)
Cellular telephones ?????
Hereditary Syndromes
Cowden,Turcot, Lynch & Li-Fraumeni (Gliomas)
Gorlin(PNET), neurofibromatosis type I&II (meningiomas, optic nerve
glioma, shwannoma)
VHL (haemangioblastoma)
9. Neuroepithelial Tumors :
Glial cell origin: Astrocytoma, Oligodendroglioma, Ependymoma, Choroid plexus
Neuronal and mixed neuro–glial origin: Gangliocytoma, Neurocytoma, Papillary
glioneuronal tumor, Rosette-forming glioneural tumor of the fourth ventricle
Embryonal Tumors : Medulloblastoma, PNET
Classification of Adult Brain
Tumors
11. Tumors of meninges (meningoepithilial cells, mesenchymal)
Tumors of haematopoitic system
Lymphoma
Plasmacytoma
Metastatic
Classification of Adult Brain
Tumors
12. WHO grade I = low proliferative potential, a frequently discrete nature,
and the possibility of cure following surgical resection alone.
WHO grade II = generally infiltrating and low in mitotic activity but recur
more frequently than grade I malignant tumors after local therapy. Some
tumor types tend to progress to higher grades of malignancy.
WHO grade III = anaplastic histology & infiltrative, usually treated with
aggressive adjuvant therapy.
WHO grade IV = mitotically active, necrosis-prone , micro-vascular
proliferation & generally associated with a rapid pre & post-operative
progression & fatal outcomes, usually treated with aggressive adjuvant
therapy.
Grading of Adult Brain Tumors
13. PATHOLOGY
Primary intracranial tumors are of ecto- and mesodermal origin and arise from the brain, cranial nerves,
meninges, pituitary, pineal, and vascular elements.
In 2016, the WHO revised its classification system for pathologic subtypes of CNS tumors to combine
histology with molecular parameters such as:
IDH1 mutation
1p19q codeletion for gliomas
H3 K27M mutation
RELA fusion for ependymoma
WNT and SHH activation for medulloblastoma
16. Two major changes:
Roman numerals have been changed to Arabic numerals (I → 1, II → 2, III →
3, IV → 4)
Grading within tumor types
(1) to provide more flexibility in using grade relative to the tumor type
(2) to emphasize biological similarities within tumor types rather than
approximate clinical behavior
(3) to conform with WHO grading in non-CNS tumor types.
20. DIAGNOSTIC WORK UP
Complete history and physical examination
Magnetic Resonance Imaging
CT Scan
Newer Imaging Modalities
FDG PET-CT is approved in USA, FLT and F-DOPA are being evaluated
Cerebrospinal Fluid Examination
Medulloblastoma, ependymoma, choroid plexus carcinoma, lymphoma, and some
embryonal pineal and suprasellar region tumors have high likelihood of spreading to CSF.
Biopsy (craniotomy / stereotactic)
IHC & Cyto-genetics
21. T1WI T2WI
FLAIR
Cerebrospinal fluid Dark Bright Dark
Fat Bright Dark Bright
Solid mass (tumor) Dark Bright Bright
Edema Dark Bright Bright
Cyst Dark Bright Dark
MRI
22. High-grade glioma — High-grade gliomas are typically hypointense masses on T1-
weighted images that enhance heterogeneously following contrast infusion
23. Low-grade glioma — Low-grade gliomas in adults generally appear as T2/FLAIR
hyperintense, expansile lesions involving both cortex and underlying white matter
matter
24. Meningioma — On MRI, a typical meningioma is an
extra-axial, dural-based mass that is isointense or
hypointense to gray matter on T1 and isointense or
hyperintense on T2-weighted images
25. Brain metastases — Brain metastases typically appear as rounded, well-
circumscribed masses that enhance after administration of contrast
26. Biopsy
When biopsy is not indicated
Known active systemic cancer and multiple lesions that are radiographically
consistent with brain metastases
Brainstem glioma
Optic nerve meningioma
HIV positive patients with CT or MRI findings consistent with primary CNS
lymphoma (PCNSL)
Positive Epstein-Barr virus PCR in the CSF
Patients with secretory germ cell tumors
28. IDH 1/2 Mutation 1p/19q Co-deletion MGMT promoter
methylation
Diffuse astro (GRII) 70%-80% 15% 40%-50%
Oligod/astro (GRII) 70%-80% 30%-60% 60%-80%
Astro(GR III) 50%-70% 15% 50%
Oligod/astro (GR III) 50%-80% 50%-80% 70%
GBM (GR IV) 5% - 10% <5% 35%
Diagnostic role DD glioma vs.gliosis
Typical for transformed
LGG
Pathognomonic for
oligodendroglioma
None
Prognostic role Protracted natural history
in IDH-mutated tumors
Protracted natural history
in 1p/19q codeleted
tumours
Prognostic for AG (+/-
with IDH mutations)
treated with RT / CT
Predictive role Absence of mutation
suggests predictive role
for MGMT promoter
methylation
Prolongation of survival
with early chemotherapy
in 1p/19-co-deleted OD
Predictive in GBM for benefit
from alkalating CT Elderly
GBM: MGMT-methyl = TMZ
MGMT – unmethyl=RT
30. GENERAL MANAGEMENT
Cerebral Edema
Glucocorticoids are used to control neurologic signs and symptoms
Dexamethasone 2-4mg twice daily
Seizures
Anticonvulsants, such as levetiracetam, lacosamide, lamotrigine, and
pregabalin are preferred
Prophylactic anticonvulsant use (in patients who have never experienced a
seizure) remains controversial because there is lack of data.
32. RADIATION THERAPY
Radiobiologic Considerations Underlying Tissue Injury
The process of radiation injury depends on
Technical factors: Dose, Volume, Fraction size, Specific target cell population,
Secondary mechanisms: blood vessel injury resulting in hypoxia, edema
Reactive gliosis
Host factors: Inherent Radiosensitivity of different organs within brain (Ex. Optic
chiasm, hypothalamus, Lacrimal gland, Lenses are sensitive to radiation than
others)
34. CT SIMULATION ADVANTAGE : Coverage of meninges in
subfrontal region and sparing of lens in CSI.
35. CT SIMULATION
•Contouring of the cord and
overlying meninges that
extend laterally to the lateral
aspect of the spinal ganglia
results in a field width than
one based on bony anatomy.
•The addition of shielding
further reduces the volume of
normal tissues included in the
treated volume.
36.
37.
38. Surgery :
Except deep seated lesions such as pontine glioma
Complete resection not achievable frequently
Radiotherapy :
RT immediately or after progression
EORTC TRIAL 22845 – 7.4 vs .7.2 yrs OS. but PFS 5.3 vs. 3.4
Conclusion in doubt
No difference in survival of dose escalation
Surveillance
General principle of treatment in
adult Low Grade Gliomas (LGG)
39. Risk factors for survival in Low Grade Gliomas
Age (<40 vs, > 40 years old)
Tumor largest diameter (<6 cm vs. > 6 cm)
Tumor crossing midline (yes vs. no)
HPE tumor type (oligodendroglioma or mixed vs. astrocytoma)
Neurologic deficit present preoperatively (absent vs. present)
Survival
Low risk (0-2) 7.8 (6.8 - 8.9) yrs.
High risk (3-5) 3.7 (2.9 - 4.7) yrs.
General principle of treatment in
adult Low Grade Gliomas (LGG)
43. BRACHYTHERAPY
Selection criteria:
Tumor confined to one hemisphere
No transcallosal or subependymal spread
Small size (<5 to 6 cm)
Well circumscribed on CT or MRI
Accessible location for the implant.
44. Procedure:
A balloon based system, GliaSite, placed into the cavity at the time of surgery
Balloon is filled with organically bound iodine-125 (125I)
Treatment is completed within 3 to 7 days
Direct infusion of radioimmunoglobulins has been used in primary and
recurrent brain gliomas
45. CHEMOTHERAPY AND
TARGETED AGENTS
CNS tumors are resistant to most chemotherapeutic agents as they are unable to
cross BBB.
Alkylating agents such as BCNU (carmustine) and CCNU (lomustine) cross the
BBB, but prolonged use causes myelotoxicity and pulmonary fibrosis
Procarbazine has similar efficacy but is better tolerated
Temozolomide (TMZ), has excellent bioavailability and is the only agent to
demonstrate a survival benefit for glioblastoma and anaplastic astrocytoma
46. Radiation therapy with immediate chemotherapy (PCV) prolongs survival in patients
with anaplastic oligodendroglioma and high-risk low-grade gliomas.
Implantation of slow-release chemotherapy wafers into a tumor resection cavity or
convection-enhanced drug (CED) delivery have been used to bypass BBB.
VEGF pathway inhibitor bevacizumab is the only targeted agent approved for GBM
Two large randomized trials of bevacizumab for the treatment of newly diagnosed GBM
improved PFS but failed to improve OS
47. Vaccines under development:
Rindopepimut (EGFRvIII-targeted peptide vaccine)
DC Vax (autologous tumor lysate-pulsed dendritic cell vaccine)
ICT-107 (dendritic cells prepared from autologous mononuclear cells that are
pulsed with six synthetic peptides)
HSPPC-96 (autologous tumor-derived heat shock protein [glycoprotein 96])
48. TOXICITY
General symptoms:
Fatigue
Headache
Drowsiness
Dermatitis
Alopecia
Nausea and vomiting (raised ICP, posterior fossa or brainstem irradiation)
Otitis externa (if ear in the field)
49. Acute Toxicity
Transient worsening of pretreatment deficits may develop during the course of
radiotherapy, and further acute toxicities may manifest up to 6 weeks following
completion of irradiation.
These symptoms are consequence of a transient peritumoral edema and usually
respond to a short-term increase of corticosteroids
50. Sub Acute Toxicity
Toxicity that develops during the 6-week to 6-month period following irradiation is
is attributed to changes in capillary permeability as well as transient demyelination
demyelination due to damage to oligodendroglial cells.
Symptoms include: headache, somnolence and fatigability
51. Late Toxicity
Late sequelae of radiotherapy appear from 6 months to many years following
treatment and are usually irreversible and progressive
They are thought to be due to white matter damage from vascular injury,
demyelination, and necrosis
The most serious late reaction to radiotherapy is radiation necrosis, which has a
peak incidence at 3 years
52. FOLLOW UP
Periodic MRIs are used to detect tumor recurrence/ treatment response
Assessment of cognitive functioning and quality of life
Monitoring of for neuroendocrine and ophthalmologic side effects
53. Type Location Clinical F Survival RT CT
A Supratent slow growing 5 yr MS Res At recc.
AA Supratent Rapid growing 2.5 yr MS Yes Yes
GBM Supratent Malignant 1 yr MS Yes Yes
OG Supratent Seizures 5 yr MS Yes Yes
MN convexity Women Long term Yes Rare
clival (Gr II& III, res Gr I)
LYMP Multifocal CSF/ ocular 3-5 Yr MS Yes Yes
periventricular Diss.
A=Astrocytoma (adult>child), AA=Anaplastic astrocytoma, GBM=Glioblastoma (elderly), OG=Oligodendroglioma (any
age), MN= Meningioma, Res= residual, Recc= recurrence
54. Type Location Clinical F Survival RT CT
BSG Pons Fatal 1 Yr MS Yes Seldom
PA Cerebellum Cure with TR 80% 10 yr Res Yes
hypothalamus
EPDM 4th ventricle Cure with TR 70% 5 yr Yes# Seldom
cauda equina can diss. in CSF
MDBM Cerebellum likely to 70% - 80% Yes Yes
diss. in CSF
GERM Pineal & Sensitive to CT 80% 5Yr Yes Yes
suprasellar & RT
BSG=brain stem glioma,PA=Pilocytic astrocytoma (child>adult), EPDM=Ependymoma (child, adult), MDBM=
medulloblastoma (child>adult), GERM = Germinoma, #= Gr II & III, Res
55. SUMMARY
Metastases from a systemic cancer are the most common brain tumors in
adults
Among primary brain tumors, meningiomas and gliomas together account for
more than two-thirds of all adult primary brain tumors
Pignatti scoring, RPA and GPA used for prognosis grading
MRI with contrast is the optimal study for evaluation of brain tumors
Histopathology is gold standard for final diagnosis until or unless eloquent
area
56. SUMMARY
Molecular markers important aspect of diagnosis
Glucocorticoids are used to decrease peritumoral edema and elevated ICP
Conformal radiotherapy better spares OAR as compared to conventional
techniques
Hippocampal avoidance may improve neurocognitive function
57. Your best quote that reflects your
approach… “It’s one small step for
man, one giant leap for mankind.”
- NEIL ARMSTRONG
Editor's Notes
Falx cerebri divides right and left cerebrum
Falx cerebelli divides cerebrum with cerebellum and brainstem
Surgical procedures can be summarized as biopsy for diagnosis only, resection
for cure, surgical debulking for management of mass effect-related symptoms,
CSF diversion procedures to relieve acute symptoms caused by increased
intracranial pressure or hydrocephalus, and increasingly re-resection to
distinguish and manage the effects of progressive tumor from symptomatic
necrosis or pseudoprogression.