Tumors associated with familial syndromes
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Von Hippel-Lindau |
Hemangioblastoma |
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Tüberoskleroz |
Subependymal giant cell tumor |
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NF-1 |
Optic glioma, astrocytoma, neurofibroma |
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NF-2 |
Acoustic neuroma, meningioma, ependymoma, astrocytoma |
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Li-Fraumeni |
Astrocytoma, PNET |
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Turcot |
Glioblastoma, medulloblastoma |
Radiosensitive tumors
Medulloblastoma, ependymoma, germ cell tumors.
Grade 1 tumors
Subependymal giant cell astrocytoma, pilocytic astrocytoma, subependymoma, choroid, plexus papilloma, schwannoma, neurofibroma, meningioma, craniopharyngeoma, hemongioblastoma
Grade 4 tumors
Glioblastoma, gliosarcoma, pineoblastoma, medulloblastoma, PNET, Teratoıd-rhabdoid tumor
Location
Brain tumors are located mostly infratentorial in children and supratentorial in adults. If tumors are detected in different areas, first of all, metastasis should be considered.
Cerebral lesions with calcification
Craniopharyngeoma, oligodendroglioma, meningioma, aneurysms, AVM, chordoma, tuberculosis, hydatid cyst
Astrocytomas
The most common type of primary brain tumors are astrocytomas.
- Pilocytic astrocytomas (grade 1)
Age of incidence is lower than other astrocytomas.
It is benign.
Rosenthal fibers and microcysts are present.
It is the brain tumor with the best prognosis.
It is the most common benign tumor of childhood.
- Low-grade astrocytomas (grade 1 -2)
It is well differentiated.
It is common at the age of 30-50 years.
They may show malignant transformation.
- Anaplastic astrocytoma (grade 3)
Less malignant than glioblastoma.
There is no necrosis.
Glioblastoma (grade 4)
It is common in 50-60 years of age.
There is necrosis, mitotic pleomorphism and neovascularization.
It is the most common primary brain tumor with the worst prognosis.
oligodendroglioma
0 The mean age of onset is 40.
0 It is more located in the frontal lobe.
0 Grows slowly and causes prolonged focal symptoms (focal seizure).
0 40% has calcification.
0 Classic histological findings such as fried egg and chicen wire vascular structures are present in the cytoplasm.
0 Most are grade 2, but grade 3 (anaplastic) ones are also available.
Ependymoma (Grade 2)
0 It is most commonly seen in the spinal cord in middle ages.
0 Occurs in the ventricles in young people.
0 fibers are structures, often with an epithelial appearance
0 Rosette and pseudoroset formation are seen.
0 It can spread to CSF by sowing.
Medulloblastoma (Grade 4)
0 Often arises from the cerebellar vermis.
0 It is the most common among childhood malignant brain tumors.
Propagation by sowing to CSF is frequent.
0 They are highly radiosensitive.
Meningioma (Grade 1)
0 They are benign tumors arising from arachnoid granulation and growing slowly.
0 They arise around the venous sinuses and are most commonly located parasagittal.
0 Sometimes they can be multiple (type 2 neurofibromatosis).
0 It causes hyperostosis in the bone just above it and there is swelling on the side of the bone.
0 Histologically, there are vortex-like structures and psammoma bodies.
0 Meningioma may contain progesterone receptor.
0 Pregnancy and hormone therapy can cause rapid growth.
metastases
0 50% of all central nervous system tumors are metastases.
0 The most common metastasis is lung cancer, followed by breast cancer metastasis.
0 They are frequently in the middle cerebral artery distribution.
0 The prostate does NOT metastasize to the brain, it metastasizes to the dura.
Choroid Plexus Papilloma
0 It always shows a normal choroid plexus structure and may cause hydrocephalus because it secretes CSF.
0 Most common in the lateral ventricle in children; In adults, it occurs in the 4th ventricle.
Primary Brain Lenfoma
0 Occurs in immunosuppressives and AIDS patients.
0 is of B cell origin. Grade is very high and resistant to treatment.
0 Epstein-Barr virus can be detected in 30-50% of patients. It is positive in almost all AIDS-related cases.
Craniopharyngioma
0 They are sellar-suprasellar localized tumors.
0 They originate from the Rathke pouch.
0 About half contain calcification and almost all cystic area.
Germ Cell Tumors
0 It is most commonly seen in the pineal and suprasellar regions.
hemangioblastoma
0 Causes polycythemia.
0 It is associated with Van-Hippel-Lindau syndrome.
0 It is the most common primary cerebellar tumor in adults.
Acoustic Schwannoma
0 Benign structure.
0 90% of corner tumors are acoustic schwannoma (most common) and meningioma.
0 Symptoms are due to compression in the neurovascular structures (CN 5-6-7-8-9-10-11) located in the corner.
0 It gives the earliest 8th cranial nerve findings. Then facial numbness (5th KS), then weakness in mimic muscles (7th KS) are seen.