brain tumor
TRANSCRIPT
Brain tumors
A brain tumor or intracranial neoplasm occurs when abnormal cells form within the brain
What is tumor?
What is brain tumor?
Kinds of tumor?
There are two main types of tumors: malignant or cancerous tumors and benign tumors.[1]
Cancerous tumors can be divided into primary tumors that started within the brain and those that spread from somewhere else known as brain metastasis tumors
most dangerous?
Beningn or malignant
Both are dangerous incase of brain tumors
These tumors don not have premalignant or insitu stages Even low grade lesions may infiltrate large regions of the brain leading to a serious clinical deficits,non resectionability and poor prognosis
The anatomic site of the neoplasm can influence outcome on different organ(eg.., beningn meningioma may cause cardiorespiratory arrest from compression of the medulla)
Even the most highly malignant tumor rarely spread out of CNS. But the local infiltration spread to distant areas along th neurotaxis through? Sub arachanoid space
Unique feature;-
.
Diagnosis;-
CT computed tomography
Magnetic resonance imaging
Biopsy
Treatment
radiotherapy,
chemotherapy
surgery
People with brain tumors often suffer from:
HeadachesSeizuresSensory (touch) and motor (movement control) lossDeep venous thrombosis (DVT, or blood clot)Hearing lossVision lossFatigueDepressionBehavioral and cognitive (thinking) changesEndocrine dysfunction (hormone/gland changes)
causesAge
Medical radiation
Genetic conditions and family history ---- Neurofibromatosis type 1 and 2Tuberous sclerosisLi-Fraumeni syndromeVon Hippel-Lindau syndromeTurner syndromeTurcot syndromeGorlin syndrome
Other medical conditions and medicines
Body size and exercise
Other possible risk factors ----- Power linesMobile phonesHair dyeSmoking and alcohol
Tumors of the brain
Glioma Astrocytoma:- diffuse astrocytoma, pilocytic astrocytoma,
Oligodendroglioma
Ependymoma
Neuronal tumors central neurocytoma, ganglioglioma, dysembryoplastic neuroepithelial tumor
Embryonal (primitive) neoplasms
Other parenchymal tumors
Meningioma Metastatic tumors
medulloblastoma
Germ cell tumors
Glioma
Astrocytoma:- diffuse astrocytoma, pilocytic astrocytoma,
Oligodendroglioma
Ependymoma
Mostly in adults
80% of the adult gliomas are considered as diffuse astrocytoma
Especially in fourth to sixth decade
This kind of tumor mostly found in cerebral hemispheres
Symptoms :- seizures,headache, mood swings, neuralgia defect on the affected site
Genetic findings;
Loss of function by mutuations in the p53 and Rb tumor suppressor
Gain of function in the oncogene p13k pathways
These mutations also alter the enzymatic activity of IDH1 and IDH2
Diagnosis :- immunostaining in the biopsy specimen is the best procedure for conclusion
Diffuse astrocytoma
pilocytic astrocytoma
mostly vulnerable in children and in young adults
Region :- cerebellum and also in third ventricle (may be in optic pathway)
tumors in hypothalamus region are especially problematic why? because they cannot be resected completely
symptoms Lack of appropriate weight gain, headache, nausea, vomiting, irritability, torticollis (tilt neck or wry neck) difficulty to coordinate movements and visual complaints (including nystagmus).
Genetic findings :-Because of mutations in the serine threonine kinase
Oligodendroglioma
They are 5 to 15% of gliomas
Vulnerable in the age 30-50 yrs
Mostly in cerebral hemisphere especially in frontal and temporal lobes
Unlike astrocytoma they have better prognosis
Survival rate is 10 – 15 yrs
Genetic findings:- deletion of chromosome 1p and 19q
Tumors with this genetic deletion are highly responsible for chemo and radiotheraphy
• Round nuclei with fine chromatin • surrounded by halo of cytoplasm• Calcification
Ependymoma
5 to 10% of glioma
Age onset :- first 2 decades
Most vulnerable region :- 4th ventricle
In adults mainly in spinal cord especially in central canal
They mostly arise next to ependymalined ventricular system
Neuronal tumors
central neurocytoma,
ganglioglioma,
dysembryoplastic neuroepithelial tumor
central neurocytoma
With in and adjacent to ventricular system
Characterized by evenly spread , round, uniform nuclei, and often island of neuropil
Ganglioglioma
It is a mixture of glial cells and astrocytoma
They are slow growing tumors
Mostly in temporal lobe
Irregularly clustered with neurites
Dysembryoplastic neuroepithelial tumor These are Childhood tumor
Most appropriate region is in the supratentorial region
Grows slowly
Good prognosis after resection
They form multiple discrete intracortical nodules, floating neurons
Tumors of neuroectoderm origin have a primitive small round cell which look like progenitor cells
Which are responsible for the developing of CNS
The most common embryonal neoplasm is medulloblastoma
Embryonal neoplasm
medulloblastoma It is malignant
20% of pediatric brain tumor
Exclusively in cerebellum
Prognosis for untreated person is so horrible
These tumors have increased neutropin receptors or elevated intranuclear beta-catenin
The tumors are radiosensitive but the suggested treatment is chemotheraphy or surgical resection because it is best to avoid CNS radiotheraphy in children
5 year of survival is possible
Germ cell tumor Accur along the pineal and suprasellar regions
Tumors of young especially in first and second decades
90% of parenchymal tumors are germ cell tumors
The male has the most predominance
The most common germ cell tumor is germinoma
meningiomas
It is usually occur in adults
Arise from the arachanoid cells and often attaches to the dura.. They may also found in brain as well as in ventricular system?
They are easily seperable
When a person has multiple meningioma especially in association with glial tumor. Diagnosis of neurofibromais-2 is considered
Metastatic tumor
Most common primary sites are lung , breast,skin,kidney,and G.I tract
They form masses often at the grey - white matter junction and elicit edema
A 11 years old boy appearing to you with the symptoms of headache,vomiting,loss of apetite.by inspection he looks too thin and very calm,and his skin is so dry.for further investigation(palpation) you made him to lie and when you starts your procedure suddenly the boy goes aggressive and scolding you and not permitting you to do your procedures unexpectedly he got seizures so you concluded that this patient has confirmed neurologic problem.after treating with antiseizure medications he was sent for the radiological,cytological,immunological investigations.
The results arrived let us go and check
Radiological cytological
References
Michael J. Mastrange seminar of oncologyRobbins pathology www.cancerresearchuk.org
Thank you