The most common cause of CTs in adults are secondary tumour that arise from metastasis of other tumours (mainly melanoma, lung, renal and breast cancers) to the brain.
Statistics: Brain tumours are more prevalent in the developed world; affect Caucasians more than Africans and Asians; estimated global incidence of primary malignant brain tumours is 28 - 58 per million in males and 20 - 41 per million in females; brain tumours are more common in children than in adults and it is the 2nd most common cancer in children after leukemia.
The most common primary CNS tumour in adults is glioblastoma mutiforme (Grade 4 astrocytoma) followed by meningioma (pia, dura and arachnoid) and accoustic neuroma.
The most common CNS tumours in children are: pilocytic astrocytoma, medulloblastoma and ependymomas (in that order).
It is the most common CNS cancer in children.
It affects astrocytes, mainly in cerebellum)
It has solid part, cystic part and protruding nodules
Histological examination of tumour reveals Rosenthal fibres and pilocytic astrocytes.
It is the 2nd most common tumour in children
Generally it causes malignant tumours
Histological examination of tumour reveals solid tumour and sheets of small blue cells with scanty cytoplasm.
It is the 3rd most common tumour in children
It affects ependymal cells which are the cells that line the ventricles (where CSF is produced in choroid plexus) hence the common symptom of this tumour is hydrocephalus.
It arises mainly from the arachnoid layer of meninges
Histological examination of tumour reveals psammoma bodies (that are caused by dystrophic calcification). Other cancers that manifest with psammoma bodies are papillary cancer of thyroid, serous/adenocarcinoma of ovary and m
Astrocytes are star-shaped cells that are found in the brain and spinal cord.
Astrocytoma is classified into glioma, ependymal tumour and oligodendroglioma.
Glioma (or optic nerve glioma) affects optic nerves occasionally causing monocular blindness (blindness in one eye).
Oligodendroglioma (in CNS) is known as Swannoma when it occurs in the peripheral nervous system. It is characterized by whirling myelination.
##Glioblastoma mutiforme (GBM)
This highly malignant tumour is common in men between 40 to 70 yrs of age
It has a grave prognosis
It displays a butterfly-distribution pattern between the two lobes of the brain.
Necrosis and hemorrhage are the key evident features of the tumour.
Histological examination reveals characteristic pseudoparasiding necrosis (necrotic areas surrounded by tumour cells), new blood vessels and giant cells
Headaches (worse in the morning) due pressure of the tumor on the brain. Unfortunately, they are manifested in the late stage of the tumour.
Ataxia (tumor in the cerebellum)
Drowsiness (pressure of the tumor on the brain)
Altered menstrual periods (pituitary tumor)
Changes in personality or memory
Confusion with left and right sides of the body (tumor in the frontal or parietal lobe of the cerebrum)
Growth in hands and feet in adults (pituitary tumor)
Inability to look upward (caused by a pineal gland tumor).
Lactation (pituitary tumor)
Seizures/convulsions (pressure of the tumor on the brain or spinal cord)
Speech coordination challenges
Vision changes such as loss of part of the vision or double vision (tumor in the temporal lobe, occipital lobe, or brain stem).
Paresis (muscular weakness and partial paralysis) of arms and/or legs
MRI (is the diagnostic of choice)
Biopsy and histology
Acute Subdural Hematoma
To avoid exposure to carcinogenic agents
Adjuvant radiotherapy after surgery
Radiotherapy without surgery
Chemotherapy can be delivered through the following routes: intravenous, intra-arterial; interstitial (using Gliadel wafers soaked with antineoplatic agent); convection-enhanced delivery(where catheters are placed on the tumour or near the tumour for delivery of drug) and intrathecal.
MTOR inhibitors (everolimus, siroliumus and tacrolimus) are used for treatment of glioblastoma multiforme and astrocytoma.
Bevacizumab: treatment of glioblastoma that is resistant to the common chemotherapy and radiation
Carmustine: For treatment of glioblastoma, medulloblastoma, and astrocytoma
Temozolomide: For adults with anaplastic astrocytoma that is resistant to other treatments and as adjuvant therapy in treatment of glioblastoma multiforme.
Combination therapy of procarbazine, lomustine and vincristine (PCV regime) for treatment of oligodendrogliomas and mixed oligoastrocytomas.
Cisplatin or carboplatin for treatment of glioma, medulloblastoma, and other types of brain tumors.
Other useful drugs include: TKIs (erlotinib and imatinib); tamoxifen, paclitaxel, topotecan, and irinotecan.
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