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central_nervous_system_tumor

Central nervous system tumor

Classification

Epidemiology

Tumours of central nervous system constitute 1%-2% of tumours in adults. The incidence of brain tumours has been reported to be around 3.9 and 3.0/one lac/year in males and females respectively.

Glioma and meningioma are the two most common primary central nervous system tumors, representing 70% and 20% of brain tumors, respectively 1) 2).

A total of 16 116 institutional records of CNS tumors were analyzed. The frequency and distribution of CNS tumors were evaluated by tumor type, patient age and patient gender. The annual relationship between CNS tumors and surgical discharges (SD) over the last 20 years was estimated.

The frequencies of most CNS tumors were consistent with those found worldwide, and the most common tumors were neuroepithelial tumors (33%), particularly astrocytic tumors (67%); meningeal tumors (26%); and pituitary tumors (20%). The incidence of pituitary tumors in these data was twice as high as that reported in other regions of the world, and the relationship between CNS tumors and SD was consistent over time (0.22-0.39).

This study summarizes the largest sample of CNS tumor cases analyzed in Mexico and provides an important reference of the frequency of this tumor type in the country. This work will serve as a basis for conducting studies evaluating factors associated with the presence of CNS tumors and for identifying adequate public health interventions 3).

see Central Brain Tumor Registry of the United States.

Diagnosis

Differential diagnosis

Many diseases can present as tumefactive lesions and mimic neoplastic lesions.

Torres et al., aimed to determine the frequency of pseudotumoral CNS lesions referred to an Oncology center and the frequency of the tumor mimickers

In a retrospective study at the National Institute of Cancer, Rio de Janeiro, Brazil. Medical charts of patients admitted to the Neurosurgery and Pediatrics services from 2007 to 2011 were reviewed. Clinical and radiological features of cases initially diagnosed with primary CNS tumors but received a final diagnosis of pseudotumoral disease were recorded.

Among 891 patients referred as primary brain tumors, 38 cases had pseudotumoral lesions (4.3%). Most were adults (63%), with mean age of 29.4 years, and women (60.5%). Most frequent symptoms were headache (28.9%), motor signs (23.7%) and seizures (15.8%). Mean time from initial symptoms to diagnosis was 12.2 months. Lesions were single in 84.2% of patients, had contrast enhancement in 45.6% and surrounding edema in 17.4%. Twenty patients (52,6%) underwent biopsy. Systemic autoimmune diseases were the most frequent etiologies (28.9%), followed by idiopathic inflammatory demyelinating diseases, infections and vascular abnormalities (15.8% each). Good outcome with no major deficits was observed in 60.5% cases.

The frequency of pseudotumoral lesions in an oncology reference center was low. Young women were most affected, and lesions were associated more frequently to systemic autoimmune diseases. Prompt recognition is important to avoid unnecessary treatment since most patients had a good outcome 4).

Outcome

Central nervous system tumors account for the highest mortality among pediatric malignancies.

1)
Ohgaki H and Kleihues P (2005) Epidemiology and etiology of gliomas. Acta Neuropathol 109: 93–108.
2)
Longstreth WT Jr., Dennis LK, McGuire VM, Drangsholt MT and Koepsell TD (1993) Epidemiology of intracranial meningioma. Cancer 72: 639–648.
3)
Aguirre-Cruz L, Rangel-López E, Cruz-Aguilera DL, Rodríguez-Pérez CE, Ruano L, Velásquez-Pérez L, Martínez-Moreno M, Garduño-Espinosa J, Sotelo J. Historical distribution of central nervous system tumors in the Mexican National Institute of Neurology and Neurosurgery. Salud Publica Mex. 2016 Apr;58(2):171-178. PubMed PMID: 27557375.
4)
Torres YC, Alves-Leon SV, Lima MA. Frequency of pseudotumoral CNS lesions in an oncology center. World Neurosurg. 2019 Jun 19. pii: S1878-8750(19)31635-3. doi: 10.1016/j.wneu.2019.06.083. [Epub ahead of print] PubMed PMID: 31228702.
central_nervous_system_tumor.txt · Last modified: 2019/06/23 13:31 by administrador