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Brain tumors PowerPoint Presentation

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Description : Check out this medical presentation on astrocytoma in childhood, which is titled "Brain tumors", to know everything about brain tumors, including epidemiology, classification etc.

Tags : astrocytoma, childhood, Brain Tumor, 101, Neoplasm, Lesion, Space occupying mass

Published on : May 06, 2021 | Views : 1966 | Downloads : 3

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Slide 1-

Brain tumors
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Epidemiology Incidence: 8-25/ 100.000 2. reason of the death Metastasis – ¼ of all tumors
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Etiology Genetical predisposition Hereditary factors – m. Recklinghausen (also brain tumors), tuberous sclerosis...) Viral infections: Epstein-Barr virus - primary brain lymphoma Environmental factors: pesticides, chemicals, RAT
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Secondary brain tumors I - MTS Lung Breast Kidneys Malignant melanoma GIT Thyroid gland Gynecologic tumors Prostate
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Secondary tumors I Originate from malignant tumors located primarily in other organs Lung Skin - Malignant melanoma Kidney - hypernephroma Breast – breast carcinoma Colon – colon carcinoma These tumors cells reach the brain via the blood-stream
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Secondary tumors I Originate from malignant tumors located primarily in other organs Lung Skin - Malignant melanoma Kidney - hypernephroma Breast – breast carcinoma Colon – colon carcinoma These tumors cells reach the brain via the blood-stream
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Secondary brain tumors II - MTS 25% of all brain tumors MTS – not only tu brain tissue, also to meninges - meningeal carcinomatosis , malignant cell in CSF
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Tumors of childhood 20% of all tumors – tumors of childhood More frequently malignant than in adults The most frequent localisation - infratentorial (brainstem, cerebellum)
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Benign vs malignant? According histological structure biopsy - (cell atypia, mitotic actibity, abnormal mitosis) Localisation !!! Benign tumors in brainstem or deep structures – bad prognosis
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Brain tumors classification Neuroepitelial tumors 1. Astrocytoma Astrocytoma I, II benign III (anaplastic astrocytoma) - malignant IV (gliobastoma multiforme) 2. Oligodendroglial tumors Oligodendroglioma 3. Ependymal tumors Ependymoma
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Brain tumors classification 4. Mixed gliomas 5. Neuroepitelial tumors – unknown etiology 6. Chorioidal plexus tumors Papiloma, papilocarcinoma 7. Neuronal and mixed neuronalglial tumors 8. Pineal parenchymal tumors 9. Tumors with neuroblastic or glioblastic elements (embryonal tumors) Meduloblastoma
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Brain tumors classification Other CNS tumors 1. Tumors of sellar region 1. Pituitar adenoma 2. Pituitar karcinoma 3. Kraniofaryngeoma 2. Hemopoetic tumors 1. Primary malignant lymfoma 2. Plazmocytoma
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Brain tumors classification 3. Tumors from germinativ cells 4. Meningioma 5. Non-meningotelial meningeal tumors malignant melanoma malignant lymphoma
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Brain tumors classification 6. Tumors of cranial and spinal cord nerves Neurinoma (Schwannoma) Neurofibroma 7. Local tumors Chondrosarkoma Chondrocarcinoma 8. Metastatic tumors 9. Nonclassified tumors 10. Cysts
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Clinical feature I. General symptoms Intracranial hypertension syndrome Headache, vomiting, dizziness, blurred vision Papilledema (prominent optic disc at the fundoscopis examination) Dilatation of the pupile on the side of the lesion (anisocoria) New onset of epilepsy Focal, GM Altered state of consciousness Somnolence, coma Psychological changes (behavioral problems)
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Clinical feature II. Focal signs Depends on the localisation of tumor
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I. Neuroepitelial tumors Astrocytoma 4 grades of malignity I, II benign III (anaplastic astrocytoma) – malignant IV (gliobastoma multiforme) Adults Frontal and temporal lobe Rarely in childhood – pons
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Astrocytoma MRI T1 weighted T2 weighted flair
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Astrocytoma Astrocytoma – low grade – in pons Anaplastic astrocytoma
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Gliobastoma multiforme The most malignant tumor of CNS Rapid progression 5. a 6. decade , men 2x more often Deep part of hemispheres (bazal ganglia, talamus, white matter) Spreading by CSF, infiltration of corpus callosum, spreadin on the other side, infiltration of meninges) MTS also outside of CNS CT scan – cystic, necrosis, heamorrhages
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Glioblastoma multiforme MRI T1 weighted T2 weighted
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Glioblastoma multiforme Frequent mitosis Atypic cells Neovascularisation Bleeding
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Glioblastoma multiforme MRI T2 weighted SPECT
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Glioblastoma multiforme
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I. Neuroepitelial tumors Oligodendroglial tumors Adults Frequently with calcifications Frontal lobe 5% of CNS tumors Low % is histological malignant
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I. Neuroepitelial tumors Ependymal cells tumors 4% of CNS tumors Adults, children IV. Ventricle – obstructive hydrocefalus Spreading by CSF MTS in CNS
Slide 27-

Ependymoma
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I. Neuroepitelial tumors plexus choroideus tumors Papiloma or papilocarcinoma Rare Childhood Ventricles Hydrocefalus
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Plexus choroideus tumors MRI histology
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I. Neuroepitelial tumors Neuroectodermal tumors Childhood High grade of malignity MEDULOBLASTOMA 23% of CNS tumors in childhood Vermis, cerebellar hemispheres Rapid progression, compression of CSF athways, intracranial hypertension MTS in brain and outside of CNS – bones, lymphatic nodes
Slide 31-

Meduloblastoma
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4. Tumors of the meninges Meningioma 15% of brain tumors Localisation - hemisphers convexity, parasagital, n. olfactorius, sella turcica, pontocerebellar angle, tentorium Benign Bone usuration or hyperostosis
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Meningioma CT MRI T1 weighted
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Meningioma Parasagital Monoparesis of contralateral lower extremity or paraparesis Near bulbus olfactorius Unilateral anosmia Near optic nerve Exoftlamus, monocular blindnsess, ipsilateral mydriasis with absent FR
Slide 35-

Meningioma Meningioma near optic nerve on the right side
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Meningioma Near sphenoidal bone wings Epileptic seazures, lesion of cranial nerves – process near fissura orbitalis superior Pontocerebellar angle Loss of hearing, dizziness, Bells palsy
Slide 37-

Brain CT – PCA meningioma
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Brain CT - PCA meningioma
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PCA meningioma
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Meningioma Angiography
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Meningioma Histology
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Tumors of sellar region Adenoma, adenocarcinoma Chiasma opticum compression – bitemporal hemianopsy Endocrinne lesions Skull X-ray – enlargment of sella turcica
Slide 43-

Tumors of sellar region
Slide 44-

Secondary tumors CT MRI
Slide 45-

Diagnosis Slowly progressive focal neurological signs and signs of intracranial hypertension, epilepsy in a patient with negative history of epilepsy Optic fundus (oedema) Imaging CT MRI Skull X-ray Angiography EEG, Histological examination of brain tumor tissue samples obtained either by means of brain biopsy or open surgery – definitive diagnosis
Slide 46-

Therapy Surgery Classical Gamma knife Conservative Radiotherapy Chemotherapy Therapy of ICH and symptomatic therapy
Slide 47-

Gamma knife
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Leksell gamma knife Súčasti: radiačná jednotka s operačným lôžkom a kolimátorovými helmicami, stereotaktický koordinačný rám a Gamma Plan - computerizovaný systém pre plánovanie a optimalizáciu radiochirurgickej liečby.
Slide 49-

Pseudotumor cerebri Idiopatic intracranial hypertension Intracranial hypertension syndrome without tumor Papilledema (prominent optic disc at the fundoscopic examination) Women of middle age – more often After head injury Therapy – kortikosteroids, antidiuretics?
Slide 50-

Paraneoplastic syndromes Disease or symptom that is the consequence of the presence of cancer in the body, but is not due to the local presence of cancer cells These phenomena are mediated by humoral factors (by hormones or cytokines) excreted by tumor cells or by an immune response against the tumor Middle aged to older patients The most commonly - cancers of the lung, breast, ovaries or lymphatic system (a lymphoma), also stomach, ovaria, prostata
Slide 51-

Paraneoplastic syndromes Sometimes the symptoms of paraneoplastic syndromes are present even before the diagnosis of a malignancy 6,6% - 10% patients with tumors Antibodies against neuronal structures (anti Yo, anti Hu, anti Ri)
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Paraneoplastic syndromes All parts of nervous system Central NS Periferal NS Neuromuscular junction Muscles
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Paraneoplastic syndromes Small cell lung carcinoma Breast carcinoma Ovarial carcinoma Hodgkin lymphoma Tymoma Neuroblastoma Prostatic carcinoma
Slide 54-

Paraneoplastic syndromes Central nervous system Multifocal encephalomyelitis Cerebellar degeneration Limbic encephalitis Opsoclonus-myoclonus Extrapyramidal syndrome Brain-stem encephalitis Necrotizing myelopathy Motor neuron disease Stiff person syndrome Optic neuritis Retinal degeneration Peripheral nervous system Sensory neuronopathy Nerve vasculitis Sensorimotor polyneuropathy Motor neuropathy Neuromyotonia Autonomic insufficiency Lambert–Eaton syndrome Inflammatory myopathy Necrotizing myopathy