This chapter discusses the incidence, pathology and classification, clinical features, and management of tumors of the central nervous system (CNS). Approximately 80, 000 adult and 3600 childhood primary CNS tumors are estimated to be diagnosed in 2018. Most tumors of the CNS present symptomatically by mass effect on nearby normal brain tissue. In these cases, symptoms correspond to the neuro-anatomic location of the tumor. Certain hormone secreting tumors, such as those derived from the pituitary, may present more constitutionally due to hormonal changes. The new 2016 World Health Organization (WHO) Classification of CNS tumors represented a major change in the classification of brain tumors. Generally, tumors are classified as tumors of glial or non-glial origin. Novel molecular markers are now being used to distinguish glial tumors that otherwise are not distinguishable by pathology alone (such as in 1p19q in oligodendroglioma). Other markers, such as isocitrate dehydrogenase (IDH) mutations in glioblastoma, can also provide prognostic significance. The management of tumors of the CNS depends upon its histology. Tissue biopsy is generally required to make management decisions. Some malignant tumors such as glioblastoma require maximal resection followed by adjuvant chemoradiation. In contrast, non glial-tumors such as seminoma, germinoma and lymphoma respond well to non-surgical therapy. Novel therapies at the molecular level are now being developed and utilized to further improve patient outcomes.
|Title of host publication||Abeloff’s Clinical Oncology|
|State||Published - Jan 1 2019|
- 2016 WHO classification
- Brain tumor
- CNS tumor
- Central nervous system tumor