III. /7.: Central nervous system tumors
Sándor Ilniczky, Imre Fedorcsák, Tibor Kovács, István Nyáry, György Várallyay
The aim of this chapter is to provide an overview of central nervous system tumors.
Introduction
This learning unit first discusses general information about the regulation of intracranial pressure, causes of increased intracranial pressure, space-occupying effects, brain edema, brain herniations, and then provides specific details about the different types of central nervous system tumors.
In order to understand the information presented in this chapter, a review of knowledge acquired during earlier studies is recommended.
This includes mainly neuroanatomical knowledge, with special emphasis on intracranial compartments, the mechanism of CSF production and circulation, and the location of cortical and subcortical centers with different functions. Neuroimaging techniques should also (CT, MRI, SPECT, PET) be reviewed. Furthermore, the general histopathological characteristics of benign and malignant tumors should be read again.
Significance, epidemiology
Nervous system tumors account for only a few percent of all neoplasms, but they are clinically significant due to their special characteristics. The lifetime prevalence of primary malignant brain tumors is 0.54% and 0.66% (male-female respectively). The chance of death due to a malignant brain tumor is 0.41% and 0.5% (male-female respectively). These data show that the success rate of the treatment of nervous system malignancies - even with todays advanced technology- is well below that of other malignancies. In Hungary, between
2000-2005, approximately 2,000 patients per year were hospitalized due to malignant CNS tumors. This comprises 2% of all patients treated with malignant neoplasms. During this period, 700-750 patients per year underwent surgery at least once, and 40 to 45,000 hospital days care were reported in this disease group. Malignant neurological disorders are responsible for 350 hospital deaths annually.
Structure of the chapter
This chapter follows the following structure:
III./7.1. Classification of tumors of the nervous system III./7.2. Clinical characteristics and symptoms
III./7.3. Diagnosis
III./7.4. Pathological characteristics, most common types of tumors
III./7.5. Therapy
Learning time requirements: Each part of this chapter requires about 60 to 90 minutes. The practice test should be solved in 30 minutes.
Recommended references
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The following reference provides further knowledge on the epidemiology and underlying causes of brain tumors:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2861559/
Bondy ML. Brain Tumor Epidemiology: Consensus from the Brain Tumor Epidemiology Consortium (BTEC). Cancer. 2008 October 1;
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