DOCSLIB.ORG

Cystic-Appearing Intracranial Neoplastic Lesions

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Cystic-Appearing Intracranial Neoplastic Lesions Pictorial Essay Cystic-appearing Intracranial neoplastic lesions Pablo Sartori1, Nicolás Sgarbi2 1 Diagnóstico Mediter, Ciudad Autónoma de Buenos Aires, Argentina. 2 Clinical Radiology Department, Hospital de Clínicas de Montevideo, Montevideo, Uruguay. Abstract Cystic and cyst-appearing intracranial lesions are common findings of brain neoplastic tumors. This paper intends to re- viewed the origin of this lesion, radiologic appearance and differential diagnosis as guidance for the treating physician. This paper will review the cystic lesions of neoplastic etiology that most frequently occur in the brain. Keywords Brain, cysts, neoplasms, tomography, magnetic resonance imaging Introduction There is a more aggressive variant known as pilomyxoid as- trocytoma.6 A cystic lesion can be defined as an epithelium-lined cavity On computed tomography (CT), these tumors appear as iso- that contains fluid or semisolid material.1-3 to hypodense solid/cystic expansive masses; calcifications are Expansive lesions may be entirely cystic or have cavitary areas rare, and there is enhancement of the solid component after and are sub-classified into intra-or extra-axial lesions depend- intravenous (IV) contrast administration.4,6,7 ing on their location. On MRI, the cystic component appears isointense on T1- and The most common intracranial expansive cystic lesions are T2-weighted images compared with cerebrospinal fluid (CSF) detailed in Table 1. The purpose of this article is to illustrate the wide spectrum Table 1 of intracranial cystic lesions of neoplastic origin and describe their morphologic characteristics. Location Examples Pilocytic astrocytoma Intra-axial tumors4,5 Hemangioblastoma Central neurocytoma Differential diagnoses are mentioned in Table 2. Ependymoma 1) Pilocytic astrocytoma Medulloblastoma This is the most common glial tumor in children and young Intra-axial Ganglioglioma adults, usually located near the midline. Two-thirds of lesions occur in the cerebellum, in the optic chiasma, around the Pleomorphic xanthoastrocytoma third ventricle and in the hypothalamic-pituitary region. In Dysembryoplastic embryonal tumor adults, one-half of tumors are supratentorial.4,6,7 Cerebellar astrocytomas have been reported to be associated Glioblastoma multiforme with neurofibromatosis type I, Ollier’s disease and Turcot and Metastasis PHACE syndromes.4,6-8 Signs and symptoms depend on location. In the posterior Meningioma fossa tumors, there is a mass effect with signs of raised intra- Schwannoma cranial pressure.6 Extra-axial Pituitary macroadenoma These tumors appear as well-circumscribed solid/cystic mass- es of round or oval shape, with a solid mural nodule, occa- Craniopharyngioma 6,7 sionally with a necrotic center. Source: References 4, 5. Rev. Argent. Radiol. 2021;85:11-20 11 Cystic-appearing Intracranial neoplastic lesions signal intensity, and hyperintense on FLAIR images, and it is 2) Hemangioblastoma associated with a mural nodule that is usually isointense on This is a rare vascular tumor, generally associated with von T1-weighted sequences and hyperintense on T2-weighted / Hippel-Lindau disease, although these tumors may be seen FLAIR images, generally enhancing after the administration sporadically.4,8 Hemangioblastomas occur in young patients in of gadolinium (Fig. 1).4-7 the cerebellum or, less commonly, in the spinal cord.4,8 Both the cystic and solid components may enhance after On CT, these tumor appear as cystic/solid posterior fossa mass- gadolinium administration.6,7 es, with enhancement of the solid portion after IV contrast a b c d Fig. 1 Brain MRI. (A) Axial T1-weighted, (B) coronal T2-weighted, (C) axial FLAIR and (D) gadolinium-enhanced axial T1- weighted images. Seven-year-old male patient with headaches and dizziness. The images show an expansive, predominantly cystic lesion on the right cerebellar hemisphere (star) with an eccentric solid mural nodule (arrows). The lesion produces mass effect with midline shift to the left, surrounded by a mild vasogenic edema. The solid portion shows irregular enhancement after gadolinium administration. Considering patient’s age and clinical presentation, the lesion is consistent with pilocytic as- trocytoma (confirmed by biopsy). Table 2: Differential diagnoses of cystic-appearing intracranial neoplastic lesions. Tumors with cystic components Differential diagnoses Ependymoma and medulloblastoma (children in the posterior fossa) Metastases or hemangioblas- Pilocytic astrocytoma toma (adults) Hemangioblastoma Pilocytic astrocytoma Oligodendroglioma, Pilocytic astrocytoma, subependymal giant cell astrocytoma, ependymoma, Central neurocytoma meningiomas Pituitary adenoma, hypothalamic or optic pathway glioma, Rathke cleft cyst, epidermoid cyst, throm- Craniopharyngioma bosed aneurysms Supratentorial intraparenchymal: Pilocytic astrocytoma, Pleomorphic xanthoastrocytoma, primitive Ependymoma neuroectodermal tumor, ganglioglioma/gangliocytoma and oligodendroglioma Medulloblastoma Pilocytic astrocytoma, atypical teratoid/rhabdoid tumor and ependymoma Ganglioglioma Ependymoma Pleomorphic xanthoastrocytoma Meningioma, glioblastoma, DNET, oligodendroglioma, metastasis Dysembryoplastic neuroepithelial tumor (DNET) Gangliocytoma, Pilocytic xanthoastrocytoma Glioblastoma Metastasis, abscesses Metastasis Abscesses, glioblastoma, astrocytoma, Pleomorphic xanthoastrocytoma Meningiomas Schwannomas Schwannomas Meningiomas Pituitary macroadenoma / Craniopharyngioma Craniopharyngioma /pituitary macroadenoma 12 Rev. Argent. Radiol. 2021;85:11-20 Pablo Sartori et al. a b c d Fig. 2 Brain MRI. (A) Axial T1-weighted, (B) T2-weighted images, (C) Axial and (D) coronal T1-weighted images with gado- linium. Images show a cystic expansive lesion on the left cerebellar hemisphere (star), with internal septa and a peripheral mural nodule. The solid portion strongly enhances after gadolinium administration (arrows). The diagnosis of Hemangioblastoma was confirmed by pathology. a b c d Fig. 3 Brain MRI. (A) Axial T1-weighted image, (B) axial T2-weighted image (C) coronal T2-weighted image and (D) gadolinium- enhanced axial T1-weighted image. A solid expansive lesion originates near the foramen of Monro, containing multiple cysts (arrows) and causing midline shift and left supratentorial obstructive hydrocephalus, heterogeneously enhancing after gado- linium administration. Central neurocytoma was diagnosed by biopsy. administration.8 On MRI, these tumors appear as iso- to hy- Central neurocytomas present with symptoms of increased in- pointense lesions on T1-weighted sequences and hyperintense tracranial pressure secondary to obstructive hydrocephalus.9-11 on T2-weighted sequences, with a strongly enhancing solid These tumors appear as heterogeneous, well-demarcated, mural nodule (Fig. 2).8 lobulated lesions with a solid/cystic component, with an at- On T2-weighted sequences, signal voids occur because of the tachment to the septum pellucidum.4,9-11 high vascularity of these tumors.8 Calcifications are rare and Central neurocytomas appear heterogeneous on CT; on MRI, the presence of spontaneous hyperintensity on T1-weighted they have a “bubbly” appearance due to the presence of sequences is suggestive of recent bleeding.8 cysts. These tumors appear isointense on T1-weighted se- Digital angiography is a diagnostic tool that may be consid- quences, iso- to hyperintense on T2-weighted sequences, ered, given the high vascularity of these tumors. with associated calcifications in 50% of cases (Fig. 3).4,9,11 3) Central neurocytoma 4) Ependymoma This is a benign tumor, formerly known as “ependymoma of the These tumors may be either supratentorial (40%) or in- foramen of Monro” or “intraventricular oligodendroglioma”.9 fratentorial (60%) in location. The former may affect the Typically intraventricular, located in the lateral ventricles close brain parenchyma or ventricular cavities, being more com- to the foramen of Monro, although it may have other loca- mon in young patients. Those arising in the posterior fossa tions (gray nuclei, fourth ventricle, intramedullary location, occur in children.12,13 etc.), this tumor usually affects young adults and has a favor- Symptoms vary and depend on tumor location (supra/infraten- able prognosis.4,9-11 torial), with possible manifestations of increased intracranial Rev. Argent. Radiol. 2021;85:11-20 13 Cystic-appearing Intracranial neoplastic lesions pressure occurring most frequently with infratentorial tumors creased intracranial pressure secondary to obstructive hydro- due to their intraventricular location. Patients with supratento- cephalus being common.14 rial Ependymoma may experience headache, seizures or neu- These tumors are often associated with Turcot syndrome type rologic deficit.12,13 2, Gorlin-Goltz syndrome, Li Fraumeni syndrome, Rubinstein- These tumors appear as masses with cystic areas and chunky Taybi syndrome, Fanconi anemia and Nijmegen syndrome.14 calcification, and may occasionally bleed.12 Medulloblastomas are frequently located at the poste- Supratentorial ependymomas are larger in size (owing to rior fossa midline, involving the vermis, extending into the their typically intra-parenchymal location) and tend to con- fourth ventricle, with leptomeningeal dissemination; there- tain a cystic component, while infratentorial ependymomas fore a complete evaluation of the neuroaxis should be per- commonly have an intraventricular location and therefore are formed.14,15 smaller in size.13 In adults and older children, these tumors may be located
Load more

Recommended publications
  • Bartholin's Cyst, Also Called a Bartholin's Duct Cyst, Is a Small Growth Just Inside the Opening of a Woman’S Vagina
    Saint Mary’s Hospital Bartholin’s cyst Information For Patients 2 Welcome to the Gynaecology Services at Saint Mary’s Hospital This leaflet aims to give you some general information about Bartholin’s cysts and help to answer any questions you may have. It is intended only as a guide and there will be an opportunity for you to talk to your nurse and doctor about your care and treatment. What is a Bartholin;s cyst? A Bartholin's cyst, also called a Bartholin's duct cyst, is a small growth just inside the opening of a woman’s vagina. Cysts are small fluid-filled sacs that are usually harmless. Normal anatomy Bartholin gland cyst Bartholin’s glands The Bartholin’s glands are a pair of pea-sized glands that are found just behind and either side of the labia minora (the inner pair of lips surrounding the entrance to the vagina). The glands are not usually noticeable because they are rarely larger than 1cm (0.4 inches) across. 3 The Bartholin’s glands secrete fluid that acts as a lubricant during sexual intercourse. The fluid travels down tiny ducts (tubes) that are about 2cm (0.8 inches) long into the vagina. If the ducts become blocked, they will fill with fluid and expand. This then becomes a cyst. How common is a Bartholin’s cyst? According to estimates, around 2% (1 in 50) of women will experience a Bartholin’s cyst at some point. The condition usually affects sexually active women between the ages of 20 and 30. The Bartholin’s glands do not start functioning until puberty, so Bartholin’s cysts do not usually affect children.
    [Show full text]
  • Endothelial-Tumor Cell Interaction in Brain and CNS Malignancies
    International Journal of Molecular Sciences Review Endothelial-Tumor Cell Interaction in Brain and CNS Malignancies Maria Peleli 1,2,3,*, Aristidis Moustakas 1 and Andreas Papapetropoulos 2,3 1 Department of Medical Biochemistry and Microbiology, Science for Life Laboratory, Uppsala University, Box 582, SE-751 23 Uppsala, Sweden; [email protected] 2 Clinical, Experimental Surgery and Translational Research Center, Biomedical Research Foundation of the Academy of Athens, 115 27 Athens, Greece; [email protected] 3 Laboratory of Pharmacology, Faculty of Pharmacy, National and Kapodistrian University of Athens, 157 71 Athens, Greece * Correspondence: [email protected]; Tel.: +46-768-795-270 Received: 28 August 2020; Accepted: 3 October 2020; Published: 6 October 2020 Abstract: Glioblastoma and other brain or CNS malignancies (like neuroblastoma and medulloblastoma) are difficult to treat and are characterized by excessive vascularization that favors further tumor growth. Since the mean overall survival of these types of diseases is low, the finding of new therapeutic approaches is imperative. In this review, we discuss the importance of the interaction between the endothelium and the tumor cells in brain and CNS malignancies. The different mechanisms of formation of new vessels that supply the tumor with nutrients are discussed. We also describe how the tumor cells (TC) alter the endothelial cell (EC) physiology in a way that favors tumorigenesis. In particular, mechanisms of EC–TC interaction are described such as (a) communication using secreted growth factors (i.e., VEGF, TGF-β), (b) intercellular communication through gap junctions (i.e., Cx43), and (c) indirect interaction via intermediate cell types (pericytes, astrocytes, neurons, and immune cells).
    [Show full text]
  • Central Nervous System Tumors General ~1% of Tumors in Adults, but ~25% of Malignancies in Children (Only 2Nd to Leukemia)
    Last updated: 3/4/2021 Prepared by Kurt Schaberg Central Nervous System Tumors General ~1% of tumors in adults, but ~25% of malignancies in children (only 2nd to leukemia). Significant increase in incidence in primary brain tumors in elderly. Metastases to the brain far outnumber primary CNS tumors→ multiple cerebral tumors. One can develop a very good DDX by just location, age, and imaging. Differential Diagnosis by clinical information: Location Pediatric/Young Adult Older Adult Cerebral/ Ganglioglioma, DNET, PXA, Glioblastoma Multiforme (GBM) Supratentorial Ependymoma, AT/RT Infiltrating Astrocytoma (grades II-III), CNS Embryonal Neoplasms Oligodendroglioma, Metastases, Lymphoma, Infection Cerebellar/ PA, Medulloblastoma, Ependymoma, Metastases, Hemangioblastoma, Infratentorial/ Choroid plexus papilloma, AT/RT Choroid plexus papilloma, Subependymoma Fourth ventricle Brainstem PA, DMG Astrocytoma, Glioblastoma, DMG, Metastases Spinal cord Ependymoma, PA, DMG, MPE, Drop Ependymoma, Astrocytoma, DMG, MPE (filum), (intramedullary) metastases Paraganglioma (filum), Spinal cord Meningioma, Schwannoma, Schwannoma, Meningioma, (extramedullary) Metastases, Melanocytoma/melanoma Melanocytoma/melanoma, MPNST Spinal cord Bone tumor, Meningioma, Abscess, Herniated disk, Lymphoma, Abscess, (extradural) Vascular malformation, Metastases, Extra-axial/Dural/ Leukemia/lymphoma, Ewing Sarcoma, Meningioma, SFT, Metastases, Lymphoma, Leptomeningeal Rhabdomyosarcoma, Disseminated medulloblastoma, DLGNT, Sellar/infundibular Pituitary adenoma, Pituitary adenoma,
    [Show full text]
  • A Case of Intramedullary Spinal Cord Astrocytoma Associated with Neurofibromatosis Type 1
    KISEP J Korean Neurosurg Soc 36 : 69-71, 2004 Case Report A Case of Intramedullary Spinal Cord Astrocytoma Associated with Neurofibromatosis Type 1 Jae Taek Hong, M.D.,1 Sang Won Lee, M.D.,1 Byung Chul Son, M.D.,1 Moon Chan Kim, M.D.2 Department of Neurosurgery,1 St. Vincent Hospital, The Catholic University of Korea, Suwon, Korea Department of Neurosurgery,2 Kangnam St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea The authors report a symptomatic intramedullary spinal cord astrocytoma in the thoracolumbar area associated with neurofibromatosis type 1 (NF-1). A 38-year-old woman presented with paraparesis. Magnetic resonance imaging revealed an intramedullary lesion within the lower thoracic spinal cord and conus medullaris, which was removed surgically. Pathological investigation showed anaplastic astrocytoma. This case confirms that the diagnosis criteria set by the National Institute of Health Consensus Development Conference can be useful to differentiate ependymoma from astrocytoma when making a preoperative diagnosis of intramedullary spinal cord tumor in patients of NF-1. KEY WORDS : Astrocytoma·Intramedullary cord tumor·Neurofibromatosis. Introduction eurofibromatosis type 1 (NF-1), also known as von N Recklinghausen's disease, is one of the most common autosomal dominant inherited disorders with an incidence of 1 in 3,000 individuals and is characterized by a predisposition to tumors of the nervous system5,6,12,16). Central nervous system lesions associated with NF-1 include optic nerve glioma and low-grade gliomas of the hypothalamus, cerebellum and brain stem6,10). Since the introduction of magnetic resonance(MR) imaging, Fig. 1. Photograph of the patient's back shows multiple subcutaneous incidental lesions with uncertain pathological characteristic nodules (black arrow) and a cafe-au-lait spot (white arrow), which have been a frequent finding in the brain and spinal cord of are typical of NF-1.
    [Show full text]
  • Practical Applications of Molecular Testing in the Cytologic Diagnosis of Pancreatic Cysts
    Review Practical Applications of Molecular Testing in the Cytologic Diagnosis of Pancreatic Cysts Mingjuan Lisa Zhang * and Martha B. Pitman * Department of Pathology, Massachusetts General Hospital, Boston, MA 02114, USA * Correspondence: [email protected] (M.L.Z.); [email protected] (M.B.P.) Abstract: Mucinous pancreatic cysts are precursor lesions of ductal adenocarcinoma. Discoveries of the molecular alterations detectable in pancreatic cyst fluid (PCF) that help to define a mucinous cyst and its risk for malignancy have led to more routine molecular testing in the preoperative evaluation of these cysts. The differential diagnosis of pancreatic cysts is broad and ranges from non-neoplastic to premalignant to malignant cysts. Not all pancreatic cysts—including mucinous cysts—require surgical intervention, and it is the preoperative evaluation with imaging and PCF analysis that determines patient management. PCF analysis includes biochemical and molecular analysis, both of which are ancillary studies that add significant value to the final cytological diagnosis. While testing PCF for carcinoembryonic antigen (CEA) is a very specific test for a mucinous etiology, many mucinous cysts do not have an elevated CEA. In these cases, detection of a KRAS and/or GNAS mutation is highly specific for a mucinous etiology, with GNAS mutations supporting an intraductal papillary mucinous neoplasm. Late mutations in the progression to malignancy such as those found in TP53, p16/CDKN2A, and/or SMAD4 support a high-risk lesion. This review highlights PCF triage and analysis of pancreatic cysts for optimal cytological diagnosis. Keywords: pancreatic cytology; pancreatic cyst fluid; cyst fluid triage; molecular testing; mucinous cyst; intraductal papillary mucinous neoplasm; mucinous cystic neoplasm Citation: Zhang, M.L.; Pitman, M.B.
    [Show full text]
  • Risk-Adapted Therapy for Young Children with Embryonal Brain Tumors, High-Grade Glioma, Choroid Plexus Carcinoma Or Ependymoma (Sjyc07)
    SJCRH SJYC07 CTG# - NCT00602667 Initial version, dated: 7/25/2007, Resubmitted to CPSRMC 9/24/2007 and 10/6/2007 (IRB Approved: 11/09/2007) Activation Date: 11/27/2007 Amendment 1.0 dated January 23, 2008, submitted to CPSRMC: January 23, 2008, IRB Approval: March 10, 2008 Amendment 2.0 dated April 16, 2008, submitted to CPSRMC: April 16, 2008, (IRB Approval: May 13, 2008) Revision 2.1 dated April 29, 2009 (IRB Approved: April 30, 2009 ) Amendment 3.0 dated June 22, 2009, submitted to CPSRMC: June 22, 2009 (IRB Approved: July 14, 2009) Activated: August 11, 2009 Amendment 4.0 dated March 01, 2010 (IRB Approved: April 20, 2010) Activated: May 3, 2010 Amendment 5.0 dated July 19, 2010 (IRB Approved: Sept 17, 2010) Activated: September 24, 2010 Amendment 6.0 dated August 27, 2012 (IRB approved: September 24, 2012) Activated: October 18, 2012 Amendment 7.0 dated February 22, 2013 (IRB approved: March 13, 2013) Activated: April 4, 2013 Amendment 8.0 dated March 20, 2014. Resubmitted to IRB May 20, 2014 (IRB approved: May 22, 2014) Activated: May 30, 2014 Amendment 9.0 dated August 26, 2014. (IRB approved: October 14, 2014) Activated: November 4, 2014 Un-numbered revision dated March 22, 2018. (IRB approved: March 27, 2018) Un-numbered revision dated October 22, 2018 (IRB approved: 10-24-2018) RISK-ADAPTED THERAPY FOR YOUNG CHILDREN WITH EMBRYONAL BRAIN TUMORS, HIGH-GRADE GLIOMA, CHOROID PLEXUS CARCINOMA OR EPENDYMOMA (SJYC07) Principal Investigator Amar Gajjar, M.D. Division of Neuro-Oncology Department of Oncology Section Coordinators David Ellison, M.D., Ph.D.
    [Show full text]
  • Astrocytoma: a Hormone-Sensitive Tumor?
    International Journal of Molecular Sciences Review Astrocytoma: A Hormone-Sensitive Tumor? Alex Hirtz 1, Fabien Rech 1,2,Hélène Dubois-Pot-Schneider 1 and Hélène Dumond 1,* 1 Université de Lorraine, CNRS, CRAN, F-54000 Nancy, France; [email protected] (A.H.); [email protected] (F.R.); [email protected] (H.D.-P.-S.) 2 Université de Lorraine, CHRU-Nancy, Service de Neurochirurgie, F-54000 Nancy, France * Correspondence: [email protected]; Tel.: +33-372746115 Received: 29 October 2020; Accepted: 27 November 2020; Published: 30 November 2020 Abstract: Astrocytomas and, in particular, their most severe form, glioblastoma, are the most aggressive primary brain tumors and those with the poorest vital prognosis. Standard treatment only slightly improves patient survival. Therefore, new therapies are needed. Very few risk factors have been clearly identified but many epidemiological studies have reported a higher incidence in men than women with a sex ratio of 1:4. Based on these observations, it has been proposed that the neurosteroids and especially the estrogens found in higher concentrations in women’s brains could, in part, explain this difference. Estrogens can bind to nuclear or membrane receptors and potentially stimulate many different interconnected signaling pathways. The study of these receptors is even more complex since many isoforms are produced from each estrogen receptor encoding gene through alternative promoter usage or splicing, with each of them potentially having a specific role in the cell. The purpose of this review is to discuss recent data supporting the involvement of steroids during gliomagenesis and to focus on the potential neuroprotective role as well as the mechanisms of action of estrogens in gliomas.
    [Show full text]
  • The New WHO Classification of Brain Tumors and Molecular Profiling in the Diagnosis of Gliomas
    The New WHO Classification of Brain Tumors and Molecular Profiling in the Diagnosis of Gliomas Aivi Nguyen, MD Neuropathology Fellow Division of Neuropathology Center for Personalized Diagnosis (CPD) Glial neoplasms – infiltrating gliomas Astrocytic tumors • Diffuse astrocytoma II • Anaplastic astrocytoma III • Glioblastoma • Giant cell glioblastoma IV • Gliosarcoma Oligodendroglial tumors • Oligodendroglioma II • Anaplastic oligodendroglioma III Oligoastrocytic tumors • Oligoastrocytoma II • Anaplastic oligoastrocytoma III Courtesy of Dr. Maria Martinez-Lage 2 2016 3 The 2016 WHO classification of tumours of the central nervous system Louis et al., Acta Neuropathologica 2016 4 Talk Outline Genetic, epigenetic and metabolic changes in gliomas • Mechanisms/tumor biology • Incorporation into daily practice and WHO classification Penn’s Center for Personalized Diagnostics • Tests performed • Results and observations to date Summary 5 The 2016 WHO classification of tumours of the central nervous system Louis et al., Acta Neuropathologica 2016 6 Mechanism of concurrent 1p and 19q chromosome loss in oligodendroglioma lost FUBP1 CIC Whole-arm translocation Griffin et al., Journal of Neuropathology and Experimental Neurology 2006 7 Oligodendroglioma: 1p19q co-deletion Since the 1990s Diagnostic Prognostic Predictive Li et al., Int J Clin Exp Pathol 2014 8 Mutations of Selected Genes in Glioma Subtypes GBM Astrocytoma Oligodendroglioma Oligoastrocytoma Killela et al., PNAS 2013 9 Escaping Senescence Telomerase reverse transcriptase gene
    [Show full text]
  • Malignant CNS Solid Tumor Rules
    Malignant CNS and Peripheral Nerves Equivalent Terms and Definitions C470-C479, C700, C701, C709, C710-C719, C720-C725, C728, C729, C751-C753 (Excludes lymphoma and leukemia M9590 – M9992 and Kaposi sarcoma M9140) Introduction Note 1: This section includes the following primary sites: Peripheral nerves C470-C479; cerebral meninges C700; spinal meninges C701; meninges NOS C709; brain C710-C719; spinal cord C720; cauda equina C721; olfactory nerve C722; optic nerve C723; acoustic nerve C724; cranial nerve NOS C725; overlapping lesion of brain and central nervous system C728; nervous system NOS C729; pituitary gland C751; craniopharyngeal duct C752; pineal gland C753. Note 2: Non-malignant intracranial and CNS tumors have a separate set of rules. Note 3: 2007 MPH Rules and 2018 Solid Tumor Rules are used based on date of diagnosis. • Tumors diagnosed 01/01/2007 through 12/31/2017: Use 2007 MPH Rules • Tumors diagnosed 01/01/2018 and later: Use 2018 Solid Tumor Rules • The original tumor diagnosed before 1/1/2018 and a subsequent tumor diagnosed 1/1/2018 or later in the same primary site: Use the 2018 Solid Tumor Rules. Note 4: There must be a histologic, cytologic, radiographic, or clinical diagnosis of a malignant neoplasm /3. Note 5: Tumors from a number of primary sites metastasize to the brain. Do not use these rules for tumors described as metastases; report metastatic tumors using the rules for that primary site. Note 6: Pilocytic astrocytoma/juvenile pilocytic astrocytoma is reportable in North America as a malignant neoplasm 9421/3. • See the Non-malignant CNS Rules when the primary site is optic nerve and the diagnosis is either optic glioma or pilocytic astrocytoma.
    [Show full text]
  • Meningioma ACKNOWLEDGEMENTS
    AMERICAN BRAIN TUMOR ASSOCIATION Meningioma ACKNOWLEDGEMENTS ABOUT THE AMERICAN BRAIN TUMOR ASSOCIATION Meningioma Founded in 1973, the American Brain Tumor Association (ABTA) was the first national nonprofit advocacy organization dedicated solely to brain tumor research. For nearly 45 years, the ABTA has been providing comprehensive resources that support the complex needs of brain tumor patients and caregivers, as well as the critical funding of research in the pursuit of breakthroughs in brain tumor diagnosis, treatment and care. To learn more about the ABTA, visit www.abta.org. We gratefully acknowledge Santosh Kesari, MD, PhD, FANA, FAAN chair of department of translational neuro- oncology and neurotherapeutics, and Marlon Saria, MSN, RN, AOCNS®, FAAN clinical nurse specialist, John Wayne Cancer Institute at Providence Saint John’s Health Center, Santa Monica, CA; and Albert Lai, MD, PhD, assistant clinical professor, Adult Brain Tumors, UCLA Neuro-Oncology Program, for their review of this edition of this publication. This publication is not intended as a substitute for professional medical advice and does not provide advice on treatments or conditions for individual patients. All health and treatment decisions must be made in consultation with your physician(s), utilizing your specific medical information. Inclusion in this publication is not a recommendation of any product, treatment, physician or hospital. COPYRIGHT © 2017 ABTA REPRODUCTION WITHOUT PRIOR WRITTEN PERMISSION IS PROHIBITED AMERICAN BRAIN TUMOR ASSOCIATION Meningioma INTRODUCTION Although meningiomas are considered a type of primary brain tumor, they do not grow from brain tissue itself, but instead arise from the meninges, three thin layers of tissue covering the brain and spinal cord.
    [Show full text]
  • Impact of Adjuvant Radiotherapy in Patients with Central Neurocytoma: a Multicentric International Analysis
    cancers Article Impact of Adjuvant Radiotherapy in Patients with Central Neurocytoma: A Multicentric International Analysis Laith Samhouri 1,†, Mohamed A. M. Meheissen 2,3,† , Ahmad K. H. Ibrahimi 4, Abdelatif Al-Mousa 4, Momen Zeineddin 5, Yasser Elkerm 3,6, Zeyad M. A. Hassanein 2,3 , Abdelsalam Attia Ismail 2,3, Hazem Elmansy 3,6, Motasem M. Al-Hanaqta 7 , Omar A. AL-Azzam 8, Amr Abdelaziz Elsaid 2,3 , Christopher Kittel 1, Oliver Micke 9, Walter Stummer 10, Khaled Elsayad 1,*,‡ and Hans Theodor Eich 1,‡ 1 Department of Radiation Oncology, University Hospital Münster, Münster 48149, Germany; [email protected] (L.S.); [email protected] (C.K.); [email protected] (H.T.E.) 2 Alexandria Clinical Oncology Department, Alexandria University, Alexandria 21500, Egypt; [email protected] (M.A.M.M.); [email protected] (Z.M.A.H.); [email protected] (A.A.I.); [email protected] (A.A.E.) 3 Specialized Universal Network of Oncology (SUN), Alexandria 21500, Egypt; [email protected] (Y.E.); [email protected] (H.E.) 4 Department of Radiotherapy and Radiation Oncology, King Hussein Cancer Center, Amman 11942, Jordan; [email protected] (A.K.H.I.); [email protected] (A.A.-M.) 5 Department of Pediatrics, King Hussein Cancer Center, Amman 11942, Jordan; [email protected] 6 Cancer Management and Research Department, Medical Research Institute, Alexandria University, Alexandria 21500, Egypt 7 Military Oncology Center, Royal Medical Services, Amman 11942, Jordan; [email protected] 8 Princess Iman Research Center, King Hussein Medical Center, Royal Medical Services, Amman 11942, Jordan; Citation: Samhouri, L.; Meheissen, [email protected] 9 M.A.M.; Ibrahimi, A.K.H.; Al-Mousa, Department of Radiotherapy and Radiation Oncology, Franziskus Hospital Bielefeld, A.; Zeineddin, M.; Elkerm, Y.; 33699 Bielefeld, Germany; [email protected] 10 Department of Neurosurgery, University Hospital Münster, 48149 Münster, Germany; Hassanein, Z.M.A.; Ismail, A.A.; [email protected] Elmansy, H.; Al-Hanaqta, M.M.; et al.
    [Show full text]
  • Non-Cancerous Breast Conditions Fibrosis and Simple Cysts in The
    cancer.org | 1.800.227.2345 Non-cancerous Breast Conditions ● Fibrosis and Simple Cysts ● Ductal or Lobular Hyperplasia ● Lobular Carcinoma in Situ (LCIS) ● Adenosis ● Fibroadenomas ● Phyllodes Tumors ● Intraductal Papillomas ● Granular Cell Tumors ● Fat Necrosis and Oil Cysts ● Mastitis ● Duct Ectasia ● Other Non-cancerous Breast Conditions Fibrosis and Simple Cysts in the Breast Many breast lumps turn out to be caused by fibrosis and/or cysts, which are non- cancerous (benign) changes in breast tissue that many women get at some time in their lives. These changes are sometimes called fibrocystic changes, and used to be called fibrocystic disease. 1 ____________________________________________________________________________________American Cancer Society cancer.org | 1.800.227.2345 Fibrosis and cysts are most common in women of child-bearing age, but they can affect women of any age. They may be found in different parts of the breast and in both breasts at the same time. Fibrosis Fibrosis refers to a large amount of fibrous tissue, the same tissue that ligaments and scar tissue are made of. Areas of fibrosis feel rubbery, firm, or hard to the touch. Cysts Cysts are fluid-filled, round or oval sacs within the breasts. They are often felt as a round, movable lump, which might also be tender to the touch. They are most often found in women in their 40s, but they can occur in women of any age. Monthly hormone changes often cause cysts to get bigger and become painful and sometimes more noticeable just before the menstrual period. Cysts begin when fluid starts to build up inside the breast glands. Microcysts (tiny, microscopic cysts) are too small to feel and are found only when tissue is looked at under a microscope.
    [Show full text]