General Central Nervous System

Steven H. Lin and Anita Mahajan

 Background

What is the estimated annual incidence of primary CNS tumors in the U.S.?

~50,000–55,000 cases/yr of CNS tumors (per the National Program of Cancer Registries database)

What is the most common intracranial tumor?

Brain mets (20%–40% of all cancer pts develop brain mets)

What is the most common type of primary CNS tumor?

Glioma ( ~40%) > meningioma (15%–20%)

What % of adult astrocytomas are low grade vs. high grade?

25% low grade vs. 75% high grade

What is the most common histologic type of malignant CNS tumor in children? In adults?

1. 
   

   Children: juvenile pilocytic astrocytoma (JPA) (20% <14 yo vs. 12% >14 yo)

   
   
2. 
   

   Adults: glioblastoma

What is the strongest risk factor for developing CNS tumors?

Ionizing RT in children (no threshold–glioma, meningioma, nerve sheath)

What CNS tumors are linked to the following?

1. 
   

   Optic glioma, JPA

   
   
2. 
   

   Bilat acoustic neuroma, spinal ependymoma

   
   
3. 
   

   Subependymal giant cell astrocytoma, retinal hamartoma

   
   
4. 
   

   Hemangioblastoma

   
   
5. 
   

   Glioma

   
   
6. 
   

   Meningioma

   
   
7. 
   

   Medulloblastoma

   
   
8. 
   

   Medulloblastoma, glioblastoma

   
   
9. 
   

   Pineoblastoma

   
   
10. 
    

    CNS lymphoma

    
    
11. 
    

    Pituitary adenoma

What are the 4 factors used for grading in the WHO brain tumor grading system?

1. 
   

   Nuclear Atypia

   
   
2. 
   

   Cellularity and Mitosis

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