II./4. chapter: Clinical aspects of the primary brain tumours

Imre Szirmai

II./4.1.: Introduction

In the following chapter we will briefly discuss the most prevalent and diagnostically and therapeutically most important primary brain tumours.

Classification of tumours of the central nervous system is based on the cell type. Tumours are divided into four groups based on the WHO’s classification system. Grade 1 refers to benign, grade 4 to the most malignant version. Recent cytogenetic research has revealed several suppressor genes and oncogenes playing an important role in the pathogenesis of brain tumours. Based on those, two genetic pathways are being differentiated in the development of glioblastoma multiforme (GBM).

1. ábra

Abbreviations: EGFR (epidermal growth factor receptor), PDGFR (platelet derived growth factor receptor), MDM2 (murine double minute 2), RB (retinoblastoma), PTEN (phosphatase/tensin suppressor genen), LGG (low grade glioma), AA (anaplastic astrocytoma), LOH (loss of heterozygosity)

The chapter structure

• II./4.1.: Introduction

• II./4.2.: Epidemiology

• II./4.3.: Symptoms

• II./4.4.: Diagnostic methods besides imaging

• II./4.5.: Neuroepithelial tumours

  • II./4.5.1.: Pilocytic astrocytoma (WHO: grade I)

  • II./4.5.2.: Low grade gliomas (LGG, WHO: grade II)

  • II./4.5.3.: Malignant glioma (WHO: grade III)

  • II./4.5.4.: Glioblastoma multiforme (WHO: grade IV)

  • II./4.5.5.: Ependymoma

  • II./4.5.6.: Medulloblastoma (WHO: grade IV)

• II./4.6.: Primary central nervous system lymphoma (PCNSL)

• II./4.7.: Treatment

  • II./4.7.1.: Pilocytic astrocytoma (WHO: grade I.)

  • II./4.7.2.: Low grade glioma

  • II./4.7.3.: Malignanat gliomas

  • II./4.7.4.: Glioblastoma multiforme

  • II./4.7.5.: Ependymoma and medulloblastoma

  • II./4.7.6.: Primary central nervous system lymphoma (PCNSL)

References

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Deckert M, Engert A, Brück W, Ferreri AJ, Finke J et al: Modern concepts in the biology, diagnosis, differential diagnosis and treatment of primary central nervous system lymphoma. Leukemia (12):1797-807, 2011

Hegi ME, Diserens AC, Gorlia T, Hamou MF, Tribolet N et al.:MGMT gene silencing and benefit from temozolomide in glioblastoma. N Eng J Med 352:997-1003, 2005.

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Stupp R, Mason WP, Bent MJ, Weller M, Fisher B et al.: Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Eng J Med, 352:987-996, 2005.