Garima Gautam

Adult Primary Brain tumors

Glioblastoma Multiforme (Astrocytoma) Oligodendroglioma Meningioma Hemangioblastoma Schwannoma

Cell Origin Astrocytes(Grade IV) Oligodendrocytes Arachnoid cells Blood vessel Schwann cell ​S100

Location
Corpus Callosum Arachnoid Cerebellar Cerebellopontine angle
Affected

Malignancy Malignant Malignant; slow growing Benign

Butterfly
lesion ​-
infiltrative tumors that Compression of
form gelatinous, gray underlying brain;
Gross/ Radio masses & may show attaches to the
hemorrhagic and cysts, focal hemorrhage, underside of dura ​;involves
necrotic & ​calcification ​Common in frontal superior sagittal sinus
Mass in Right parietal lobe-​ring enhancing lobe; chicken wire capillary pattern
lesion cross corpus callosum

Biphasic -
Psammoma Closely dense,
Well differentiated- ​Fried
body(papillary type) arranged, thin hypercellular
Egg appearance
Spindle cells walled areas containing
Micro
concentrically arranged capillaries ​with spindle cells
Pseudopalisading​—​Necrosis,hemorrhage in a whorled pattern minimal alternating with
or microvascular proliferation surrounded intervening parenchyma hypocellular
by tumor cells myxoid areas

1. Can produce EPO →

polycythemia CN VII, VIII but also peripheral
Female; Parasagittal can compress the leg
Characteristic GFAP + ; >65 yrs Heterozygous loss for chr. 1&19 2. Assoc w/ VHL syndrome- nerve. Bilateral vestibular
similar to ACA stroke
AD - also retinal angiomas, schwannomas found in NF-2
RCC, pheochromocytoma

can localize to CN VIII in internal

Poor prognosis ~ 1 year survival - Sometimes seizures; ​resect acoustic meatus → vestibular
Course
infiltrates, unresectable, resistant to tx schwannoma; Resection or
stereotactic radiosurgery

Best Prognos Younger -+IDH-1,2 1p and 19q deletions RF is radiation to head in childhood cancer
 Garima Gautam

Childhood primary brain tumors

Pilocytic Astrocytoma Medulloblastoma Ependymoma Craniopharyngioma Pinealoma

Cell Origin Astrocytes Neuroectodermal origin Ependymal cells Rathke pouch(ectoderm)

Location
Posterior fossa -cerebellum + Hypothalamus Cerebellum 4th ventricle Pineal gland
Affected

Malignancy Benign (low grade) Malignant Malignant

CSF spread
well
circumscribed, Calcification
Well circumscribed
Gross- cystic+solid gray & friable
Gross/ Radio
- Tumor found in midline and can
expand to compress leptomeninges - destroys superior Tumor
midline cerebellum grows into ventricles,
distorting and compressing &
infiltrating

Rosenthal
fibers​—corkscrew Poorly differentiated Perivascular Cholesterol
eosinophilic bundle Homer-Wright Rosettes pseudorosettes crystals
(pseudorosettes) Rod shaped found in Similar to germ cell tumors
Micro
Small round blue cells, scanty blepharoplasts “motor oil- - seminoma of testes
cytoplasm with giant dark blue nucleus (basal ciliary bodies) found
near the nucleus

Can cause Parinaud

MC childhood tumor Bipolar cells w/
Characteristic
hair-like processes ​GFAP+
MC ​childhood supratentorial
PNET; ​Can compress 4th ventricle →
tumor ; can cause bitemporal
noncommunicating hydrocephalus ​→ headaches,
hemianopia(confused with
papilledema;
pituitary adenoma)
syndrome -​compression of
tectum → vertical gaze
palsy -​Pseudoargyll
Robertson pupil​;
obstructive hydrocephalus
(compression of cerebral
aqueduct) Precocious
puberty in males - B-HCG

Cerebellar signs- ataxia, slurred speech, intention

Course Resect tremor, nystagmus 3Ds Poor
can send “drop” metastases to spinal cord
Garima Gautam