CNS Tumors

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Life is 10 of what happens to you, and 90 of
how you respond to it.
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CNS Tumors

• Dr. Venkatesh M. Shashidhar, MD
• Senior Lecturer in Pathology
• Fiji School of Medicine
• SUVA, Fiji Islands.

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Characteristics

• Limited space.
• Vital structures.
• Location determines clinical features than the
  tumor itself.

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Clinical features

• Local Compression Infiltration
• Nerve tract deficits, Paralysis, seizures etc.
• Raised Intracranial Pressure.
• Headache, vomiting, slow pulse, papilloedema.

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• Neurons being incapable of regeneration do not
  give rise to neoplasms.
• (Permanent cells)

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Classification

• Neuroectodermal neoplasms
• Mesodermal neoplasms
• Neoplasms of Developmental structures
• Neoplasms of Nerve sheath
• Secondary neoplasms (Metastasis)

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Mesodermal Neoplasms

• Meningiomas - From meninges.
• Gliomas - From neuroglia
• Astrocytes, Oligodendrocytes ependyma.
• Others
• Tumors of blood vessels
• Tumors of bone
• Tumors of Fibroblasts

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Meningioma

• Arise from meningothelial cells of arachnoid
  granulations.
• Adjacent to venous sinuses.
• Form whorls of cells Well differentiated.
• Psammoma bodies in the center of whorls
• capsulated, slow growing (Benign)
• Effect by pressure.
• No infiltration or metastasis (Benign).

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Meningioma
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Meningioma
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Meningioma
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Meningioma
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Meningioma
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Meningioma
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Meningioma
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Glioma

• Gliomas are neoplasms of glial cells.
• Astrocytoma Commonest benign tumors with
  malignant behavior.
• Ependymoma Rare, 4th ventricle.
• Oligodendroglioma Benign, adults, rare.

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Astrocytoma

• Astrocytoma Commonest tumors of adults. (80)
• Well differentiated, slow growing.
• Benign - but malignant behavior.
• Infiltrative, poor demarcation
• Glioblastoma Multiforme - Malignant form of
  Astrocytoma.

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Glioma Brain Stem
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Glioma Cerebrum
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Glioma
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Glioma
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Cystic Astrocytoma
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Glioblastoma Multiforme
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Glioma Cerebrum
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Glioma
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Glioma
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Astrocytoma
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Glioblastoma Multiforme
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Glioblastoma Multiforme
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Schwannoma Cerebellum
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Ependymoma Cerebellum
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Ependymoma-hemorrhage
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Ependymoma - Myxopapillary
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Ependymoma
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Neuroectodermal Tumors

• Origin from primitive blast cells.
• Rosettes - attempted nerve formation.
• Medulloblastoma Cerebellum
• Retinoblastoma - Retina
• Neuroblastoma Adrenal glands
• Ganglioneuroma - Mediastinum

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Medulloblastoma
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Medulloblastoma
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Nerve Sheath Tumors

• Neurofibroma
• Epi endoneurial fibroblasts.
• Form whorls of fibroblasts with nerves
• Well differentiated, benign, capsulated.
• Schwannoma
• Schwann cells, form whorls
• Nuclear palisading

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Neurilemmoma
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Schwannoma
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Schwannoma
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Schwannoma
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Spinal Ependymoma
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Schwannoma Cerebellum
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Brain Metastasis - (lung)
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MetastasisMelanoma
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Thank you...