Book contents
- Frontmatter
- Contents
- List of contributors
- Foreword by Professor Lord Ara Darzi KBE
- Preface
- Section 1 Perioperative care
- Section 2 Surgical emergencies
- Section 3 Surgical disease
- Hernias
- Dysphagia: gastro-oesophageal reflux disease (GORD)
- Dysphagia: oesophageal neoplasia
- Dysphagia: oesophageal dysmotility syndromes
- Gastric disease: peptic ulcer disease (PUD)
- Gastric disease: gastric neoplasia
- Hepatobiliary disease: jaundice
- Hepatobiliary disease: gallstones and biliary colic
- Hepatobiliary disease: pancreatic cancer
- Hepatobiliary disease: liver tumours
- The spleen
- Inflammatory bowel disease: Crohn's disease
- Inflammatory bowel disease: ulcerative colitis
- Inflammatory bowel disease: infective colitis
- Inflammatory bowel disease: non-infective colitis
- Colorectal disease: colorectal cancer
- Colorectal disease: colonic diverticular disease
- Perianal: haemorrhoids
- Perianal: anorectal abscesses and fistula in ano
- Perianal: pilonidal sinus and hidradenitis suppurativa
- Perianal: anal fissure
- Chronic limb ischaemia
- Abdominal aortic aneurysms
- Diabetic foot
- Carotid disease
- Raynaud's syndrome
- Varicose veins
- General aspects of breast disease
- Benign breast disease
- Breast cancer
- The thyroid gland
- Parathyroid
- Adrenal pathology
- Multiple endocrine neoplasia (MEN)
- Obstructive urological symptoms
- Testicular lumps and swellings
- Haematuria
- Brain tumours
- Hydrocephalus
- Spinal cord injury
- Superficial swellings and skin lesions
- Section 4 Surgical oncology
- Section 5 Practical procedures, investigations and operations
- Section 6 Radiology
- Section 7 Clinical examination
- Appendices
- Index
Brain tumours
Published online by Cambridge University Press: 06 July 2010
- Frontmatter
- Contents
- List of contributors
- Foreword by Professor Lord Ara Darzi KBE
- Preface
- Section 1 Perioperative care
- Section 2 Surgical emergencies
- Section 3 Surgical disease
- Hernias
- Dysphagia: gastro-oesophageal reflux disease (GORD)
- Dysphagia: oesophageal neoplasia
- Dysphagia: oesophageal dysmotility syndromes
- Gastric disease: peptic ulcer disease (PUD)
- Gastric disease: gastric neoplasia
- Hepatobiliary disease: jaundice
- Hepatobiliary disease: gallstones and biliary colic
- Hepatobiliary disease: pancreatic cancer
- Hepatobiliary disease: liver tumours
- The spleen
- Inflammatory bowel disease: Crohn's disease
- Inflammatory bowel disease: ulcerative colitis
- Inflammatory bowel disease: infective colitis
- Inflammatory bowel disease: non-infective colitis
- Colorectal disease: colorectal cancer
- Colorectal disease: colonic diverticular disease
- Perianal: haemorrhoids
- Perianal: anorectal abscesses and fistula in ano
- Perianal: pilonidal sinus and hidradenitis suppurativa
- Perianal: anal fissure
- Chronic limb ischaemia
- Abdominal aortic aneurysms
- Diabetic foot
- Carotid disease
- Raynaud's syndrome
- Varicose veins
- General aspects of breast disease
- Benign breast disease
- Breast cancer
- The thyroid gland
- Parathyroid
- Adrenal pathology
- Multiple endocrine neoplasia (MEN)
- Obstructive urological symptoms
- Testicular lumps and swellings
- Haematuria
- Brain tumours
- Hydrocephalus
- Spinal cord injury
- Superficial swellings and skin lesions
- Section 4 Surgical oncology
- Section 5 Practical procedures, investigations and operations
- Section 6 Radiology
- Section 7 Clinical examination
- Appendices
- Index
Summary
Introduction
2% of all cancer deaths are due to brain tumours and 20% of paediatric neoplasms are in the CNS. Overall they account for 10%of all malignancies. Although it is difficult to generalize about all brain tumours, there are some common themes.
Classification
May be according to cell origin (see table) or histological grading by the World Health Organization (WHO):
▪ Grade I: benign – growth is slow, cells are similar to normal cells and rarely spread into adjacent tissue; total excision can be curative.
▪ Grade II: growth is slow but local spread possible. The tumour may ‘transform’ into higher grade.
▪ Grade III: malignant – growth is quick, cells are pleomorphic with higher nuclear-to-cell ratio. Local spread likely.
▪ Grade IV: highly malignant – aggressive growth with high mitotic rate.
Incidence
15–20 per 100 000 (primary and metastatic); 35 000 new cases per annum (USA).
20–30% of patients with systemic cancer will have brain metastases. Gliomas 7 per 100 000; meningiomas 1.2 per 100 000. Meningiomas and pituitary adenomas slightly commoner in women. 3.6 per 100 000 children per annum have a primary brain tumour, the second commonest cause of paediatric cancer after leukaemia, and the most prevalent solid tumour in children.
Aetiology
Unknown in most cases. Developmental abnormality: teratoma, dermoid, epidermoid, craniopharyngioma, chordoma, hamartoma, angioma, ganglioneuromas. Hereditary: haemangioblastoma in von Hippel-Lindau disease; meningiomas and acoustic neuromas in neurofibromatosis; astrocytomas in tuberous sclerosis. Immunosuppression: lymphoma. Radiation: meningioma, sarcoma, glioblastoma.
Symptoms
Benign slow growing tumours may reach large size without causing significant symptoms.
- Type
- Chapter
- Information
- Hospital SurgeryFoundations in Surgical Practice, pp. 540 - 543Publisher: Cambridge University PressPrint publication year: 2009