Neuro-Oncology: Difference between revisions

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{{NoteBox|secondary}}<strong>Related pages</strong>
* [[Pediatric Neuro Oncology]]
* [[Extrinsic Brain Tumors]]
* [[Skull and Skull Base Tumors]]
* [[Genetic Syndromes of Brain Tumors]]
<hr>
* [[Colloid cysts]]
* [[Hemangioblastoma]]
* [[Schwannoma]]{{NoteBoxEnd}}
= Brain Tumor Frequency =
= Brain Tumor Frequency =
<ul>
<ul>
Line 18: Line 27:
* Unclassified (5.6%)
* Unclassified (5.6%)
* Lymphoma and hematopoietic (2.1%)
* Lymphoma and hematopoietic (2.1%)
* Germ cell tumors and cysts (0.4%)
* [[Germ cell tumors]] and cysts (0.4%)
|
|
*[[Meningioma]] (36%)
*[[Meningioma]] (36%)
*Pituitary tumors (15.5%)
*Pituitary tumors (15.5%)
*Glioblastoma multiforme (15.1%)
*[[Glioblastoma]] multiforme (15.1%)
*Nerve sheath tumors (8.1%)
*Nerve sheath tumors (8.1%)
* Diffuse astrocytoma (2.3%)
* [[Diffuse astrocytoma]] (2.3%)
*Primary CNS lymphoma (2%)
*Primary [[CNS lymphoma]] (2%)
*Ependymal (1.9%)
*Ependymal (1.9%)
*Anaplastic astrocytoma (1.7%)
*Anaplastic [[astrocytoma]] (1.7%)
*Pilocytic astrocytoma (1.4%)
*[[Pilocytic astrocytoma]] (1.4%)
*Neuronal and neuronal mixed (1.2%)
*Neuronal and neuronal mixed (1.2%)
*[[Oligodendroglioma]] (1.1%)
*[[Oligodendroglioma]] (1.1%)
*Oligoastrocytoma (0.9%)
*Oligoastrocytoma (0.9%)
*Craniopharyngioma (0.8%)
*[[Craniopharyngioma]] (0.8%)
*Anaplastic oligodendroglioma (0.5%)
*Anaplastic oligodendroglioma (0.5%)
|}


= Immunohistochemical staining patterns for nervous system tumor =
<table class="wikitable" width="100%">
        <tr>
            <th>Neoplasm</th>
            <th>GFAP</th>
            <th>CAM5.2</th>
            <th>EMA</th>
            <th>S-100</th>
            <th>CgA</th>
            <th>Syn</th>
        </tr>
        <tr>
            <td>[[Oligodendroglioma]]</td>
            <td>+</td>
            <td rowspan="2">–</td>
            <td>–</td>
            <td rowspan="4">+</td>
            <td rowspan="2">–</td>
            <td>0</td>
        </tr>
        <tr>
            <td>[[Ependymoma]]</td>
            <td>0</td>
            <td rowspan="2">0</td>
            <td>–</td>
        </tr>
        <tr>
            <td>Choroid plexus papilloma</td>
            <td rowspan="8">-</td>
            <td rowspan="5">+</td>
            <td>0</td>
            <td>+</td>
        </tr>
        <tr>
            <td>[[Chordoma]]</td>
            <td rowspan="4">+</td>
            <td rowspan="2">-</td>
            <td rowspan="2">-</td>
        </tr>
        <tr>
            <td>[[Craniopharyngioma]]</td>
            <td rowspan="2">–</td>
        </tr>
        <tr>
            <td>Carcinoma</td>
            <td>0</td>
            <td>0</td>
        </tr>
        <tr>
            <td>Pituitary adenoma</td>
            <td rowspan="3">0</td>
            <td rowspan="2">+</td>
            <td rowspan="2">+</td>
        </tr>
        <tr>
            <td>Paraganglioma</td>
            <td rowspan="2">0</td>
            <td>-</td>
        </tr>
        <tr>
            <td>[[Meningioma]]</td>
            <td>+</td>
            <td rowspan="3">–</td>
            <td rowspan="2">-</td>
        </tr>
        <tr>
            <td>Melanoma</td>
            <td rowspan="2">–</td>
            <td rowspan="2">-</td>
            <td>+</td>
        </tr>
        <tr>
            <td>[[Hemangioblastoma]]</td>
            <td>0</td>
            <td>0</td>
            <td>0</td>
        </tr>
</table>
= Performance Scales =
== Karnofsky Performance Scale ==
{| class="wikitable"
!Score
!Description
|-
|100
|Normal; no complaints, no signs of disease
|-
|90
|Capable of normal activity, minor symptoms or signs of disease
|-
|80
|Normal activity with some difficulty, some symptoms or signs
|-
|70
|Caring for self, not capable of normal activity or work
|-
|60
|Requiring some help, can take care of most personal requirements
|-
|50
|Requires help often, requires frequent medical care
|-
|40
|Disabled, requires special care and help
|-
|30
|Severely disabled, hospital admission required but no imminent risk of death
|-
|20
|Very ill, urgently requiring admission, requires supportive measures or treatment
|-
|10
|Moribund, rapidly progressive fatal disease processes
|-
|0
|Dead
|}
== Recursive partitioning analysis (RPA) ==
{| class="wikitable"
!RPA class
!Description
!Median survival (mos)
|-
|1
|
* KPS ≥70 and
* age < 65 yrs
* controlled or absent primary tumor w/ the brain the only site of metastasis
|7
|-
|2
|all others (i.e., not RPA class 1 or 3)
|4
|-
|3
|KPS <70
|2
|}
== ECOG Performance Scale ==
{| class="wikitable"
!Score
!Description
|-
|0
|Asymptomatic (fully active, able to carry on all predisease activities without restriction)
|-
|1
|Symptomatic but completely ambulatory (restricted in physically strenuous activity but ambulatory and able to carry out work of a light or sedentary nature)
|-
|2
|Symptomatic, <50% in bed during waking hours (ambulatory and capable of all self-care but unable to carry out any work activities)
|-
|3
|Symptomatic, >50% in bed during waking hours, but not bedbound (capable of limited self-care)
|-
|4
|Bedbound (completely disabled; cannot carry on any self-care; totally confined to bed or chair)
|-
|5
|Dead
|}
|}
<hr>
<ul>
    <li> [[Pediatric Neuro Oncology]] </li>
</ul>

Latest revision as of 22:35, 27 July 2025

Related pages

Brain Tumor Frequency

  • MC intracranial tumors: Brain Metastases (just over 50%).
  • Incidence of primary brain tumors: approximately 20-30 per 100,000 in adults and 5 per 100,000 in children.
  • About one third of primary brain tumors in adults are malignant, whereas they account for two thirds in childhood.
  • Frequency of WHO subgroups and specific tumors is given (information not provided in the text).
Commonest Primary Brain Tumors by WHO Group Commonest Primary Brain Tumors by Subtype
  • Meninges (37.6%)
  • Neuroepithelial tissue (29.9%)
  • Sellar region (16.3%)
  • Cranial and spinal nerves (8.1%)
  • Unclassified (5.6%)
  • Lymphoma and hematopoietic (2.1%)
  • Germ cell tumors and cysts (0.4%)

Immunohistochemical staining patterns for nervous system tumor

Neoplasm GFAP CAM5.2 EMA S-100 CgA Syn
Oligodendroglioma + – – + – 0
Ependymoma 0 0 –
Choroid plexus papilloma - + 0 +
Chordoma + - -
Craniopharyngioma –
Carcinoma 0 0
Pituitary adenoma 0 + +
Paraganglioma 0 -
Meningioma + – -
Melanoma – - +
Hemangioblastoma 0 0 0

Performance Scales

Karnofsky Performance Scale

Score Description
100 Normal; no complaints, no signs of disease
90 Capable of normal activity, minor symptoms or signs of disease
80 Normal activity with some difficulty, some symptoms or signs
70 Caring for self, not capable of normal activity or work
60 Requiring some help, can take care of most personal requirements
50 Requires help often, requires frequent medical care
40 Disabled, requires special care and help
30 Severely disabled, hospital admission required but no imminent risk of death
20 Very ill, urgently requiring admission, requires supportive measures or treatment
10 Moribund, rapidly progressive fatal disease processes
0 Dead

Recursive partitioning analysis (RPA)

RPA class Description Median survival (mos)
1
  • KPS ≥70 and
  • age < 65 yrs
  • controlled or absent primary tumor w/ the brain the only site of metastasis
 7
2 all others (i.e., not RPA class 1 or 3) 4
3 KPS <70 2

ECOG Performance Scale

Score Description
0 Asymptomatic (fully active, able to carry on all predisease activities without restriction)
1 Symptomatic but completely ambulatory (restricted in physically strenuous activity but ambulatory and able to carry out work of a light or sedentary nature)
2 Symptomatic, <50% in bed during waking hours (ambulatory and capable of all self-care but unable to carry out any work activities)
3 Symptomatic, >50% in bed during waking hours, but not bedbound (capable of limited self-care)
4 Bedbound (completely disabled; cannot carry on any self-care; totally confined to bed or chair)
5 Dead
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