Tumors of the Nervous

System
 General features
 All CNS tumors clinically behave like malignant
tumors
 They have the following features
– Poorly demarcated & difficult to resect without
producing neurological deficits
– Grow like intracranial space occupying lesions and
compress the vital centers
– They do not metastasize to extracranial sites
– They spread through CSF
– Secondary tumors are more common than the primary
tumors in the brain.
– Carcinomas arising from the breast, thyroid, stomach,
lung & melanomas commonly metastasize to the brain.
Classification of CNS
tumors
I) Neuroglial tissue

II) Primitive neuroectoderm

III) Neurons
IV) Meningeal tissue
 Classification of CNS
tumors
I) Neuroglial tissue

 Astrocytes Astrocytoma Commoner in the older

patients, in the cerebral
hemispheres
Highest grade
astrocytoma is called
glioblastoma
multiforme (more
common after the 50s)

 Oligodendrocytes Oligodendroglioma Commoner in the young

adult
 Ependymal cells Ependymoma
(line the ventricles
and the spinal
canal )
II) Primitive Undifferentiated
neuroectoderm Neuroblastoma

Medulloblastoma Usually in the posterior

fossa & is the
commonest tumor in
the children

Lymphocytes-
Lymphoma Rare tumors but are
commonly seen in
HIV patients

Leukemia Infiltration of the CSF

 III) Neurons Differentiated-
Ganglioneuroma

IV) Meningeal Meningioma Benign and can be

tissue resected easily
 V) Other tissues - tumors may arise within the cranial cavity or
spinal canal

1. Vascular tissue Hemangioblastoma

2. Schwann cells Schwanomma Arise from the peripheral

nerves & may be single
or multiple
Acoustic schwannoma is
associated with
Neurofibromatosis II &
causes deafness.

Neurofibroma Neurofibromatosis type I-

von Recklinghausen’s
disease– is an autosomal
dominant disorder
resulting in very
disfiguring
neurofibromas
V) Other tissues (contd)

3. Notochord remnants in the Chordomas

spine

4. Rathke’s pouch Craniopharyngioma

Pituitary fossa tumor

5. Pituitary gland

Pineal tumors
6. Pineal gland
Signs and Symptoms of
Brain Tumors
 The symptoms of both primary and metastatic
brain tumors depend mainly on the location in
the brain and the size of the tumor. Since each
area of the brain is responsible for specific
functions, the symptoms will vary a great deal.
 Site Symptom
Frontal lobe • Weakness and paralysis,
• mood disturbances,
• difficulty thinking,
• confusion and disorientation, and
• wide emotional mood swings

Parietal lobe • Seizures,

• numbness or paralysis,
• difficulty with handwriting,
• inability to perform simple mathematical problems,
• difficulty with certain movements, and
• loss of the sense of touch.

Occipital lobe • Loss of vision in half of each visual field,

• visual hallucinations, and
• seizures.
Temporal lobe •Seizures,
•perceptual and spatial disturbances, and
•inability to understand simple of multi-step commands,
known as receptive aphasia.

Cerebellum •Difficulty in maintaining their balance, known as ataxia,

loss of coordination,
•headaches, and
•vomiting.

Hypothalamus •Emotional changes,

•changes in the perception of hot and cold.
•In addition, hypothalamic tumors may affect growth and
nutrition in children.
 With the exception of the cerebellum, a tumor on one side of the
brain causes symptoms and impairment on the opposite side of
the body.
– For example, a tumor on the left side of the brain may cause numbness
in the right arm.

 As a brain tumor grows, it invades the healthy tissue in the brain,

often causing further deterioration.
– Because of the limited space within the skull, the tumor may place
pressure on the brain.

 There may also be a buildup of edema fluid around the tumor and
obstruction to the flow of CSF resulting in hydrocephalus
(accumulation of excess CSF in the cranium).
 Both of these (tumor and hydrocephalus) may cause frequent
headaches that are often unrelieved by over-the-counter
medications. Headaches are the most common presenting