# 42 Brain Tumors ![](https://f001.backblazeb2.com/file/wikiFiles/C0jkjHY.jpg) * in order of frequency * kids: most in posterior fossa near cerebellum ![](https://f001.backblazeb2.com/file/wikiFiles/xjoe5eE.jpg) ![](https://f001.backblazeb2.com/file/wikiFiles/RQZ0yBw.jpg) * one of most common symptoms: headache ![](https://f001.backblazeb2.com/file/wikiFiles/XkEUpm4.jpg) ## Adult ### Glioblastoma ![](https://f001.backblazeb2.com/file/wikiFiles/bP898xV.jpg) ![](https://f001.backblazeb2.com/file/wikiFiles/Yb9J1O1.jpg) * left: nuclei lining up (schwannoma, nuclei line up on their own) * pseudopallisading: nuclei lining up because being pushed by necrosis from middle * right: tumor invading cerebral cx., ![](https://i.imgur.com/a9EjGu8.jpg) ![](https://f001.backblazeb2.com/file/wikiFiles/ma01gdo.jpg) ### Meningioma ![](https://f001.backblazeb2.com/file/wikiFiles/IqjXccr.jpg) * not in brain tissue itself, can attach to dura with tail ![](https://f001.backblazeb2.com/file/wikiFiles/T3m19sK.jpg) * if large enough: seizures * tumor expresses estrogen receptors ![](https://f001.backblazeb2.com/file/wikiFiles/DnmC11U.jpg) ![](https://i.imgur.com/v975okt.jpg) * Ca deposits ![](https://i.imgur.com/VwRVO4h.jpg) ![](https://i.imgur.com/r0P309Z.jpg) * whorled appearance ### Schwannoma ![](https://f001.backblazeb2.com/file/wikiFiles/9C0odSa.jpg) * locate more peripherally * **S100 marker of schwann cells** ![](https://f001.backblazeb2.com/file/wikiFiles/yLZK2IE.jpg) ### Neurofibromatosis ![](https://f001.backblazeb2.com/file/wikiFiles/gz1dcGS.jpg) * association with schwannomma * diffused neurofibromas: upper right, diffused skin nodules all over body * lower right: cafe au lait, like coffee spilled on skin * lower left: lisch nodules, brown spots * neurofibromas: neural crest origin ![](https://f001.backblazeb2.com/file/wikiFiles/6peqbgP.jpg) * type 2: almost all get bilateral schwannomas (deaf) * MISME: multiple tumors ### Oligodendroglioma ![](https://f001.backblazeb2.com/file/wikiFiles/Og4Rqju.jpg) * calcified tumors present in frontal lobe, presenting with seizures * oligodendrocytes myelinate axons in white matter * fried egg appearance ![](https://f001.backblazeb2.com/file/wikiFiles/oCj0ztS.jpg) ### Pituitary Adnoma ![](https://f001.backblazeb2.com/file/wikiFiles/P7vY1dP.jpg) ![](https://f001.backblazeb2.com/file/wikiFiles/uXqRXgB.jpg) ### Cavernous Hemangioma ![](http://www.uworld.com/media/L27692.jpg) **Cavernous hemangiomas** are vascular malformations that frequently involve the deeper tissues of the body, such as the liver and brain. Gross examination of hemangiomas reveals a "mulberry-like" appearance due to their purple vascular clusters. Histologically, they are composed of abnormal, **dilated blood vessels** with a thin adventitia lacking elastic fibers and smooth muscle. The reduced structural support gives them a tendency to leak, causing **recurrent hemorrhage**. Most patients with cavernous hemangiomas are asymptomatic, although hemangiomas in the brain may cause **neurologic deficits** and **seizures** due to compression of the surrounding tissue and irritation from recurrent bleeding. Surgical resection is indicated for lesions causing intractable epilepsy or progressive neurologic deficits. ## Childhood Tumors ![](https://f001.backblazeb2.com/file/wikiFiles/vB8SFhE.jpg) * most common to least common ### Pilocytic astrocytoma ![](https://f001.backblazeb2.com/file/wikiFiles/eLjwxJO.jpg) * derived from astrocytes * cerebellar dysfunction: ataxia, loss of balance * top right: rosenthal fibers (long red lines), seen anytime gliosis (growth of glial cells) * GFAP: Glial fibrillary acidic protein, expressed in astrocytes ![](https://f001.backblazeb2.com/file/wikiFiles/MT1I7C3.jpg) * cystic lesion with nodule growing on its wall ![](https://f001.backblazeb2.com/file/wikiFiles/0yJPO2v.jpg) ### Medulloblastoma ![](https://f001.backblazeb2.com/file/wikiFiles/iRWNxcT.jpg) * second most common * can't stand/sit up without falling * neuroectoderm embryonic structures, thus more often in children * association with **Turcot** Syndrome * PNET: tumor suppressor gene ![](https://f001.backblazeb2.com/file/wikiFiles/Z2FDOUn.jpg) * hearing loss, neurocognitive impairment * noncommunicating hydrocephalus * can cause cauda equina syndrome ![](https://f001.backblazeb2.com/file/wikiFiles/FpVM0Me.jpg) * left: rosettes, circulation orientation of flowers ### Ependymoma ![](https://f001.backblazeb2.com/file/wikiFiles/4RSMsFG.jpg) ![](https://f001.backblazeb2.com/file/wikiFiles/VuR54oY.jpg) * curcles of cell surrounding blood vessel as central core ![](https://i.imgur.com/WuKuShH.jpg) ### Hemangioblastoma * EPO * VHL., ![](https://f001.backblazeb2.com/file/wikiFiles/8udcojy.jpg) ![](https://f001.backblazeb2.com/file/wikiFiles/x06jg8W.jpg) ### Craniopharyngioma ![](https://f001.backblazeb2.com/file/wikiFiles/MyptQ4k.jpg) * occur above sella tursica ![](https://f001.backblazeb2.com/file/wikiFiles/45Ekluo.jpg) * calcified and look like teeth because derived from mouth tissues ![](https://f001.backblazeb2.com/file/wikiFiles/YMOYEn4.jpg) * right: Ca inside ### Pineal tumor ![](https://f001.backblazeb2.com/file/wikiFiles/ighmTTU.jpg) ## Histology and markers * craniopharyngioma * meningioma * glioblastoma, pseudopallisading * oligodengroglioma, fried egg * rosenthal fibers, pilocytic astrocytoma * rosettes, medulloblastoma * pseudorossettes, ependymoma * Schwannoma * craniopharyngioma * meningioma --- # Agent Instructions: Querying This Documentation If you need additional information that is not directly available in this page, you can query the documentation dynamically by asking a question. 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