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Home > Medicine & Health Science textbooks > Clinical and internal medicine > Diseases and disorders > Oncology > Malignant Brain Tumours
Malignant Brain Tumours

Malignant Brain Tumours


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About the Book

This volume covers, in a logical sequence, the neurological data which underpins current management of malignant brain tumours. Cellular and molecular studies are considered, as well as current concepts of histopathological classification and grading. The clinical manifestations and natural history of these tumours are set in context by a discussion of the pathophysiology of intracranial mass lesions. Special attention is given to low-grade and childhood tumours. The more common cerebral gliomas and cerebral metastases are also examined. Diagnostic imaging methods are described and the differential diagnosis of benign and malignant tumours is explored. The final chapters are devoted to conventional and innovative methods, along with the results of treatment by surgery, radiation, chemotherapy and immunotherapy.

Table of Contents:
1 Cellular and Molecular Approaches to the Study of Gliomas and Glial Development.- Glial cell development in the rat optic nerve.- Control of self-renewal in the O-2A lineage.- Glial and neuronal development in the retina and cortex.- Ramifications of current development studies for neuropathology.- A serological analysis of gliomas.- Glioma-derived cells can be divided into two superfamilies on the basis of antigen expression.- Antigenic and morphological analyses of gliomas yield conflicting classification systems.- Potential for positive feedback loops as contributors to growth of gliomas.- Conclusion.- References.- 2 Molecular Genetics of Brain Tumours.- Genetic techniques in studies of brain tumours.- Molecular basis of tumorigenesis.- Molecular genetics of benign brain tumours.- Cytogenetic and molecular genetic studies of malignant brain tumours: gliomas.- Oncogenes and gliomas.- Molecular genetics of neuroblastomas.- Conclusion.- References.- 3 Current Concepts of the Histopathological Classification of Tumours of the Central Nervous System.- Tumours of neuroepithelial tissue.- Astrocytic tumours.- Astrocytomas: fibrillary; protoplasmic; gemistocytic (neuroimaging correlations).- Anaplastic astrocytoma.- Glioblastoma multiforme: giant cell glioblastoma; gliosarcoma.- Pilocytic astrocytoma.- Pleomorphic xanthoastrocytoma.- Subependymal giant cell astrocytoma.- Oligodendroglial tumours.- Oligodendroglioma.- Anaplastic oligodendroglioma.- Ependymal tumours.- Ependymoma.- Anaplastic ependymoma.- Myxopapillary ependymoma.- Subependymoma.- Mixed gliomas.- Mixed oligo-astrocytoma.- Malignant oligo-astrocytoma.- Choroid plexus tumours.- Choroid plexus papilloma.- Choroid plexus carcinoma.- Neuronal and mixed neuronal-glial tumours.- Gangliocytoma.- Dysplastic gangliocytoma of the cerebellum.- Desmoplastic infantile ganglioglioma.- Dysembryoplastic neuroepithelial tumour.- Ganglioglioma.- Malignant ganglioglioma.- Central neurocytoma.- Pineal parenchymal tumours.- Pineocytoma.- Pineoblastoma.- Mixed pineocytoma/pineoblastoma.- Embryonal tumours (neuroimaging correlations).- Medulloepithelioma.- Neuroblastoma.- Ependymoblastoma.- Retinoblastoma.- Medulloblastoma.- Tumours of the meninges.- Tumours of meningothelial cells.- Meningioma.- Atypical meningioma.- Anaplastic (malignant) meningioma.- Papillary meningioma.- Mesenchymal, non-meningothelial tumours.- Haemangiopericytoma.- Tumours of uncertain histogenesis.- Haemangioblastoma.- References.- Colour plate section appears between pages 42 and 43.- 4 General Introduction to the Clinical Features of Malignant Brain Tumours.- Epidemiology.- Clinical presentation of primary malignant brain tumours.- Symptoms and signs of raised intracranial pressure.- Epilepsy.- Focal signs.- Specific clinical syndromes.- Glioblastoma.- References.- 5 Complications of Primary Malignant Brain Tumours.- Complications of the tumour itself.- Raised intracranial pressure.- Clinical effects.- Brain compliance.- Tumour volume.- Brain oedema.- Hydrocephalus.- Pathology of intracranial expanding lesions.- Supratentorial expanding lesions: supracallosal hernia; tentorial hernia; central transtentorial hernia; haemorrhage and infarction in the midbrain and pons.- Infratentorial expanding lesions: tonsillar hernia.- Other features: pressure effects upon the skull; external herniation; pituitary.- Focal or site-specific complications.- Epilepsy.- Focal neurological deficit.- Spontaneous haemorrhage.- Metastasis of primary brain tumours.- Complications of treatment.- Surgery.- Risks and benefits.- Freehand biopsy.- Stereotaxic biopsy.- Internal decompression of tumour.- Radiotherapy.- Acute reactions.- Early delayed reactions.- Late delayed reactions: radionecrosis; diffuse leucoencephalopathy; intellectual deficits; hypothalamic-pituitary dysfunction; blindness; induction of brain tumours; alternative techniques of focused radiation.- Chemotherapy: systemic complications; CNS complications; acute cerebellar syndrome; acute encephalopathy; chronic encephalopathy; neuropathology of disseminated necrotizing leucoencephalopathy; osmotic blood-brain barrier opening; other complications of antineoplastic agents.- Steroids.- References.- 6 Low-grade Gliomas.- Low-grade cerebral astrocytoma.- Incidence.- Patient series.- Clinical presentation.- Special features.- Development of malignancy.- Infiltration of astrocytomas.- Neurosurgical management.- Expectant management.- Biopsy.- Stereotaxic biopsy.- Open biopsy.- Removal of tumour.- Stereotaxic resection of low-grade astrocytoma.- Non-stereotaxic resection of low-grade astrocytoma: rehearsal of surgical procedure; placement of craniotomy; ultrasound imaging; microsurgical dissection.- Evaluation of surgical results.- Future Considerations.- Acknowledgements.- References.- 7 Management of Brain Tumours in Childhood.- Introduction: the sites; the cells; the patients.- Primitive neuroectodermal tumour (PNET).- Surgery.- Radiation therapy.- Chemotherapy.- Brain stem glioma.- Craniopharyngioma.- Surgery.- Radiation therapy.- Chemotherapy.- Conclusion.- Ependymoma.- Surgery.- Radiation therapy and chemotherapy.- Pineal region tumours.- Radiation therapy and chemotherapy.- Conclusion.- References.- 8 Central Nervous System Neoplasms in Acquired Immunodeficiency Syndrome.- Primary CNS lymphoma.- Clinical manifestations.- Pathology.- Treatment and prognosis.- Systemic non-Hodgkin's lymphoma.- Clinical manifestations.- Pathology.- Treatment and prognosis.- Kaposi's sarcoma.- Pathogenesis of neoplasms in immune deficiency.- References.- 9 Metastatic Brain Tumours.- General aspects.- Primary tumours.- Sites of metastatic involvement.- Histological diagnosis.- Age and sex.- Signs and symptoms.- Neurological symptoms.- Time of onset.- Investigations.- Computed tomography scan.- Magnetic resonance imaging.- Angiography.- Electroencephalography.- Cytological examination of cerebrospinal fluid.- Tumour markers.- Treatment.- Surgery.- Indication.- Preoperative management.- Surgical technique.- Postoperative care.- Radiotherapy.- Chemotherapy.- Biological response modifiers.- Outcome of treatment.- References.- 10 Diagnostic Imaging of Brain Tumours.- Detection of an abnormality.- Computed tomography and magnetic resonance imaging.- Fluid.- Calcification.- Haemorrhage.- Oedema.- Contrast enhancement.- Mass effect of tumours.- Localization and assessment of extent of abnormality.- Supratentorial masses.- Cerebellar masses.- Brain stem tumours.- Characterization of a lesion.- Glial tumours.- Infarction.- Intracerebral haemorrhage.- Cerebral abscess.- Granuloma.- Opportunistic infection.- Progressive multifocal leucoencephalopathy.- Herpes simplex virus encephalitis.- Parasitic infections.- Hydatidosis.- Cysticercosis.- Paragonimiasis, schistosomiasis.- Extrinsic tumours.- Meningioma.- Epidermoid.- Cholesterol granuloma.- Dermoid.- Parasellar tumours (intrinsic and extrinsic).- Chordoma, chondroma, chondrosarcoma.- Neurinoma.- Paraganglioma.- Extrinsic malignancies.- Sphenoid mucocele.- Subdural and extradural empyema.- Meningeal infiltration.- Intracerebral metastasis.- Imaging characteristics of intrinsic tumours.- Anaplastic or malignant astrocytoma - grades III and IV.- Benign astrocytoma - grades I and II.- Subependymal giant cell astrocytoma.- Lhermitte-Duclos disease.- Ganglioglioma.- Hamartoma.- Ependymoma.- Oligodendroglioma.- Malignant lymphoma.- Primitive neuroectodermal tumour.- Classical medulloblastoma.- Adult medulloblastoma.- Congenital medulloblastoma.- Supratentorial neuroectodermal tumour.- Colloid cyst.- Choroid plexus papilloma.- Intraventricular meningioma.- Pineal region tumour.- Germinoma.- Pineal teratoma.- Pineocytoma.- Pineal astrocytoma.- Haemangioblastoma.- Multiple primary brain tumours.- Cavernous haemangioma.- Neuroblastoma.- Facilitation of treatment and further surgical planning.- Monitoring of therapy and outcome of treatment.- Surgery.- Radiotherapy.- References.- 11 Surgery for Primary Malignant Brain Tumours.- Historical introduction.- Principles of surgery.- Establishment of diagnosis.- Cytoreduction and alteration of tumour kinetics.- Relief of symptoms and improvement in survival.- Principles of perioperative care.- Surgical methods.- Methods of establishing tissue diagnosis.- Freehand biopsy.- Image-guided stereotaxic biopsy.- Ultrasound-guided biopsy.- Methods of tumour resection.- Principles of craniotomy: positioning and exposure; identification of tumour and resection.- Lobectomy as a method of resection: frontal; temporal; occipital.- Additional surgical methods.- Surgical treatment of gliomas within a specific site.- Recent advances in surgical methods.- Operating microscope.- Lasers.- Ultrasonic surgical aspirator.- Computer-interactive stereotaxic tumour excision.- Intraoperative ultrasonography.- Results of surgery.- The case for reoperation for gliomas.- Conclusion.- References.- 12 Radiotherapy for Malignant Brain Tumours.- Biological basis of radiotherapy.- Radiation tolerance of the central nervous system.- Spinal cord tolerance.- Brain tolerance.- Radiotherapy technique.- New radiotherapy techniques.- Radiotherapy in specific tumours.- High-grade astrocytomas.- New approaches.- Low-grade astrocytomas.- Oligodendroglioma.- Ependymoma.- Medulloblastoma.- Pineal tumours.- Primary cerebral lymphoma.- Radiotherapy in other tumours: optic nerve glioma; meningioma; craniopharyngioma.- Brain metastases.- Conclusion.- References.- 13 Chemotherapy of Malignant Brain Tumour.- Summary.- Curative concepts.- Evaluation of therapy.- Special features of chemotherapy of malignant brain tumours.- Space limitation.- Absence of lymph drainage.- Blood-brain barrier.- Neurotoxicity.- Topographical considerations and tumour vascularization.- Postoperative radiological appearances.- Specific treatment.- Symptomatic therapy.- Mode of application.- Systemic administration: intravenous; oral.- Local application: intra-arterial; intratumoral.- Modifications of the blood-brain barrier.- Administration into the cerebrospinal fluid.- Timing of chemotherapy.- Clinical classification of malignant CNS neoplasia.- Proliferation.- Chemotherapy of specific tumour types.- Malignant intrinsic brain tumours.- Anaplastic gliomas and glioblastomas: overview of results of intravenous therapy.- Malignant mesenchymal neoplasms (sarcomas).- Lymphomas and leukaemias.- Brain metastases.- Carcinomatous meningitis: management.- Conclusion.- Appendix I: Some abbreviations and acronyms.- References.- 14 Immunotherapy of Brain Tumours.- Brain tumour immunology: surface antigens on brain tumour; humoral immune response; cell-mediated immune response; modulation of the host immune response by gliomas.- Immunotherapy.- Monoclonal antibodies.- Biological response modifiers: interferons; interleukin-2; tumour necrosis factor; OK-432 and PS-K.- Adoptive cellular therapy.- Conclusion.- References.

Review :
"...an example of an excellent co-operation between neurosurgery and neuropathology...an excellent compendium of current thought and practice of brain tumours...The book may serve as a reference both for study, practice, research and teaching. It can be fully recommended" - Journal of Brain Research


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Product Details
  • ISBN-13: 9783540196891
  • Publisher: Springer-Verlag Berlin and Heidelberg GmbH & Co. KG
  • Publisher Imprint: Springer-Verlag Berlin and Heidelberg GmbH & Co. K
  • Height: 235 mm
  • Returnable: N
  • Width: 155 mm
  • ISBN-10: 3540196897
  • Publisher Date: 09 Dec 1994
  • Binding: Hardback
  • Language: English
  • Weight: 890 gr


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