central nervous system (CNS) neoplasm

Introduction

Primary central nervous system neoplasms, intra- and extra-axial.

Classification

• neuroepithelial tumors
  • glial tumors (45%)
    • astrocytic tumors
      • pilocytic astrocytoma.
      • diffuse astrocytoma (fibrillary, protoplasmic, gemistocytic).
      • anaplastic astrocytoma.
      • glioblastoma
        • giant cell glioblastoma
        • gliosarcoma
      • pleomorphic xanthoastrocytoma.
      • subependymal giant cell astrocytoma
    • oligodendroglial
      • oligodendroglioma
      • anaplastic oligodendroglioma
    • mixed gliomas
      • oligoastrocytoma
        • malignant oligoastrocytoma
    • ependymal tumors
      • ependymoma (cellular, papillary, clear cell, tanycytic)
      • anaplastic ependymoma
      • myxopapillary ependymoma
      • subependymoma
    • glial tumors of unceratin origin
      • astroblastoma
      • chordoid glioma of the third ventricle
      • gliomatosis cerebri
  • neuronal/mixed neuronal-glial tumors
    • gangliocytoma
    • ganglioglioma
    • desmoplastic infantile astrocytoma/ganglioglioma
    • dysembryoplastic neuroepithelial tumor
    • central neurocytoma
    • cerebellar liponeurocytoma
    • paraganglioma
  • embryonal tumors
    • ependymoblastoma
    • medulloblastoma
      • desmoplastic
      • large cell
      • nedullomyoblastoma
      • melanotic
    • medulloepithelioma
    • supratentorial primitive neuroectodermal tumor (PNET)
      • neuroblastoma
      • ganglioneuroblastoma
  • choroid plexus tumors
    • choroid plexus papilloma
    • choroid plexus carcinoma
  • pineal parenchymal tumors
    • pineocytoma
    • pineoblastoma
• meningeal tumors
  • meningioma (27%)
  • mesenchymal non-meningeal tumors
    • hemangiopericytoma
    • sarcomas
  • melanocytic lesions
• germ cell tumors
  • germinoma
  • embryonal carcinoma
  • yolk sac tumor (endodermal sinus tumor)
  • choriocarcinoma
  • teratoma
  • mixed germ cell tumors
• tumors of the sellar region
  • craniopharyngioma
    • adamantinomatous
    • papillary
  • pituitary adenoma (10%)
  • pituitary carcinoma
  • granular cell tumor
• primary lymphomas and hematopoietic neoplasms (4%)
  • lymphoma
  • plasmacytoma
  • granulocytic sarcoma
• peripheral nervous system tumors (some can also affect CNS)
  • schwannoma (7%)
  • neurofibroma
  • malignant peripheral nerve sheath tumor

See also: metastatic tumors

Laboratory

• see ARUP consult

Complications

• cerebral herniation fatal if unrecognized

Management

• anticonvulsant only in patients with seizures
  • may be used for 1 week postoperatively

More general terms

• nervous system neoplasm
• central nervous system (CNS) disease

More specific terms

• brain neoplasm (intracranial neoplasm)
• capillary hemangioblastoma
• CNS cyst
• CNS malignancy
• meningeal neoplasm
• primary intracranial germ cell neoplasm
• primary melanocytic CNS lesion
• secondary central nervous system (CNS) neoplasm
• spinal cord neoplasm