Brain tumors (ICD-10-GM C71.-: Malignant neoplasm of the brain) are tumors of the neuroectodermal tissue of the central nervous system. The following brain tumors (intracranial space-occupying processes) can be distinguished:
- Neuroepithelial tumors (gliomas) – circa 50% of cases.
- Astrocytomas – neoplasm originating from astrocytes; 25% of primary brain tumors, in children 50%.
- Ependymomas – are composed mainly of neoplastic ependymal cells (belong to the group of glial cells).
- Ganglioblastomas – neoplasm originating from the neuroepithelial cell; about 50% of all brain tumors in adults.
- Gangliocytomas – neoplasm originating from ganglion cells and Schwann cells (gliocytus periphericus, also Schwann’s cell or lemnocyte).
- Glioblastoma (astrocytoma grade III-IV) – 15% of all primary tumors.
- Oligodendrogliomas – neoplasm originating from oligodendrocytes; 10% of primary brain tumors.
- Medulloblastomas – neoplasm originating from neuroectodermal or neuroepithelial cells; 5% of primary brain tumors (20% in children).
- Neurinomas (synonyms: schwannoma, benign peripheral nerve sheath tumor BPNST) – benign (benign) and usually slow-growing tumor of the peripheral nervous system arising from Schwann cells.
- Plexus tumors – neoplasm originating from venous plexuses.
- Pinealomas – originating from the pineal gland.
- Spongioblastomas (pilocytic astrocytoma).
- Mesodermal tumors – circa 20% of cases.
- Angioblastomas (included in the subgroup of “tumors of uncertain histognesis”).
- Meningiomas – the most common neoplasm.
- Sarcomas – neoplasm originating from mesenchymal tissue.
- Ectodermal tumors – circa 10% of cases.
- Pituitary adenomas – are benign tumors arising from the parenchymatous cells of the anterior lobe of the pituitary gland (adenohypophysis; anterior lobe of the pituitary gland); 10-15% of all brain tumors.
- Craniopharyngeoma (Erdheim tumor, craniopharyngioma, craniopharyngeoma; Engl : craniopharyngioma) – neoplasm originating from the squamous epithelium; occur mainly in children / adolescents and between the 50th and 75th year of life.
- Germ cell tumors – circa 2-3% of cases.
- Dermoid – rare, benign, slow-growing neoplasm that may involve various tissues.
- Epidermoids – embryonically derived tumors of the CNS; they are among the most important tumors in space-occupying lesions in the cerebellopontine angle.
- Germinomas – germ cell tumor of the central nervous system (CNS).
- Hamartomas – tumor arising from tissue maldevelopment.
- Teratomas – congenital, often organ-like mixed tumor that develops from primitive pluripotent stem cells.
- Brain metastases (metastatic/daughter tumors, symptomatic) – up to 20% of cases; occur in approx. 15-30% of all patients with systemic tumor disease: especially in bronchial carcinoma (lung cancer), mammary carcinoma (breast cancer), renal cell carcinoma, malignant (malignant) melanoma (black skin cancer), lymphoma, prostate carcinoma (prostate cancer), gastrointestinal neoplasms, thyroid carcinoma.
Sex ratio: in primary brain tumors, the sex ratio male to female is estimated at 6: 4.Men are affected by astrocytoma, glioblastoma, medulloblastoma, neurinoma more often than women. In pinealoma, males are significantly more commonly affected than females at 12: 1. In the other brain tumors the gender distribution is balanced. Frequency peak: The maximum incidence of brain tumors is between the 40th and 60th (70th) year of life. Another peak of incidence is in childhood (brain tumors are the second most common malignant neoplasms in children). Oligodendroglioma frequently occurs in children between the ages of 3 and 10. Pinealoma occurs primarily between the ages of 10 and 30 years. Ependymomas commonly occur in children between the ages of 8 and 15. The incidence (frequency of new cases) is about 10 cases per 100,000 inhabitants per year. In Germany, there are approximately 3,000-5,000 new cases of glioblastoma per year. The incidence of neurinoma is about 1 disease per 100,000 inhabitants per year. The incidence of craniopharyngeoma is 0.5-2 cases per 100,000 inhabitants per year.Course and prognosis: The course and prognosis depend on the histological (fine tissue) grading and the localization of the tumor. If children were affected by brain tumors, the earlier the children were diagnosed, the greater the likelihood of later needing support. More than 50% of children who survive central nervous system tumors do not lead independent lives in adulthood. Medulloblastoma, astrocytoma, and ependymoma were the most common tumors affecting children. 5-year survival rate: The 5-year survival rate for astrocytoma is 10-60% depending on the grade. For glioblastoma, it is only a maximum of three percent. With therapy the survival time is about one year, without therapy about four to five months. Malignant oligodendrogliomas have a 5-year survival rate of 35-60% (depending on the exact histology). Medulloblastomas have a survival rate of 50-60%. The median survival for pinealoma is 4 years. Mortality (number of deaths in a given period, based on the number of the population in question) is only two percent or less for neurinoma. The 5-year survival rate is 20-60% for ependymoma. Cerebral metastases in patients with breast carcinoma or patients with metachronous metastases from small cell renal carcinoma often show long survival (≥ 24 months); brain metastases from patients with malignant melanoma have the least favorable prognosis.
