Cell specific tumors

Glioblastomas are tumors that originate from certain glial cells, the so-called astrocytes, and have the most severe “malignancy”. They are the most common malignant tumors of the nervous system and are associated with a very poor prognosis. They usually occur between the ages of 60 and 70 years.

Moreover, men are affected twice as often as women. Glioblastomas can develop anywhere in the brain, so the specific symptoms can vary greatly. In most cases, treatment of glioblastoma consists of surgery followed by radiation and chemotherapy.

However, since the tumor grows very infiltratively into the surrounding tissue, not all tumor cells can usually be removed, which drastically reduces the prognosis. The average survival time after initial diagnosis is between 17 and 20 months. A medulloblastoma is a malignant tumor of the cerebellum, which usually occurs in children between the ages of four and nine years.

It develops at the base of the cerebellum and usually infiltrates both halves of the cerebellum and the surrounding tissue. From the described destruction of the surrounding tissue, the typical symptoms of medulloblastoma follow. Due to the involvement of the cerebellum, especially ataxia with intention tremor is one of them.

This describes a motor disorder with an increasing tremor with intentional movement. Further symptoms are presented: The extent of the symptoms depends largely on the size of the tumor. Treatment consists of a complete surgical removal of the tumor, which is usually completed by subsequent radiation.

The 10-year survival rate for medulloblastoma is 60%. The prognosis depends on the age of the child. The older the child is at first diagnosis, the better the chances of recovery.

Severe headaches
Nausea
Vomiting
Occasional seizures
Or changes of character.

Meningiomas are one of the most common types of brain tumors, accounting for 15% of all tumors. They develop from the cells of the so-called meninges, the soft meninges. 80-90% of meningiomas are classified as benign, which dramatically improves the chances of cure.

They are called “pleomorphic”. Almost exclusively adults are affected by this tumor. The frequency peak lies between the age of 40 and 60.

Most meningiomas grow very slowly and only displace the surrounding tissue, in contrast to the destruction of the surrounding tissue in “malignant” tumors. As a result, the symptoms usually do not appear until the tumor is already of considerable size. Depending on the localization, the symptom spectrum contains general signs of an increase in intracranial pressure such as Unless there is a contraindication, the therapy of a menigeoma always consists of surgical removal.

If, for example, this is not possible due to a complicated location, radiation therapy is the best possible alternative. The prognosis here depends largely on the histology of the tumor, i.e. whether it is a “benign” or “malignant” tumor. The prognosis for the more frequent benign meningiomas is generally good.

However, there is also a risk of recurrence of up to 20%. Malignant meningiomas have a significantly worse 5-year survival rate and 78% of patients will have at least one recurrent tumor within the next 5 years.

Headaches
Nausea
Vomiting
Visual field failures
Seizures
Motor disorders

The term astrocytoma is derived from the original cells of this tumor, the so-called astrocytes.

These are part of the supporting tissue of the brain, the so-called glia. This is the reason why astrocytomas belong to the gliomas. They account for about one quarter of all brain tumors.

The WHO distinguishes here between 4 different tumor grades. The symptoms of an astrocytoma usually merely indicate a general increase in intracranial pressure. Therefore, if there is any suspicion, imaging in the form of CT or MRT is always required.

Therapy and prognosis depend on the “degree of malignancy” of the tumor.For example, a grade 1 astrocytoma, unlike grade 3 and 4 astrocytomas, does not require subsequent steel or chemotherapy after surgical removal. In addition, a good prognosis is generally given for grade 1 astrocytomas. In contrast, the average life span of a grade 4 astrocytoma (glioblastoma, see below) is only about 18 months.

Oligodendrogliomas are counted among the so-called gliomas and are benign in most cases. They occur mainly between the ages of 25 and 40 years. Depending on the “malignancy” of the tumor, 4 different grades are classified.

As with most brain tumors, the symptoms consist of signs of a general increase in intracranial pressure (headaches, nausea, confusion), but epileptic seizures are also common. The therapy, as well as the prognosis, of the oligoendroglioma depends on the degree of the tumor and may include chemo- and radiotherapy or surgery. The 10-year survival rate for a rather benign and well-located tumor is about 50%.

However, in the case of a grade 4 oligoendroglioma, this drops to 20%. Ependymomas develop from the so-called ependymal cells. They form a cell layer between the nerve cells and the cerebrospinal fluid (liquor) surrounding them.

The therapy usually consists of a surgical intervention to reduce the tumor burden, and the tumor can also be irradiated. In general, however, ependymomas have a poor prognosis, as they can quickly spread via the cerebrospinal fluid into the CNS in case of “malignancy”. Thus, the therapy usually follows a life-prolonging intention rather than a curative (healing) approach.

The 5-year survival rate for all degrees of malignancy is given as approx. 45%. The therapy usually consists of a surgical intervention to reduce the tumor burden, and radiation of the tumor can also be performed.

The mostly benign pituitary tumors develop from hormone-producing cells of the pituitary gland, which regulates large parts of the human hormone balance. Pituitary tumors are basically divided into hormone-producing (active) tumors and those that do not produce hormones (inactive). The symptoms of active pituitary tumors can be very numerous due to their influence on the hormone system.

These include the absence of periods, in men a possible enlargement of the breast, osteoporosis (bone density decreases), altered size growth, the formation of a bull neck and many others. In addition, with these tumors, attention must be paid to the proximity of the pituitary gland to a part of the visual path, the so-called optic chiasma. Above a certain size of the tumor, compression of the optic chiasm can lead to visual field loss.

The therapy of pituitary tumors usually consists of a surgical intervention, which can be performed through the nose. The prognosis is very good due to the “benignity” of the tumor and the good surgical access. The Schwannoma, also called neurinoma, is a benign tumor that originates from the so-called Schwann cells.

These cells are located everywhere in the peripheral nervous system, but Schwannomas preferably develop at two specific sites. Firstly, Schwannomas develop from parts of the cerebral nerve, which is responsible for hearing and the sense of balance (vestibulochlear nerve). In this case the schwannoma is called acoustic neuroma.

The other common location is the sensitive nerve roots in the spinal cord. Depending on the localization, different symptoms occur. In the case of an acoustic neuroma, most of those affected initially report hearing loss, which increases as the disease progresses.

Tinnitus (ringing in the ears) or dizziness may also occur. If swarming occurs on spinal nerves of the spinal cord, paralysis, sensitivity disorders or radiating pain may occur. Depending on the size of the tumor, different treatment options are available.

If the swanoma is still small, a targeted radiation therapy can be considered. However, most swanomas are completely removed surgically, which leads to healing. Neurofibromas are benign nerve tumors that can grow inside or outside a nerve.

Although they partly consist of Schwann cells, they are characterized by a Schwannoma by their inseparability from the nerve. Thus, when a neurofibroma is surgically removed, the affected nerve is usually also lost. In principle, neurofibromas can occur anywhere where nerve tissue is present.

However, they often occur on the skin. People who suffer from the genetic disease neurofibromatosis 1 can have hundreds of small neurofibromas, which cannot be removed without scarring.For the therapy of neurofibromas on the skin, laser treatment with a carbon dioxide laser has become widely accepted. A hemangioma (also called blood sponge) is a benign tumor that affects blood vessels and occurs mainly in children.

Two thirds of hemangiomas develop in the head and neck area. Hemangiomas that are diagnosed in children are usually congenital. However, there are also non congenital hemangiomas, which usually do not develop until adulthood.

Hemangiomas can develop anywhere where there are vessels, including in the brain. If a wait-and-see therapy option is often chosen in other areas, such as the skin, because hemangiomas can regress on their own, the decision in the case of hemangiomas in the brain depends largely on their size and symptoms. Thus, in addition to dizziness and headaches, other neurological deficits can occur, which can be a sign of an undersupply of oxygen to the nerve tissue.

The therapy then usually consists of radiation, embolization (closure of the hemangioma via a catheter) or a surgical intervention. Hemangioblastomas or angioblastomas for short are benign tumors that occur in the central nervous system. They usually develop in the spinal cord or in the posterior fossa of the skull.

The development of a hemangioblastoma is usually associated with the growth of a cyst, as this can be part of the firmer outer layer. These tumors produce so-called erythropoietin (short: EPO), which increases the production of red blood cells. Depending on the localization, further symptoms may occur.

If the hemangioblastoma is located in the cerebellum, for example, movement disorders, dizziness, nausea and headaches can occur. However, since these tumors usually grow only slowly, a wait-and-see procedure is usually chosen first. Once the tumor has reached a critical size, it can usually be completely removed by surgery.