CNS sarcomas, other oncological diseases - meningiomas, oligodendrogliomas, astrocytomas - all these cases are relatively rare in modern medicine. They differ in forecasts, prospects, severity, complexity of diagnosis. If the patient was diagnosed with this, no doubt this is very scary. Consider what kind of cancer.
Relevance of the issue
In 1951, a study was organized to determine how urgent the problem of cancer of the central nervous system is for medicine. Research was conducted under the control of Smirnov. As the researcher was able to find out, on average, tumor processes covering the central nervous system occurred in 1.22% of patients. Around the same time, similar studies were organized by American scientists. For one hundred thousand people, the frequency of occurrence was estimated at 0.9-1 cases. French doctors estimate that there are about five patients with brain tumor processes per one hundred thousand people.
There is no information on changes in the frequency of occurrence in recent years. Specialized literature practically does not touch on this issue. As observations have shown, the disease equally affects men and women, there is no dependence on gender. At the same time, certain nuances for specific varieties were identified. So, a neurinoma located in the nerve responsible for hearing is more often diagnosed in women. This sex is more likely to have meningiomas. Men are more dangerous medulloblastoma, glioblastoma.
Distribution Features
More often, CNS tumors are diagnosed in people over the age of 20 years. On average, it is believed that risks are increased for people no older than fifty. Age, as studies have shown, correlates with the histological features of the process, the nuances of location. In childhood, the risk of congenital pathology is higher, the risk of glioma is greater. For adults, the likelihood of metastatic cancer, meningiomas, is increased. Children are more characteristic of pathological processes localized under the cerebellar mark; for adults, the situation above this site is more typical.
Causes and consequences
Scientists tried to determine what causes tumors of the elements of the nervous system, what provokes them. At the moment, not only the genesis, but also the etiology of such diseases remain hidden by the veil of secrecy. The theory that proposes to search for a cause in a complex of phenomena arouses the greatest interest and confidence. Dysontogenetic factors, according to scientists, affect the body, coupled with the external influences of the environment in which a person lives. In addition, the age and gender of the person, the processes of hyperplasia, anaplasia, hormonal imbalance and heredity are considered important. The dedifferentiation of the structural elements of the central nervous system plays its role.
It was determined that some types of oncology of the nervous system are hereditary. A separate group of family diseases has been identified. These include neurofibromatosis developing in the brain. Angioreticulomatosis belongs to the family. Glioblastomatosis, which is characterized by diffusion, belongs to this class. Etiology, according to scientists - injuries, viruses, hormonal disorders, radiation.
There is no clear statistical information on the dependence of cancer processes and areas of residence.
Categorization
Cancer is a disease that has a large number of varieties. While there is no single classification system that would consider all oncological processes in the central nervous system. There are several systems, and in previous times there were significantly more of them - some were recognized as ineffective. On the one hand, the abundance of approaches to systematization creates difficulties in the perception of scientific material, while different scientists use the same words to designate different diseases from each other. At the moment, in our country, mainly doctors resort to the classification system developed in 1967 by Khominsky.
If tumors of the hematopoietic system, nervous and any other are revealed, it is necessary first to study the histological features of the process. Histogenesis allows you to divide all patients into several classes. Some found neuroectodermal, while others - pituitary, heterotopic ectodermal, as well as metastatic tumor processes. Histogenesis happens: from the tissues of the pituitary gland, mesenchyme. There are teratomas. The most common variety is the first one mentioned.
Neuroectodermal: which ones?
Astrocytomas belong to this class. The term refers to cancer of the nervous system, whose source material is astrocytes. Among gliomas, the neoplasm is considered one of the safest. Astrocytomas (in most cases) - the area of localization of cysts of different sizes. In the study, you can see a node that does not have clear boundaries. Perhaps diffuse development. Pathology can appear in an unpredictable part of the brain. In adults, it is more often formed in the hemispheres; in childhood, it is more likely to appear in the cerebellum. The most malignant variant of the course is astrocytoma with atypical cell structures. The official medical name is the de-differentiated type. One of the subspecies is large-cell.
Oligodendrocytoma is another form of cancer of the nervous system. It is based on the cellular elements of oligodendroglia. More often the disease is diagnosed in patients of the middle age group. Among all patients, up to three and a half percent account for such cases. Often the location area is the cerebral hemispheres, the ganglion of the subcortical layer. The neoplasm develops slowly, belongs to the number of relatively safe ones, it can form dedifferentiated. Structurally, these are isomorphic cells that are densely located and have small dimensions.
Glioblastoma
This term refers to cancer of the nervous system of the multiform type. This is a malignant disease based on astrocytes. Sometimes formed from ependyma, oligodendroglia. Among other tumor processes within the skull, this species accounts for up to 15%. It is more often detected in the cerebral hemispheres, ganglia under the cortex. The tumor can pass through the corpus callosum and cover the second hemisphere. The disease is more often diagnosed in the stronger sex.
A macroscopic study of cancer of the nervous system gives a rather varied picture, as there are necrotic foci, hemorrhages. Usually the tumor is complemented by cysts. More often, a process is a clearly bounded node. The substance of the brain near the focus has an infiltrate. It is customary to talk about polymorphic cell forms, isomorphic cell and accompanied by normal level polymorphism.
Medulloblastoma
This term refers to a malignant tumor process of a dysgenetic type. It starts from embryonic cells. The diagnosis is often made to children. At an early age, it accounts for about one fifth of all cases of tumor processes inside the skull. The disease is more commonly seen in boys. A typical area of localization is the cerebellar worm. The study reflects a friable knot of a pinkish, grayish tint. The tumor is formed by densely spaced cells. Metastases can spread throughout the subarachnoid block, sometimes to the spinal structures, less often to the cerebral hemispheres. The sensitivity of the disease to radiation therapy has been proven.
Meningioma
An alternative name for this pathological process is arachnoidendothelioma. Doctors have long known what meningioma is. This term refers to the process starting from the cerebral endothelium. Among all the tumors inside the skull, the disease accounts for up to 19% of cases. Among oncological spinal diseases, the occurrence of meningioma is estimated at 40%.
The benign format of the disease develops extracerebral. The processes are localized on the basal surface. Less commonly detected in the spinal canal, cerebral ventricle. Finding out what meningioma is, it was found that structural features differ from case to case. There is a possibility of a psamo-, xantho-, angiomatous case, ossifying. Sometimes a disease of the mesenchymal, meningothelial or fibroblastic type is diagnosed.
Options
Pathology can develop in a malignant form. With this course, malignant meningioma is diagnosed. An alternative name for the pathological process is meningial sarcoma. The disease starts from the meninges.
The parasagittal process occurs on one or two sides. All cases are divided into front, rear, center. To be classified as a class, the location of the focus relative to the sinus length is analyzed.
Neurinoma
The term refers to an oncological benign process affecting the auditory nerve. While scientists can not say what triggers the disease. Assume that heredity plays a role. Among indirect factors, according to some researchers, neurofibromatosis should be noted. This disease, as you know, can also be transmitted between generations.
There are three ways to treat neurinoma. You can expect to assign the patient radiation or surgery. A concrete decision is made, focusing on the features of the case. It is important to analyze the dimensions of education, localization, state of the body, tone, quality of hearing. Take into account the wishes of the needy.
How to clarify
If neuroma is suspected, hearing should be checked. The otolaryngologist may notice a deterioration in function during a routine examination of the patient. They organize an auditory test that gives an idea of the reaction of the brain stem. Electronistagmography is recommended - a study in which nystagmus is determined, that is, the involuntary activity of the elements of the eye. Liquid is supplied to the ear canal; the equipment connected to the person captures the reciprocal movements of the eyes. If on the basis of the research you can assume cancer, it is necessary to do an MRI.
Will wait?
Such treatment of neurinoma is recommended for small foci and an arrangement that does not threaten the nearby nervous structures. If the dimensions are relatively large, but the phenomenon does not manifest itself as symptoms, they can also recommend an expectation. Observation is indicated if surgery is prohibited. This is possible due to old age or poor health.
Surveillance includes annual MRI and regular consultations.
Operation
This approach to treatment involves the removal of the auditory nerve. The event is considered extremely difficult and problematic. This is a delicate operation requiring skill and experience, high-quality equipment. Surgery is indicated for young patients, if the tumor site increases in size, surgery by the radio wave method does not show a reliable result. Surgery helps maintain the ability to see and hear, and also protects the facial nerve.
There are several methods of intervention. Translabyrinth, retrosigmoid access or through the middle fossa is possible. Surgery requires complete anesthesia, cranial trepanation. The duration of rehabilitation is 6-12 months.
Irradiation
The classic effective approach is a gamma knife. This is a non-invasive method, almost as effective as open surgery, but with fewer risks of complications. Currently, more than 28 thousand patients have already received treatment with neuroma with a gamma knife and have successfully rehabilitated. In the process of processing the area affected by the pathology, the DNA of the degenerated cells is destroyed, blood clots of the vascular elements are formed, due to which the diseased area is fed.
A gamma knife is recommended for patients with tumor dimensions of up to three centimeters. This method is used for relapse and residual tumor process against the background of a microsurgical operation. Before the start of the course, a detailed examination of the condition is shown to determine the localization of pathological cells with the maximum possible scientific accuracy. Take into account the features of nerve formations nearby, reconstruct the area in a three-dimensional format. Only after this they begin to work, using special equipment.