1. Group 1

4. Incidence & prevalence: •
•
•
•

5. Risk Factors

10. 1- Consequences of intracranial
hypertension:
• are the most common symptom in brain
tumor patients.
• present at the initial
encounter with at least 40% of patients.
• must be distinguished from seizure.
•

11. 2-Dysfunction .
•
•
•
•
•
•

12. 2-Dysfunction (cont):
•
•
•
•
•

13. 3-Irritation
• 25% to 50% of all patients with brain tumors experience
seizures at some point in their disease course.
•
•
•

14. Brain tumors can be benign or malignant: •
• Benign brain tumors do not contain cancer cells:
 Usually, benign tumors can be removed, and they seldom grow back.
 The border or edge of a benign brain tumor can be clearly seen. Cells
from benign tumors do not invade tissues around them or spread to
other parts of the body. However, benign tumors can press on
sensitive areas of the brain and cause serious health problems.
 Unlike benign tumors in most other parts of the body, benign brain
tumors are sometimes life threatening.

15. Malignant brain tumors contain cancer cells:
Malignant brain tumors are generally more serious and often are life
threatening.
They are likely to grow rapidly and crowd or invade the surrounding
healthy brain tissue.
Very rarely, cancer cells may break away from a malignant brain
tumor and spread to other parts of the brain, to the spinal cord, or
even to other parts of the body. The spread of cancer is
called metastasis.
Sometimes, a malignant tumor does not extend into healthy tissue.
The tumor may be contained within a layer of tissue. Or the bones of
the skull or another structure in the head may confine it. This kind of
tumor is called encapsulated.

16. Grade I: The tissue is benign. The cells look nearly
like normal brain cells, and cell growth is slow.
Grade II: The tissue is malignant. The cells look less
like normal cells than do the cells in a grade I tumor.
Grade III: The malignant tissue has cells that look
very different from normal cells. The abnormal cells are
actively growing. These abnormal-appearing cells are
termed anaplastic.
Grade IV: The malignant tissue has cells that look
most abnormal and tend to grow very fast.

17. Tumor type :
1. Primary brain tumor:
Tumors that begin in brain tissue are known as primary
tumors of the brain.
Primary brain tumors are named according to the type of cells
or the part of the brain in which they begin.
The most common primary brain tumors are gliomas. They
begin in glial cells. There are many types of gliomas:

18. Astrocytoma - The tumor arises from star-shaped
glial cells called astrocytes. In adults, astrocytomas
most often arise in the cerebrum. In children, they
occur in the brain stem, the cerebrum and the
cerebellum. A grade III astrocytoma is sometimes
called an anaplastic astrocytoma. A grade IV
astrocytoma is usually called a glioblastoma
multiforme.
Brain stem glioma - The tumor occurs in the
lowest part of the brain. Brain stem gliomas most
often are diagnosed in young children and middle-
aged adults.

19. Ependymoma - The tumor arises from cells that
line the ventricles or the central canal of the
spinal cord. They are most commonly found in
children and young adults.
Oligodendroglioma - This rare tumor arises from
cells that make the fatty substance that covers
and protects nerves. These tumors usually occur
in the cerebrum. They grow slowly and usually do
not spread into surrounding brain tissue. They
are most common in middle-aged adults.

20. Some types of brain tumors do not begin in glial
cells. The most common of these are:
 Medulloblastoma - This tumor usually arises in the
cerebellum. It is the most common brain tumor in children.
It is sometimes called aprimitive neuroectodermal tumor.
 Meningioma - This tumor arises in the meninges. It usually
grows slowly.
 Schwannoma - A tumor that arises from a Schwann cell.
These cells line the nerve that controls balance and
hearing. This nerve is in the inner ear. The tumor is also
called an acoustic neuroma. It occurs most often in adults.

21.  Craniopharyngioma - The tumor grows at the base of the
brain, near the pituitary gland. This type of tumor most
often occurs in children.
 Germ cell tumor of the brain - The tumor arises from
a germ cell. Most germ cell tumors that arise in the brain
occur in people younger than 30. The most common type
of germ cell tumor of the brain is agerminoma.
 Pineal region tumor - This rare brain tumor arises in or
near the pineal gland. The pineal gland is located between
the cerebrum and the cerebellum.

22. 2. Secondary brain tumor (metastatic) :
 Metastatic brain tumors are made of cancerous cells that
spread through the bloodstream from a tumor located
elsewhere in the body (e.g. lung, breast and kidney).
 Metastatic brain tumors are the most common type of tumor
found in the brain and are much more common than primary
brain tumors.
 Metastatic tumors are usually named after the type of tissue
from which the original cancer cells arose (for example,
metastatic lung or metastatic breast cancer).

23.  No one knows the exact causes of brain tumors.
Research has shown that people with certain risk
factors are more likely than others to develop a brain
tumor.
The following risk factors are associated with an
increased chance of developing a primary brain
tumor:

24. I. Being male - In general, brain tumors are more common in
males than females. However, meningiomas are more
common in females.
II. Race - Brain tumors occur more often among white people
than among people of other races.
III. Age - Most brain tumors are detected in people who are 70
years old or older. However, brain tumors are the second
most common cancer in children. Brain tumors are more
common in children younger than 8 years old than in older
children.
IV. Family history - People with family members who have
gliomas may be more likely to develop this disease.
V. Being exposed to radiation or certain chemicals at work (e.g.
Formaldehyde, Vinyl chloride)
reference : http://www.medicinenet.com/brain_tumor/

25. • The Common Brain Tumor in Child :
1- Astrocytoma
2-neuroblastoma
3-Medulloblastoma
4-ependymoma
• Which one of this tumor is not a gliomas :
1- Ependymoma
2- Germ cell tumor
3- Astrocytoma
4-Brain stem

26. 1-Diagnosis
2- Treatment
3- Prognosis
Seif el eslam Wael Bedir

27. Increase Intracranial pressure
Neurological symptoms
History examination Investigation
meningitis vitals EEC
Space occupying fundoscope Spinal fluid analysis
lesion
Complete Radiological work up
neurological
examination

28. • computed tomography (CT)-scans
• magnetic resonance imaging (MRI).
• Neoplasms will often show as
differently colored masses (also
referred to as processes) in CT or MRI
results.

29. Benign brain tumors often
show up as hypodense (darker
than brain tissue) mass lesions
on cranial CT-scans.
On MRI, they appear either
hypo- (darker than brain
tissue) or isointense (same
intensity as brain tissue) on T1-
weighted scans, or
hyperintense (brighter than
brain tissue) on T2-weighted
MRI, although the appearance
is variable.

31. • Contrast agent uptake, sometimes
in characteristic patterns, can be
demonstrated on either CT or MRI-
scans in most malignant primary
and metastatic brain tumors.
• Perifocal edema

32. • histological examination of tumor tissue samples
obtained either by means of brain biopsy or
open surgery.
• This examination, performed by a pathologist, typically
has three stages:
• interoperative examination of fresh tissue,
• preliminary microscopic examination of prepared
tissues,
• Follow up examination of prepared tissues after
immuno histochemical staining or genetic analysis.

34. Overview
These various types of treatment are available depending
on neoplasm type and location and may be combined
to give the best chances of survival:
• surgery: complete or partial ressection of the tumor with
the objective of removing as many tumor cells as possible
• radiotherapy
• Chemotherapy: with the aim of killing as many as possible of
cancerous cells left behind after surgery and of putting
remaining tumor cells into a non dividing, sleeping state for
as long as possible

35. A)Surgery
• The primary and most desired course of action
described in medical literature is surgical removal
(resection) via craniotomy.
• The prime remediating objective of surgery is to
remove as many tumor cells as possible, with complete
removal being the best outcome
and cytoreduction ("debulking") of the tumor
otherwise.
• In some cases access to the tumor is impossible and
impedes or prohibits surgery.

37. • Any person undergoing brain surgery may
suffer from epileptic seizures. Medication is
prescribed and administered to minimize or
eliminate the occurrence of seizures.

38. B) Radiation therapy
• The goal of radiation therapy is to selectively
kill tumor cells while leaving normal brain
tissue unharmed.
• Radiotherapy is the most common treatment
for secondary brain tumors.
• The amount of radiotherapy depends on the
size of the area of the brain affected by cancer.

39. • Conventional external beam
1-'whole brain radiotherapy treatment' (WBRT)
or 'whole brain irradiation‘
may be suggested if there is a risk that other
secondary tumors will develop in the future
2- Stereotactic radiotherapy is usually
recommended in cases involving fewer than
three small secondary brain tumors.

40. C) Chemotherapy
• Patients undergoing chemotherapy are administered drugs
designed to kill tumor cells. Although chemotherapy may improve
overall survival in patients with the most malignant primary brain
tumors, it does so in only about 20 percent of patients.
• Chemotherapy is often used in young children instead of
radiation, as radiation may have negative effects on the developing
brain.
• The decision to prescribe this treatment is based on a patient’s
overall health, type of tumor, and extent of the cancer. The toxicity
and many side effects of the drugs, and the uncertain outcome of
chemotherapy in brain tumors puts this treatment further down
the line of treatment options with surgery and radiation therapy
preferred.

41. Type Treatment prognosis
Glioma Surgical debulking 90% deis with treatment
radiation
meningioma Preoperative
embolisation & surgical
resection
Cerebellar astrocytoma Surgical resection 90% exceed 5 years
survival rate
Medulloblastoma Surgical removal 50% exceed 5 years
Radio survival rate
Chemotherapy

42. Other
• A shunt is used not as a cure but to relieve
symptoms by reducing hydrocephalus caused
by blockage of cerebrospinal fluid.
• Researchers are presently investigating a
number of promising new treatments
including gene therapy, highly focused
radiation therapy, immunotherapy and novel
chemotherapies.

44. • The prognosis of brain cancer varies based on the type of cancer.
• Medulloblastoma
has a good prognosis with chemotherapy, radiotherapy, and surgical
resection while
• glioblastoma multiforme
has a median survival of only 12 months even with
aggressive chemoradiotherapy and surgery.
• Brainstem gliomas
have the poorest prognosis of any form of brain cancer, with most patients dying
within one year, even with therapy that typically consists of radiation to the
tumor along with corticosteroids.
However, one type of brainstem glioma, a focal seems open to exceptional
prognosis and long-term survival has frequently been reported.