CNS TUMORCNS TUMOR

GliomaGlioma

** Stem cells are unspecialized immature cells that can ** Stem cells are unspecialized immature cells that can renew themselves through cell division for long periods of renew themselves through cell division for long periods of time.time.

** A glioma is a type of tumor that start in the brain or ** A glioma is a type of tumor that start in the brain or spine. It is called a glioma because it arises from glial cells. spine. It is called a glioma because it arises from glial cells. The most common site of gliomas is the brain. The most common site of gliomas is the brain.

IntracranialIntracranial IntraspinalIntraspinal

Types of CNS tumorTypes of CNS tumor

Main Types of Brain Tumor

Primary – tumor starts in the brain Types of Primary Tumor 1. Benign - do not contain cancer cells 2. Malignant- do contain cancer cells.

Metastatic – Tumor starts somewhere else in the body.

Cell Types and Associated Tumors of the Central Nervous Cell Types and Associated Tumors of the Central Nervous SystemSystem..

Cell Type Function Associated Tumors

Astrocyte

Provides nutrition, insulation,and structural support for neurons

Astrocytoma Pilocytic astrocytoma Diffuse astrocytoma Anaplastic astrocytoma GlioblastomaOligoastrocytomaPleomorphic xanthoastrocytomaSubependymal giant-cellastrocytoma

NeuronConducts electrical signalswithin neural systems

GangliogliomaGangliocytomaCentral neurocytoma

Oligodendrocyte

Provides insulation to neuronal axons to facilitate signal conduction

OligodendrogliomaOligoastrocytoma

Ependymal cell Forms lining of the ventricularSystem

Ependymoma

GLIOMASGLIOMASClassificationClassification::AstrocytomasAstrocytomas

from astrocyte, invasive, slow growing in the brain and spinal from astrocyte, invasive, slow growing in the brain and spinal cord cord

Glioblastoma MultiformeGlioblastoma Multiforme extremely malignant, highly vascular tumors that arise extremely malignant, highly vascular tumors that arise

fromfrom undifferentiated astrocytomasundifferentiated astrocytomas

OligodendrocytomasOligodendrocytomas from oligodendroglia, avascular, encapsulated, malignantfrom oligodendroglia, avascular, encapsulated, malignant

form is form is oligodendroblastomaoligodendroblastoma

EpendymomaEpendymoma from ependymal cells, more common in children, from ependymal cells, more common in children,

malignant form is called malignant form is called ependymoblastomaependymoblastoma..

GradingGrading

Low-grade Well-differentiated (benign) with a better prognosis .

High-grade

Undifferentiated (malignant) with worst prognosis.

WHO grading system for astrocytomaWHO grading system for astrocytoma GRADE 1

Least malignant and slowest to grow. If they are surgically totally

removed they can be associated with long term remission .

GRADE 2 Have more malignant cells in them, they grow faster and

have the tendency to recur, often more cancerous than the first time .

GRADE 3 Malignant cells undergoing mitosis, infiltrating and may recur

at a higher grade .

GRADE 4 Tumors are very malignant and are often difficult to treat ,

also known as Glioblastoma Multiforme, usually requires operation to

take as much tumor as possible followed by radiation therapy and

sometimes chemotherapy

Another Grading Another Grading SystemSystem

GRADE I

GRADE II

GRADE III

GRADE IV

Earlier Stages

Advanced Stages

LocationLocation

Supratentorial Above the tentorium, in the

cerebrum, most common in adults .

Infratentorial Below the tentorium, in the cerebellum, most common in

children . 

Source: the New England Journal of Medicine, Published January 25, 2005

Neural stem cells are multipotent and self- renewing, have been isolated

from the subventricular zone ,

Subcortical white matter

Dentate gyrus

B. Germinal Region of the Adult Human Brain

CA3

CA1

CA3

the New England Journal of Medicine, Published January 25, 2005

Principal neurons

GLIAL PROGENITOR CELLS — self-renewing precursors capable of producing astrocytes

and oligodendrocytes

NEOPLASTIC TRANSFORMATION .

ACCUMULATE ADDITIONAL MUTATION

INTRASPINAL TUMORSINTRASPINAL TUMORSClassified according to location in relation to the Classified according to location in relation to the dura and spinal corddura and spinal cord

Extradural- arising from the extradural space

Intradural - originating within the neural tissue .

1 .Extramedullary arising from the blood vessels, meninges or nerve

roots, forming an intradural tumor

Neurofibromas (Nerve sheath tumor) grow in the nerve root that extends into the

extradural space

Meningiomas tumor originates from the dura matter and

arachnoid membranes

22 . .IntramedullaryIntramedullary

tumors arising from within the substance tumors arising from within the substance ofof

the spinal cord itselfthe spinal cord itself

ExEx . .

Ependymomas, Astrocytomas, Ependymomas, Astrocytomas, Glioblastomas, Oligodendrogliomas, Glioblastomas, Oligodendrogliomas,

GanglioneuromasGanglioneuromas , ,

Medulloblastomas, HemangiomaMedulloblastomas, Hemangioma , ,

HemangioblastomasHemangioblastomas

INTRASPINAL TUMORSINTRASPINAL TUMORSClassified according to location in relation to the Classified according to location in relation to the dura and spinal corddura and spinal cord

RISK FACTORRISK FACTOR

Genetics

- Cells contain genetic material called chromosomes . - Controls growth of the cells .

- When the genetic material becomes abnormal it can loose its ability to control its growth.

Infections Diet:

Nitrate C Exposure to Chemicals:

Formaldehyde Vinyl Chloride

Acrylonitrile

RISK FACTORSRISK FACTORS

Multi hit hypothesis Cellular telephones

Exposure to high tension wires Hair dyes

Head trauma 

RISK FACTORSRISK FACTORS

CausesCauses

Radiation therapy

Unknown

PathophysiologyPathophysiology

INTRACRANIAL TUMOR

INTRASPINAL TUMOR

Nursing DiagnosisNursing Diagnosis

Ineffective breathing pattern r/t denervation of the intercostals Impaired tissue perfusion r/t damage of SNS .Impaired physical mobility r/t loss of muscle control/function .Altered Sensory Perception r/t neuromuscular deficit with

loss of sensory reception and transmission .Impaired Urinary Elimination r/t loss of nerve conduction

above the level of reflex arc .

DiagnosticsDiagnostics

Bone Scan PET scan CT- guided needle biopsy Open biopsy