Brain Tumors characteristics

Schwannoma

Neurofibromatosis type II Associated with CN VIII S-100 Positive

Glioblastoma

# 1 in adults Pseudopalisading necrosis Stain with GFAP Glioblastoma multiforme, the most common primary adult brain tumor. It is generally localized to the cerebral cortex, and typically presents with severe headache and symptoms consistent with increased intracranial pressure. Histology will typically show hypercellular, multinucleated tumor cells, which may surround areas of necrosis (tumors cells around necrotic zones, shown in this image). Glioblastoma multiforme is rarely found in children and would have different histopathology. The prognosis is poor, with most mortality occurring within the first year, and a 5-year survival rate of near zero. Histologic findings: *Pleomorphic, anaplastic cells with foci of necrosis in a palisading pattern*

Pilocytic Astrocytoma

#1 pediatric tumor Rosenthal fibers Increased GFAP

Craniopharyngioma

Bitemporal Hemianopsia Pediatric Supratentorial tumor Derived from Rathke's pouch *Stratified squamous epithelium in spongy reticular stroma with prominent peripheral gliosis* describes a craniopharyngioma. Histology would include areas of "wet keratin" and areas of basaloid cells. Craniopharyngioma presents with severe headaches, visual changes, and growth failure secondary to pituitary dysfunction. It is derived from embryologic remnants of the Rathke pouch and is the most common supratentorial tumor in children. Incidence peaks in children and in the fifth decade of life. The survival rate for patients younger than 20 years is 99% at 5 years and but is 38% at 5 years for those older than 65 years. This describes a craniopharyngioma, the most common supratentorial tumor in children, which is derived from embryologic remnants of the Rathke pouch. Craniopharyngioma incidence peaks in children and in the fifth decade of life. This image demonstrates pathology areas of "wet keratin" and areas of basaloid cells, which are all classic histologic features of craniopharyngioma. The clinical presentation typically involves severe headaches, visual changes, and growth failure secondary to pituitary dysfunction. However, this patient's condition presents with cerebellar signs, not signs of pituitary dysfunction.

Medulloblastoma

Homer-Wright rosettes 4th ventricle compression Cerebellar Tumor

Oligodendroglioma

Perinuclear cystoplasmic clearing Frontal lobes Slow growing *Regular round cells with spherical nuclei and finely granular chromatin in clear cytoplasm* are consistent with oligodendroglioma, a rare, slow-growing tumor which typically arises in the frontal lobe and is associated with headache, seizures, changes in cognition, and focal symptoms such as localized weakness, sensory loss, or aphasia. The most frequently affected age groups are individuals in the fourth to fifth decades. Necrosis, signs of vascular invasion, and high mitotic activity are associated with poorer prognosis. oligodendroglioma, a relatively rare, slow-growing tumor that is most often found in the frontal lobes. General symptoms include headaches, seizures, and changes in cognition, and focal lesions can present with localized weakness, sensory loss, or aphasia. Necrosis, signs of vascular invasion, and high mitotic activity are associated with poorer prognosis. Pathology demonstrates a characteristic fried egg appearance, shown in this image. The most frequently affected age groups are individuals in the fourth to fifth decades. It is less likely to present in the patient's age group.

Ependimoma

Perivascular rosettes 4th ventricle compression Pediatric brain tumor

Meningioma

Psammoma bodies Whorled pattern Adult tumor *Whorls of meningothelium, oval nuclei with indistinct cytoplasm, and psammoma bodies* describes a meningioma, a benign tumor of meningothelium. It manifests with seizures or a neurologic deficit that gradually worsens over time secondary to mass effect. A meningioma would not be typical in this patient's age group and it would need to be very large in size to create the cerebellar signs seen in this patient. Focal symptoms can vary. A benign primary intracranial neoplasm localized to the meninges. Pathology will demonstrate whorls of uniform meningothelial cells with psammoma bodies, as shown with the black arrow in this image. Clinically, these tumors often manifest with seizures or a neurologic deficit that gradually worsens over time secondary to mass effect. Focal symptoms can vary by location; however, a neoplasm derived from the meninges is unlikely to result in radiologic findings localized to the cerebellar vermis. A meningioma would not be typical in children and it would need to be very large in size to create the cerebellar signs

Prolactinoma

Secretes prolactin Amenorrhea, decreased libido Bitemporal hemianosia

Hemangioblastoma

von Hippel-Lindau syndrome Polycytemia Cerebellar tumor