GLIOMA

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A brain tumor may arise from brain cells or other cells that support the brain. Classically, we can examine it in two groups: benign and malignant brain tumors.  In order to distinguish between good and bad, it is necessary to operate and examine. It is possible to predict the behavior of the tumor before surgery.  

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Classifications of brain tumors and treatment guidelines according to these classifications

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Below I have provided some brief information about brain tumors that may be a guide:

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If someone close to you has a headache, fainting, vomiting, losing consciousness, etc.

or if a brain tumor was revealed accidentally in an MRI or tomography

First of all, the following questions must be answered.

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1-      Is the tumor actually a mass that originates from another part of the body but has spread to the brain?

2-      Does the tumor originate from the brain itself?

3-      Is the tumor a mass that originates from the membranes of the brain and puts pressure on the brain from the outside?

4-      Is the tumor on the surface of the brain or is it deeply located?

5-      Is the tumor in a sensitive area of the brain where surgery could cause serious damage to the brain?

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Brain tumors are classified according to the answers to these questions and their pathological examinations.

Classification helps us understand how tumors behave and how long patients survive.

It is very important for prediction.

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What are the types of brain tumors?

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Generally, brain tumors in the central nervous system are examined in 9 separate categories.

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1- Tumors of brain tissue (Neuroepithelial brain tumors).

2- Nerve-derived tumors (nerve roots originating from the brain and spinal cord)

3- Tumors of the membranes of the brain (meningeal tumors)

4- Tumors related to blood diseases (Hematopoietic tumors)

5- Tumors arising from prenatal cells (Germ cell)

6- Cyst and tumor-like formations

7- Pituitary region tumors (sellar region tumors)

8- Tumors extending from outside to the brain region

9- Tumors that spread from another part of the body (Metastasis)

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There are many classifications of brain tumors. Until 2016, the most well-known was the 2007 WHO classification. In 2016, a working group was formed by taking the opinions of 117 participants from 20 countries. The working group included 35 neuropathologists and neuro-oncology clinicians and scientists from 10 countries  To unite his opinion  He held a consensus meeting that lasted 3 days.  Following the consensus meeting, the 2016 WHO classification was published.

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In the 2016 WHO classification, genetic and molecular features, as well as histological features, were also evaluated in diagnosis. However, basic histological criteria are still used to determine the grade of brain tumors.

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What causes brain tumor?

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The brain contains nerve cells and cells that support nerves. If we could somehow remove the nerve cells from the brain, all the remaining cells are generally called astrocytes or glial cells. Astrocytes are called astrocytes, which can be translated into Turkish as star-like cells, because they appear to have radial arms like stars under the microscope. The majority of brain tumors arise from various astrocyte cells.

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Glial cells are examined in 4 parts.

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1- Astrocytes

2- Oligodendroglia

3- Microglia

4- Ependymal cells

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Uncontrolled proliferation of each cell or group of similar cells means tumor formation. For this reason, pathologists and scientists examine tumors under a microscope, stain them with various dyes, perform immunohistochemical tests, and finally, when they deem necessary, they also perform genetic tests and give the tumors a name.

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It can be thought that in order for a brain tumor to occur, the genetic structure of the cells that cause the tumor must be disrupted. Nowadays, genetic examinations are also performed to diagnose tumors. However, this does not mean that the disease is transmitted familially. The damaged structure is only in that person. Familial transmission has not been demonstrated in most brain tumors.

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There are also some brain tumors that are known to be inherited in families. these

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1-Hemangioblastoma is seen in Von-Hippel Lindau syndrome.

2-Subependymal giant cell astrocytoma may be seen in tuberous sclerosis disease.

3-Optic glioma, astrocytoma and neurofibroma can be seen in Neurofibromatosis Type 1.

4- Acoustic neuroma, meningioma, ependymoma and astrocytoma can be seen in Neurofibromatosis Type 2.

Astrocytoma and primitive neuroectodermal tumor can be seen in 5-Li-Fraumeni syndrome.

6-Advanced stage tumors such as glioblastoma and medulloblastoma may be seen in Turcot syndrome.

 

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Staging in brain tumor:

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There is also a type of grading system we call grade or stage in the examination of brain tumors. Brain tumors are classified into 4 grades (4 stages if we try to translate them into Turkish, although they do not have the same meaning). In other words, the name of the tumor is different, and presumably the grade it is included in is different. We call Grade 1 the best-behaved tumor and Grade 4 the worst-behaved tumor. The name, grade, behavior, and division rate of each tumor are data for us to estimate how long the patient will survive. However, another issue that is as important as these is the general condition of the patient, that is, whether he can do his own work or not and whether he is self-sufficient. People who are in good general condition and are self-sufficient and can do their own work live longer. In addition, brain tumors with the same characteristics arising in sensitive areas of the brain may have different results than those occurring in adjacent or distant parts of the brain. In general, tumors that arise on the left side of the brain and tumors that arise on the right side have different results. Because there is mostly a speaking and understanding area on the left side, the tumor may not be completely removed. This may cause the tumor to grow back much faster and cause the patient to die.

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