Possible Risk Factors
Genetic predispositions for the development of brain tumors have been identified.
Population-based studies suggest that no more than 4% are attributed to heredity.
Several environmental factors that may be associated with CNS tumors.
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Possible Risk Factors
Epstein-Barr virus in the DNA of primary lymphoma suggests a viral etiology for CNS tumors.
Reference: “Surveillance of Primary Intracranial and Central Nervous System Tumors: Recommendations from the Brain Tumor Working Group.”
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Genetic Syndromes
Genetic syndromes associated with multiple CNS tumors are:
•Neurofibromatosis I (von Recklinghausen’s disease)
•Neurofibromatosis II (bilateral acoustic neurofibromatosis)
•Von Hippel-Lindau disease
•Tuberous sclerosis (Bourneville-Pringle syndrome)
•Gorlin syndrome (Nevoid Basal Cell Carcinoma syndrome
•Hermans-Grosfeld-Spaas-Valk disease
•Li-Fraumeni syndrome
•Familial retinoblastoma
•Turcot syndrome (Adenomatous Polyposis syndrome)
•Cowden disease
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Diagnostic Tools – Physical Exam
Neurological examination
•Eye movements
•Vision
•Hearing
•Reflexes
•Balance and coordination
•Sense of smell and touch
•Abstract thinking
•Memory
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Diagnostic Tools: Radiology
Computerized tomography (CT) scan
Magnetic resonance imaging (MRI)
Positron emission tomography (PET)
Single photon emission computed tomography (SPECT)
Magnetoencephalography (MEG)
Angiography
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Diagnostic Tools: Laboratory
tests
Audiometry
Electroencephalogram (EEG)
Endocrine evaluation
Evoked potentials
Lumbar puncture
Myelogram
Perimetry
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Diagnostic Tools
Needle biopsy
•Needle inserted through a burr hole and tissue extracted for tissue diagnosis.
Stereotactic biopsy
•Computer used to guided needle biopsy to extract tissue.
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College of American Pathologist
(CAP) Protocols
Site-specific checklists
•Required to be completed in the health record in hospitals with COC-approved cancer programs for cases diagnosed January 1, 2004 and later.
www.cap.org/cancerprotocols/protocols_index. html.
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Brain and Spinal Cord
CAP Protocols (1)
Macroscopic
•Specimen type
•Specimen size
•Tumor site
•Tumor size
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Brain and Spinal Cord
CAP Protocols
Microscopic
•Histologic type
•Histologic grade
•Margins
•Additional studies*
•Additional pathologic findings*
•Comments*
*Not required for COC approval.
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