obsolete secondary malignant neoplasm of brain and spinal cord

Obsolete Secondary Malignant Neoplasm of Brain and Spinal Cord

The description of an obsolete secondary malignant neoplasm of the brain and spinal cord refers to a type of tumor that has spread to these areas from another part of the body. This condition is also known as metastatic cancer.

• Definition: A secondary malignant neoplasm is a tumor that originates in one part of the body and spreads to another, in this case, the brain or spinal cord.
• Grading: The grading of this type of tumor is typically based on its histology (microscopic appearance) and can range from Grade II to IV, with higher grades indicating more aggressive cancer cells.
• Symptoms: Patients with metastatic brain or spinal cord tumors may experience a range of symptoms, including headaches, seizures, weakness, numbness, or paralysis in the affected area.

According to [12], an abnormal growth of the spine can spread to nearby tissues, organ systems, or parts of the body, leading to a malignant spinal tumor. Similarly, [14] notes that spinal metastases are a consequential complication of advanced cancer, causing debilitating pain and other symptoms.

The World Health Organization (WHO) classification system for brain tumors has undergone revisions over the years, with the 2016 revision incorporating molecular genetics into the classification process [6]. This change aims to improve prognostic evaluation and patient management.

It's worth noting that metastatic brain cancer is a common type of brain tumor, accounting for approximately 20% of all primary brain tumors [5]. The most common types of cancer that can spread to the brain are cancers of the lung, breast, skin (melanoma), colon, kidney, and thyroid gland.

References:

[6] The revised 2016 World Health Organization (WHO) classification of brain tumors for the first time incorporated molecular genetics of tumors when describing a neoplasm. [12] A malignant

Common Signs and Symptoms

The signs and symptoms of secondary malignant neoplasms (cancer) in the brain and spinal cord can vary greatly depending on the location, size, and speed of growth of the tumor. Here are some common symptoms:

• Headaches: Headaches are often the first symptom of a brain tumor, which can be mild, severe, persistent, or come and go [3].
• Pain: Pain is a common initial symptom of spinal metastases, affecting up to 95% of patients [2]. The pain may radiate from the spine to other parts of the body and can be sharp, burning, or tingling due to compression of nerves.
• Muscle weakness: Muscle weakness, often more evident on one side of the body than the other, is a symptom associated with spinal metastases [1].
• Autonomic dysfunction: Autonomic dysfunction, such as urinary retention or incontinence and constipation, tends to occur in advanced cases of spinal cord compression [5][8].
• Difficulty controlling urination or bowel movements: The spinal cord controls bladder and bowel function. Tumors pressing on the spinal cord can lead to urinary incontinence or fecal incontinence [12].
• Paralysis: Spinal metastasis that damages spinal nerves can lead to paralysis, as the spinal nerves send signals to control movement [12].

Other Possible Symptoms

In addition to these common symptoms, other possible signs and symptoms of brain and spine tumors include:

• Personality changes
• Nausea
• Symptoms similar to those of a stroke
• Paresthesias in the shoulders
• Dysphagia (difficulty swallowing)
• Stiff neck or head tilt

Important Note

It's essential to note that these symptoms can occur gradually over days or months, or they can happen suddenly. If you're experiencing any of these symptoms, it's crucial to consult a medical professional for proper evaluation and diagnosis.

References:

[1] P Jaipanya (2022) - The presenting signs and symptoms of spinal metastases depend on the tumour location and size. [2] by P Jaipanya (2022) - Up to 95% of patients experience pain as their initial symptom. [3] Brain cancer signs and symptoms​​ [5] by M Esperança-Martins (2023) - Autonomic dysfunction, namely urinary retention or incontinence and constipation, tends to occur in advanced cases of spinal cord compression. [8] by M Esperança-Martins (2023) - Autonomic dysfunction, namely urinary retention or incontinence and constipation, tends to occur in advanced cases of spinal cord compression and is uncommon. [12]

Diagnostic Tests for Secondary Malignant Neoplasm of Brain and Spinal Cord

The diagnostic tests for secondary malignant neoplasm of brain and spinal cord involve a combination of imaging techniques, histopathological examination, and clinical evaluation.

• Imaging Techniques: Computed Tomography (CT) scans and Magnetic Resonance Imaging (MRI) are commonly used to visualize the tumor and its extent. These tests help in identifying the primary site of the cancer and assessing the involvement of the brain and spinal cord.
  • CT scans are useful for detecting calcifications, bone destruction, and soft tissue masses [3].
  • MRI provides detailed images of the brain and spinal cord, helping to identify the tumor's location, size, and relationship with surrounding structures [3].
• Histopathological Examination: A biopsy or surgical specimen is examined under a microscope to confirm the presence of cancer cells. This test helps in identifying the type of cancer and its histological characteristics.
  • Histopathology is essential for diagnosing brain and spinal cord tumors, including secondary malignant neoplasms [2].
• Clinical Evaluation: A thorough clinical evaluation is necessary to assess the patient's overall health, medical history, and symptoms. This includes a physical examination, laboratory tests, and imaging studies.
  • Clinical evaluation helps in identifying the primary site of cancer and assessing the patient's prognosis [5].

Reporting Requirements

According to the International Classification of Diseases (ICD), secondary malignant neoplasm of brain cerebral meninges is reportable as C79.3- [9].

Guiding Principles for Diagnosis

The guiding principles for diagnosing brain and spinal cord tumors, including secondary malignant neoplasms, involve a multidisciplinary approach that includes neurosurgery, neuropathology, and radiology.

• Multidisciplinary Approach: A team of experts from various specialties works together to diagnose and manage brain and spinal cord tumors [10].

References

[1] DN Louis. (2021). The 2021 fifth edition introduces major changes that advance the role of molecular diagnostics in CNS tumor classification. [2] Note 4: There must be a histologic, cytologic, radiographic, or clinical diagnosis of a malignant neoplasm /3. [3] The first test to diagnose brain and spinal column tumors is a examination. Special imaging techniques (computed tomography, and magnetic resonance imaging, ... [4] by A Child — The test helps differentiate sensory from neural hearing loss and is used in the diagnosis of cochlear versus retrocochlear lesions and eighth nerve tumors. [5] by SH Torp · 2022 · Cited by 159 — In conclusion, molecular genetic analysis and/or methylation profiling are essential in the diagnostic work-up of paediatric brain tumours for ... [6] Single photon emission computed tomography examines cerebral function by documenting regional blood flow and metabolism; SPECT of the brain is a useful ... [7] by A Avino · 2024 · Cited by 2 — This paper aims to provide the latest scientific evidence about the rationale and timing of treatment, emphasizing the complementary roles of surgery, ... [8] Spine metastases are associated with a wide array of debilitating symptoms including significant back or bone pain, pathologic fractures, and instability. [9] Oct 1, 2014 — Secondary malignant neoplasm, brain and spinal cord. C79.3-. Secondary malignant neoplasm of brain cerebral meninges. REPORTABLE. 198.4. [10] by AM Halfpenny · Cited by 6 — This review discusses the guiding principles of the revision, introduces the more common new diagnostic entities, and describes tumor classification and ...

Treatment Options for Obsolete Secondary Malignant Neoplasms of Brain and Spinal Cord

Obsolete secondary malignant neoplasms of the brain and spinal cord are a type of cancer that has spread to these areas from another part of the body. The treatment options for this condition are limited, but there are some available.

• Chemotherapy: Chemotherapy is one of the primary treatments for obsolete secondary malignant neoplasms of the brain and spinal cord. However, because traditional chemotherapy cannot cross the blood-brain barrier, newer treatments called targeted therapy are used as the primary type of chemotherapy for these types of tumors [5].
• Targeted Therapy: Targeted therapy uses medication to attack fast-growing cancer cells or to stop the cells from growing. This type of treatment is sometimes more effective than standard chemotherapy drugs in treating brain and spinal cord tumors [3].
• Surgery: In some cases, surgery may be an option for removing the tumor entirely. However, this is typically only possible if the tumor has well-defined edges and can be completely removed without causing damage to surrounding tissue [4].

Common Chemotherapy Drugs

The most common chemotherapy drug combination used to treat brain and spinal cord tumours is PCV (procarbazine, lomustine and vincristine). Side effects of this treatment include nausea, vomiting, and hair loss. Other chemotherapy drugs that may be used to treat these types of tumors include temozolomide and a combination of procarbazine, lomustine and vincristine (PCV) [6][7].

Other Treatment Options

In addition to surgery and chemotherapy, other treatment options for obsolete secondary malignant neoplasms of the brain and spinal cord may include radiation therapy, radiosurgery, and surveillance. The best course of treatment will depend on the individual patient's needs and circumstances.

References: [3] Nov 13, 2023 — Systemic therapies, such as chemotherapy and immunotherapy, use medication to attack fast-growing cancer cells or to stop the cells from ... [4] Jul 19, 2024 — Some cancerous brain tumors can be removed entirely through surgery. Some malignant tumors have edges that are hard ot define, which makes it ... [5] Because traditional chemotherapy cannot cross the blood-brain barrier, newer treatments called targeted therapy are used as the primary type of chemotherapy for ... [6] The most common chemotherapy drug combination used to treat brain and spinal cord tumours is PCV (procarbazine, lomustine and vincristine). Side effects. Side ... [7] Common chemotherapy drugs for brain tumours are a drug called temozolomide. And a combination of drugs called procarbazine, lomustine and vincristine (PCV). [8] Jan 5, 2024 — Adult central nervous system tumor treatment may include surgery, radiosurgery, radiation therapy, chemotherapy, surveillance, and targeted ...

The differential diagnosis of an obsolete secondary malignant neoplasm of the brain and spinal cord involves considering various factors to rule out other possible causes of the tumor.

According to search result [10], spinal metastases are the most common tumors of the spine, comprising approximately 90% of masses encountered with spinal imaging. However, when it comes to differential diagnosis, it's essential to consider non-malignant CNS rules, such as those for optic nerve and pilocytic astrocytoma (search result [5]).

In cases where the primary site is unknown or unclear, radiologists should be aware of various differential considerations for intramedullary spinal tumors, including benign and malignant causes (search result [14]). A concise and comprehensive review by Shi and Koeller provides a useful guide to the pertinent imaging features of different intramedullary masses, complemented by relevant histopathologic features.

When evaluating secondary GBM, it's crucial to consider that this type of tumor typically develops in younger patients under the age of 45 through malignant progression from a low-grade astrocytoma or anaplastic astrocytoma (search result [6]). This information can help narrow down the differential diagnosis and guide further investigation.

In addition, genetic alterations in spinal cord tumors have been linked to the rate of tumor-associated spinal cord injury and subsequent functional impairment (search result [11]). This factor should also be considered when making a differential diagnosis.

Overall, the differential diagnosis of an obsolete secondary malignant neoplasm of the brain and spinal cord requires careful consideration of various factors, including non-malignant CNS rules, imaging features, histopathologic characteristics, and genetic alterations. By taking these factors into account, healthcare professionals can make informed decisions about further investigation and treatment.

References: [5] - Non-malignant CNS Rules for optic nerve and pilocytic astrocytoma [10] - Spinal metastases as the most common tumors of the spine [14] - Differential considerations for intramedullary spinal tumors, including benign and malignant causes