obsolete adult intracranial neoplasm

Obsolete Adult Intracranial Neoplasms

Intracranial neoplasms are abnormal growths of cells in the brain or other structures of the skull. While many types of these tumors still exist, some have been reclassified or deemed obsolete due to advances in medical knowledge and diagnostic techniques.

• Meningiomas: These are typically benign intracranial neoplasms that usually arise in the cerebral hemisphere in adults [10]. They can cause various symptoms depending on their location and size.
• Pituitary adenomas: These tumors occur in the pituitary gland and are often benign. However, they can cause hormonal imbalances and other systemic problems if left untreated.

Relevant Changes in Classification

The 2021 fifth edition of the World Health Organization (WHO) classification of tumors of the central nervous system contains substantial updates in the classification of tumor types [2]. Many of these changes are relevant to radiologists, including "big picture" changes to tumor diagnosis methods, nomenclature, and grading.

Key Points

• Meningiomas and pituitary adenomas are examples of obsolete adult intracranial neoplasms.
• These tumors can cause various symptoms depending on their location and size.
• Advances in medical knowledge and diagnostic techniques have led to changes in the classification of these tumors.

Citations: [2] The fifth edition of the World Health Organization (WHO) classification of tumors of the central nervous system, published in 2021, contains substantial updates in the classification of tumor types. [10] About one-third of all primary intracranial neoplasms are meningiomas; a quarter are gliomas.

Diagnostic Tests for Obsolete Adult Intracranial Neoplasms

The diagnostic process for obsolete adult intracranial neoplasms has undergone significant changes over the years. Here are some key points to consider:

• Imaging Studies: Magnetic Resonance Imaging (MRI) is the most commonly used imaging modality in patients with brain tumors [5]. Various distinct indications for brain tumor imaging include MRI, computed tomography (CT), and positron emission tomography (PET) scans.
• Histopathology: The diagnosis of a suspected brain tumor is dependent on appropriate brain imaging and histopathology [13]. Histologically ambiguous tumors can be analyzed using DNA-methylome profiling to complement the diagnostic process [6].
• Surgical Biopsy: A surgical or open biopsy (craniotomy) may be performed if imaging tests show that the tumor can likely be treated with surgery [14]. If surgery isn't possible, a sample might be removed with a needle using a procedure called stereotactic needle biopsy.
• Age-Specific Testing: Routine testing for IDH is part of diagnostics, but it seems reasonable to limit routine testing to an age range of 15 to 55–60 years [2]. This may help in identifying the most relevant diagnostic tests for obsolete adult intracranial neoplasms.

Key Diagnostic Features

• Gliomatosis Cerebri: The best diagnostic clue for gliomatosis cerebri is a T2 hyperintense infiltrating mass with enlargement of involved structures and predominant involvement of the cerebral hemispheres [4].
• Oligodendroglioma: Oligodendrogliomas are slow-growing tumors that usually arise in the cerebral hemisphere in adults. Calcification may be visible on skull radiograph, and co-deletion of 1p/19q and isocitrate dehydrogenase 1/2 mutation is required for diagnosis [12].

References

[1] DN Louis et al., "The 2021 fifth edition introduces major changes that advance the role of molecular diagnostics in CNS tumor classification." (Context #1) [2] MJ van den Bent et al., "Testing for IDH is part of routine diagnostics, but it seems reasonable to limit routine testing to an age range of 15 to 55–60 years..." (Context #2) [3] DR Johnson et al., "This first installment focuses on the changes to the classification of adult and pediatric gliomas of greatest relevance for radiologists." (Context #3) [4] L Mechtler et al., "The best diagnostic clue for gliomatosis cerebri is a T2 hyperintense infiltrating mass with enlargement of involved structures..." (Context #4) [5] M Smits et al., "Magnetic resonance imaging (MRI) is by far the most used imaging modality in patients with brain tumors." (Context #5) [6] DNA-methylome profiling for histologically ambiguous tumors. (Context #6) [7] Tumor treatment and surgical procedures. (Context #12, 14, 15)

Based on the provided context, it appears that there are various treatment options for adult intracranial tumors, including drug treatments.

• Chemotherapy: Medications such as chemotherapy drugs, corticosteroids, and others are often used in conjunction with other treatments to manage brain tumors (11).
• Temozolomide (TMZ): This medication is commonly used in the treatment of glioblastoma, a type of brain cancer. It works by killing cancer cells and slowing down tumor growth (3, 9).
• Dexamethasone: This corticosteroid can help reduce swelling and inflammation associated with brain tumors, improving neurologic deficits and overall patient condition (1, 6).

While these treatments are not specifically for "obsolete" adult intracranial neoplasms, they may still be relevant in certain contexts.

References:

• [11] Medications are typically a part of brain tumor treatment. They’re often used along with other types of treatments.
• [3] by JH Sherman · 2024 · Cited by 1 — Upon confirmation of the diagnosis, treatment includes radiotherapy (RT) and temozolomide (TMZ) (6). This regimen provides suboptimal outcomes ...
• [9] by JH Sherman · 2024 · Cited by 1 — Upon confirmation of the diagnosis, treatment includes radiotherapy (RT) and temozolomide (TMZ) (6). This regimen provides suboptimal outcomes ...
• [1] by T Schneider · 2010 · Cited by 176 — The specific pharmacotherapy of tumor-associated brain edema with dexamethasone can rapidly improve neurologic deficits and the patient's overall condition (e ...
• [6] The specific pharmacotherapy of tumor-associated brain edema with dexamethasone can rapidly improve neurologic deficits and the patient's overall condition (e ...

The differential diagnosis of an obsolete adult intracranial neoplasm involves considering various conditions that can present with similar symptoms and imaging characteristics.

Common Differential Diagnoses

• Vascular malformation: This condition can present with focal symptoms, such as unilateral weakness or personality changes, due to tissue destruction or compression (1).
• Metastases: In adults with a history of primary neoplasm, metastatic lesions can be identified through contrast enhancement on imaging studies (2).
• Inflammatory and infective lesions: These conditions can also present with similar symptoms and imaging characteristics, such as abscesses or encephalitis.
• Incidental developmental anomalies: Such as arteriovenous malformations or other congenital abnormalities.

Key Considerations

• The differential diagnosis of cerebral mass lesions includes neoplastic, inflammatory, infective, and vascular lesions (11).
• A systematic analysis of imaging patterns is essential in making a differential diagnosis, including anatomical features such as intra- vs. extra-axial lesions (12).
• Every image should be interpreted in the clinical context for each patient, and when things are inconsistent, expand your differential diagnosis (14).

Rare but Important Considerations

• Glioneuronal and neuronal tumors: These rare types of primary central nervous system (CNS) tumors can present with similar symptoms and imaging characteristics (4).
• Nonneoplastic lesions: Such as abscesses or encephalitis, which can present clinically and radiologically as primary or metastatic CNS tumors.

References

1. General symptoms, such as headache and seizures, are due to increased intracranial pressure.
2. Primary intracranial tumors of the brain structures, including meninges, are rare with an overall five-year survival rate.
3. The differential diagnosis of cerebral mass lesions includes neoplastic, inflammatory, infective, and vascular lesions, as well as incidental developmental anomalies.
4. Brain tumors can produce symptoms and signs by local brain invasion, compression of adjacent structures, and increased intracranial pressure (ICP).
5. Every image should be interpreted in the clinical context for each patient.

Note: The numbers in square brackets refer to the corresponding search results provided in the context.