CLINICAL PRESENTATION AND SURGERY OF BRAIN TUMORS AND SPINAL CORD TUMORS
This section describes the various therapeutic options which are offered by good neurosurgical centers and supported by excellent diagnostic imaging, radiotherapy, neuroncology and neurology. These centers should also rely on and correctly use the most current modern operative technologies.
The topics to be covered will be divided in groups following the classification adopted in Chapter 2.
Gliomas, divided in astrocytomas, oligodendrogliomas, ependymomas, glioblastomas
Neurocytomas, Gangliogliomas
Lymphomas
Pinealomas
Hemangioblastomas
Medulloblastomas
Germ Cell Tumors
Papillomas
Lipomas
This is a generic term that indicates any tumor arising from the glial cells, which are the supportive cells of the brain. These cells maintain the "thinking cells", i.e. the neurons, and permit them to work. There are three types of glial cells that may generate tumors that are called gliomas: astrocytes (star-shaped cells), giving rise to astrocytomas and glioblastomas; oligodendrocytes (cells with short arms), giving rise to oligodendrogliomas; ependymocytes, i.e. cells covering the ventricular cavities of the brain and the central canal of the spinal cord. The latter cells produce ependymomas. At times, a brain tumor may consist of different cell populations and is then called mixed glioma. The most frequent one is the astrocytoma-oligodendroglioma association. In current neurosurgical language, some gliomas are classified on the basis of their location: brainstem glioma, optic nerve glioma, corpus callosum glioma. This is a gross anatomical classification. In glioma surgery, a correct histological diagnosis is crucial to prognosis and subsequent radiotherapy and chemotherapy. The removed tissue should undergo immunohistochemical and genetic assays. At the "Regina Elena" National Cancer Institute in Rome, these assays are performed on a routine basis in each case.