SPECTRUM OF CENTRAL NERVOUS SYSTEM TUMOURS–A SINGLE CENTER HISTOPATHOLOGICAL REVIEW OF 761 CASES OVER 5 YEARS
AbstractBackground: The incidence of central nervous system (CNS) tumours has rapidly increased over the past few years. There is no accurate nationwide CNS tumour epidemiology in Pakistan that makes policy making for tumour screening and early treatment difficult. The purpose of this study was to provide the spectrum of CNS tumours in a premier diagnostic and referral centre of Pakistan. Methods: This cross-sectional study was carried out at Histopathology Department, Armed Forces Institute of Pathology over a period of 5 years. A total of 761 cases patients who were diagnosed with CNS tumours on histopathology, both benign and malignant, belonging to both genders, between the ages of 1–85 years, from 11.2009 to 31.12.2013 were included in the study. Results: Seven CNS tumour categories were as follows; tumours of neuroepithelial tissue (56.0%), tumours of the meninges (28.3%), tumour of the sellar region (2.6%), germ cell tumour (0.1), tumour of cranial and paraspinal nerves (5.4%), lymphomas and haematopoietic neoplasm (2.4%), metastatic tumours (4.9%), where histological types by age and gender showed great variability. Astrocytic tumours were the commonest neuroepithelial tumours (69.4%). Glioblastoma multiform forming the largest subtype of neuroepithelial tumours (40.4%) with a mean age at diagnosis being 47.1 years. Overall, males exceeded females in number of most of the CNS tumour types, however meningeal tumours were more frequently noted in females. Conclusions: Neuroepithelial tumours are commonest tumour and comprise more than half of all operated CNS tumours in our setup, followed by meningeal tumours. Glioblastoma multiforme is largest subtype of neuroepithelial tumour, and comprising 40.4% of all.Keywords: Central nervous system, Neuroepithelial tumours, Meningeal tumours, Glioblastoma multiforme
Bauchet L, Rigau V, Mathieu-Daudé H, Figarella-Branger D, Hugues D, Palusseau L, et al. French brain tumor data bank : methodology and first results on 10,000 cases. J Neurooncol. 2007;84(2):189–99
Kaneko S, Nomura K, Yoshimura T, Yamaguchi N: Trend of brain tumor incidence by histological subtypes in Japan: estimation from the Brain Tumor Registry of Japan, 1973–1993. J Neurooncol. 2002;60(1):61–9.
Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. GLOBOCAN 2008 v2.0 (accessed Aug 2012), Cancer incidence and mortality worldwide: IARC CancerBase No. 10 [Internet]. Lyon, France: International Agency for Research on Cancer; 2010. Available from http://globocan. iarc.fr
Brain and central nervous system tumours - UK incidence statistics, Cancer Research UK [Cited on Jan 25,2014] (http://www.cancerresearchuk.org/cancer-info/cancerstats/types/brain/mortality/uk-brain-and-central-nervous-system-cancer-mortality-statistics)
Jamal S, Moghal S, Mamoon N, Mushtaq S, Luqman M, Anwar M. The pattern of malignant tumors: Tumor registry data analysis, AFIP, Rawalpindi, Pakistan (1992–2001). J Pak Med Assoc 2006; 56(8):359–62
Committee of Brain Tumor Registry of Japan. Report of Brain Tumor Registry of Japan (1969-1996). Neurol Med Chir (Tokyo) 2003;43:1–111.
Hoffman S, Propp JM, McCarthy BJ. Temporal trends in incidence of primary brain tumors in the United States, 1985–1999. Neuro Oncol. 2006;8(1):27–37
Ayaz B, Lodhi FR, Hasan M. Central Nervous System Tumours: A hospital Based Analysis : Pak Armed Forces Med J 2011; 61(1): 61–4
Ahmed Z, Arshad H, Hasan SH, Fatima S, Idrees R, Aftab K, et al. CNS neoplasms in Pakistan, a pathological perspective. Asian Pac J Cancer Prev 2011;12(1):317–21.
Chen L, Zou X, Wang Y, Mao Y, Zhou L. Central Nervous system tumours: a single center pathology review of 34,140 cases over 60 yeara. BMC Clin Pathol. 2013;13(1):14
CBTRUS Statistical Report: Primary brain and central nervous system tumors diagnosed in the united states in 2004–2007. http://www.cbtrus.org/2011-NPCR-SEER/WEB-0407-Report-3-3-2011.pdf.
Filippini G: Epidemiology of primary central nervous system tumors. Handb Clin Neurol 2012;104:3–22.
Nakamura H, Makino K, Yano S, Kuratsu J, Kumamoto Brain Tumor Research Group. Epidemiological study of primary intracranial tumors: a regional survey in Kumamoto prefecture in southern Japan–20-year study. Int J Clin Oncol 2011;16(4):314–21.
Lonn S, Klaeboe L, Hall P, Mathiesen T, Auvinen A, Christensen HC, et al. Incidence trends of adult primary intracerebral tumors in four Nordic countries. Int J Cancer 2004;108(3):450–5.
Schwartzbaum JA, Fisher JL, Aldape KD, Wrensch M. Epidemiology and molecular pathology of glioma. Nat Clin Pract Neurol. 2006;2(9):494–503.
Lee CH, Jung KW, Yoo H, Park S, Lee SH, Epidemiology of primary brain and central nervous system tumours in Korea: J Korean Neuroaurg Soc 2010;48(2):145–52
Jamal S. Mamoon N, Mushtaq S, Luqman M : Pattern of childhood malignancies: study of 922 cases at Armed Forces Institute of Pathology (AFIP), Rawalpindi, Pakistan. Asian Pac J Cancer Prev 2006;7(3):420–2.
Asirvatham JR, Deepti AN, Chyne R, Prasad MS, Chacko AG, Rajshekhar V et al: Pediatric tumors of the central nervous system: a retrospective study of 1,043 cases from a tertiary care center in South India. Childs Nerv Syst 2011;27(8):1257–63.
Wong TT, Ho DM, Chang KP, Yen SH, Guo WY, Chang FC, et al. Primary pediatric brain tumors: statistics of Taipei VGH, Taiwan (1975–2004). Cancer 2005;104(10):2156–67.
Makino K, Nakamura H, Yano S, Kuratsu J, Kumamoto Brain Tumor Group. Population-based epidemiological study of primary intracranial tumors in childhood. Childs Nerv Syst 2010;26(8):1029–34.
Bauchet L, Rigau V, Mathieu-Daudé H, Fabbro-Peray P, Palenzuela G, Figarella-Branger D, et al. Clinical epidemiology for childhood primary central nervous system tumors. J Neurooncol 2009;92(1):87–98.
Pinho RS, Andreoni S, Silva NS, Cappellano AM, Masruha MR, Cavalheiro S, et al. Pediatric central nervous system tumors: a single-center experience from 1989 to 2009. J Pediatr Hematol Oncol 2011;33(8):605–9