Brain tumor staging

Brain tumor Microchapters
Patient Information
Overview
Classification Adult brain tumors Glioblastoma multiforme Oligodendroglioma Meningioma Hemangioblastoma Pituitary adenoma Schwannoma Primary CNS lymphoma Childhood brain tumors Pilocytic astrocytoma Medulloblastoma Ependymoma Craniopharyngioma Pinealoma Metastasis Lung cancer Breast cancer Melanoma Gastrointestinal tract cancer Renal cell carcinoma Osteoblastoma Head and neck cancer Neuroblastoma Lymphoma Prostate cancer
Causes
Differentiating Brain Tumor from other Diseases

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

A staging system is used for most other types of cancer. There is a formal staging system for adult brain tumors; however, the grading system described below is always used instead.

After a brain tumor has been diagnosed, additional tests will be done to learn more about the tumor. If the tumor is a glial brain tumor, the pathologist will assign a “grade” using a number from I to IV (one to four). The grade indicates how different the tumor cells are from healthy cells, with a higher grade tumor having cells that are the least like healthy cells. The characteristics of the tumor, as seen under the microscope, help determine how cancerous a tumor is. Generally, the lower the grade, the better the prognosis (chance of recovery or long-term control of the tumor).

WHO Histologic Grading for CNS Tumors

Grade I

• Lesions with low proliferative potential, a frequently discrete nature, and the possibility of cure following surgical resection alone
• Juvenile pilocytic astrocytoma, subependymal giant cell astrocytoma

Grade II

• Lesions that are generally infiltrating and low in mitotic activity but recur; some tumor types tend to progress to higher grades of malignancy
• Diffuse astrocytoma, oligodendroglioma, oligoastrocytoma

Grade III

• Lesions with histologic evidence of malignancy, generally in the form of mitotic activity, clearly expressed infiltrative capabilities, and anaplasia
• Anaplastic astrocytoma, anaplastic oligoastrocytoma, anaplastic oligoastrocytoma

Grade IV

• Lesions that are mitotically active, necrosis-prone, and generally associated with a rapid preoperative and postoperative evolution of disease
• Glioblastoma