Presentation1.pptx, supratentorial brain tumour

Extra-axial NeoplasmsMeningiomas account for 15 of all intracranial tumors and are the most common extra-axial tumor They originate from the dura or arachnoid and occur in middle-aged adults Women are affected twice as often as men Meningiomas are well-differentiated benign and encapsulated lesions that indent the brain as they enlarge They grow slowly and may be present for many years before producing symptoms The histologic picture shows cells of uniform size that tend to form whorls or psammoma bodiesThe parasagittal region is the most frequent site for meningiomas followed by the sphenoid wings parasellar region olfactory groove cerebello-pontine angle and rarely the intraventricular region Meningiomas often induce an osteoblastic reaction in the adjacent bone resulting in a characteristic focal hyperostosis They are also hypervascular receiving their blood supply predominantly from dural vessels

Meningioma CT Imaging10487081048708 Non-Contrastndash Sharply Circumscribedndash Homogeneousndash Hyperdense (+- Ca++)10487081048708 NOT from psammoma bodies ndash Broad Dural Surfacendash Bone Changes (Hyperostosis)10487081048708 Enhanced CTndash Homogeneous Enhancement

Meningioma Vasogenic Edema10487081048708 VASCULARndash parasitization of MCA etcndash compression of cortical aavv10487081048708 COMPRESSIVE TRAUMA10487081048708 SECRETORY EFFECT10487081048708 ldquoTRANSCORTICAL FLOWrdquondash Close apposition of tumor to brainndash Thinned cortexndash +- infiltration of brainndash Fluid gradient from meningioma into brain

Dural Tail10487081048708 Curvilinear enhancement10487081048708 ldquodural flairrdquo10487081048708 First reported wmeningioma10487081048708 First reported to be neoplastic invasion10487081048708What is it REALLYndash Thickening of the durandash Vasocongestion of the durandash Edema of the dura

Prevalence of dural tail signRokni-Yazdi H Sotoudeh H Eur J Radiol2006 Oct60(1)42-510487081048708 2298 patients (2244) of intracranialmasses had dural tail signldquondash 18 meningiomasndash 2 pituitary adenomasndash 1 primary cerebral lymphoma10487081048708 The dural tail sign had a sensitivity of586 and specificity of 9402 indiagnosis of meningioma

Anterior falcine meningioma

ldquoEn plaquerdquo Meningioma

Multiple Meningioma

Intraventricular meningioma

Optic nerve sheath meningioma right optic nerve mimicking optical glioma

Hemangiopericytoma10487081048708 Syn ldquoangioblastic meningiomardquo10487081048708 Cell of Origin ndash perivascular pericyte ofZahn andor Zimmerman10487081048708WHO 2-310487081048708lt 1 of primary CNS10487081048708 M 141 F10487081048708 Age ndash 40rsquos10487081048708 Dural based bone destruction lobulated

HEMANGIOPERICYTOMA (HPC)10487081048708 Narrow dural base (ldquoMushroomingrdquo)10487081048708No Hyperostosis10487081048708No Calcification in tumor10487081048708Lobulated (not hemispheric)10487081048708 Internal Signal Voids (on MRI)ndash irregular and multiple10487081048708 Hypervascular on Angiondash irregular patterns

Intracerebral lymphoma


Pilocytic astrocytoma

ASTROCYTOMA SUBEPENDYMAL GIANT CELL IN TUBEROUS SCLEROSIS


Pleomorphic xanthoastrocytoma



Diffuse astrocytoma

Diffuse astrocytoma

Anaplastic Astrocytoma

Anaplastic astrocytoma

Glioblastoma multiforme




Multicenteric glioma 75 of glioblastomas

oligodendroglioma

Oligodendroglioma

Oligodendroglioma

Gangliocytoma

Ganglioglioma

Ganglioglioma

Central neurocytoma

Central neurocytoma

Thank You

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Meningioma CT Imaging10487081048708 Non-Contrastndash Sharply Circumscribedndash Homogeneousndash Hyperdense (+- Ca++)10487081048708 NOT from psammoma bodies ndash Broad Dural Surfacendash Bone Changes (Hyperostosis)10487081048708 Enhanced CTndash Homogeneous Enhancement

Meningioma Vasogenic Edema10487081048708 VASCULARndash parasitization of MCA etcndash compression of cortical aavv10487081048708 COMPRESSIVE TRAUMA10487081048708 SECRETORY EFFECT10487081048708 ldquoTRANSCORTICAL FLOWrdquondash Close apposition of tumor to brainndash Thinned cortexndash +- infiltration of brainndash Fluid gradient from meningioma into brain





Multiple Meningioma













Diffuse astrocytoma

Diffuse astrocytoma








oligodendroglioma

Oligodendroglioma

Oligodendroglioma

Gangliocytoma

Ganglioglioma

Ganglioglioma

Central neurocytoma

Central neurocytoma

Thank You

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Multiple Meningioma













Diffuse astrocytoma

Diffuse astrocytoma








oligodendroglioma

Oligodendroglioma

Oligodendroglioma

Gangliocytoma

Ganglioglioma

Ganglioglioma

Central neurocytoma

Central neurocytoma

Thank You

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Diffuse astrocytoma

Diffuse astrocytoma








oligodendroglioma

Oligodendroglioma

Oligodendroglioma

Gangliocytoma

Ganglioglioma

Ganglioglioma

Central neurocytoma

Central neurocytoma

Thank You

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Diffuse astrocytoma








oligodendroglioma

Oligodendroglioma

Oligodendroglioma

Gangliocytoma

Ganglioglioma

Ganglioglioma

Central neurocytoma

Central neurocytoma

Thank You

Slide 1

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oligodendroglioma

Oligodendroglioma

Oligodendroglioma

Gangliocytoma

Ganglioglioma

Ganglioglioma

Central neurocytoma

Central neurocytoma

Thank You

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Oligodendroglioma

Oligodendroglioma

Gangliocytoma

Ganglioglioma

Ganglioglioma

Central neurocytoma

Central neurocytoma

Thank You

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Oligodendroglioma

Gangliocytoma

Ganglioglioma

Ganglioglioma

Central neurocytoma

Central neurocytoma

Thank You

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Gangliocytoma

Ganglioglioma

Ganglioglioma

Central neurocytoma

Central neurocytoma

Thank You

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Ganglioglioma

Ganglioglioma

Central neurocytoma

Central neurocytoma

Thank You

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Ganglioglioma

Central neurocytoma

Central neurocytoma

Thank You

Slide 1

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Central neurocytoma

Central neurocytoma

Thank You

Slide 1

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Central neurocytoma

Thank You

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Thank You

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Presentation1.pptx, supratentorial brain tumour

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Transcript of Presentation1.pptx, supratentorial brain tumour