title: Clinicomorphologic markers for predicting behavior and guiding therapy for brain tumors.
abstract: More specific therapy can be achieved for brain tumors by identifying morphologic markers like primitive neuroectodermal tumor cells that tend to be radioresponsive and spread diffusely through the cerebrospinal fluid (CSF). Utilizing clinical manifestations to suspect and then localize the brain tumor, morphologic markers, that can be appreciated with computerized tomography and cerebral angiography as well as at operation, provide a basis for more aggressive extirpation and the usefulness of radiation and chemotherapy. Metastatic neoplasms possess such markers as tumor hemorrhage and meningeal involvement suggesting specific extraneural sources. In almost half of these patients, cytologic examination of the CSF should help to identify the malignant cells. Although most gliomas do not metastasize either within or outside the central nervous system, the occurrence of primitive neuroectodermal tumor cells (undifferentiated malignant small cells) in about 20% of all glioblastomas implies spread throughout the CSF and some radioresponsiveness. With thorough clinicomorphologic evaluations of all patients with brain tumors in concert with liberal clinical consultations, the aggressive, newer therapeutic modalities can be used more effectively.
mesh_terms: D000368:Aged; D001932:Brain Neoplasms / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000473:pathology* / Q000556:secondary; D002533:Cerebral Angiography; D002543:Cerebral Hemorrhage / Q000209:etiology; D003581:Cytodiagnosis; D005909:Glioblastoma / Q000473:pathology; D005910:Glioma / Q000473:pathology; D006261:Headache / Q000209:etiology; D006801:Humans; D007427:Intracranial Pressure; D008297:Male; D008577:Meningeal Neoplasms / Q000473:pathology; D014057:Tomography, X-Ray Computed