Skip to main content

Intraparenchymal Intrinsic Brain Tumours

  • Chapter
  • First Online:
Gamma Knife Neurosurgery
  • 1190 Accesses

Abstract

This chapter deals with tumours whose origin is from intracerebral cells. They include a whole family of tumours of which the commonest are the gliomas. However, the list includes ependymomas, haemangioblastomas and others. The chapter sections will be grouped according to the cell of origin of the tumours being considered. Clinical presentations will not be presented since they are to be found in any standard neurosurgery textbook. The questions to be examined here are the suitability of GKNS as a treatment once the diagnosis is established. Since the role of the treatment is in fact in debate for all the indications mentioned in this chapter, the subject matter will be limited to the commoner disease processes concerning which there is some degree of useful documentation. Moreover, it should be mentioned that stereotactic fractionated treatments are in use and their role is being assessed. They are however not included in this chapter being considered outside the scope of this book.

This chapter is also contributed by Paal-Henning Pedersen.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Notes

  1. 1.

    The information on tumour type and pathology for all groups is taken from http://www.icdns.org/,the website of the International Classification of Diseases of the Nervous System.

References

  1. Irish WD, Macdonald DR, Cairncross JG. Measuring bias in uncontrolled brain tumor trials – to randomize or not to randomize? Can J Neurol Sci 24(4): 307–312; 1997

    PubMed  CAS  Google Scholar 

  2. Low-Grade Glioma Guidelines Team in Association with the Guidelines and Outcomes Committee of the American Association of Neurological Surgeons. Practice parameters in adults with suspected or known supratentorial nonoptic pathway low-grade glioma. Neurosurgical Focus 4(6): e10; 1998

    Article  Google Scholar 

  3. Ganz JC, Smievoll AI, Thorsen F. Radiosurgical treatment of gliomas of the diencephalon. Acta Neurochir Suppl 62: 62–66; 1994

    Article  PubMed  CAS  Google Scholar 

  4. Kihlstrom L, Lindquist C, Lindquist M, Karlsson B. Stereotactic radiosurgery for tectal low-grade gliomas. Acta Neurochir Suppl 62: 55–57; 1994

    Article  PubMed  CAS  Google Scholar 

  5. Somaza SC, Kondziolka D, Lunsford LD, Flickinger JC, Bissonette DJ, Albright AL. Early outcomes after stereotactic radiosurgery for growing pilocytic astrocytomas in children. Pediatr Neurosurg 25(3): 109–115; 1996

    Article  PubMed  CAS  Google Scholar 

  6. Boethius J, Ulfarsson E, Rahn T, Lippittz B. Gamma knife radiosurgery for pilocytic astrocytomas. J Neurosurg 97(5 Suppl): 677–680; 2002

    PubMed  Google Scholar 

  7. Hadjipanayis CG, Kondziolka D, Gardner P, Niranjan A, Dagam S, Flickinger JC, Lunsford LD. Stereotactic radiosurgery for pilocytic astrocytomas when multimodal therapy is necessary. J Neurosurg 97(1): 56–64; 2002

    Article  PubMed  Google Scholar 

  8. Scott RM, Ballantine HT. Cerebellar astrocytoma: malignant recurrence after prolonged postoperative survival. Case report. J Neurosurg 39(6): 777–779; 1973

    Article  PubMed  CAS  Google Scholar 

  9. Kleinman GM, Schoene WC, Walshe TM, Richardson EP. Malignant transformation in benign cerebellar astrocytoma. Case report. J Neurosurg 49(1): 111–118; 1978

    Article  PubMed  CAS  Google Scholar 

  10. Kano H, Kondziolka D, Niranjan A, Flickinger JC, Lunsford LD. Stereotactic radiosurgery for pilocytic astrocytomas part 1: outcomes in adult patients. J Neurooncol 95(2): 211–218; 2009

    Article  PubMed  Google Scholar 

  11. Kano H, Niranjan A, Kondziolka D, Flickinger JC, Pollack IF, Jakacki RI, Lunsford LD. Stereotactic radiosurgery for pilocytic astrocytomas part 2: outcomes in pediatric patients. J Neurooncol 95(2): 219–229; 2009

    Article  PubMed  Google Scholar 

  12. Hadjipanayis CG, Kondziolka D, Flickinger JC, Lunsford LD. The role of stereotactic radiosurgery for low-grade astrocytomas. Neurosurg Focus 14(5): e15; 2003

    Article  PubMed  Google Scholar 

  13. Rozen WM, Joseph S, Lo PA. Spontaneous regression of low-grade gliomas in pediatric patients without neurofibromatosis. Pediatr Neurosurg 44(4): 324–328; 2008

    Article  PubMed  Google Scholar 

  14. Kida Y, Kobayashi T, Mori Y. Gamma knife radiosurgery for low-grade astrocytomas: results of long-term follow up. J Neurosurg 93(Suppl 3): 42–46; 2000

    PubMed  Google Scholar 

  15. Hadjipanayis CG, Niranjan A, Tyler-Kabara E, Kondziolka D, Flickinger JC, Lunsford LD. Stereotactic radiosurgery for well-circumscribed fibrillary grade II astrocytomas: an initial experience. Stereotact Funct Neurosurg 79(1): 13–24; 2002

    Article  PubMed  Google Scholar 

  16. Heppner PA, Sheehan JP, Steiner LE. Gamma knife surgery for low-grade gliomas. Neurosurgery 62(Suppl 2): 755–762; 2008

    PubMed  Google Scholar 

  17. Heppner PA, Sheehan JP, Steiner LE. Gamma knife surgery for low-grade gliomas. Neurosurgery 57(6): 1132–1139; 2005

    Article  PubMed  Google Scholar 

  18. Wang LW, Shiau CY, Chung WY, Wu HM, Guo WY, Liu KD, Ho DM, Wong TT, Pan DH. Gamma knife surgery for low-grade astrocytomas: evaluation of long-term outcome based on a 10-year experience. J Neurosurg 105(Suppl): 127–132; 2006

    Google Scholar 

  19. Kondziolka D, Comment on Heppner PA, Sheehan JP, Steiner LE. Gamma knife surgery for low-grade gliomas. Neurosurgery 57(6): 1138; 2005

    Google Scholar 

  20. Pollock BE, Comment on Heppner PA, Sheehan JP, Steiner LE Gamma knife surgery for low-grade gliomas. Neurosurgery 57(6): 1138; 2005

    Google Scholar 

  21. Mørk SJ, Lindegaard KF, Halvorsen TB, Lehmann EH, Solgaard T, Hatlevoll R, Harvei S, Ganz J. Oligodendroglioma: incidence and biological behavior in a defined population. J Neurosurg 63(6): 881–889; 1985

    Article  PubMed  Google Scholar 

  22. Kano H, Niranjan A, Khan A, Flickinger JC, Kondziolka D, Lieberman F, Lunsford LD. Does radiosurgery have a role in the management of oligodendrogliomas? J Neurosurg 110(3): 564–571; 2009

    Article  PubMed  Google Scholar 

  23. Sarkar A, Pollock BE, Brown PD, Gorman DA. Evaluation of gamma knife radiosurgery in the treatment of oligodendrogliomas and mixed oligodendroastrocytomas. J Neurosurg 97(5 Suppl): 653–656; 2002

    PubMed  Google Scholar 

  24. Roberge D, Souhami L. High-grade gliomas. in (eds) Chin LS, Regine WF: Principles and Practice of Stereotactic Radiosurgery. Springer Science + Business Media LLC, New York: pp 207–222; 2008

    Chapter  Google Scholar 

  25. Hsieh PC, Bhangoo S, Panagiotopoulos K, Kalapurakal JA, Marymont MH, Cozzens. JW, Levy RM. Adjuvant gamma knife stereotactic radiosurgery at the time of tumor progression potentially improves survival for patients with glioblastoma. Neurosurgery 57: 684–692; 2005

    Article  PubMed  Google Scholar 

  26. Lim YJ, Leem W. Two cases of gamma knife radiosurgery for low-grade optic chiasm glioma. Stereotact Funct Neurosurg 66(Suppl 1): 174–183; 1996

    Article  PubMed  Google Scholar 

  27. Yen CP, Sheehan J, Steiner M, Patterson G, Steiner L. Gamma knife surgery for focal brainstem gliomas. J Neurosurg 106(1): 8–17; 2007

    Article  PubMed  Google Scholar 

  28. Krishnan S, Brown PD, Scheithauer BW, Ebersold MJ, Hammack JE, Buckner JC. Choroid plexus papillomas: a single institutional experience. J Neurooncol 68(1): 49–55; 2004

    Article  PubMed  Google Scholar 

  29. Mansur DB, Drzymala RE, Rich KM, Klein EE, Simpson JR. The efficacy of stereotactic radiosurgery in the management of intracranial ependymoma. J Neurooncol 66(1–2): 187–190; 2004

    Article  PubMed  Google Scholar 

  30. Applegate GL, Marymont MH. Intracranial ependymomas: a review. Cancer Invest 16(8): 588–593; 1998

    Article  PubMed  CAS  Google Scholar 

  31. Bertalanffy A, Roessler K, Koperek O, Gelpi E, Prayer D, Knosp E. Recurrent central neurocytomas. Cancer 104(1): 135–142; 2005

    Article  PubMed  Google Scholar 

  32. Endo H, Kumabe T, Jokura H, Shirane R, Tominaga T. Stereotactic radiosurgery for nodular dissemination of anaplastic ependymoma. Acta Neurochir 146(3): 291–298; 2004

    Article  PubMed  CAS  Google Scholar 

  33. Jawahar A, Kondziolka D, Flickinger JC, Lunsford LD. Adjuvant stereotactic radiosurgery for anaplastic ependymoma. Stereotact Funct Neurosurg 73(1–4): 23–30; 1999

    Article  PubMed  CAS  Google Scholar 

  34. Lo SS, Abdulrahman R, Desrosiers PM, Fakiris AJ, Witt TC, Worth RM, Dittmer PH, Desrosiers CM, Frost S, Timmerman RD. The role of gamma knife radiosurgery in the management of unresectable gross disease or gross residual disease after surgery in ependymoma. J Neurooncol 79(1): 51–56; 2006

    Article  PubMed  Google Scholar 

  35. Stafford SL, Pollock BE, Foote RL, Gorman DA, Nelson DF, Schomberg PJ. Stereotactic radiosurgery for recurrent ependymoma. Cancer 88(4): 870–875; 2000

    Article  PubMed  CAS  Google Scholar 

  36. Krieger MD, McComb JG. The role of stereotactic radiotherapy in the management of ependymomas. Childs Nerv Syst 25(10): 1269–1273; 2009

    Article  PubMed  Google Scholar 

  37. Kano H, Niranjan A, Kondziolka D, Flickinger JC, Lunsford LD. Outcome Predictors for intracranial ependymoma radiosurgery. Neurosurgery 64(2): 279–288; 2009

    Article  PubMed  Google Scholar 

  38. Woo C, Stea B, Lulu B, Hamilton A, Cassady JR. The use of stereotactic radiosurgical boost in the treatment of medulloblastomas. Int J Radiat Oncol Biol Phys 37(4): 761–764; 1997

    Article  PubMed  CAS  Google Scholar 

  39. Inoue HK, Nakamura M, Ono N, Kawashima Y, Hirato M, Ohye C. Long-term clinical effects of radiation therapy for primitive gliomas and medulloblastomas: a role for radiosurgery. Stereotact Funct Neurosurg 61(Suppl 1): 51–58; 1993

    Article  PubMed  Google Scholar 

  40. Blakeley JO, Grossman SA. Management of pineal region tumors. Curr Treat Options Oncol 7(6): 505–516; 2006

    Article  PubMed  Google Scholar 

  41. Bruce JN, Ogden AT. Surgical strategies for treating patients with pineal region tumors. J Neurooncol 69(1–3): 221–236; 2004

    Article  PubMed  Google Scholar 

  42. Lekovic GP, Shetter AG. Pineal region tumours. in (eds) Chin LS, Regine WF: Principles and Practice of Stereotactic Radiosurgery. Springer Science + Business Media LLC, New York: pp 355–364; 2008

    Chapter  Google Scholar 

  43. Deshmukh VR, Smith KA, Rekate HL, Coons S, Spetzler RF. Diagnosis and management of pineocytomas. Neurosurgery 55(2): 349–355; 2004

    Article  PubMed  Google Scholar 

  44. Endo H, Kumabe T, Jokura H, Tominaga T. Stereotactic radiosurgery followed by whole ventricular irradiation for primary intracranial germinoma of the pineal region. Minim Invasive Neurosurg 48(3): 186–190; 2005

    Article  PubMed  CAS  Google Scholar 

  45. Hasegawa T, Kondziolka D, Hadjipanayis CG, Flickinger JC, Lunsford LD. Stereotactic radiosurgery for CNS nongerminomatous germ cell tumors. Report of four cases. Pediatr Neurosurg 38(6): 329–333; 2003

    Article  PubMed  Google Scholar 

  46. Hasegawa T, Kondziolka D, Hadjipanayis CG, Flickinger JC, Lunsford LD. The role of radiosurgery for the treatment of pineal parenchymal tumors. Neurosurgery 51(4): 880–889; 2002

    PubMed  Google Scholar 

  47. Kano H, Niranjan A, Kondziolka D, Flickinger JC, Lunsford D. Role of stereotactic radiosurgery in the management of pineal parenchymal tumors. Prog Neurol Surg 23: 44–58; 2009

    Article  PubMed  Google Scholar 

  48. Reyns N, Hayashi M, Chinot O, Manera L, Peragut JC, Blond S, Régis J. The role of gamma knife radiosurgery in the treatment of pineal parenchymal tumours. Acta Neurochir 148(1): 5–11; 2006

    Article  PubMed  CAS  Google Scholar 

  49. Amendola BE, Wolf A, Coy SR, Amendola MA, Eber D. Pineal tumors: analysis of treatment results in 20 patients. J Neurosurg 102(Suppl): 175–179; 2005

    Article  PubMed  Google Scholar 

  50. Chasan CB, Goetsch S, Ott K. Radiosurgery for pineal tumors: is biopsy indicated? Stereotact Funct Neurosurg 66(Suppl 1): 157–163; 1996

    Article  PubMed  Google Scholar 

  51. Dempsey PK, Kondziolka D, Lunsford LD. Stereotactic diagnosis and treatment of pineal region tumours and vascular malformations. Acta Neurochir 116(1): 14–22; 1992

    Article  PubMed  CAS  Google Scholar 

  52. Dempsey PK, Lunsford LD. Stereotactic radiosurgery for pineal region tumors. Neurosurg Clin N Am 3(1): 245–253; 1992

    PubMed  CAS  Google Scholar 

  53. Kobayashi T, Kida Y, Mori Y. Stereotactic gamma radiosurgery for pineal and related tumors. J Neurooncol 54(3): 301–309; 2001

    Article  PubMed  CAS  Google Scholar 

  54. Lekovic GP, Gonzalez LF, Shetter AG, Porter RW, Smith KA, Brachman D, Spetzler RF. Role of gamma knife surgery in the management of pineal region tumors. Neurosurg Focus 23: E12; 2007

    Article  PubMed  Google Scholar 

  55. Manera L, Régis J, Chinot O, Porcheron D, Levrier O, Farnarier P, Peragut JC. Pineal region tumors: the role of stereotactic radiosurgery. Stereotact Funct Neurosurg 66(Suppl 1): 164–173; 1996

    Article  PubMed  Google Scholar 

  56. Mori Y, Kobayashi T, Hasegawa T, Yoshida K, Kida Y. Stereotactic radiosurgery for pineal and related tumors. Prog Neurol Surg 23: 106–118; 2009

    Article  PubMed  Google Scholar 

  57. Subach BR, Lunsford LD, Kondziolka D. Stereotactic radiosurgery in the treatment of pineal regions tumours. in (eds) Lunsford LD, Kondziolka D, Flickinger JC: Gamma Knife Brain Surgery. Proc Neurol Surg Basel, Karger 14: 175–194; 1998

    Google Scholar 

  58. Levivier M, Brotchi J. Comment on ‘Hasegawa T, Kondziolka D, Hadjipanayis CG, Flickinger JC, Lunsford LD. The role of radiosurgery for the treatment of pineal parenchymal tumors. Neurosurgery 51(4): 880–889; 2002’ Neurosurgery 51(4): 887–888

    Google Scholar 

  59. Germanwala AV, Mai JC, Tomycz ND, Niranjan A, Flickinger JC, Kondziolka D, Lunsford LD. Boost gamma knife surgery during multimodality management of adult medulloblastoma. J Neurosurg 108: 204–209; 2008

    Article  PubMed  Google Scholar 

  60. Bowers DC, Georgiades C, Aronson LJ, Carson BS, Weingart JD, Wharam MD, Melhem ER, Burger PC, Cohen KJ. Tectal gliomas: natural history of an indolent lesion in pediatric patients. Pediatr Neurosurg 32(1): 24–29; 2000

    Article  PubMed  CAS  Google Scholar 

  61. Stark AM, Fritsch MJ, Claviez A, Dörner L, Mehdorn HM. Management of tectal glioma in childhood. Pediatr Neurol 33(1): 33–38; 2005

    Article  PubMed  Google Scholar 

  62. Guillamo JS, Monjour A, Taillandier L, Devaux B, Varlet P, Haie-Meder C, Defer GL, Maison P, Mazeron JJ, Cornu P, Delattre JY, Association des Neuro-Oncologues d'Expression Française (ANOCEF). Brainstem gliomas in adults: prognostic factors and classification. Brain 124(Pt 12): 2528–2539; 2001

    Article  PubMed  CAS  Google Scholar 

  63. Hargrave D, Bartels U, Bouffet E. Diffuse brainstem glioma in children: critical review of clinical trials. Lancet Oncol 7(3): 241–248; 2006

    Article  PubMed  Google Scholar 

  64. Westphal M. Comment on ‘Deshmukh VR, Smith KA, Rekate HL, Coons S, Spetzler RF. Diagnosis and management of pineocytomas. Neurosurgery 55(2): 349–355; 2004’ Neurosurgery 55(2): 356; 2004

    Article  Google Scholar 

  65. Figarella-Branger D, Pellissier JF, Daumas-Duport C, Delisle MB, Pasquier B, Parent M, Gambarelli D, Rougon G, Hassoun J. Central neurocytomas. Critical evaluation of a small-cell neuronal tumor. Am J Surg Pathol 16(2): 97–109; 1992

    Article  PubMed  CAS  Google Scholar 

  66. Bertalanffy A, Roessler K, Dietrich W, Aichholzer M, Prayer D, Ertl A, Kitz K. Gamma knife radiosurgery of recurrent central neurocytomas: a preliminary report. J Neurol Neurosurg Psychiatry 70(4): 489–493; 2001

    Article  PubMed  CAS  Google Scholar 

  67. Anderson RC, Elder JB, Parsa AT, Issacson SR, Sisti MB. Radiosurgery for the treatment of recurrent central neurocytomas. Neurosurgery 48(6): 1231–1237; 2001

    PubMed  CAS  Google Scholar 

  68. Hara M, Aoyagi M, Yamamoto M, Maehara T, Takada Y, Nojiri T, Ohno K. Rapid shrinkage of remnant central neurocytoma after gamma knife radiosurgery: a case report. J Neurooncol 62(3): 269–273; 2003

    Article  PubMed  Google Scholar 

  69. Pollock BE, Stafford SL. Stereotactic radiosurgery for recurrent central neurocytoma: case report. Neurosurgery 48(2): 441–443; 2001

    PubMed  CAS  Google Scholar 

  70. Tyler-Kabara E, Kondziolka D, Flickinger JC, Lunsford LD. Stereotactic radiosurgery for residual neurocytoma. Report of four cases. J Neurosurg 95(5): 879–882; 2001

    Article  PubMed  CAS  Google Scholar 

  71. Kim CY, Paek SH, Jeong SS, Chung HT, Han JH, Park CK, Jung HW, Kim DG. Gamma knife radiosurgery for central neurocytoma: primary and secondary treatment. Cancer 110: 2276–2284; 2007

    Article  PubMed  Google Scholar 

  72. Yen CP, Sheehan J, Patterson G, Steiner L. Gamma knife surgery for neurocytoma. J Neurosurg 107: 7–12; 2007

    Article  PubMed  Google Scholar 

  73. Ammerman JM, Lonser RR, Dambrosia J, Butman JA, Oldfield EH. Long-term natural history of hemangioblastomas in patients with von Hippel-Lindau disease: implications for treatment. J Neurosurg 105: 248–255; 2006

    Article  PubMed  Google Scholar 

  74. Jagannathan J, Lonser RR, Smith R, DeVroom HL, Oldfield EH. Surgical management of cerebellar hemangioblastomas in patients with von Hippel-Lindau disease. J Neurosurg 108(2): 210–222; 2008

    Article  PubMed  Google Scholar 

  75. Jawahar A, Kondziolka D, Garces YI, Flickinger JC, Pollock BE, Lunsford LD. Stereotactic radiosurgery for hemangioblastomas of the brain. Acta Neurochir 142(6): 641–644; 2000

    Article  PubMed  CAS  Google Scholar 

  76. Kano H, Niranjan A, Mongia S, Kondziolka D, Flickinger JC, Lunsford LD. The role of stereotactic radiosurgery for intracranial haemangioblastomas. Neurosurgery 63(3): 443–450; 2008

    Article  PubMed  Google Scholar 

  77. Matsunaga S, Shuto T, Inomori S, Fujino H, Yamamoto I. Gamma knife radiosurgery for intracranial haemangioblastomas. Acta Neurochir 149: 1007–1013; 2007

    Article  PubMed  CAS  Google Scholar 

  78. Niemela M, Lim YJ, Soderman M, Jaaskelainen J, Lindquist C. Gamma knife radiosurgery in 11 hemangioblastomas. J Neurosurg 85(4): 591–596; 1996

    Article  PubMed  CAS  Google Scholar 

  79. Park YS, Chang JH, Chang JW, Chung SS, Park YG. Gamma knife surgery for multiple hemangioblastomas. J Neurosurg 102(Suppl): 97–101; 2005

    Article  PubMed  Google Scholar 

  80. Rajaraman C, Rowe JG, Walton L, Malik I, Radatz M, Kemeny AA. Treatment options for von Hippel-Lindau’s haemangioblastomatosis: the role of gamma knife stereotactic radiosurgery. Br J Neurosurg 18(4): 338–342; 2004

    Article  PubMed  CAS  Google Scholar 

  81. Tago M, Terahara A, Shin M, Maruyama K, Kurita H, Nakagawa K, Ohtomo K. Gamma knife surgery for hemangioblastomas. J Neurosurg 102(Suppl): 171–174; 2005

    Article  PubMed  Google Scholar 

  82. Wang EM, Pan L, Wang BJ, Zhang N, Zhou LF, Dong YF, Dai JZ, Cai PW, Chen H. The long-term results of gamma knife radiosurgery for hemangioblastomas of the brain. J Neurosurg 102(Suppl): 225–229; 2005

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jeremy C. Ganz .

Rights and permissions

Reprints and permissions

Copyright information

© 2011 Springer-Verlag/Wien

About this chapter

Cite this chapter

Ganz, J.C. (2011). Intraparenchymal Intrinsic Brain Tumours. In: Gamma Knife Neurosurgery. Springer, Vienna. https://doi.org/10.1007/978-3-7091-0343-2_16

Download citation

  • DOI: https://doi.org/10.1007/978-3-7091-0343-2_16

  • Published:

  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-7091-0342-5

  • Online ISBN: 978-3-7091-0343-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics