Clinicopathological Study of Primary Central Nervous System Tumours - A Descriptive Study in a Tertiary Care Center Hospital of Dakshina Kannada

Abstract

BACKGROUND The central nervous system (CNS) consisting of brain and spinal cord is a delicate and a complex organ. Even a minor lesion within the central nervous system can significantly affect the higher functions and the voluntary and involuntary systems of the body. The CNS tumours have become one among the leading cause of cancer death in the present days. Early diagnosis and proper grading of these tumours can significantly improve the patient outcome. This study was conducted with an objective of correlating the clinical features with histomorphological characteristics of the primary CNS tumours and to grade the primary CNS tumors based on World Health Organization (WHO) classification. METHODS This was a descriptive observational study. A total of 117 cases of primary CNS tumours were collected from January 2012 to June 2017 at the central diagnostic laboratory of A.J Institute of Medical Sciences and Research Centre, Mangalore belonging to the Dakshina Kannada district of Karnataka, India. Out of 117 cases, 35 cases were retrieved from the files and remaining 82 were fresh cases. The tissues were fixed in 10 % buffered formalin and routinely processed. The tissue sections were stained with haematoxylin and eosin and were classified based on WHO classification. Special stain like reticulin was done in selected cases to establish the diagnosis. Patient details including the complete clinical history was collected to correlate with the histological findings. RESULTS Meningeal tumours were the maximum (37.6 %) among the central nervous system tumours in present study. Clinically, most of them (40.9 %) presented with headache and seizures. The commonest clinical presentation of central nervous system tumours observed in the present study was seizures (31.6 %). Middle cranial fossa was the preferred site for the CNS tumours (35 %). The study showed a female preponderance for CNS tumour with a male to female ratio of 1 : 1.3. The mean age for primary CNS tumours observed in the present study was 43.94 years. CONCLUSIONS In the present study, a systematic analysis of primary central nervous system tumour has been done giving due importance to the clinical features. The present study also showed a significant correlation with that of other studies. Despite of having modern imaging technique, the histopathological examination remains as the gold standard in diagnosing CNS tumours. KEY WORDS CNS Tumours, Neuroepithelial Tumours, Meningioma, Astrocytoma, Schwannoma.