Central Nervous System (CNS) Tumors

The term central nervous system tumors includes both primary and metastatic tumors of the brain and spine. The etiology of CNS tumors remains largely elusive with certain genetic syndromes having increased risk. With advances in imaging technology and patient awareness, the incidence of these tumors is increasing worldwide. The histological spectrum of tumors is variable with both benign and malignant tumors seen across all the age groups. Meningiomas and gliomas are among the common primary tumors in adults while medulloblastomas and gliomas are common in children. Surgery is the mainstay of treatment in the majority of tumours and involves the use of multiple adjuncts for achieving maximal safe resection. Unlike other solid tumors, oncological resections (margin negative resections) are difficult (due to eloquent location) and adjuvant treatment (radiotherapy and chemotherapy) plays an important role in the management of the disease, even for benign tumors. Advances in radiation and particle therapy have greatly improved outcomes. Therapy-related sequelae may be associated with significant morbidity. Rehabilitation is vital in improving acute as well as long-term patient outcomes. Even after complete treatment, the risk of disease progression/recurrence always remains and close clinical follow-up is essential.