Amanuel Negussie DOS 531 Week II

Acoustic Neuroma Epidemiology:

Figure 1. Reprinted from American hearing research foundation1 Acoustic neuroma, also known as vestibular shwanoma, is a non malignant tumor of the 8th cranial nerve, vestibulochoclear nerve.1 The nerve transmits sound and sends balanced information from the inner ear to the brain. Acoustic neuroma is usually a slow growing benign cancer, but it can also grow rapidly and press against the brain. Acoustic neuroma accounts for 6% of all intracranial tumors, 30% of brainstem tumors, and 85% of the tumors around the cerebellopontine angle.1 About 2000 to 3000 new cases arise each year.1 In addition, patients with hearing asymmetry, 1 in 1000 has acoustic neuroma.1

Etiology: About 95% of acoustic neuromas are caused sporadically.1 The only apparent environmental risk identified is an exposure of high dose radiation to the head and neck region. The association of acoustic neuroma to cell phone use and loud noises is a controversial subject, and is still being

investigated. The rest 5% of acoustic neuromas are caused by inherited syndrome known as neurofibromatosis type II (NF2).1 NF2 is an autosomal dominant disorder, where the mutation can be passed from one parent only. Each child of an affected parent has a 50:50 chance. About 1 in 40,000 people and 5% of patients with acoustic neuroma are affected by NF2.

Low Grade Astrocytoma Epidemiology: Low Grade Astrocytomas are rare tumors. Only 1500 new cases occur each year.1 These tumors are classified as Grade II. They are characterized as slow growing tumors and their borders are not well defined.2 Low Grade Astrocytomas rarely spread to other part of the central nervous system (CNS).2

Etiology: There is no known cause for Low Grade Astrocytomas. However, people with a family history of neurofibromatosis have a higher risk of developing these tumors.2

Anaplastic Astrocytoma Epidemiology: Anaplastic Astrocytomas are rapidly growing tumors that are more aggressive than Grade II astrocytomas.3 Approximately 65% of anaplastic astrocytoma arise in the cerebral hemispheres, 20% in the thalamus and hypothalamus, 15 % in the region of cerebrum and brain stem.3 Anaplastic Astrocytomas are rare and accounts for 2% of all brain tumors.3 Anaplastic astrocytomas have a non-uniform appearance and often invade neighboring tissue.3 This form of cancer more commonly occur in adults between age 30 and 50.

Etiology: The cause of Anaplastic Astrocytoma is commonly sporadic. However, a small portion is suspected to be caused by hereditary predisposition including neurofibromatosis type I, LiFraumeni syndrome, hereditary nonpolyposis colorectal cancer, and tuberous sclerosis.3 Anaplastic Astrocytoma can also occur from vinyl chloride and high dose radiation to the brain.3

GBM Epidemiology: Glioblastoma maliform (GBM) is the most common and deadliest brain tumor in adults. It accounts for 50% to 60% of all CNS malignancy and 12% to 15% of all intracranial tumors.4 GBM is more common in men and peaks in the 60s and 70s.4 In Europe and North America, 2 to 3 per 100,000 people are diagnosed with GBM each year.4 GBM can develop in the cerebral hemisphere, brainstem, and spinal cord.4

Etiology: Most GBMs occur sporadically. Possible risk factors include: Alcohol consumption5 Ionizing radiation of the brain6 Genetic predisposition of7 o Neurofibromitosis o Tuberous sclerosis o Von hippel-Lindaue disease o Li-Fraumeni syndrome o Turcot syndrome Oligodendrioma Epidemiology: Oligodendroglioma is type of glioma that develops from ologodendrocytes. It often occurs in frontal and temporal lobes and accounts for 2% of all brain tumor, 5% of intracranial tumors, and 10% of gliomas.8 Oligodendroglioma is identified by its box like or fried egg appearance.8 This type of tumor is more common in men and peaks between the age of 20 and 40.8

Etiology: The cause for oligodendroglioma is unkown, but most tumors show abnormalities of chromosome 19 and 1.8

References 1. Hain TC. Acoustic Neuroma. American hearing research foundation. http://americanhearing.org/disorders/acoustic-neuroma. Accessed June 3, 2013. 2. Astrocytoma. American brain tumor association. http://hope.abta.org/site/DocServer/LowGradeAsx.pdf?docID=301. Accessed June 3, 2013. 3. Anaplastic carcinoma. Boston Childrens hospital. http://www.childrenshospital.org/az/Site782/mainpageS782P1.html. Accessed June 3, 2013 4. Glioblastoma Multiform (GBM). National Brain Tumor Society. http://www.braintumor.org/patients-family-friends/about-brain-tumors/tumortypes/glioblastoma-multiforme.html. Accessed June 3, 2013. 5. Baglietto L, Giles GG, English DR, et al. Alcohol consumption and risk of glioblastoma; evidence from the Melbourne Collaborative Cohort Study. Int J Cancer. 2011; 128 (8): 19291934. 6. Cavenee, WK. High-grade gliomas with chromosome 1p loss. J neurosurg. 2000; 92 (6): 108010811. 7. Glioblastoma Multiforme. Mount Sinai Hospital. http://www.mountsinai.org/patientcare/health-library/diseases-and-conditions/glioblastoma-multiforme. Accessed June 3, 2013 8. Oligodendroglioma. University of Connecticut Health Center. http://radiology.uchc.edu/eAtlas/CNS/1766.htm. Accessed June 3, 2013.