甲、 腦瘤
1.分類(WHO, 1990)
A.神經上皮性組織腫瘤
a.星狀細胞瘤
I.Astrocytoma, (12.6%)
II.Malignant astrocytoma
III.GBM (glioblastoma multiforme) (6.3%)
IV.Pilocytic astrocytoma
V.Pleomorphic xanthoastrocytoma
b.Oligodendroglioma (1.6%)
c.Ependymoma (1.6%)
d.mixed glioma
e.Choroid plexus tumors：如choroid plexns papiloma (0.5%)
f.起源不明之上皮性腫瘤如astroblastoma
g.神經細胞性及混合神經膠細胞性瘤： 如gangliocytoma, ganglioglioma
h.松果體腫瘤：如pineocytoma, pineoblastoma
B.embryonal tumors：
a.medulloepithelioma
b.neuroblastoma
c.epencymoblastoma
d.retinoblastoma
e.PNET (primitive neuroectodermal tumors)如Medulloblastoma (1.5%)
C.腦脊髓神經腫瘤(6.6%)
a.schwannoma(或neurilemoma, neurinoma)
b.neurofibroma
D.meningeal tumor
a.meningioma (23.3%)
b.腦膜細胞以外由中胚層來者
I.良性：chondroma, lipoma, fibroma
II.惡性：chondrosarcoma, Rhabdomyosarcoma
c.原發性黑色素細胞瘤
d.起源不明者：hemangioblastoma, hemangioericytoma
E.造血組織
如malignant lymphoma、plasmacytoma
F.germ cell tumors
如germinoma, embryonal carcinoma, yalksac tumor, choriocarcinoma, teratoma
G.cystic and tumor like lesions
如Rathke s cleft cyst, epidermoid cyst, Dermoid cyst,第三腦室colloid cyst
H.腦垂體腫瘤：如pituitary adenoma (20.6%) pituitary carcinoma
I.local extension from regional tumors
a.craniopharyngioma(分adamantinomatous, squamous, papillary三型)
b.paraganglioma
c.Chordoma
d.chondroma
J.metastatic tumors (14.1%)＊括弧內之百分比為1997年高醫之統計
2.腦瘤之特點
A.glioima最常見，其他依次為meningioma, pituitary adenoma, metastatic tumor
B.性別：男:女為55:45，但在schwannoma和meningioma以女性為多
C.成人和小孩好發之腫瘤不同：成人以天幕上區為多，而小孩以天幕下為多(二歲以下又以天幕上區較多)
兒童常見之腦瘤為：cerebellar astrocytoma, medulloblastoma (PNET), ependymoma, brain stem glioma, craniopharyngioma, optic glioma
成年人中年、壯年：glioma, pituitary adenoma, schwanoma, meningioma
老年人：metastatic tumor, GBM