Actualización en tumores del sistema nervioso central

Abstract

Primary tumors of the central nervous system (CNS) are the third cause of death by cancer in the adult and the first in children. They account for 10% of the CNS tumors, since 90% are metastases. The glioblastoma is the most frequent malignant tumor and the meningioma the most frequent benign one. Their clinical manifestations are due to the increase of intracranial pressure (headaches, nausea, instability and cranial pair involvement) reorganization of the cortex cytoarchitecture (epilepsy) and focal functional deficits (paresias, apraxias, cognitive deficits). Although biopsy is recommended for diagnosis in difficult-to-access sites, magnetic resonance imaging, spectroscopy and magnetoencephalography techniques make it possible to detect, characterize and establish the prognosis. Surgery is elective as long as it spares the eloquent cortex. It cures most of the benign ones and increases survival in the malignant ones. Stereotactic radiotherapy and radiosurgery are useful for both and with the metastases. Survival is approximately 15% at 5 years and the benign tumors generally recur. More selective collimators for radiotherapy will be used and neuronavigation guided surgery or ultrasound will be more precise with fewer neurological sequels.