Analysis of the course of the disease in patients with primary multiple cerebral tumors of various histological types

INTRODUCTION. Primary multiple cerebral tumors of various histological types are a rare form of neuro-oncological pathology. In the literature, there are only a few references to various combinations of cerebral tumors in the form of individual clinical cases and series of observations.

MATERIALS AND METHODS. We analyzed 40 cases of primary multiple cerebral tumors of various histological types in patients treated at the Polenov Neurosurgery Institute – the branch of Almazov National Medical Research Centre (St. Petersburg) from 2011 to 2024.

RESULTS. The following combinations of synchronous tumors were identified: meningioma + schwannoma – 16 (57 %) cases; glioma + meningioma – 3 (10 %) cases; pituitary adenoma + glioma – 2 (6 %) cases; glioma + schwannoma – 2 (6 %) cases; glioma

+ ganglioglioma – 1 (3 %) case; ependymoma + meningioma – 1 (3 %) case; lymphoma + meningioma – 1 (3 %) case; pituitary adenoma + schwannoma – 1 (3 %) case; pituitary adenoma + meningioma – 1 (3 %) case; schwannoma + ependymoma – 1 (3 %) case; hemangioblastoma + meningioma – 1 (3 %) case. The combinations of metachronous tumors were as follows: meningioma

+ schwannoma – 3 (23 %) cases; pituitary adenoma + meningioma – 3 (23 %) cases; meningioma + ependymoma – 2 (14 %) cases; pituitary adenoma + schwannoma – 1 (8 %) case; medulloblastoma + meningioma + ependymoma – 1 (8 %) case; schwannoma

+ ependymoma – 1 (8 %) case; glioma + meningioma – 1 (8 %) case; teratoblastoma + malignant tumor of the peripheral nerve sheath – 1 (8 %) case.

CONCLUSION. According to our data, the number of patients with this pathology is 0.58 % of all patients with brain tumors requiring surgical treatment. The course of the disease is not specific. In most cases, the disease debuts with the detection of two tumors of different histological types (65 %), in the absence of extracerebral oncological history (95 %). Male gender (p=0.025), the presence of neurofibromatosis (p<0.001) and associated spinal neoplasms (p<0.001) are associated with an earlier onset of the disease. Metachronous tumors occur on average earlier (39 versus 56.5 years; p=0.042) and are associated with worse outcomes (Karnofsky 70 versus 85 %; p=0.023). The survival and functional status of patients are affected by the degree of malignancy of neoplasms (p<0.001, p<0.001); age at the time of first detection affected only the survival of patients (p=0.021). The best prognosis of the disease is observed when schwannoma is combined with other types of tumors (p=0.040), and the worst in patients with gliomas (p<0.001). No reliable improvement in disease outcomes has been proven with radical surgical removal of all synchronous tumors (p=0.703).

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