Tumor of the frontal share of ICD 10. Brain tumors and other departments of the central nervous system

03.08.2020

Under the tumor it is customary to understand all brain neoplasms, that is, benign and malignant. This disease is made to the international classification of diseases, each of which is assigned the code, the brain tumor code on the ICD 10: C71 denotes a malignant tumor, and D33 is a benign tumor of the brain and other departments of the central nervous system.

Since this disease relates to oncology, the causes of the development of brain cancer as well as other diseases of this category are still unknown. But there is a theory that the specialists of this area adhere to. It is based on a multifactority - brain cancer can develop under the influence of several factors at the same time, from here and the name of the theory. Among the factors most often found:

Basic symptoms

To testify to the presence of a brain tumor (ICD code 10), the following symptoms and violations can be:

an increase in the volume of the brainstant, and subsequently an increase in intracranial pressure;
cephalgic syndrome, which is accompanied by the presence of a strong headache especially in the morning and during the change of body position, as well as vomiting;
system dizziness. It differs from the usual the fact that the patient feels that the items surrounding it are rotated. The reason for such a notem is in violation of blood supply, that is, when blood cannot normally circulate and flow into the brain;
violation of the processes of perception of the world around the world;
the failures of the musculoskeletal function, the development of paralysis - localization depends on the brain lesion area;
epileptic and convulsive seizures;
violation of speech and hearing organs: it becomes unnecessary and incomprehensible, and instead of sounds, only noise is heard;
the loss of concentration, complete confusion, and other symptoms are also possible.

Brain Tumor: Stage

Cancer stage is made to distinguish clinical signs And only 4. In the first stage, the most common symptoms are manifested, for example, headaches, weakness and dizziness. Since these symptoms cannot directly indicate the presence of cancer, even doctors cannot identify oncology on early stage. However, a small chance of detection still remains, there are cases of cancer detection during computer diagnostics.

Tumor of the temporal lobe of the brain

In the second stage of symptoms are more pronounced, in addition, patients have a violation of vision and coordination of movements. Most effective method The detection of brain tumors is MRI. At this stage, in 75% of cases, a positive outcome is possible as a result of operational intervention.

The third stage is characterized by a violation of vision, hearing and motor function, an increase in body temperature, fast fatigue. At this stage, the disease penetrates deep into and begins to destroy the lymph nodes Both fabrics and then applies to other organs.

The fourth stage of the brain cancer is Giliblastoma, which is the most aggressive and dangerous form of the disease, is diagnosed in 50% of cases. Hemp glioblastoma has a code on the ICD 10 - C71.9 is characterized as a multiform disease. This brain neoplasm refers to the astrocytic subgroup. It is usually developing as a result of the conversion of a benign tumor into malignant.

Methods for the treatment of brain cancer

Unfortunately, oncological diseases Categories the most dangerous diseases and difficult to treat, especially oncology of the brain. However, there are methods that can suspend further destruction of cells, and they are successfully used in medicine. The most famous among them

An earlier manifestation of the cerebral tumor process is focal symptoms. It can have the following development mechanisms: chemical and physical impact on the surrounding cerebral tissues, damage to the wall of the brain vessel with hemorrhage, vascular occlusion by metastatic ehambol, hemorrhage in metastasis, compression of the vessel with the development of ischemia, the compression of the roots or cranial nerve compression. Moreover, at the beginning, the symptoms of local irritation of a certain cerebral plot occur, and then the loss of its function arises (neurological deficit).
As The increase in the compression tumor, swelling and ischemia spread first to the adjacent fabric with the affected area, and then to more remote structures, caused the appearance of respectively symptoms "next door" and "at the distance". The commozoase symptoms caused by intracranial hypertension and an edema of the brain develops later. With a significant amount of cerebral tumor, the mass effect (displacement of basic cerebral structures) is possible with the development of dislocation syndrome - the cerebellum and the oblong brain into the occipital hole.
Local Headache may be early symptom tumors.It arises due to irritation of receptors, localized in cranial nerves, venous sinuses, walls of shell vessels. Diffuse Cefalgia is observed in 90% of cases of subitative neoplasms and in 77% of cases of supracentucleory tumor processes. It has the character of a deep, fairly intense and sawing pain, often bred.
Vomot usually performs a communal symptom.Its main feature is the lack of communication with food intake. With the cerebellum tumor or IV ventricle, it is associated with direct influence on the pumped center and may be a primary focal manifestation.
System dizziness may occur in the form of a feeling of falling, rotating its own body or surrounding items. In the period of manifestation clinical manifestations Dizziness is considered as a focal symptom indicating the defeat of the tumor of the vestibular cholear nerve, the bridge, the cerebellum or IV ventricle.
Motor disorders (pyramid disorders) are as primary tumor symptoms in 62% of patients. In other cases, they arise later due to the growth and spread of the tumor. The earliest manifestations of pyramidal failure include the growing anisuflection of tendon reflexes from the limbs. Then there is muscle weakness (paresis), accompanied by spasticity due to the muscle hypertonus.
Sensory violations Basically accompany pyramid failure.Clinically manifested about a quarter of patients, in other cases are detected only with neurological examination. As primary focal symptom Muscular-articular feeling may be considered.
Convulsive syndrome more characteristic of supracentorial neoplasms.In 37% of patients with cerebral tumors, epiprigances are manifestic clinical symptom. The occurrence of absans or generalized tonic-clonic epiprigances is more typically for the tumors of the median localization; Paroxysis in the type of Jackson epilepsy - for neoplasms located near the brain bark. The character of the Epiprust Aura often helps to establish a lesion top. As the neoplascence increases, generalized epiprigances are transformed into partial. In progression of intracranial hypertension, as a rule, a decrease in epics is observed.
The disorders of the mental sphere during the period of manifestation occurs in 15-20% of cases of cerebral tumors, mainly by their location in the frontal share. Non-initiativeness, slope and apathy are typical for the tumors of the frontal lobe. Euphoricity, complacency, caustic functions indicate the defeat of the base of the frontal lobe. In such cases, the progression of the tumor process is accompanied by an increase in aggressiveness, maliciousness, negativism. Spectative hallucinations are characteristic of neoplasms located at the junction of temporal and frontal lobes. Mental disorders in the form of a progressive memory deterioration, violations of thinking and attention acts as generalizing symptoms, since they are due to growing intracranial hypertension, tumor intoxication, damage to associative tracts.
Stagnation spectator nerves diagnosed in half patients more often in more late stagesHowever, children can serve as a debut symptom of the tumor. Due to elevated intracranial pressure, there may be a transient binding of vision or "flying" before the eyes. Under the progression of the tumor, an increasing impairment of vision associated with atrophy of the visual nerves is noted.
Changes in fields of view occur during the damage to the chiasms and visual tracts.In the first case, heteronimary hemiananopsy is observed (loss of variepete half of the visual fields), in the second - the homonymy (loss in the fields of view of both right or both left half).

Gilarlastoma is called malignant neoplasm, developing in brain tissues. Despite the lack of metastases, the tumor represents serious threat For a person's life. The prognosis of the disease is determined by a complex of factors, among which the priority site occupies the localization of the tumor and its degree of development at the time of diagnosis. The risk group includes elderly. However, there are cases of developing glioblastoma in children.

The glioblastoma of the brain (code according to the ICD 10 - C71) is a cancer. There are two ways for its development:

primary - from glial cells (in most cases);
secondary - from the existing astrocytoma (a type of brain cancer).

The second option is characteristic of middle-aged people and is characterized by slow growth.

Regardless of the path of development, the neoplasm is characterized by the following features:

predominant defeat of the frontal and temporal lobe of the brain;
the presence of 4 degrees (tumor cells are subject to rapid growth and reproduction);
diffuse nature of growth, the presence of its own network of blood vessels;
rare metastasis;
different consistency and different sizes;
the presence of cell infiltration outside the visible tumor.

The etiology of the disease is unclear. The factors provoking the development of the tumor are presented:

genetic pathologies;
sV40, HHV-6 virus and cytomegalovirus;
previously conducted radiation therapy;
head injuries;
smoking.

The risk group for the development of glioblastomes falls:

men aged from 40 years;
people who have a history of astrocyst;
patients suffering from neurofibromatosis, since the latter is accompanied by genetic disorders;
men and women in contact with polyvinyl chloride (this chemical substance has a negative effect on glial cells), with ionizing radiation (for a long time);
people suffering from frequent viral diseases;
patients with burded heredity.

Symptoms

Clinical picture Brain tumors include wide spectrum Symptoms. At an early stage, it is possible to suspect the presence of a neoplary by the emergence of frequent faints, on speech disorders or movements. This happens if the tumor is located next to the centers controlling speech and movement.

Symptoms of glioblastoma include the following manifestations:

regular headaches that cannot be removed using analgesics;
nausea after awakening;
olfactory hallucinations;
violation of vision and speech;
weakening of memory;
changing the sensitivity and mobility of the hands and legs;
drowsiness;
dizziness;
cramps.

An increase in the growth rate of the aggressive tumor leads to an increase in clinical manifestations. In some cases, the size of the neoplasm is small, or the tumor is located far from the nervous centers. In this case, the timely diagnosis of glioblastoma represents complexity.

Classification

Depending on the type of cells, 3 types of tumors are isolated:

gybandist gyplastoma, when the neoplasm includes large cells containing two or more kernels;
multiform glioblastoma, the fabric of which includes blood vessels, foci of necrosis, etc.;
giosarcoma, consisting of a glill (auxiliary cells of nervous tissue) and connective tissue cells.

The difference in the localization of the tumor allows you to distinguish its following types:

cerebral (tumor is in temporal, frontal or other areas of the brain);
the trunk, when the formation is located in the brain barrel (inexperience tumor, since surgery leads to a violation in the operation of the musculoskeletal system).

According to histological classification, 3 types of glioblastoma are distinguished:

isomorphones, when the tumor consists of single-type cells;
multiform, in which the neoplasm consists of cells of different types;
polymorphnellular (cells of glioblastoma of different sizes and shapes).

Another reason for classification is the number of malignant neoplasm cells. In accordance with this, 4 stages of glioblastoma are distinguished.

The first stage is transitional. Diagnostics is impossible due to the complete absence of manifestations. Only a part of benign cells develop into cancer.
Second phase - slow Rost. cells.
The third stage is the development of malignant tumor. There is a rapid growth of atypical cells.
The fourth stage is the manifestation of a bright clinical picture. More often diagnosed with giliblastic 4 degrees. The life expectancy of the patient after diagnosis is several months.

Types of glioblastoma

4 main types of glioblastoma are isolated depending on cells predominate in tumor tissue. Each type is distinguished by the specific nature of the pathology and the degree of malignancy.

Multiform pathology

This type of glioblastoma is distinguished by a species variety of cancer cells. The basis for the development of the neoplasm becomes Gliya, which is a connecting tissue of neurons networks. The launching mechanism for rebirth is the impact of adverse factors.

The active growth of atypical cells contributes to the spread of cancer in other departments of the nervous system (for example, with the subsequent development of the glioblastoma of the spinal cord). Treatment of multiform pathology has certain difficulties. They are due to the fact that each type of cancer cells is susceptible to different methods of therapy and has different growth rate and development. Multifocal glioblastoma is considered the most dangerous.

Gigantaeer form

During the study of the material, large pathological cells are detected. They include several nuclei. The disease relates to less dangerous.

Glyosarcoma

The neoplasm is characterized by bidermality. The tumor is a mixture of glial cells and cells connective tissue. Glyosarcoma is difficult to treat.

Polymorphnellular form

Atypical cells are large, different shapes. In the study, a small amount of cytoplasm is detected. The kernels have a different structure and dimensions. Polymorphnes glioblastoma meets more often than other types.

Diagnostic methods

To form a diagnosis, there is a certain scheme of examination of patients. The main principle is complexity. Diagnostic measures include carrying out:

primary inspection and collection of anamnesis;
neurological inspection;
ophthalmologic inspection;
MRI brain with the use of contrasting strengthen;
electroencephalography;
clinical blood testing;
biochemical blood test (including the functions of the liver and kidney function).

The estimation of the general functional status is carried out on a special scale - Karnovsky scale.

Tumor treatment methods

Gyoblastoma is incurable, but the suffering of the patient can be eased.

Therapy is aimed at:

maximum reduction of education size without damage to normal cells;
suspension of further reproduction of pathological cells;
creating conditions for improving the quality of life of the patient.

The initial stage of treatment of glioblastomes of the brain is operational intervention. Subsequent steps are chemotherapy and radiation therapy. Fully tumor is not deleted in two cases:

Pathological education is located in vital brain departments.
Around the tumor is migrating oncoclections, invading a healthy area.

Partial removal of affected fabrics allows you to increase the lifespan. After consulting with the attending physician, it is possible to use non-traditional methods. The purpose of the modified diet with glioblastoma will slow down the growth of atypical cells and increase their sensitivity to the therapy. It is possible to use corticosteroid drugs. So, dexamethasone will help remove the brain swelling and reduce the feeling of pain. The preparation has a lot side phenomenaTherefore, the decision on his appointment is made by a doctor based on the state of the patient's health.

Neurosurgical intervention

Operation is carried out on the brain. In the process surgical intervention They try to remove the tumor as much as possible. In some situations, the method does not apply or is risky. This is connected with the close location of the neoplasm next to the vital areas of the brain. When recurring can assign a re-operation.

Combined treatment

The use of radiation therapy in combination with the drug temmod

The essence of treatment is an effect on atypical cells by ionizing radiation. This is necessary to reduce the activity of the neoplasm, inhibition of its growth. The duration of radiation therapy with glioblastoma is an average of 30 days. Treatment is carried out within 6 weeks (5 times a week).

At the same time, the reception is necessary to eat the antitumor drug. The treatment of glioblastoma for each patient is determined individually depending on age category and previous chemistry.

A variety of radiation therapy is radiosurgery. The cybernet method with glioblastoma is characterized by the smallest trauma due to point exposure. Thanks to this, the number of sessions is less, and therapeutic effect above.

Supporting chemotherapy

The effects of chemotherapy are carried out to block the growth and development of pathological cells. As active substance Temolomide contained in the preparation is used in the drug. Chemotherapy in the glioblastoma of the brain is carried out in a complex with radiation therapy. Then supporting courses are needed. Their duration is 5 days. The break is 23 days. On average, 6 courses needed.

Target therapy

The use in the treatment of the drug Avastin allows you to disrupt the circulatory system in the neoplasm. As a result, the tumor growth is reduced. The drug is used in the relapses of glioblastoma. The initial diagnosis of the tumor is not an indication for the purpose of this medicinal product.

How dying from glioblastoma

Patients with glioblastic brain 4 degrees suffer from constant strong headaches and convulsive seizures. Growth and reproduction of malignant cells leads to violations of mental activity and mental disorders. Paralysis becomes the result of the disease.

Effects

Giliblastoma is distinguished by special malignancy. The prognosis is unfavorable. It depends on several factors:

general condition of the patient;
the age of the patient;
location of the neoplasm;
tumor size;
the reaction of the body on the therapy conducted.

On average, life expectancy with glioblastoma ranges from 12 to 15 months. The inoperability of the tumor significantly reduces this period of time.

A small percentage of patients survive 2 years or more.

However, the presence of a neoplary leads to a number of consequences:

the emergence of relapses even after effective treatment primary neoplasm;
with the localization of the tumor next to the vital brain centers, it grows and negatively acts on the centers responsible for the respiratory function and blood circulation;
partial removal of glioblastoma leads to neurological disorders.

It is impossible to defeat glioblasts. However, you can slow the growth of atypical cells. Tumor treatment should begin after diagnosis immediately.

New methods of treating this malignant neoplasm are being developed. In Germany experienced new drug LY2109761. Israel's doctors experiment with exposure to glioblastically adjustable electromagnetic field. It is possible that new techniques will allow to increase the life expectancy of patients with glioblastoma.

Brain tumors - a heterogeneous group of neoplasms for which general sign is to find or secondary penetration into the skull cavity. Histogenesis is poured and reflected in the Histological classification of WHO (see below). Allocate 9 main types of TSNs tumors. A: Neuroepithelial tumors. B: Sheath tumors. C: Tumors of cranial and spinal nerves. D: Hematopoietic tumors. E: germinative - cell tumors. F: Cysts and tumor education. G: Tumors of the region of the Turkish saddle. H: Local propagation of tumors from adjacent anatomical regions. I: Metastatic tumors.

Code of PO international Classification MKB-10 diseases:

Epidemiology. Taking into account the heterogeneity of the concept of "brain tumor", there are no accurate generalized statistics. It is known that the tumors of the CNS in children occupy second place among all malignant neoplasms (after leukemia) and the first in the group of solid tumors.

Classification. The main working classification used to develop tactics of treatment and definition of the forecast is the WHO classification for TSS tumors. Neuroepithelial tumors .. astrocytic tumors: Astrocytoma (fibrillar, protoplasmic, gemistotsitarnaya [mast cell] or macrocellular), anaplastic (malignant) astrocytoma, glioblastoma (giant cell glioblastoma and gliosarcoma), pilocytic astrocytoma, pleomorphic ksantoastrotsitoma, subependimarnaya giant cell astrocytoma (tuberous sclerosis) .. Oligodendroglial Tumors (Oligodendroglyoma, Anaplastic [malignant] oligodendroglyoma) .. Ependime tumors: ependymoma (cell, packer, light-cell), anaplastic (malignant) ependymoma, mixpinal ependymoma, subependimoma .. Mixed glyomes: oligosasitoma, anaplastic (malignant) oligosasitoma and others. . Vascular plexus tumors: papilloma and cancer of vascular plexus .. Hyroeepithelial tumors of unclear origin: Astroblastoma, Polar spongistoma, brain glyomatosis .. Hanon and mixed neuronally glial tumors: gangliocytoma, dysplastic ha ngliotsitoma cerebellum (Lhermitte Duclos), desmoplastic ganglioglioma in children (infantile) dizembrioplasticheskaya neuroepithelial tumor, ganglioglioma, anaplastic (malignant) ganglioglioma, central neyrotsitoma, paraganglioma terminal thread olfactory neuroblastoma (esthesioneuroblastoma), option: olfactory neyroepitelioma Parenchymal tumor .. sishkovoid gland: Pininocytoma, pineoblastoma, mixed / transient tumors of the cisheloid gland .. Embryonic tumors: medulosepithelioma, neuroblastoma (option: ganglioneoblastoma), ependimoblastoma, primitive neuroectodermal tumors (Medulovoblastoma [Options: Desmoplastic Medulovoblastoma], Medulooblastoma, melanin-containing medulosoblastoma). Tumors of cranial and spinal nerves .. Svannoma (innurry, neuromy); Options: cellulular, plexiform, melanine-containing .. HEVROFIBROOM (neurofibrome): limited (solitary), plexiform (mesh) .. malignant tumor of the peripheral nervous barrel (neurogenic sarcoma, anaplastic neurofibrome, "malignant shwannoma"); Options: Epithelioid, malignant tumor peripheral nervous trunk with divergence of mesenchymal and / or epithelial differentiation, melanin-containing. Tumors brain shells .. Tumors from meningothelial cells: meningioma (meningothelial, fibrous [fibroblastic], transitional [mixed], psammomatous, angiomatous, microcistal, secretory, light-cell, chordoid, rich in lymphoplasmic cells, metaplastic), atypical meningoma, papillary meningoma, anaplastic (malignant) Meningioma .. Mesenchymal non-Meningothelial tumors: benign (osteochondral tumors, lipoma, fibrous histiocytome, etc.) and malignant (hemangietericitoma, chondrosarcoma [Option: Mesenchymal chondroshromancoma] malignant fibrous histiocytome, rhabomiosarcoma, meningeal sarcomaths, etc.) tumors .. Primary melanocytic lesions : Diffuse melanomine, melanocytoma, malignant melanoma (option: shell melanomatosis) .. Tumors of unclear histogenesis: hemangioblastoma (capillary hemangioblastoma). Lymphoma and tumors of blood-fitora .. Malignant lymphomas .. plasmacitoma .. GranuleColochnya sarcoma .. Others. Germinal cell tumors (Herminogenic) .. Hermic .. Embryonic cancer .. The tumor of the yolk bag (endodermal sinus tumor) .. chorioncarcinoma .. teratoma: immature, mature, teratoma with mischief .. mixed germinogenic tumors. Cysts and tumor-like lesions .. Cyst pocket Ratke .. Epidermoid cyst .. Deroid cyst .. Colloid cyst III ventricle .. Enterogenic cyst .. Hanoglyal cyst .. grainy cell tumor (chorister, pithycitoma) .. Haineal heterotopia Glya .. Plasmocitar granule. Tumors of the "Turkish Saddle" area .. Adenoma pituitary gland .. pituitary cancer .. Cranephorgioma: Adamantine-like, papillary. Tumors growing into the cavity of the skull .. Paraganglioma (chemodector) .. Hordom .. Chondrom .. Chondrosarcom .. Cancer. Metastatic tumors. Classified tumors

Symptoms (signs)

Clinical picture. Most frequent symptoms Brain tumors - progressive neurological deficit (68%), headaches (50%), epipridges (26%). The clinical picture mainly depends on the localization of the tumor and, to a lesser extent, from its histological characteristics. Suprattorial semide tumors .. Signs of increased GFD due to mass - effect and edema (headaches, congestive discs of optic nerves, disturbances) .. epileptiform seizures .. focal neurological deficit (depending on localization) .. personality changes (most characteristic for Tumors of the frontal share). Suprattorial tumors of the median localization .. Hydrocephalic syndrome ( headache, nausea / vomiting, violations of consciousness, syndrome Parian, stagnant discs of optic nerves) .. Diancephal disorders (obesity / depletion, disorders of thermoregulation, nonachar diabetes) .. visual and endocrine disorders in tumors of the chiasmal - silly region. Subitimal tumors .. Hydrocephalic syndrome (headache, nausea / vomiting, violations of consciousness, stagnant discs of optic nerves) .. cerebellary disorders .. diplopia, rough nistagm, dizziness .. isolated vomiting as a sign of impact on the oblongable brain. Tumors of the base of the skull .. often leak up asymptomatic and only in later stages cause neuropathy card nerves, conduction disorders (hemiparesis, hemigipesthesia) and hydrocephalus.

Diagnostics

Diagnostics. With CT and / or MRI on the preoperative stage it is possible to confirm the diagnosis of brain tumor, its accurate localization and prevalence, as well as an estimated histological structure. With tumors of the rear cranial fossa and the base of the skull, the MRI is more preferable due to the lack of artifacts from the base bones (the so-called Beam - Hardering Artifacts). Angiography (both direct and MP - and CT - angiography) is carried out in rare cases to clarify the peculiarities of the tumor blood supply.

Treatment

Treatment. Medical tactics It depends on the exact histological diagnosis, the following options are possible :. Observation. Surgical resection. resection in combination with radiation and / or chemotherapy. Biopsy (more often stereotactic) in combination with radiation and / or chemotherapy. Biopsy and observation. Rady and / or chemotherapy without fabric verification based on the results of CT / MRI and the study of tumor markers.

Forecast Depends mainly on the histological structure of the tumor. Without exception, patients who operated on the brain tumors need regular MRI / CT control studies due to the risk of recurrence or continuing the tumor growth (even in cases of radically remote benign tumors).

MKB-10. C71 Malignant neoplasm brain. D33 Benignant neoplasm brain and other CNS departments