21. Audit of primary brain tumours at royal north shore hospital from 2007 to 2011

Abstract

Accurate pathological diagnosis and classification of brain tumours guides therapy and underpins translational research. We reviewed the pathological diagnosis of all primary brain tumours undergoing resection or biopsy at the Royal North Shore Hospital, an adult tertiary referral institution with a catchment population of 1.2 million during the period 2007 to 2011. Patients age ranged from 15 to 92. There were 779 cases, comprising 382 (49.04%) astrocytic, 11 (1.41%) oligoastrocytic, 35 (4.49%) oligodendroglial (0.13%) choroid plexus, 7 (0.90%) embryonal, 34 (4.36%) ependymal, 14 (1.80%) haemangioblastoma, 276 (35.43%) meningeal, 11 (1.41%) 15 (1.93%) neuronal and mixed neuronal-glial, 35 (4.49%) and 1 (0.13%) pineal. Of the astrocytic tumours 84% were glioblastoma, 10.5% anaplastic astrocytoma, 3% diffuse astrocytoma and 2% pilocytic astrocytoma. Meningeal tumours were subtyped into the following breakdowns: (72%) meningioma, (19%) atypical meningioma, (4.8%) haemangio-pericytoma, (2.8%) anaplastic meningioma, (0.7%) papillary, meningioma, (0.7%) anaplastic haemangiopericytoma and (0.34%) rhabdoid meningioma. Oligodendroglial tumours were subtyped into the following breakdowns: (74%) anaplastic oligodendroglioma, (26%) oligo-dendroglioma. Ependymal tumours were broken down into the following subcategories: (62%) ependymoma, (32%) myxopapillary ependymoma, (3%) anaplastic ependymoma and (3%) subependymoma. The incidence of most tumour subtypes in our audit was comparable to published rates in large-scale hospital-based studies. The most notable exception to this was the unusually high proportion of glioblastomas and haemangioblastomas which occurred at a rate that was double that seen in similar studies presumably because of a referral bias towards this quaternary centre.