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Original article
peer-reviewed

Demographics and Incidence of Histologically Confirmed Intracranial Tumors: A Five-year, Two-center Prospective Study



Abstract

Introduction

Intracranial tumors (ICTs) are a diverse group of malignancies that pose an immediate threat to patients' lives, no matter their local or metastatic origin, benign or malignant nature. These lesions have severe clinical courses and need to be diagnosed and treated as soon as possible, with pathological verification being the pivotal moment in the process of determining curative modalities.

Aim

The aim of this study was to compare the incidence of histologically confirmed ICTs in Eastern Bulgaria, based on their type (primary, metastatic, and non-volume occupying lesions (NVOL)), their respective subtypes, and incidence in a descriptive manner.

Materials and Methods

For a period of five full calendar years (January 1st, 2012 – December 31st, 2016), all histologically confirmed cases of intracranial tumors were prospectively collected from two individual tertiary healthcare institutions. The cases were then statistically analyzed in a descriptive manner, and incidences of primary, metastatic, and NVOL were compared with regards to their specific origins, types, and subtypes. Metastatic tumors were further segregated relative to their intracranial metastatic location.

Results

The total number of individual ICTs registered in the set timeframe was 822. Primary ICTs represented a total of 66.12% of the histologically confirmed cases, with the most common entries being tumors from a glial and meningeal origin, 30.90% were histologically confirmed as metastatic ICTs, from which the most common entries were of pulmonary origin, and the other 2.94% were NVOL. On behalf of their intracranial metastatic location, metastatic tumors were located predominantly in the supratentorial region, represented as a total of 87.80%, while the other 12.20% were located in the subtentorial region. Based on the descriptive analysis, the annual incidence per 100,000 capita of all ICTs is 9.12, comprised of 6.03 per 100,000 for primary ICTs, 2.82 per 100,000 for metastatic ICTs, and 0.27 per 100,000 for NVOL. The annual incidence of the most commonly diagnosed primary ICTs per 100,000 is 2.36 for meningioma, 2.03 for glioblastoma, and 0.48 for pituitary adenoma. The annual incidence of the most commonly diagnosed metastatic ICTs per 100,000 is 1.32 for lung cancer metastases, 0.28 for gastrointestinal tract (GIT) metastases, 0.22 for melanoma, and 0.17 for breast cancer metastases.

Conclusion

Based on our results, primary ICTs are operated and biopsied more than two times as much as metastatic ICTs and only a small fraction of neurosurgical interventions are undertaken due to NVOL. Metastatic ICTs are predominantly supratentorial with no evidence of a tumor predominantly metastasizing in the subtentorial region. The demographics reported in the study establish some aspects of age and gender preferences, as well as the annual incidence per 100,000 for the most commonly diagnosed types of ICTs in our population.



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Original article
peer-reviewed

Demographics and Incidence of Histologically Confirmed Intracranial Tumors: A Five-year, Two-center Prospective Study


Author Information

George S. Stoyanov Corresponding Author

Department of General and Clinical Pathology, Forensic Medicine and Deontology, Faculty of Medicine, Medical University – Varna “Prof. Dr. Paraskev Stoyanov”, Varna, Bulgaria

Department of Physiology and Pathophysiology, Faculty of Medicine, Medical University – Varna “Prof. Dr. Paraskev Stoyanov”, Varna, Bulgaria

Department of Anatomy and Cell Biology, Faculty of Medicine, Medical University – Varna “Prof. Dr. Paraskev Stoyanov”, Varna, Bulgaria

Deyan L. Dzhenkov

Department of General and Clinical Pathology, Forensic Medicine and Deontology, Faculty of Medicine, Medical University – Varna “Prof. Dr. Paraskev Stoyanov”, Varna, Bulgaria

Martina Kitanova

Department of General and Clinical Pathology, Forensic Medicine and Deontology, Faculty of Medicine, Medical University – Varna “Prof. Dr. Paraskev Stoyanov”, Varna, Bulgaria

Peter Ghenev

Department of General and Clinical Pathology, Forensic Medicine and Deontology, Faculty of Medicine, Medical University – Varna “Prof. Dr. Paraskev Stoyanov”, Varna, Bulgaria

Anton B. Tonchev

Department of Anatomy and Cell Biology, Faculty of Medicine, Medical University – Varna “Prof. Dr. Paraskev Stoyanov”, Varna, Bulgaria


Ethics Statement and Conflict of Interest Disclosures

Human subjects: Committee on Ethics for Scientific Research, Medical University - Varna "Prof. Dr. Paraskev Stoyanov" issued approval Protocol № 20 (1), from 26.04.2012. Animal subjects: This study did not involve animal subjects or tissue.

Acknowledgements

The authors would like to thank all of the medical and non-medical personnel, past and present, of the neurology, neurosurgery, radiology, nuclear medicine, pathology, and all other medical wards in the “St. Marina” University Hospital, Varna, Bulgaria and “St. Anna” Hospital, Varna, Bulgaria, who, while performing their medical and humanitarian duties, allowed for the implementation of this study.


Original article
peer-reviewed

Demographics and Incidence of Histologically Confirmed Intracranial Tumors: A Five-year, Two-center Prospective Study


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Original article
peer-reviewed

Demographics and Incidence of Histologically Confirmed Intracranial Tumors: A Five-year, Two-center Prospective Study

  • Author Information
    George S. Stoyanov Corresponding Author

    Department of General and Clinical Pathology, Forensic Medicine and Deontology, Faculty of Medicine, Medical University – Varna “Prof. Dr. Paraskev Stoyanov”, Varna, Bulgaria

    Department of Physiology and Pathophysiology, Faculty of Medicine, Medical University – Varna “Prof. Dr. Paraskev Stoyanov”, Varna, Bulgaria

    Department of Anatomy and Cell Biology, Faculty of Medicine, Medical University – Varna “Prof. Dr. Paraskev Stoyanov”, Varna, Bulgaria

    Deyan L. Dzhenkov

    Department of General and Clinical Pathology, Forensic Medicine and Deontology, Faculty of Medicine, Medical University – Varna “Prof. Dr. Paraskev Stoyanov”, Varna, Bulgaria

    Martina Kitanova

    Department of General and Clinical Pathology, Forensic Medicine and Deontology, Faculty of Medicine, Medical University – Varna “Prof. Dr. Paraskev Stoyanov”, Varna, Bulgaria

    Peter Ghenev

    Department of General and Clinical Pathology, Forensic Medicine and Deontology, Faculty of Medicine, Medical University – Varna “Prof. Dr. Paraskev Stoyanov”, Varna, Bulgaria

    Anton B. Tonchev

    Department of Anatomy and Cell Biology, Faculty of Medicine, Medical University – Varna “Prof. Dr. Paraskev Stoyanov”, Varna, Bulgaria


    Ethics Statement and Conflict of Interest Disclosures

    Human subjects: Consent was obtained by all participants in this study. Committee on Ethics for Scientific Research, Medical University - Varna "Prof. Dr. Paraskev Stoyanov" issued approval Protocol № 20 (1), from 26.04.2012. Animal subjects: This study did not involve animal subjects or tissue. Conflicts of interest: The authors have declared that no conflicts of interest exist.

    Acknowledgements

    The authors would like to thank all of the medical and non-medical personnel, past and present, of the neurology, neurosurgery, radiology, nuclear medicine, pathology, and all other medical wards in the “St. Marina” University Hospital, Varna, Bulgaria and “St. Anna” Hospital, Varna, Bulgaria, who, while performing their medical and humanitarian duties, allowed for the implementation of this study.


    Article Information

    Published: July 16, 2017

    DOI

    10.7759/cureus.1476

    Cite this article as:

    Stoyanov G S, Dzhenkov D L, Kitanova M, et al. (July 16, 2017) Demographics and Incidence of Histologically Confirmed Intracranial Tumors: A Five-year, Two-center Prospective Study. Cureus 9(7): e1476. doi:10.7759/cureus.1476

    Publication history

    Received by Cureus: June 13, 2017
    Peer review began: June 24, 2017
    Peer review concluded: July 10, 2017
    Published: July 16, 2017

    Copyright

    © Copyright 2017
    Stoyanov et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 3.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

    License

    This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Introduction

Intracranial tumors (ICTs) are a diverse group of malignancies that pose an immediate threat to patients' lives, no matter their local or metastatic origin, benign or malignant nature. These lesions have severe clinical courses and need to be diagnosed and treated as soon as possible, with pathological verification being the pivotal moment in the process of determining curative modalities.

Aim

The aim of this study was to compare the incidence of histologically confirmed ICTs in Eastern Bulgaria, based on their type (primary, metastatic, and non-volume occupying lesions (NVOL)), their respective subtypes, and incidence in a descriptive manner.

Materials and Methods

For a period of five full calendar years (January 1st, 2012 – December 31st, 2016), all histologically confirmed cases of intracranial tumors were prospectively collected from two individual tertiary healthcare institutions. The cases were then statistically analyzed in a descriptive manner, and incidences of primary, metastatic, and NVOL were compared with regards to their specific origins, types, and subtypes. Metastatic tumors were further segregated relative to their intracranial metastatic location.

Results

The total number of individual ICTs registered in the set timeframe was 822. Primary ICTs represented a total of 66.12% of the histologically confirmed cases, with the most common entries being tumors from a glial and meningeal origin, 30.90% were histologically confirmed as metastatic ICTs, from which the most common entries were of pulmonary origin, and the other 2.94% were NVOL. On behalf of their intracranial metastatic location, metastatic tumors were located predominantly in the supratentorial region, represented as a total of 87.80%, while the other 12.20% were located in the subtentorial region. Based on the descriptive analysis, the annual incidence per 100,000 capita of all ICTs is 9.12, comprised of 6.03 per 100,000 for primary ICTs, 2.82 per 100,000 for metastatic ICTs, and 0.27 per 100,000 for NVOL. The annual incidence of the most commonly diagnosed primary ICTs per 100,000 is 2.36 for meningioma, 2.03 for glioblastoma, and 0.48 for pituitary adenoma. The annual incidence of the most commonly diagnosed metastatic ICTs per 100,000 is 1.32 for lung cancer metastases, 0.28 for gastrointestinal tract (GIT) metastases, 0.22 for melanoma, and 0.17 for breast cancer metastases.

Conclusion

Based on our results, primary ICTs are operated and biopsied more than two times as much as metastatic ICTs and only a small fraction of neurosurgical interventions are undertaken due to NVOL. Metastatic ICTs are predominantly supratentorial with no evidence of a tumor predominantly metastasizing in the subtentorial region. The demographics reported in the study establish some aspects of age and gender preferences, as well as the annual incidence per 100,000 for the most commonly diagnosed types of ICTs in our population.



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George S. Stoyanov, M.D., Assistant Professor

Department of General and Clinical Pathology, Forensic Medicine and Deontology, Faculty of Medicine, Medical University – Varna “Prof. Dr. Paraskev Stoyanov”, Varna, Bulgaria

For correspondence:
georgi.geesh@gmail.com

Deyan L. Dzhenkov

Department of General and Clinical Pathology, Forensic Medicine and Deontology, Faculty of Medicine, Medical University – Varna “Prof. Dr. Paraskev Stoyanov”, Varna, Bulgaria

Martina Kitanova

Department of General and Clinical Pathology, Forensic Medicine and Deontology, Faculty of Medicine, Medical University – Varna “Prof. Dr. Paraskev Stoyanov”, Varna, Bulgaria

Peter Ghenev

Department of General and Clinical Pathology, Forensic Medicine and Deontology, Faculty of Medicine, Medical University – Varna “Prof. Dr. Paraskev Stoyanov”, Varna, Bulgaria

Anton B. Tonchev

Department of Anatomy and Cell Biology, Faculty of Medicine, Medical University – Varna “Prof. Dr. Paraskev Stoyanov”, Varna, Bulgaria

George S. Stoyanov, M.D., Assistant Professor

Department of General and Clinical Pathology, Forensic Medicine and Deontology, Faculty of Medicine, Medical University – Varna “Prof. Dr. Paraskev Stoyanov”, Varna, Bulgaria

For correspondence:
georgi.geesh@gmail.com

Deyan L. Dzhenkov

Department of General and Clinical Pathology, Forensic Medicine and Deontology, Faculty of Medicine, Medical University – Varna “Prof. Dr. Paraskev Stoyanov”, Varna, Bulgaria

Martina Kitanova

Department of General and Clinical Pathology, Forensic Medicine and Deontology, Faculty of Medicine, Medical University – Varna “Prof. Dr. Paraskev Stoyanov”, Varna, Bulgaria

Peter Ghenev

Department of General and Clinical Pathology, Forensic Medicine and Deontology, Faculty of Medicine, Medical University – Varna “Prof. Dr. Paraskev Stoyanov”, Varna, Bulgaria

Anton B. Tonchev

Department of Anatomy and Cell Biology, Faculty of Medicine, Medical University – Varna “Prof. Dr. Paraskev Stoyanov”, Varna, Bulgaria