Central Nervous System (CNS) Tumour Registry: A Single Neurosurgical Centre Experience of Four Years


  • Zahid Hussain Department of Neurosurgery, Combined Military Hospital, Rawalpindi
  • Abdul Ghaffar Department of Neurosurgery, Combined Military Hospital, Rawalpindi
  • Shahzad Ahmed Qasmi Department of Neurosurgery, Combined Military Hospital, Rawalpindi


Central Nervous System, Tumour registry, GBM, PNET.


Objective: To evaluate the pattern of CNS tumours according to site and age.
Study Design: Observational.
Duration of Study: 1 Jul 2011 to 30 June 2015.
Patients and Methods: This is a retrospective audit of CNS tumour registry carried out at our neurosurgical center over the period of four years. A total of 653 cases with age range of 1-80 years, both gender and histo-pathological proven CNS tumours were included in the study. Data of age, gender, location and histological diagnosis was obtained from the patient’s clinical records and entered in study proforma. Data was analyzed by using SPSS (version-17) with descriptive statistics.
Results: Overall the Supra-tentorial tumours were 69.52% with commonest site of Parietal in 24.0% and histology of Glioblastoma Multiforme (GBM) in 37.0%. Infra-tentorial tumours were 16.84% with commonest site of Cerebellar in 53.63% and histology of Primitive Neuroectodermal Tumours (PNET) in 26.36%. Sellar tumours were 6.27% and Spinal tumours 7.35% with commonest being Neurofibroma in 39.58% cases. Metastases in CNS were found in 6.38% cases.
Conclusion: This analysis depicts that most of the supratentorial tumours of adult age are neuroepithelial in lobar areas especially of GBM type while in children the more common tumours are infratentorial, in cerebellar area and of PNET origin. The audit will help us to stratify our workload management and formulate tumour pathways.


1. Brain cancer rates have risen by a quarter over the past three decades. [Online] 2013 [cited 2015July 11].
2. CBTRUS Fact Sheet 2014: incidence rates and esti-mated new cases include all primary malignant and non-malignant tumors of the brain, central nervous sys-tem (CNS) [online 2015] [cited 2015July11].
3. Louis DN, Ohgaki H, Wiestler OD, Cavenee WK, Bur-ger PC, Jouvet A, et al. The 2007 WHO Classification of Tumours of the Central Nervous System. Acta Neu-ropathologica. 2007; 114 (2): 97-109.
4. Ostrom QT, Gittleman H, Liao P, Rouse C, Chen Y, Dowling J, et al. CBTRUS Statistical Report: Primary Brainand Central Nervous System Tumors Diagnosed in the United States in 2007 – 2011. Neuro Oncol.2014? 16 (5): 1-63.
5. Cancer Research UK. Brain, Other CNS and Intracra-nial Tumours: 2009 – 2011, Average Number of New Cases Per Year and Age-Specific Incidence Rates per 100,000 Population, UK. [Online 2015] [Cited 2015 July 11].
6. Masood K, Zafar T,Zafar J. A Statistical Evaluation of Common Cancer Trends and Cancer Occurrence by Age Group in the Population of Lahore, Pakistan, 1984-2011. Journal of Registry Management, 2014; 41 (2): 85-90.
7. Ahsan J, Hashmi SN, Muhammad I, Ud Din H, Butt AM, Nazir S. Spectrum of central nervous system tum-ours – a Single center histopathological review of 761 cases Over 5 years. J Ayub Med Coll Abbottabad 2015; 27 (1): 81–4.
8. Jamal S, Moghal S, Mamoon N, Mushtaq S, Luqman M, Anwar M. The pattern of malignant tumors: Tumor registry data analysis, AFIP, Rawalpindi, Pakistan (1992 – 2001). J Pak Med Assoc 2006; 56 (8): 359–62.
9. Anonymous. Collective cancer registry report from Dec. 1994 up-till Dec. 2013, Data source: Cancer regis-try and clinical data management, SKMCH & RC; pp 1-11.
10. Wöhrer A, Waldhör T, Heinzl H, Hackl M, Feichtinger J, Gruber – Mösenbacher U, et al. The Austrian Brain Tumour Registry: a cooperative way to establish a pop-ulation – based brain tumour registry. J Neurooncol. 2009; 95 (3): 401-11.
11. Jamal S, Atique M, Khadim MT. Changing pattern of malignancies: analysis of histopathology based tumour registry data and comparison of three decades at Armed Forces Institute of Pathology, Rawalpindi, Pakistan. J Pak Med Assoc. 2014; 64: 24-7.
12. Bauchet L, Rigau V, Mathieu-Daudé H, Figarella – Branger D, Hugues D, Palusseau L, et al. French brain tumor data bank: methodology and first results on 10,000 cases. J Neurooncol. 2007; 84 (2): 189–99.
13. Ayaz B, Lodhi FR, Hasan M. Central Nervous System Tumours: A hospital Based Analysis: Pak Armed For-ces Med J. 2011; 61 (1): 61–4.
14. Ahmed Z, Arshad H, Hasan SH, Fatima S, Idrees R, Aftab K, et al. CNS neoplasms in Pakistan, a patho-logical perspective. Asian Pac J Cancer Prev. 2011; 12 (1): 317–21.
15. Hashmi AA, Faridi N, Malik B, Edhi MM, Khurshid A, Khan M. Morphologic spectrum of glial tumors: an increased trend towards oligodendroglial tumors in Pakistan. Int Arch Med. 2014; 7: 33.
16. Ahmad S, Qureshi AN, Kazmi A, Rasool A, Gul M, Ashfaq M, et al. First cancer statistics report from Hazara division. J Ayub Med Coll Abbottabad, 2013; 25 (1-2): 71–3.
17. Kaneko S, Nomura K, Yoshimura T, Yamaguchi N: Trend of brain tumor incidence by histological subtypes in Japan: estimation from the Brain Tumor Registry of Japan, 1973–1993. J Neurooncol. 2002; 60 (1): 61–9.
18. Committee of Brain Tumor Registry of Japan. Report of Brain Tumor Registry of Japan (1969-1996). Neurol Med Chir (Tokyo) 2003; 43: 1–111.
19. Chen L, Zou X, Wang Y, Mao Y, Zhou L. Central Ner-vous system tumours: a single center pathology review of 34,140 cases over 60 years. BMC Clin Pathol. 2013; 13 (1): 14.
20. Lee CH, Jung KW, Yoo H, Park S, Lee SH, Epidemio-logy of primary brain and central nervous system tum-ours in Korea: J Korean Neurosurg Soc. 2010; 48 (2): 145–52.
21. Filippini G: Epidemiology of primary central nervous system tumors. Handb Clin Neurol. 2012; 104: 3–22. 22. Malik S, Hussain SZ, Basit R, Idress N, Habib A, Zamant M, Islam N. Demographic characteristics, pre-sentations and treatment outcome of patients with pro-lactinoma. J Ayub Med Coll Abbottabad, 2014; 26 (3): 269?74.
23. Hanssens P, Karlsson B, Yeo TT, Chou N, Beute G. Detection of brain micro metastases by high resolution stereotactic magnetic resonance imaging and its impact on the timing of and risk for distant recurrences. J Neu-rosurg. Sep. 2011; 115 (3): 499-504.
24. Asirvatham JR, Deepti AN, Chyne R, Prasad MS, Cha-cko AG, Rajshekhar V et al: Pediatric tumors of the central nervous system: a retrospective study of 1,043 cases from a tertiary care center in South India. Childs Nerv Syst. 2011; 27 (8): 1257–63.
25. Pinho RS, Andreoni S, Silva NS, Cappellano AM, Mas-ruha MR, Cavalheiro S, et al. Pediatric central nervous system tumors: a single-center experience from 1989 to 2009. J Pediatr Hematol Oncol. 2011; 33 (8): 605–9.






Original Articles