By Charles F Koopmann; Willard B Moran

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Adrenocorticotropic hormone (ACTH)-secreting adenoma may be responsible for Cushing's syndrome: ecchymoses, purple striae, hirsutism, emotional lability, and osteoporosis. The compression of the chiasm from below causes superior quadrantic bitemporal hemianopsia. Craniopharyngioma The symptomatology of craniopharyngiomas is complex and varied (Fig. 14). In childhood and adolescence cachexia and emaciation are the main signs, whereas in adults psychic disorders and obesity are present. Visual defects consist of inferior quadrantic bitemporal hemianopsia, which, however, is irregular and asymmetrical.

They can be removed totally. Some originate from the filum terminale or conofilum causing a cono-caudal compression syndrome. Astrocytoma. In adulthood astrocytomas represent 30%-40% of intramedullary tumors and about 70% in childhood. The spinal cord is affected by macroscopic morphologic modifications similar to those found in ependymoma, except for the delimitation of the 52 Early Diagnosis in Neuro-oncology surrounding parenchyma, which appears fully infiltrated by the tumor, and without a clear-cut cleavage plane.

Giant -cell tumors account for nearly 5% of primitive bone tumors. The incidence in the vertebral column is 2%-5%. There is a slight predominance in women, with a greater incidence occurring roughly in the third decade. The tumor is seen more frequently at the sacral level, in most cases involving the vertebral body. Early Diagnosis of Spinal Tumors 49 Malignant Bone Tumors Osteosarcoma. After metastatic lesions, osteosarcomas are the most common malignant bone tumors. They affect fast-growing bones and thus are more easily noticed in long-bone metaphysis or in pathological conditions of fast bone rearrangement, such as Paget's disease, or during radiotherapy.

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