Mapping the clinico-pathological landscape of CNS neoplasms: an observational study from a tertiary care cohort

Abstract Background: Central nervous system (CNS) tumors encompass a wide spectrum of neoplastic and non-neoplastic conditions. Materials and Methods: This retrospective cross-sectional study was conducted in the histopathology section of the Department of Pathology at S.C.B. Medical College and Hospital, Cuttack, India. The study spanned from June 2023 to June 2024. Clinical parameters, including patient age, sex, tumor grade, radiological findings, and immunohistochemical profiles, were reviewed to establish a final diagnosis. Results: A total of 183 CNS tumor cases were analyzed, comprising 89 males (49%) and 94 females (51%). The highest incidence was observed in the sixth decade of life, with 45 cases. The oldest patient was 76, while the youngest was a 1-month-old female infant. Gliomas, glioneuronal, and neuronal tumors were the most frequently diagnosed categories, accounting for 76 cases (39.53%). Meningeal tumors followed, with 42 cases (22.95%), of which meningothelial meningioma was the most common subtype, with 25 cases (59.52%). Astrocytic tumors represented 66 cases (36%), with astrocytoma, IDH mutant, World Health Organization (WHO) Grade 2 being the most prevalent subtype (21 cases, 31.8%), followed by Grade 4 (13 cases, 19.69%) and Grade 3 (nine cases, 13.6%). Among pediatric patients, pilocytic astrocytoma emerged as the most common. Conclusion: This study highlights the distribution and burden of CNS tumors in our region and provides a detailed classification based on the 2022 WHO guidelines. Accurate categorization of CNS neoplasms is crucial for effective diagnosis, prognostication, and therapeutic planning, offering vital insights into patient outcomes and disease behavior.