BOOK REVIEW

Brain TumorsFrancis Ali-Osman, ed. Totowa, NJ: Humana Press; 2004, 400pages, $150.

Patients, family members, and physicians shudder at thediagnosis of a brain tumor. The prognosis remains dread-ful, even now, after years of tumor research. Significantprogress, however, has been made in the diagnosis and treat-ment of these devastating forms of cancer. The complex biol-ogy of brain tumors has led to bookshelves that are filled withtextbooks that contain chapters on the epidemiology of braintumors, histopathologic classification, patient management,and treatment modalities. Brain Tumors, in contrast, is a con-cisely written text that emphasizes recent research advanceswithin the current knowledge of the molecular biology ofbrain tumors. It does an excellent job of focusing attention onthis molecular biology, more than most other books on thesubject. Although not necessarily relevant to a neuroradiologyaudience, neuro-oncologists, radiation oncologists, and neu-rosurgeons, as well as neuroradiologists interested in braintumors, will find the explorations of the geneticmutations andthe influence of various growth factors significant. They willalso find the discussions of developing innovative treatmentmodalities and designer immuno- and pharmacotherapiesimportant. Medical professionals involved with brain tumorresearch and or treatmentwill also find the extensive and com-prehensive list of references very helpful for their work.

The editor, Francis Ali-Osman, enlisted many of the lead-ers in the field of neuroscience and neuro-oncology to con-tribute chapters to this textbook. The textbook is divided into3 sections. Part 1 discusses the epidemiology, biology, genet-ics, and pathology of brain tumors. Part 2 considers theirmechanisms and pathways. Part 3 details therapeutics that arebeing developed for the management of primary and meta-static tumors. This 3-part format gives the book a logical se-quence in discussing the significance of the investigation of thenature and development of brain tumors from a molecularbasis.

Ali-Osman intended this book to bring together awealth ofknowledge about the epidemiology, genetics, and molecularpathology of brain tumors that is accessible to the establishedbrain tumor scientist and clinician, as well as the new investi-

gator, graduate, or under-graduate student. In this hehas succeeded, because mostchapters of the book are wellwritten. It is clear that greatcare was taken to introducethe topic of the chapter in aneasy to understand format.The authors carefully de-scribe the current knowledgeon their particular topic. Themajor points of the chaptersare usually summarized at theend along with a discussion ofdirections for future studies.

Moreover, the text includes numerous informative illustra-tions that enhance the impact of the scholarship.

One of the significant contributions to the current re-search milieu made by Brain Tumors involves highlightingthe importance of the molecular biology of brain tumorswith a cogent discussion of the epidemiology of brain tu-mor types. This is emphasized by a discussion of the his-topathologic classification of tissue samples of brain tu-mors which has historically relied upon the World HealthOrganization system of identifying structural abnormali-ties of the tumor. This type of classification relies on theability of the pathologist to have a sufficient and represen-tative sample of the tumor when the histopathologic diag-nosis is made. This has led to a situation in which it is notuncommon for tumors to receive different classificationsfrom several different pathologic laboratories. This newtext describes how using the genetic makeup of the tumorsin the pathologic classification of the tumor types is oftenmore reliable. This may well lead to more efficacious treat-ment options for the practicing physician.

The foregoing is merely one example of the contributionAli-Osmans text makes to the scholarship focusing onbrain tumors, those who treat them and those who are af-flicted with them. I did find one difficulty with the book andeven that may have been related to my practice being moreclinically oriented with respect to this area of scholarship. Itinvolved the chapter on the genetic modeling of gliomaformation in mice. This was difficult to read at the firstsitting. The authors did little to distill the material to anunderstandable level for a broad audience. The chapter waspacked with information about the genetic modeling of gli-oma formation. It became easier to understand once I re-viewed the later chapters on the mechanisms of tumorgrowth and therapeutics and then returned to read thechapter about the mouse models again. It is clear that manyof the details about early development of tumors would beknown if only the information from human studies wereavailable. These studies of tumor growth and the influenceof the local milieu in the mouse model have answered ques-tions about the special environment of the nervous systemon tumor growth, whether it is a primary tumor or a met-astatic tumor from another site in the body.

Overall, the textbook is a highly intelligent, comprehen-sive collection of material about the molecular biology ofbrain tumors. It acknowledges that the scientific knowledgeof molecular biology has grown exponentially in the past 2decades. It details this advancement in knowledge and howit has lead to exciting new developments in the knowledgeof the basic and clinical research on brain tumors. Becausethe types of brain tumors are quite diverse and their diseasepathways are very complex, this new knowledge gained inthe molecular biology of brain tumors has lead and willcontinue to lead to many new treatment modalities. It isonly through the continued acquisition of the knowledge ofthe basic science of brain tumor genetics and pathophysi-ology and the clinical research of patient response to treat-ments that further gains will be made in the movement toeradicate these cancers.

462 Book Review AJNR 27 Feb 2006 www.ajnr.org