Tumornecrose

Tumornecrose, or tumor necrosis, is the death of cells within a tumor caused by interruption of blood supply, hypoxia, or injury from treatment. It most often occurs in rapidly growing malignant neoplasms, where the tumor outpaces its blood vessels, but can also be seen in benign tumors under severe ischemic stress or after therapies such as chemotherapy or radiotherapy.

The necrosis process in tumors is typically driven by insufficient perfusion and nutrient delivery to rapidly expanding tumor regions. In many solid cancers, the necrotic center is surrounded by viable tumor tissue, and the type of cell death is usually coagulative necrosis, although liquefactive necrosis can occur, particularly in brain tumors. In some tumors, such as glioblastoma, necrosis may display characteristic patterns like pseudopalisading tumor cells at the border of the necrotic core.

Histologically, tumor necrosis is identified as areas without intact nuclei, with debris and ghost-like cell outlines. Radiologically, necrosis may appear as a non-enhancing or ring-enhancing area within a mass on MRI or CT, often surrounded by an enhancing rim of viable tumor in imaging studies like glioblastoma. The presence and extent of necrosis can influence tumor grading and prognosis, as extensive necrosis is frequently associated with more aggressive behavior.

Clinically, necrosis can complicate treatment assessment because therapy-induced necrosis or pseudoprogression may mimic tumor progression on imaging. Management focuses on treating the underlying tumor and the complications of necrosis, with decisions guided by overall tumor biology, patient status, and response to therapy.