30 Intracranial Neoplasms Flashcards
Pathological characteristic of oligodendroglioma
fried egg appearance
-halo of unstained cytoplasm and a small round nucleus
most common site of oligodendroglioma
frontal and temporal lobe
Type of ependymoma localized exclusively in the filum terminale fo the spinal cord
myxopapillomatous type of ependymoma
Most common type of glioma of the spinal cord
ependymoma
Most common cerebral site of ependymoma
4th ventricle
Most frequent acquired genetic defect of meningioma are truncating mutations in the gene _______ on chromosome ________.
Neurofibromatosis 2 gene (Merlin)
Chromosome 22q
Microscopic characteristic of meningioma described as laminar calcifications of uniform cells with round or elongated nuclei and a visible cytoplasmic membrane
psammoma bodies
This type of brain tumor/neoplasm has a characteristic of disappearance on imaging of lesions or complete but transient resolution of contrast enhancement in response to corticosteroids
CNS lymphoma
Valveless systems of veins that runs the length of the vertebral column from the pelvic veins to the large venous sinuses of the skull bypassing the systemic circulation.
This is the presumed rout of spread of prostate CA
Batson vertebral venous plexus
Metastatic brain tumors that are likely to be single usually come from:
Give 4
Kidney
Breast
Thyroid
Adenocarcinoma of the Lung
Most common malignant tumor of childhood
Medulloblastoma
20%
Most common primary brain tumor in adults
Meningioma
Most common intra-axial posterior fossa tumor in adults
Hemangioblastoma
Most common tumor of the pineal gland
Germ cell tumor
most common type of pituitary adenoma
prolactinoma
Most common solid tumor of childhood
a. neuroblastoma
b. medulloblastoma
c. astrocytoma
d. GBM
a. neuroblastoma
p. 689
syndrome that occurs as a paraneoplastic complication of neuroblastoma
polymyoclonus with opsoclonus and ataxia
The following statements are true regarding EPENDYMOMAS, except:
a. fourth ventricle ependymomas appear most commonly in childhood
b. males are affected almost twice as often as females
c. the have a more protracted course and lack early cerebellar signs as compared to medulloblastoma
d. they arise from the roof of the 4th ventricle and extend to through the foramina of Luschka and Magendie
d. they arise from the roof of the 4th ventricle and extend to through the foramina of Luschka and Magendie
should be ‘floor’
Page 690
Most common location of choroid plexus papilloma?
a. third ventricle
b. lateral ventricle
c. fourth ventricle
d. third and fourth ventricle
b. lateral ventricle
ratio:
lateral 50
third 10
fourth 40
page 690
Syndrome that may be seen in pineal tumors causing inability to look upward and with slightly dilated pupil that react on accommodation but not to light
Parinaud syndrome
The following statements are true regarding gangliocytoma of the cerebellum, except:
a. it has a characteristic imaging: indistinct mass of ‘tiger stripe’ appearance
b. has lack of growth potential in comparison to other cerebellar tumors
c. has favorable prognosis, in comparison to other cerebellar tumors
d. none of the above
d. none of the above
refers to a more primitive undifferentiated state of the constituent cells
anaplasia
type of edema that occurs in obstructive hydrocephalus
interstitial edema
Type of edema seen in the vicinity of tumor growth
vasogenic edema
limited to the white matter and
due to increased permeability of the capillary endothelial cells so that plasma proteins exude into the extracellular space
TF
50% of glioblastomas occupy more than one lobe of a hemisphere
True
Imaging of a glioblastoma
inhomogenous mass
center : hypointense and non enhancing
irregular rim of contrast enhancement surrounds the core lesion
surrounded by non enhancing edematous brain tissue, consisting of combination of infiltrating tumor cells and vasogenic edema
+ may have necrotic areas or cystic areas
difference of glioblastoma multiforme (Grade IV) from anaplastic astrocytoma (Grade III) in pathology
no necrosis or hemorrhagic areas
50% of glioblastoma cases have a deletion in this gene
p53 tumor suppressor gene
other mutations:
1p/19q region, EGFR, ATRX, TERT promotor
genetic characteristic of glioblastoma multiforme involved in response of antitumor agents, specifically Temozolomide
MGMT promoter
dose of cranial irradiation increases the survival by 5 months on average of GBM
6000 cGy
in GBM, this anticancer medications/treatment scheme may have 3 month benefit for progression free survival but not overall survival
bevacizumab with temozolomide and radiation
treatment in GBM
tyrosine kinase inhibitors that were developed in response to upregulation of EGFR
erlotinib, gefitinib
almost all glioblastomas recur within ____ cm of their original site and 10% develop additional lesions in distant locations
2cm
most common cerebral site of ependymoma
4th ventricle
Tumors in the
floor of the 4th ventricle ________
roof of the 4th ventricle _________
floor: ependymoma
roof: medulloblastoma
most common subtype of meningioma
meningothelial (syncytial) form
majority of the infratentorial meningiomas are found in this region
CPangle
characteristic pathologic finding in medulloblastoma
Homer wright rosettes
no vascular component, NO LUMEN
genetic defect in medulloblastoma
deletion on chromosome 17 distal to the p53 region
in medulloblastoma, overexpression or amplification of this transcription factor is associated with poorer prognosis
MYCN (N-MYC)
same with neuroblastoma
most common solid tumor of childhood
neuroblastoma
paraneoplastic syndrome associated with medulloblastoma
polymyoclonus with opsoclonus and ataxia
abnormal gene associated with retinoblastoma
Rb gene
Hemangioblastoma of the cerebellum is usually associated with this disease presenting with
retinal angioma or
hepatic and pancreatic cysts
von hippel-Lindau syndrome
