5. b. Brain Tumours Flashcards
What is the location of the majority of brain tumours in adults vs in children?
Adults: supratentorial
Children: infratentorial
What is the presentation of brain tumours?
Progressive neurological deficit Symptoms of raised ICP Seizures Hydrocephalus Haemorrhage Endocrine disturbance (pituitary)
What investigations should be done into brain tumours?
History and physical exam MRI with contrast CT of chest/abdomen/pelvis for primary PET scan CSF cytology Pineal tumours: B-hCG, AFP
What cancer does immunosuppression increase the risk of?
Lymphoma
What are the most common primary brain tumours in adults?
Glial
Meningioma
Pituitary and pineal
Nerve sheath tumour
What is the most common glial tumour?
GlioBlastoma Multiforme
High grade
Peak 45-60
How are low grade glial tumours differentiated from high grade?
High grade is enhanced on CT
What is the treatment for GBM?
Maximal surgical resection
External beam radiotherapy
Temozolamide
What are the features of oligodendroglial tumours?
Grow slowly
Calcifications
What is the cell of origin of meningiomas?
Arachnoid cap cells
What is the treatment for meningiomas?
Focused radiation for small
Surgical resection
Where does a vestibular schwannoma arise from?
Vestibular branch of CNVIII
What are the features of a vestibular schwannoma?
Slowly progressive hearing loss
‘Ice cream cone’ shape
Obstructive hydrocephalus
Which mets in the brain can bleed?
Renal cell
Melanoma
Choriocarcinoma
What are the most common brain tumours in children?
Astrocytoma
Medulloblastoma
Ependymoma
Is a cerebellar astrocytoma benign or malignant?
Benign and slow growing
What is the peak age for a cerebellar astrocytoma?
5-10
Where does a medulloblastoma arise?
Cerebellar vermis
Is a medulloblastoma benign or malignant?
Malignant and aggressive: seed along CSF pathway
What gives a poor prognosis in a medulloblastoma?
Child is less than 3 as they can’t withstand radiation
Where do ependymomas arise from?
Cells lining ventricles or central canal of the spinal cord
Is a diffuse brain stem tumour benign or malignant?
Malignant with a very poor prognosis
What are the symptoms of a diffuse brain stem tumour?
Cerebellar dysfunction
Cranial nerve palsies
Paresis
