7. BRAIN TUMORS Flashcards
Strategy for Brain Tumor Diagnosis
- Decide if single or multiple
- Age
- Location
- Characteristics
Multiple masses DDx
Multifocal primary from seeding
Mets
Syndromes
Single mass + Adult DDx
Cortical
Intraventricular
CP angle
Infratentorial
Single mass + Kid
Supratentorial
Skull base/Dura
Sella/Parasella
Pineal Gland
Is it a tumor or mimic?
Mimics are =
Abscess
Infarct
big MS plaque
If you see an incomplete ring = think of
Giant MS plaque
If they show you diffusion =
Lymphoma or stroke
- Why do things enhance?
Why DON’T things enhance?
“ They DON’T enhance because of the blood brain barrier.
When things DO enhance =
a. Outside the BBB (Extra-axial)
b. They melted the blood brain barrier
Supratentorial + Restriction =
Think of two things:
- Abscess
- Lymphoma
Any hypercellular tumor can restrict = GBM and Medulloblastoma -
CP angel + Restriction =
Epidermoid
Restriction of the temproal horns
Herpes encephalitis
Midline crossing?
- GBM
- Lymphoma
- Radiation necrosis
- MS plaque in teh corpus callosum
- Meningioma in the falx
Intra-axial + Calcification =
Oligodenroglioma (90%)
T1 Bright
Most tumors are T1 dark
Exeptions:
bleeding tumors
Pituitary appoplexy
Hemorrhagic mets:
Melanoma
Renal
Carcinoid
Choriocarcinoma
Thyroid
FAT: Dermoid, lipoma
Melanin: Melanoma
Blood: bleeding mets or tumor
Cholesterol: Colloid Cyst
Cholesterol Granuloma
If you see tumors everywhre, then you are dealing with?
NF2
Just remember MSME
Multiple Schwanomas
Meningiomas
Ependymoma
Lherm itte-Duclos (Dysplastic Cerebellar Gangliocytoma)
This thing is very uncommon, but when you see it you need to have the following thoughts
Cowdens
Breast CA
Mammogram
“TIGER STRIPE” mass in one cerebellar hemisphere
NOT A cancer = HAMARTOMA
COWDEN = HAMARTOMA SYNDROME
