Brain cancer Flashcards
most adult tumours are ____tentorial whereas the majority of childhood tumours are ____tentorial
supra (adult)
infra (child)
commonest form of brain tumour?
metastases
T/F: brain metastases are often not treatable with surgical intervention
true - often multiple
commonest primary tumour in adults?
prognosis?
glioblastoma multiforme
poor prongosis (~1yr)
appearance of glioblastoma multiforme on imaging?
central necrosis
rim that enhances with contrast
histology of glioblastoma multiforme?
pleomorphic tumour cells border necrotic areas
multiforme > pleomorhpic
treatment of glioblastoma multiforme?
surgical with post-op chemo and/or radiotherapy. Dexamethasoen to treat the oedema
2nd commonest primary brain tumour in adults
meningioma
Meningiomas
1) typically BENIGN/ MALIGNANT
2) INTRINSIC/ EXTRINSIC tumours of the CNS
3) arise from the ___ mater
4) T/F: cause symptoms by invasion
5) typically located where?
1) benign
2) extrinsic
3) dura
4) false - by compression
5) falx cerebri, superior sagittal sinus, convexity (surface), skull base
histology of meningioma?
Spindle cells in concentric whorls and calcified psammoma bodies (psaMMoMa > MeningioMa)
Vestibular schwannoma (prev acoustic neuroma)
1) benign tumour arising from which CN?
2) often located where
3) presentation?
1) VIII
2) cerebellopontine angle
3) hearing loss, tinnitus, facial nerve palsy
what condition is associated with B/L vestibular shwannomas
NFT2
B/L > 2
histology of vestibular schwannomas?
Antoni A or B patterns Verocay bodies (acellular areas surrounded by nuclear palisades)
V erocay > V estibular
most common primary brain tumour in children?
pilocytic astrocytoma
histology of pilocytic astrocytoma?
Rosenthal fibres (corkscrew eosinophilic bundle)
an aggressive paediatric brain tumour that arises within the infratentorial compartment and spreads through the CSF system
Medulloblastoma
treatment of medulloblastoma?
Surgical resection + chemo
histology of medulloblastoma?
small, blue cells. Rosette pattern with many mitotic figures.
Ependymoma
1) commonly located where
2) may cause what complication
3) histology
1) commonly in 4th ventricle
2) hydrocephalus
3) perivascular pseudorosettes
Oligodendroma
1) benign, slow growing tumour in the ____ lobes
2) histology?
1) frontal
2) calcifications with ‘fried egg’ appearance
(imagine the O’s as fried eggs)
Haemangioblastoma
1) vascular tumour of the ____
2) associated with what syndrome?
3) histology?
1) cerebellum
2) von Hippel-Lindau
3) foam cells and high vascularity
T/F: Pituitary adenomas are benign tumours of the pituitary gland
true
micro- vs macro- pituitary adenoma?
micro < 1cm
marco >1cm
visual defect in pituitary adenoma and why?
bitemporal hemianopia
due to the crossing nasal fibres
Most common paediatric supratentorial tumour?
Craniopharyngioma
Craniopharyngioma
1) tumour of the sellar region that’s derived from where?
2) presentation?
3) treatment?
1) Rathke’s pouch
2) hormonal disturbance, hydrocephalus, bitemporal hemianopia
3) surgical removal +/- post-op radiotherapy
headache red flag features?
constant pain
worse at night
worse on walking, coughing, staining, bending forward
vomiting
how to recognise papilloedema on fundoscopy?
Blurring of the optic disc margin
Elevated optic disc (look for the way the retinal vessels flow across the disc to see the elevation)
Loss of venous pulsation
Engorged retinal veins
Haemorrhages around optic disc
Paton’s lines (retinal creases around the optic disc)
most common cancers that metastasise to the brain?
lung (most common) breast bowel melanoma RCC
3 types of glioma?
Astrocytoma (GM most common)
Oligodendroglioma
Ependymoma
causes distruption of the BBB and therefore are associated with vasogenic oedema
glioblastoma multiforme
