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Neuro 2 > Brain Tumors > Flashcards

Brain Tumors Flashcards

1
Q

What are some positive prognostic factors for primary brain tumors?

A
  • Young age
  • High performance status
  • Lower pathological grade
  • Long symptom duration
  • Absence of mental changes at time of diagnosis
  • Cerebellar location
  • Small tumor size
  • Complete surgical resection
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2
Q

What are some negative prognostic factors for primary brain tumors?

A
  • Tumor has spread
  • Not all of the tumor is able to be removed
  • Older age
  • Lower functional level
  • Higher tumor grade
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3
Q

What are some common risk factors for brain tumors?

A
  • Age
  • Gender
  • Home/work exposure
  • Family history
  • Viruses, infections, allergens (eg. Epstein barre)
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4
Q

What are some prognostic factors associated with brain tumors?

A
  • Age
  • Functional level
  • Type of tumor
  • Grade of tumor
  • Genetic mutations or changes in tumor cells
  • Location and size of tumor
  • How much tumor can be removed by surgery
  • Has the tumor spread through the CSF to other parts of brain or spinal cord or even beyond the CNS?
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5
Q

What are some key signs and symptoms of CNS tumors?

A
  • New onset or change in pattern of headaches
  • Headaches that are becoming more frequent or more severe
  • Unexplained N/V
  • Vision problems (blurred, double, loss of peripheral vision)
  • Gradual loss of sensation or movement in arm or leg
  • Balance difficulties
  • Speech difficulties
  • Confusion on everyday matters
  • Personality or behavior changes
  • Seizures in person with no seizure history
  • Hearing problems
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6
Q

How many grades of tumors are there?

A

4

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7
Q

Grade 1 Tumor

A

benign, slow growing, cells look almost normal under microscope, usually associated with long term survival, rare in adults

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8
Q

Grade 2 Tumor

A

Relatively slow growing, sometimes spreads to nearby normal tissue and comes back

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9
Q

Grade 3 Tumor

A

Malignant (cancerous), acitively reproduces abnormal cells, tumor spreads into nearby normal parts of the brain, cells look abnormal under the microscope, tends to come back, often as higher grade tumor

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10
Q

Grade 4 Tumor

A

most malignant, grows fast, easily spreads into nearby normal parts of brain, actively reproduces abnormal cells, cells look very abnormal under microscope, tumor forms new blood vessels to maintain rapid growth, tumors have areas of dead cells in their center (necrosis)

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11
Q

Benign tumor

A

The least aggressive type of brain tumor, usually originate from cells within or surrounding the brain, do not contain cancer cells, grow slowly, and typically have clear borders that do not spread into other tissue

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12
Q

Malignant tumor

A

brain tumors contain cancer cells and often do not have clear borders. They are considered to be life threatening because they grow rapidly and invade surrounding brain tissue.

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13
Q

Primary tumor

A

Tumors that start in cells of the brain, may spread to other parts of the brain or to the spine, but rarely to other organs.

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14
Q

Metastatic tumor

A

or secondary brain tumors begin in another part of the body and then spread to the brain. These tumors are more common than primary brain tumors and are named by the location in which they begin. (also called secondary tumor)

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15
Q

What are the most common types of cancer that metastasize to the brain?

A
  • Lung
  • Breast
  • Skin (melanoma)
  • Colon
  • Kidney
  • Thyroid gland
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16
Q

What types of tumors are gliomas?

A
  • Primary tumors
  • General term for tumors that start in glial cells, not a specific type of brain tumor
  • 3 out of 10 tumors are gliomas
  • These are the fastest growing type of tumors

Examples: Astrocytomas, Oligodendrogliomas, Ependymomas

17
Q

What are characteristics of an astrocytoma?

A
  • Start in glial cells called astrocytes
  • 2 out of 10 brain tumors are astrocytomas
  • Can spread widely throughout the brain tissue and blend into the tissue making it difficult to resect
  • Some can spread along CSF pathways
  • Rare to go outside of brain or spinal cord
18
Q

Grades of astrocytomas

A

Low-grade astrocytomas (Grade I and Grade II)

  1. Grow slowly
  2. Non-infiltrating grade I astrocytoma
  3. Good prognosis
  4. More common in children

Grade II astrocytomas

  1. Slow growing
  2. Can grow into other areas making removal harder
  3. Can be more aggressive and faster growing over time

High-grade astrocytomas (Grade III and Grade IV)

  1. Anaplastic (grade III) astrocytomas
  2. Glioblastomas (grade IV)
  3. Make up more than half of all gliomas in adults
  4. Most common
  5. Fastest growing
19
Q

What is a glioblastoma?

A

Grade 4 astrocytoma

20
Q

What are characteristics of an oligodendroglioma?

A
  • Starts in glial cells called oligodendrocytes
  • Grow slowly
  • Infiltrate other tissue often and can’t be fully removed by surgery
  • Can sometimes spread along CSF pathway
  • Rarely outside of brain and spinal cord
  • Can become more aggressive over time
  • Grade III tumors are called anaplastic oligodendrogliomas which is a very aggressive type
  • Only 1-2% of brain tumors are made up of these
21
Q

What are characteristics of an oligodendroglioma?

A
  • Starts in glial cells called oligodendrocytes
  • Grow slowly
  • Infiltrate other tissue often and can’t be fully removed by surgery
  • Can sometimes spread along CSF pathway
  • Rarely outside of brain and spinal cord
  • Can become more aggressive over time
  • Grade III tumors are called anaplastic oligodendrogliomas which is a very aggressive type
  • Only 1-2% of brain tumors are made up of these
22
Q

What are characteristics of a meningiomas?

What are the signs/symptoms?

A
  • Arises from the meninges
  • Most common type of tumor that forms in the head
  • Most grow very slowly over years and are asymptomatic
  • More common in women and often discovered in older ages
  • Signs and symptoms:
  • Double vision or blurred vision
  • Hearing loss or tinnitus
  • Memory loss
  • Loss of smell
  • Seizures
  • Weakness in arms or legs
  • Language difficulty
23
Q

What is the most common and fastest growing tumor out of all the ones reviewed?

A
  • Most common = meningiomas
  • Fastest growing = gliomas

glioblastomas are the most common and fastest growing oligodendrogliomas

(check this card)

24
Q

What are the major goals of treatment for brain tumors?

A

?

25
Q

What are characteristics of an ependymoma?

A
  • Forms in the brain or spinal cord
  • Begins in the ependymal cells that line the passageways where the CSF flows
  • Usually occurs in children
  • Children may experience headaches and seizures
  • Adults with this type of tumor is more likely to form in the spinal cord and may cause weakness in the part of the body controlled by the nerves affected by the tumor
26
Q

What are characteristics of a medulloblastoma?

What are signs/symptoms?

A
  • Malignant tumor that starts in the cerebellum
  • This effects coordination, balance and movement
  • Tends to spread through CSF
  • Rarely spreads to other areas of the body
  • Symptoms can either be due to tumor or buildup of pressure
  • Symptoms
  • Headaches
  • Nausea
  • Vomiting
  • Tiredness
  • Dizziness
  • Double vision
  • Poor coordination
  • Unsteady gait
27
Q

What are characteristics of a pituitary tumor?

A
  • Abnormal growths
  • Some tumors result in too much hormone, others cause it to produce lower levels
  • Most are benign
  • Usually don’t spread to other parts of the body
  • Usually identified incidentally on imaging
  • Macroadenomas – measure 1 cm or larger
  • Can put pressure on pituitary gland
  • Microadenomas – smaller than 1 cm
28
Q

How do symptoms differ when coming from pressure versus hormone deficiency due to pituitary tumors?

A

Symptoms from Pressure:
•Headache
•Vision loss particularly peripheral vision

Symptoms from Hormone Deficiency: 
•Nausea and vomiting
•Weakness
•Feeling cold
•Less frequent or no menstrual periods
•Sexual dysfunction
•Increased amount of urine
•Unintended weight loss or gain
29
Q

What are the side effects of radiation?

A
  • Headache
  • Hair loss
  • Nausea
  • Vomiting
  • Extreme tiredness (fatigue)
  • Hearing loss
  • Skin and scalp changes
  • Trouble with memory and speech
  • Seizures
30
Q

What are side effects of chemotherapy?

A

oFatigue
oHair loss
oEasy bruising and bleeding
oInfection
oAnemia (low red blood cell counts)
oNausea and vomiting
oAppetite changes
oConstipation
oDiarrhea
oMouth, tongue, and throat problems such as sores and pain with swallowing
oPeripheral neuropathy or other nerve problems, such as numbness, tingling, and pain
oSkin and nail changes such as dry skin and color change
oUrine and bladder changes and kidney problems
oWeight changes
oChemo brain, which can affect concentration and focus
oMood changes
oChanges in libido and sexual function
oFertility problems

Neuro 2 (30 decks)

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