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Module 9.3 > Brain Tumors > Flashcards

Brain Tumors Flashcards

1
Q

Brain tumors

A

1/2 to 3/4 of tumors: primary, rest metastatic
20% of all cancers of childhood
70% of primary tumors arise in posterior fossa in childhood

adults: tentorium (separates cerebellum from occipital lobes)

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2
Q

What are the four unique characteristics of brain tumors?

A

– Distinction between benign and malignant lesss evident in CNS than other organs
– Ability to surgically resect infiltrating glial neoplasms without compromising neurologic function is limited
– Anatomic site of neoplasm can have lethal consequences even if benign tumor
– Primary CNS neoplasms rarely spread outside of CNS

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3
Q

What are the four major classes of brain tumors?

A

Gliomas
Neuronal tumors
Poorly differentiated neoplams
Meningiomas

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4
Q

What are the three types of gliomas?

A

– astrocytomas
– oligodendrogliomas
– ependymomas

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5
Q

Where in the brain are most astrocytomas found?

A

Cerebral hemispheres

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6
Q

What two morphologic features distinguish a glioblastoma ?

A

Tufts of proliferated endothelial cells bulge into vascular lumen = glomeruloid structures

Necrosis - pseudopalisaing tumor cells at edge of necrotic areas

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7
Q

What is the usual clinical scenario for a well differentiated astrocytoma?

A

Low grade - symptoms static or progress slowly for years then enter rapid decline, anaplastic and rapid growth

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8
Q

What is the usual clinical scenario for a well differentiated glioblastoma?

A

Prognosis very poor

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9
Q

What age group do oligodendrogliomas occur in?

A

Most common in middle life

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10
Q

Where are oligodendrogliomas located?

A

Located in cerebral hemisphere, white matter

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11
Q

How do oligodendroglioma patients present?

A

May complain of neurologic issues, including seizures

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12
Q

What are the two microscopic features? Oligodendrogliomas

A

Sheets of regular cells w/round nuclei surrounded by clear halo of cytoplasm (fried eggs)

Anastamosing network of capillaries: ‘chicken feet’

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13
Q

What are the two types of poorly differentiated neoplasms?

A

Medulloblastoma - 20% of childhood tumors, cerebellum

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14
Q

In what age group and where do medulloblastomas occur?

A

Children

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15
Q

Occlusion of the flow of CSF leads to what?

A

Hydrocephalus

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16
Q

What do the tumor cells look like? (Medulloblastoma)

A

Bland, small dark cells

17
Q

What is the tumor sensitive to?

A

Radiation

18
Q

Primary CNS lymphoma is the most common CNS neoplasm in what group of patients?

A

HIV/AIDS

19
Q

What does the term primary emphasize?

A

Lymphoma is not a non-hodgkin lymphoma that spread to brain

20
Q

Do brain lymphomas metastasize outside of the CNS and conversely do NHL’s outside of the CNS metastasize to the CNS?

A

No, not to brain parenchyma

21
Q

Are meningiomas usually benign or malignant?

A

Benign

22
Q

What age group do they occur in?

A

Adults

23
Q

Meningiomas: location

A

Found along any external surface of brain as well as within ventricle system

24
Q

Meningiomas: what cell do they arise from

A

Arise form meningothelial cell of arachnid, usually attached to dura

25
Q

Meningiomas: clinical course?

A

Slow growing, may eventually have neuro manifestations

26
Q

What cell do Schwannoma’s arise from?

A

Neural crest-derived Schwann cell

27
Q

What familial syndrome are they associated with (Schwannoma’s)?

A

Inherited disorders characterized by harmatomas & neoplams located throughout the body mostly prominently involve nervous system

Many inherited autosomal dominant

28
Q

Where are they most commonly located within the cranial vault? (Schwannoma’s)

A

Cerebellopontine angle (CPA), attached to vestibular branch of 8th nerve

29
Q

How do patients present? (Schwannoma’s)

A

Tinnitus & hearing loss

30
Q

What is the other name for the tumor? (Schwannoma’s)

A

“acoustic neuroma”

31
Q

NF Type I

A

Neurofibromas (plexiform, solitary)
Acoustic nerve schwannomas
Gliomas of optic nerve
Lisch, cafe au lait

Gene of neurofibromin: 17

32
Q

NF Type II

A

Autosomal disorder w/gene on chromosome 22

Propensity to develop tumors - bilateral Schwannomas of 8th nerve; multiple menengiomas

Module 9.3 (3 decks)

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