brain tumors Flashcards
7 main questions to ask self about brain tumors
- in CNS: intracranial or extra cranial?
- if intracranial: intra or extra axial
- if intraxial: infra or supra tentorial
- if spinal: eaxta or intra canallicular?
- if intracanallicular: extra or intra dural
- if intradural: extramedullary or intrameddulary
7 primary tumor or mets?
4 DDx for CNS mass lesions in adults
- tumor
- vascular
- infectious
- inflammatory
5 post. fossa tumors in kids
- pilocytic astrocytoma
- ependyoma
- medualloblastoma
- choroid plexus papilloma
- choroid plexus carcinoma
what is pilocytic astrocytoma
- most common in children
- hydroceph or cellebellar dysfunction
- WHO gr1
what is imaging, path, goal of therapy, outcomes of pilocytic astrocytoma
imaging: cyctic lesion w mural node - may have strong contrast enhancement
path: biphasic appearance with comact fascicles
goals: surgery
outcome: 90% cure
**1 where are pediatric tumors
post. fossa
**2 signs of post. fossa tumors
cerebellar or hydroceph
**3 what are WHO gr1 tumors
non-infiltrative and curable
what are oligodendroglioma
- commonly present with seizure
- arise within cotex
- WHO gr.2
what is imaging, path, goal of therapy, outcomes of oligodendroglioma
imaging: ccalcification of cT, dark on T1, bright on T2
path: fried egg appearance
goals: prolongation of disease remission
outcome: 8-10 years with everything - will undergo malignancy
2 prognostic indicators of oligodendroglioma
- 1p/19q status
2. IDH mutation
what is effect of 1p/19q status
those with this deletion tend to do better
what is IDH mutation
enzyme mutation
- less NADPH
- creation of 2-HG metabolite, an onco metabolite
**4 what is outcome of infiltrative gliomas (WHO 2-4)
incurable
**5 what is presentation of low grade tumor
siezure rather than neuro deficit
**6 how are tumors on CT, MRI
hypodense on CT
hypodense on T1 MRI
hyperdense on T2 MRI
**7 what do low grade tumors look like on CT
no enhancement, but calcification
what is secondary glioblastoma
- 20-30% of all glioblastoma
- present with HA, neuro def. or seizure
- WHO gr 4
what is imaging, path, goal of therapy, outcomes of glioblastoma
imaging: heterogeniously enhancing mass
path: areas of low grade tumor with pockets/sheet of malignant degenaration
goals: acheivment of disease control and neuro function
outcome: 12-14 month survival
what is def. of infiltating CA
CA that has spread beyond the layers of tissue in which it had developed
what is main treatment of gliobastoma
temezolamide
what predicts response to temezolamide
MGMT methylation
MGMT will not respond to temezolamide, but methylation shuts it off
**8 what happens to low grade glioma
will invariably progress to glioblastoma
***9 what do malignant tumors look like on CT
enhance
**10 what does rapid progression of Sx predict
increased malignancy
