Brain Tumors

Question 1

Brain Tumors

Answer 1

M/c form of solid tumors in children
2nd m/c form of pediatric cancer

US 38 cases per million

Occasionally are congenital

M/c in Ages 1-20, slightly greater in males than females

Question 2

Pathology

Answer 2

Can cause symptoms:

• • directly- penetration or compression of an area of the prain
• • indirectly- causing an increase in intracranial pressure

Young children have high incidence of cerebellum or brainstem tumores

Question 3

Prognosis

Answer 3

RX includes: surgical resection, radiation, chemo

Radiation used with caution in young children d/t late onset effects on learning and cognition

Chemo effectiveness often limited due to difficulty crossing blood-brain barrier

Shunting may be required to relieve hydrocephalus if tumor blocks CSF flow

Survival rate depends on grade of malignancy and age

Prognosis is better the older the child is at onset

Prognosis is better in astrocytomas vs medullablastomas

5 yr survival rate for malignant brain tumor is ~70%, many survivors have long term neuropsychological and cognitive deficits

Question 4

Benign

Answer 4

complete cure is possible
can be life threatening if large or results in increased intracranial pressure, cerebral edema, or brain herniation especially if located in a critical area of brain for vital functions (pons or medulla)

Question 5

Malignant

Answer 5

80% of brain tumors

Life threatening

Question 6

Primary brain tumor

Answer 6

originate directly from cells in the brain and rarely spread outside of CNS

Question 7

Metastatic

Answer 7

originate from tissues outside of the brain

may occur throughout meninges and may involve sites outside of brain

Question 8

Most common brain tumors in childhood and adolescence

Answer 8

astrocytoma
medulloblastoma

both primarily occur in the cerebellum
s/s increased ICP, cerebellar signs like ataxia

Question 9

Ependymoma

Answer 9

Primary brain tumor that may occur in the posterior fossa and cerebral hemispheres

s/s: increase ICP in posterior fossa, seizures, focal cerebellar deficits

Question 10

Craniopharyngiomas

Answer 10

histologically benign, occur primarily at the midlien of the suprasellar region

S/S: visual disturbances, headaches, vomiting, endocrine disturbances

Question 11

Brainstem glioma

Answer 11

Initial signs: progressive cranial nerve dysfunction, gait disorders