Brain Tumors

Question 1

Adults in General

Answer 1

• More likely to be METs (primary tumor in other area but travels to brain)
• BUT brain metastasis may be the 1st thing that causes noticeable symptoms (dizziness, seizures, ataxia, headaches)

Question 2

3 Most Common Primary Brain Tumors in Adults

Answer 2

• 1- Meningioma
  - Often press down on brain from outside (extra-axial)
  - Commonly invades skull —> bump on head
  - Histology…meningothelial whorls & concentric calcified psammoma bodies
  - Non-neuroglial
• 2- Pituitary adenoma
  - In sella; may put pressure on optic nerve; may also cause hormonal changes
  - Non-neuroglial
• 3- Glioblastoma multiforme (Grade IV astrocytoma)
  - Really bad b/c crosses corpus colosseum
  - Contrast enhancing
  - Histology…numerous mitoses, endothelial proliferation, necrosis w/ pseudopallisading

Question 3

How can low grade tumor have bad prognosis?

Answer 3

If bad location/ not resectable

Question 4

2 Most Common Brain Tumors in Children

Answer 4

• More likely to be primary tumor than secondary METs
• 1- Pilocytic astrocytoma (Grade I astrocytoma)
  - Often associated w/ cystic area of fluid
  - 75% 10 yr survival rate
• 2- Medullablastoma
  - “small blue cell tumor”
  - In posterior fossa
  - Aggressive but also responsive to tx
  - Histology… Homer Wright rosettes

Question 5

2 Hereditary Neuro Tumor Syndromes

Answer 5

• Neurofibromatosis I (NF-I ) - cafe-au-lait spots, dermatofibromas (skin lesions), plexiform neurofibromas (widespread), optic nerve gliomas
• Neurofibromatosis II (NF-II) - bilateral acoustic neuroma & multiple meningiomas & ependymomas (SC)
  • “2 neuromas b/c bilateral & 2 others”