Brain Tumors B&B Flashcards
what are the 5 most common tumors in adults, in order?
- Glioblastoma.
- Meningioma.
- Schwannoma.
- Oligodendroma
- Pituitary adenoma
Most adult tumors occur above tentorium (supratentorial)
what are the 5 most common tumors in children, in order?
- Astrocytoma.
- Medulloblastoma.
- ependymoma
- hemangioblastoma
- Craniopharyngioma.
Most child tumors occur below tentorium (infratentorial)
[ASTROnauts BLAST-off, ENDing HuMAN Curiosity]
where are most common metastasis to brain? (3)
lung, breast, renal
(also melanoma, colon)
usually multiple lesions on brain MRI (primary usually single)
where does the most common primary brain tumor in adults develop? what is the prognosis?
glioblastoma: occurs in cerebral cortex, often crosses corpus callosum (“butterfly glioma”), expresses GFAP
rapidly progressive and malignant, usually fatal within a year (older age = worse prognosis)
rapidly progressive and malignant brain tumor which expresses GFAP, affecting adults (50% >65yo)
What is it and where does it occur?
glioblastoma: occurs in cerebral cortex, often crosses corpus callosum (“butterfly glioma”), expresses GFAP
most common primary brain tumor in adults
describe the histology finding of glioblastoma
glioblastoma: occurs in cerebral cortex, often crosses corpus callosum (“butterfly glioma”), expresses GFAP
exhibit pseudopallisading: nuclei of tumor cells line up like stakes along edge of necrosis
highly malignant, most common primary brain tumor in adults
histology shows central area of necrosis with pseudopallisading tumor cells surrounding. cells are GFAP+
what type of tumor is this
glioblastoma: occurs in cerebral cortex, often crosses corpus callosum (“butterfly glioma”), expresses GFAP
highly malignant, most common primary brain tumor in adults
where do meningiomas occur and in whom?
2nd most common primary brain tumor in adults (F>M bc tumor expresses estrogen receptors!)
occurs in convexities of hemispheres near surface of brain, arises from arachnoid cells
“extra-axial” - external to brain, can have dural attachment (“tail”)
“extra-axial” brain tumor arising from arachnoid cells
meningioma: 2nd most common primary in adults (F>M), occurs in convexities of hemispheres near surfaces of brain - appears on outside, pushing its way in
can have dural attachment (“tail”)
how do meningiomas present?
2nd most common primary in adults (F>M), occurs in convexities of hemispheres near surfaces of brain
usually benign with no metastasis, resectable, often asymptomatic (sometimes cause seizures)
Which receptors do meningiomas express and what is the clinical relevance of this?
2nd most common primary in adults (F>M), occurs in convexities of hemispheres near surfaces of brain
express estrogen receptors —> classically affects females more than males
what is an important risk factor for meningioma?
prior radiation to head (childhood malignancy) - latency period ~20 years
2nd most common primary in adults (F>M), occurs in convexities of hemispheres near surfaces of brain, arises from arachnoid cells
how do parasagittal meningiomas present?
Compress the leg area (medial surface of lobes) similar to an ACA stroke —> lower extremity weakness
2nd most common primary in adults (F>M), occurs in convexities of hemispheres near surfaces of brain, arises from arachnoid cells
what does histology of meningioma show?
2nd most common primary in adults (F>M), occurs in convexities of hemispheres near surfaces of brain, arises from arachnoid cells
histology shows psammoma bodies
57yo F w PMH of childhood malignancy presents with lower extremity weakness. MRI reveals brain tumor. Biopsy shows psammoma bodies. What type of tumor is this?
meningioma: 2nd most common primary in adults (F>M - expresses estrogen receptor), occurs in convexities of hemispheres near surfaces of brain
parasagittal meningioma can compress leg area, similar to ACA stroke
prior head radiation is risk factor (~20 year latency)
what 3 symptoms present with schwannomas?
- hearing loss
- tinnitus
- ataxia
form at cerebellopontine angle, classically located to CN VIII
what do schwannomas stain positive for?
S-100 protein
schwannomas are closely associated with which disease? how will this present?
neurofibromatosis 2: AD mutation in NF1/NF2
aka MISME: multiple inherited schwannomas, meningiomas, and ependymomas
bilateral schwannomas + meningiomas + ependymomas =
neurofibromatosis type 2
where do oligodendrogliomas occur, and how do they present?
rare/slow growing tumor of white matter, usually in frontal lobe —> often present with seizures
describe the histological appearance of oligodendroglioimas
rare, slow-growing tumor of white matter in frontal lobe (seizures)
cells histologically resemble fried eggs
46yo pt presents with new onset seizures. brain MRI reveals tumor of the frontal lobe. biopsy reveals cells with clear cytoplasms, giving the appearance of fried eggs. what is the diagnosis?
oligodendroglioma: rare, slow-growing tumor of white matter
affects adults
what is the most common primary brain tumor in children, and where do they occur?
pilocytic astrocytoma: low grade astrocytoma, usually in posterior fossa (cerebellum)
usually benign w/ no metastasis, well-circumcised and cystic/solid, often successfully treated with surgery
GFAP positive + Rosenthal fibers
for what do pilocytic astrocytomas stain positive?
pilocytic astrocytoma: low grade astrocytoma, usually in posterior fossa (cerebellum)
usually benign w/ no metastasis, well-circumcised and cystic/solid, often successfully treated with surgery
GFAP positive + Rosenthal fibers… this makes sense because astrocytes express GFAP, and Rosenthal fibers are seen whenever there is gliosis
