Brain tumour Flashcards

1
Q

Astrocytic tumour classifications

A

I: pilocytic astrocytoma
II: astrocytoma
III anaplastic astrocytoma
IV: glioblastoma

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2
Q

Oligodendricytic tumour classifications

A

II: oligodendroglioma

anaplastic oligodendroglioma

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3
Q

Classes of brain tumours

A

I: in-situ/localized
II: diffuse
III: undefied
IV: malignant

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4
Q

Neuron tumour classifications

A

I: gangliocytoma
II: neurocytoma

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5
Q

Ependymal tumour classifications

A

I: subependymoma
II; ependymoma
III: anaplastic ependymoma

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6
Q

Meningeal tumour classifications

A

I: meningioma
II: atypical meningioma
III: anaplastic meningioma

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7
Q

Neurononal stem cell tumour classification

A
IV: neuroblastoma (PNET) - named by location
Medulloblastoma
Neuroblastoma
Retinoblastoma
Pineoblastoma
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8
Q

Mixed brain tumour classification

A

I: ganglioglioma
II: mixed oligoastrocytoma
III: anaplastic oligoastrocytoma

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9
Q

PSNS tumour classifications

A

I:Schwannoma/neurofibroma
IV: malignant peripheral nerve sheath tumour

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10
Q

General principles of brain tumours

A

1/2 are “benign” but mass effect
cure rate for malignant brain tumours much lower than other cancers
lifetime risk: 1/200
leading cause of cancer deaths in children/teenagers
2nd leading cause of cancer deaths in males 20s-40s
40% primary CNS tumours: gliomas
80% of malignant CNS tumours: gliomas

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11
Q

CNS tumour etiology

A
majority are unknown
Irradiation --> meningoma, glioma, nerve sheath tumours
Genetic
Immunosuppression: CNS lymphoma
Experimental: SV40
Occupation: some risk
Trauma, diet- no convincing data
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12
Q

CNS tumour risk factors

A

Sex: gliomas Men. women
Meningiomas: women > men
Association with breast cancer and meningioma
Cell phone: of concern

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13
Q

Clinical features of CNS tumours

A
epilepsy
headache
raised ICP
focal neurologic deficit
short history: more aggressive
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14
Q

Intracranial CNS tumour distribution

A

adults: 70% supratentorial, 30% infra
children: 30% supra, 70% infra

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15
Q

CNS tumours common among adults

A
glioblastoma
metastasis
malignant astrocytoma
meningioma
pilocytic
Schwannoma
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16
Q

CNS tumours common among children

A
medulloblastoma
astrocytoma
ependymoma
craniopharyngioma
glioblastoma
17
Q

Glioblastoma 5 year survival

A

3-4%

18
Q

Anaplastic astrocytoma 5 year survival

A

30%

19
Q

Oligodendroglioma 5 year survival

A

60%

20
Q

Ependymoma 5 year survival

A

60%

21
Q

Medulloblastoma 5 year survival

A

60%

22
Q

Pilocytic astrocytoma 5 year survival

A

> 80%

23
Q

Meningioma 5 year survival

A

70-95%

24
Q

Pilocytic astrocytoma features

A
predominantly in childhood
usually cerebellum, optic tract, hypothalamus
others: more guarded prognosis
often cystic (esp cerebellum)
potentially curable by complete excision
25
Q

Pilocytic astrocytoma genetics

A

most common: gains on 7q34
Often associated with duplications of BRAF, HIPK2 genes
- not associated with clinical outcome for cerebellar tumours
- predict better clinical outcome for low grade gliomas in pediatric patients
- activation of MAP kinase signalling pathway

26
Q

DIffuse gliomas

A

40% of all primary CNS tumours
78% of malignant CNS tumours
>80% of high grade gliomas

27
Q

Tumour suppressor genes involved in CNS tumours

A

p53
Rb: retinoblastoma
p16
p19

28
Q

Oncogenes involved in CNS tumours

A

Epidermal growth factor receptor: GBM

pltaelet-derived growth receptor alpha: low grade astrocytoma

29
Q

CNS tumour metastasis

A
Lung (50%)
Breast (15%)
Skin (melanoma - 10%)
GI 
GU
80-90% are in the brain, 10-20% spinal
30
Q

CNS effects of cancer treatment

A
Radiotherapy:
encephalopathy
delayed myelopathy
hypothalamic/pituitary disturbance
oncogenesis

Chemo:
encephalopathy/myelopathy
cerebellar