Brain tumours Flashcards
What is the most common extra-axial tumour?
Meningioma
What are some other extra-axial tumours?
Pituitary adenoma
Craniopharyngioma
Choroid plexis papilloma
Acoustic neuroma
How do brain tumours present?
Progressive neurological defecit:
- headache
- seizures
- motor weakness
How do brain tumours cause raised ICP and how would this present?
Brain tumour mass or surrounding oedema blocks CSF circulation
Presents as seizures, headaches, vomiting, mental changes
How does a headache associated with tumour present?
Worse in the morning; wakes them up
Worse with coughing / leaning forward (30%)
May be associated with vomiting
May be associated with diplopia or difficulty focusing
What cells do glial tumours arise from?
Astrocytes or oligodendrocytes
What is the progressive malignant scale of glial tumour?
Low grade astrocytoma
Anaplastic astrocytoma
Glioblastoma multiforme
Who gets grade 1 astrocytomas?
Children and young people
What is the best treatment for grade 1 astrocytomas?
Surgical removal
Are grade 1 astrocytomas benign or malignant?
Benign
Where are pilocytic astrocytomas found?
Optic nerve
Hypothalamic gliomas
Cerebellum
Brainstem
How do low grade astrocytomas present?
Seizures
What are poor prognostic factors with low grade astrocytomas?
Age >50 Focal deficit (complex focal seizures) Short duration of symptoms Raised ICP Altered consciousness Enhancement on contrast studies
Where are low grade astrocytomas commonly found?
Temporal lobe
Posterior Frontal
Anterior Parietal
What are the malignant astrocytomas?
Anaplastic astrocytoma
Glioblastoma multiforme
Where do oligodendral tumours occur?
Frontal lobes
Who gets oligodendral tumours?
Adults 25-45 years
How do oligodendral tumours present?
Seizures
How are oligodendral tumours treated?
Surgery and chemotherapy
How are malignant astrocytomas treated?
Non-curative surgery
Radiotherapy
Some chemotherapy
What are meningiomas?
Tumours arising from the arachnoid “cap” cells of the arachnoid villi in the meninges
Are meningiomas benign or malignant?
Most meningiomas are benign, but a small percentage are malignant
Which meningiomas are malignant?
Clear cell Chordoid Rhabdoid Papillary Radiation induced meningiomas
What are the symptoms of meningioma?
Focal seizures
Spastic weakness
Diplopia
Increased ICP
What tumour condition are vestibular schwannomas associated with?
Neurofibromatosis type 2
At what age do germ cell tumours occur?
Mostly under 20, peak incidence 10-12 years old
What is the most common CNS germ tumour?
Germinoma
How are germinomas managed?
They are radiosensitive, so mainstay of therapy is with radiation
What tumour marker will be present in germinoma?
Placental alkaline phosphatase (PLAP)
