Central Nervous System Tumours

Question 1

Definition

Answer 1

Tumours of the central nervous system#

NOTE: brain tumours cannot be truly differentiated into benign and malignant because supposedly ‘benign’ tumours can cause significant morbidity and mortality

Question 2

Differentiation

Answer 2

o High-Grade = a tumour that grows rapidly and aggressively
· Glioma and glioblastoma multiforme
· Primary cerebral lymphoma
· Medulloblastoma

o Low-Grade = a tumour that grows slowly and may or may not be successfully treated
· Meningioma
· Acoustic neuroma
· Neurofibroma
· Pituitary tumour
· Craniopharyngeoma
· Pineal tumour

Question 3

Brain metastases commonly arise from

Answer 3

· Lung
· Breast
· Stomach
· Prostate
· Thyroid
· Colorectal

Question 4

Aetiology

Answer 4

· Can arise from any of the cells in the CNS (e.g. glial cells, ependymal cells, oligodendrocytes)

Question 5

Risk factors

Answer 5

o Ionising radiation

o Immunosuppression (e.g. HIV)

o Inherited syndromes (e.g. neurofibromatosis, tuberous sclerosis

Question 6

Epidemiology

Answer 6

· Primary brain tumours = 2% of tumours diagnosed in the UK

· AIDS patients have an increased risk of developing CNS tumours

· Can develop at any age but are more common between 50-70 yrs

Question 7

Presenting symptoms

Answer 7

· Presentation depends on the size and location of the tumour
· Headache (worse in the morning and when lying down)
· Nausea and vomiting
· Seizures
· Progressive focal neurological deficits
· Cognitive and behavioural symptoms
· Papilloedema

Question 8

Investigations

Answer 8

· Bloods - check CRP/ESR to eliminate other causes (e.g. temporal arteritis)
· CT/MRI
· Biopsy and tumour removal
· Magnetic resonance angiography - define changing size and blood supply of the tumour
· PET

· NOTE: distant metastases are RARE with primary CNS tumours