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Onco Board Review 2 > CNS > Flashcards

CNS Flashcards

1
Q

What is the most common secondary brain tumor in dogs?

A

HSA

#2 = pituitary tumors, #3 tie between LSA and metastatic carcinoma

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2
Q

What is the most common c/s in dogs with brain tumors?

A

Seizures

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3
Q

Which IHC stain was shown to be prognostic in dogs with benign meningiomas treated with surgery and pRT?

A

VEGF
MST 748d with <75% VEGF+ cells
MST 442.5d with >75% VEGF+ cells

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4
Q

What marker of proliferation is prognostic in canine meningioma?

A

PCNA

2 year PFS 42% with high PCNA and 91% with low PCNA

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5
Q

T/F: Canine gliomas commonly overexpress COX-2.

A

False

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6
Q

What is the most common c/s in cats with brain tumors?

A

Behavior change.

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7
Q

What are the three most common intracranial tumors in cats?

A
  1. Meningioma
  2. LSA
  3. Pituitary tumor
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8
Q

Is surgery or RT more effective for canine meningiomas?

A

RT

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9
Q

What is the MST for dogs with meningiomas treated with pred and hydoxyurea? What about steroids alone?

A

28 weeks - pred + hydroxyurea

14 weeks - pred alone

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10
Q

What is the typical signalment and location of a canine spinal nephroblastoma?

A

6 months to years
Goldens, GSD
T10-L2 spinal cord

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11
Q

What is the typical signalment and location of feline spinal LSA?

A

young cat
FeLV positive
TL spine
multiple extraneural lesions

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12
Q

What is the most common CN and most common spinal site for PNST?

A

CN 5

C6-T2

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13
Q

What is the most common primary spinal cord tumor in dogs? Cats?

A

Dogs - meningioma

Cats - lymphoma

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14
Q

What is the most common secondary spinal cord tumor in dogs? Cats?

A

Dogs - HSA

Cats - OSA

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15
Q

What is meant by “secondary brain tumor?”

A

compressive or metastatic brain tumors

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16
Q

In a necropsy study, what % of dogs with pituitary tumors had ACA?

A

6%

61% adenoma, 33% invasive adenoma

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17
Q

What are the most specific neurologic signs in dogs with pituitary macroadenomas?

A

lethargy, mental dullness, decreased appetite

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18
Q

What % of dogs with PDH and a visible pituitary tumor on MRI will develop neurologic signs?

A

15-25%

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19
Q

What % of dogs with hypophysectomy for PDH develop DI?

A

53%

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20
Q

Neurologic signs, but not Cushing’s signs, are expected to resolve after RT for canine pituitary tumors.

A

True

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21
Q

What is the reported MST for dogs receiving no tx for a pituitary mass?

A

551d (18 months)

1405d (3.8 yrs with radiation

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22
Q

What is the best test for diagnosing feline acromegaly?

A

IGF-1 levels

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23
Q

Most common brain tumor in dogs and cats?

A

meningioma

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24
Q

What % of cats have > 1 meningioma?

A

17%

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25
What % of dogs with primary brain tumor have another unrelated cancer?
23-25%
26
What is the accuracy of predicting brain tumor type based on MRI?
70%
27
Why are canine meningiomas less predictable for ease of surgical removal than feline?
~1/3 are invasive
28
What % of dogs with brain tumors treated with pRT develop late side effects resulting in death/euthanasia?
14.5%
29
Is surgery or RT more effective for canine meningiomas?
RT | VCO 2013
30
What is the reported MST for canine brain tumors without tx?
< 2 months
31
What % of canine meningiomas are benign, atypical, or malignant?
56% benign 43% atypical 1% malignant
32
MST for a cat with meningioma treated with surgery alone?
~2 years
33
What % of feline meningiomas recur?
20.6%
34
T/F: Feline intracranial LSA is typically associated with multicentric dz.
True
35
Is chemotherapy recommended as primary treatment for brain tumors in dogs?
No, not supported 2015 JVIM review by Hu. Surgery and RT had no difference in outcome in this review.
36
What do fluid and fat look like on T1?
fluid is dark fat is white They usually do T1 pre and post contrast, so then contrast will be white
37
What do fluid and fat look like on T2?
fluid and fat are both white
38
What does a meningioma look like on pre- and post-contrast studies?
extra-axial | hyperintense on pre-contrast, very enhancing on post; bright on T2
39
What is characteristic of a meningioma on MRI?
T1 hypointense, T2 hyperintense Dural tail sign - thick and tapered along meninges adjacent to tumor (HiSa can also have dural tail) 95% accompanied by edema
40
What is characteristic of a glioma on MRI?
T1 hypointense, T2 hyperintense intra-axial heterogenous mass in middle of brain tissue (think Boxer) ring enhancement and more peritumoral edema than others
41
``` What is dark and bright on T1? bone air fat fluid (CSF) grey matter white matter ```
``` bone - dark air - dark fat - bright fluid (CSF) - dark grey matter - grey white matter - whiter (in humans) ```
42
``` What is dark and bright on T2? bone air fat fluid (CSF) grey matter white matter ```
``` bone - dark air - dark fat - bright fluid (CSF) - bright grey matter - grey white matter - darker than grey ```
43
What do astrocytomas look like on T1/T2? What breeds are predisposed? What stains are they positive for?
T1 - mild to moderately hyperintense T2 - moderately hyperintense Breeds = Boxers, brachycephalics Positive for GFAP and nesting
44
What do oligodendrogliomas look like on T1/T2? What breeds are predisposed?
T1 - hypointense T2 - marked hyperintensity (because they are mutinous) Breeds = Boxers, brachycephalic
45
What breed is over-represented with choroid plexus tumors? What ventricle do 50% arise from? What features are seen on MRI? What is unique about metastasis?
Golden Retrievers 4th ventricle mild/moderate edema; marked uniform contrast enhancement can have "drop metastases" to other parts of spinal cord CSF protein higher for carcinomas than papillomas
46
What was MST with SRT for brain tumors? When were worsening neuro signs observed? What dose constrictions were recommended in this study? (Griffin 2014)
``` MST 561d (18 months) Worsening neuro signs in 37% of dogs 3-16 weeks post-tx Keep < 1 cc to 24 Gy (predicted death w/in 6 months) ```
47
Most common brain tumor in dogs? (Snyder 2006)
meningioma (45%)
48
T/F: Secondary brain tumors are more common than primary in dogs.
True (Snyder 2008)
49
What % of dogs with secondary brain tumor also had lung mets?
47% | 35% kidney mets, 31% heart mets
50
T/F: Ki67 and VEGF expression is increased in meningiomas and both are predictive of survival.
False True that expression is increased (91% Ki67, 96% VEGF), but only VEGF predictive of survival (Platt 2006 and Matiasek 2009)
51
What % of feline hyperadrenocorticism is due to PDH?
80%
52
How did survival for RT treated dogs differ from untreated for pituitary masses? (Kent 2007)
Tx = 1405d (3.8 yrs), Un-tx = 358 (0.9 yrs) | Tx 3 Gy daily to 48 Gy
53
What are 4 features consistent with acromegaly?
diabetic male cat, insulin resistance, weight gain, big head
54
What was MST for pituitary adenomas treated with SRT? (Wormhoudt 2018)
1072d (3 years)
55
How did RR with frameless SRT + temozolomide compare to frameless SRT alone for canine gliomas? (Dolera VCO 2018)
RT alone - 63.2% RT + TMZ - 90.9% (survival was a little over a year for both - slightly longer for RT/TMZ but not significant)
56
In dogs with presumed gliomas tx with lomustine, how did survival compare to supportive care? What toxicities were seen? (Moirano 2018)
MST with lomustine = 138d, supportive care = 35d | Neutropenia 46%, renal tox 15%, hepatotox 50%
57
Most common branch of trigeminal nerve affected by nerve sheet tumor? (Swift 2017)
mandibular (26 dogs) maxillary was 22 dogs, ophthalmic was 10 dogs treated with SRT in this study (follow-up not sufficient for survival to be statistically significant)
58
Which is more common - primary intramedullary spinal cord tumors or secondary? (Pancotto JVIM 2013)
primary | tend to occur in spinal cord of young dogs
59
Which breeds are overrepresented for CNS HiSa? (Mariani 2013)
Retrievers and Corgis
60
What was the prevalence of intracranial neoplasia in a postmortem study with n=9574? Which breeds had higher risk of primary intracranial neoplasia? (Song 2013)
4.5% | Goldens, Boxers, Boston Terriers, Frenchies, Rat Terriers
61
Which brain location was associated with better outcome with palliative care for primary brain tumors? (Rossmeisl 2013)
supratentorial - survival > 3 months | seizures most common with this location

Onco Board Review 2 (20 decks)

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