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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
Q

What % of dogs with primary brain tumor have another unrelated cancer?

A

23-25%

26
Q

What is the accuracy of predicting brain tumor type based on MRI?

A

70%

27
Q

Why are canine meningiomas less predictable for ease of surgical removal than feline?

A

~1/3 are invasive

28
Q

What % of dogs with brain tumors treated with pRT develop late side effects resulting in death/euthanasia?

A

14.5%

29
Q

Is surgery or RT more effective for canine meningiomas?

A

RT

VCO 2013

30
Q

What is the reported MST for canine brain tumors without tx?

A

< 2 months

31
Q

What % of canine meningiomas are benign, atypical, or malignant?

A

56% benign
43% atypical
1% malignant

32
Q

MST for a cat with meningioma treated with surgery alone?

A

~2 years

33
Q

What % of feline meningiomas recur?

A

20.6%

34
Q

T/F: Feline intracranial LSA is typically associated with multicentric dz.

A

True

35
Q

Is chemotherapy recommended as primary treatment for brain tumors in dogs?

A

No, not supported 2015 JVIM review by Hu. Surgery and RT had no difference in outcome in this review.

36
Q

What do fluid and fat look like on T1?

A

fluid is dark
fat is white
They usually do T1 pre and post contrast, so then contrast will be white

37
Q

What do fluid and fat look like on T2?

A

fluid and fat are both white

38
Q

What does a meningioma look like on pre- and post-contrast studies?

A

extra-axial

hyperintense on pre-contrast, very enhancing on post; bright on T2

39
Q

What is characteristic of a meningioma on MRI?

A

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
Q

What is characteristic of a glioma on MRI?

A

T1 hypointense, T2 hyperintense
intra-axial
heterogenous mass in middle of brain tissue (think Boxer)
ring enhancement and more peritumoral edema than others

41
Q 
What is dark and bright on T1?
bone
air
fat
fluid (CSF)
grey matter
white matter
A 
bone - dark
air - dark
fat - bright
fluid (CSF) - dark
grey matter - grey
white matter - whiter (in humans)
42
Q 
What is dark and bright on T2?
bone
air
fat
fluid (CSF)
grey matter
white matter
A 
bone - dark
air - dark
fat - bright
fluid (CSF) - bright
grey matter - grey
white matter - darker than grey
43
Q

What do astrocytomas look like on T1/T2? What breeds are predisposed? What stains are they positive for?

A

T1 - mild to moderately hyperintense
T2 - moderately hyperintense
Breeds = Boxers, brachycephalics
Positive for GFAP and nesting

44
Q

What do oligodendrogliomas look like on T1/T2? What breeds are predisposed?

A

T1 - hypointense
T2 - marked hyperintensity (because they are mutinous)
Breeds = Boxers, brachycephalic

45
Q

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?

A

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
Q

What was MST with SRT for brain tumors? When were worsening neuro signs observed? What dose constrictions were recommended in this study? (Griffin 2014)

A 
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
Q

Most common brain tumor in dogs? (Snyder 2006)

A

meningioma (45%)

48
Q

T/F: Secondary brain tumors are more common than primary in dogs.

A

True (Snyder 2008)

49
Q

What % of dogs with secondary brain tumor also had lung mets?

A

47%

35% kidney mets, 31% heart mets

50
Q

T/F: Ki67 and VEGF expression is increased in meningiomas and both are predictive of survival.

A

False
True that expression is increased (91% Ki67, 96% VEGF), but only VEGF predictive of survival (Platt 2006 and Matiasek 2009)

51
Q

What % of feline hyperadrenocorticism is due to PDH?

A

80%

52
Q

How did survival for RT treated dogs differ from untreated for pituitary masses? (Kent 2007)

A

Tx = 1405d (3.8 yrs), Un-tx = 358 (0.9 yrs)

Tx 3 Gy daily to 48 Gy

53
Q

What are 4 features consistent with acromegaly?

A

diabetic male cat, insulin resistance, weight gain, big head

54
Q

What was MST for pituitary adenomas treated with SRT? (Wormhoudt 2018)

A

1072d (3 years)

55
Q

How did RR with frameless SRT + temozolomide compare to frameless SRT alone for canine gliomas? (Dolera VCO 2018)

A

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
Q

In dogs with presumed gliomas tx with lomustine, how did survival compare to supportive care? What toxicities were seen? (Moirano 2018)

A

MST with lomustine = 138d, supportive care = 35d

Neutropenia 46%, renal tox 15%, hepatotox 50%

57
Q

Most common branch of trigeminal nerve affected by nerve sheet tumor? (Swift 2017)

A

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
Q

Which is more common - primary intramedullary spinal cord tumors or secondary? (Pancotto JVIM 2013)

A

primary

tend to occur in spinal cord of young dogs

59
Q

Which breeds are overrepresented for CNS HiSa? (Mariani 2013)

A

Retrievers and Corgis

60
Q

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)

A

4.5%

Goldens, Boxers, Boston Terriers, Frenchies, Rat Terriers

61
Q

Which brain location was associated with better outcome with palliative care for primary brain tumors? (Rossmeisl 2013)

A

supratentorial - survival > 3 months

seizures most common with this location

Onco Board Review 2 (20 decks)

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