CNS neoplasms Flashcards
Grading of CNS neoplasms
I = benign II = malignant III = malignant tissue that has cells actively growing IV = malignant tissue that looks most abnormal and tend to grow quickly
What are the 3 broad Types of Tumors and what are their subtypes?
Neuroglial (glioma)
- astrocytoma
- oligodendroglioma
- ependymoma
Meningioma
Schwannoma
-acoustic neuroma
Gliomas/Neuroglial:
-comes from what types of cells?
-what is the most common type?
-astrocytes, oligodendrocytes, ependymal cells
MC is astrocytoma
Grading of Astrocytomas & Tx
I = benign; surgery, usually in kids
II = slow growing and invade surrounding
III = rare and require aggressive tx d/t tentacle growth and hard to resect
IV = aka glioblastoma; aggressive fast growing cancer
*very hard to resect; debulk to reduce sx, if tumor in inoperable area use chemo/radiation
What is the most common malignant brain tumor?
Glioblastoma (which is a type of astrocytoma which is a glioma/neuroglial)
survival 2 years
Oligodendroglioma:
- grading
- location of tumor
- MC presenting feature
- tx
- prognosis
Grading: II or III
- location: frontal and temporal lobes
MC presenting feature is seizures
Tx:
-surgery, radiation, chemo
Prognosis:
-slower growing, survival 4-10years
Ependymoma:
- comm age
- location
- prognosis
Age 5-6 years and then again 20-30years
Location: intracranial(kids) spinal cord (adults)
Prognosis:
- intracranial = poor
- spinal = better
Meningioma
- location
- MC in which gender
- describe tumor growth
- tx
- prognosis
- sx
-meningies
MC on women
Growth: grow inwards putting pressure on the brain and spinal globe, can grow outward and cause thickening of the skull
Tx: surgery, radiation’
Prognosis:
-5 years, die from other causes
Sx:
- depends upon where tumor is as this will cause different sx.
ex: irritation = seizure, visual changes
Schwannoma
- location of tumor
- growth
- MC type
location: cranial and paraspinal nerves
Growth: slow growing, stay on outside of the nerve, benign
MC: acoustic
Acoustic Neuroma
- location
- sx
- tx
- prognosis
location: arises from the 8th CN
sx:
- unilateral hearing loss***
- tinnitus
- dizziness
- diff swallowing
- impaired eye movement
- taste disturbance
- unsteadiness
Tx:
-surgery, radiation
Prognosis:
- tinnitus relieved in 60%
- hearing preserved in 80%
- facial nerve dysfunction variable
if the pt has hearing loss, tinnitus, and HA you need to r/o what?
-acoustic neuroma
Primary CNS Lymphoma
- common in who?
- derived from what cells?-
- location
- tx
Common in pts with immunodeficiencies (organ transplant, HIV)
Derived from B lymphocytes
Location: cerebral hemisphere
Tx:
- steroids AFTER definitive dx to decrease brain edema (may cause regression of tumor)
- chemo
- inoperable
*cant give steroids before actual dx because it can change the tumor itself leading to incorrect dx
Metastatic Tumors
- location
- common cancers to metastasize
- tx
Location: can be anywhere!!!
Common tumors to metastasize:
- lung*
- Renal Cell *
- melanoma
- breast
- colon
Tx: radiation/chemo
Sx of CNS tumors
sx begin with focal neurological signs and move to generalized sx as the tumor size increases
Focal: seizure, weakness, sensory loss, aphasia, visual sptial dysfunction
Generalized: HA, seizures, n/v, deceased LOC
any new neurologic finding is a sx…..
-HA, seiz, syncope, numb/tingle, balance issue, personality/memory changes
Describe tumor HA
- dull, constant
- bilateral and NOT throbbing
- incerased with coughing or strain
- postural; change in body position
- tend to be worse at night and may awaken the patient from sleep
- n/v
- change in HA pattern
