CNS Primary Tumors

Question 1

most common tumor of childhood

Answer 1

Pilocystic astrocytoma

Question 2

Sites of predilection of PA (3)

Answer 2

Cerebellum
ON
Brainstem

Question 3

PA Imaging

Answer 3

Cystic lesions with enhancing mural nodule

Question 4

Appear as non-enhancing tumors with increased T2/FLAIR signal
Young adult presenting with seizures

Answer 4

Grade 2 Astrocytomas

Question 5

The most common malignant primary brain tumor
Present in 6th and 7th decades of life
Ring-enhancing lesions with central necrosis and surrounding edema

Answer 5

Glioblastoma

Question 6

Treatment for Glioblastoma

Answer 6

Maximal surgical resection

XBRT + Temozolomide

Question 7

Adverse prognostic factors in patients with Glioblastoma (5)

Answer 7

Older age
Absence of IDH mutation
Unmethylated MGMT promoter
Poor Karnofsky score
Unresectable tumor

Question 8

Histologically:
Perinuclear clearing, “fried egg” appearance
Reticular pattern of blood vessel growth

Codeletion of 1p/19q with IDH mutations

Answer 8

Oligodendroglioma

Question 9

Tumors derived from ependymal cells lining the ventricular surface

Answer 9

Ependymoma

Question 10

Ependymoma

Arise?
Location?

Answer 10

Wall of 4th ventricle

Posterior fossa

Question 11

The most common malignant brain tumor of childhood

Answer 11

Medulloblastoma

Question 12

Medulloblastoma arise from

Answer 12

Granule cell progenitors

Multipotent progenitors from ventricular zone

Question 13

Syndrome predisposing to medulloblastoma

Answer 13

Turcot
Gorlin
Li-Fraumeni

Question 14

Histologically:

Highly cellular tumors with abundant dark staining, round nuclei, and rosette formation

Answer 14

Medulloblastoma

Question 15

Germinomas respond to irradiation

T/F?

Answer 15

T

Question 16

Pineoblastomas and nongerminomatous GCT require radiation and chemotherapy?

T/F?

Answer 16

T

Question 17

Arise from meningothelial (arachnoidal cap) cells

Located over cerebral convexities esp adjacent to sagittal sinus

Answer 17

Meningiomas

Question 18

Meningiomas on imaging

Answer 18

Denselyenhancing extra-axial tumor arising from dura with a dural tail

Question 19

Densely enhancing lesions, enlarging the internal auditory canal and often extending into the CP angle

Answer 19

Vestibular Schwannoma

Question 20

Suprasellar, partially calcified, solid, or mixed solid-cystic benign tumors that arise from remnants of the Rathke pouch

Answer 20

Craniopharyngioma

Question 21

Benign, supratentorial tumors, usually in the temporal lobe.

Children and young adults with long-standing hx of seizures

Answer 21

Dysembryoplastic Neuroepithelial Tumors