CNS Tumors Flashcards
Which is MC, cranial or spinal CNS tumors?
Cranial are MC
T/F
Most CNS tumors are secondary tumors
False,
Primary tumors from neuronal tissues
What characterizes the premalignant (in situ) stages of CNS tumors?
None, there is none.
What is associated with non-resectable CNS tumors (all CNS tumors)?
Poor prognosis
How often do CNS tumors metastasize outside the CNS?
Rarely
What are the features of CNS tumors?
HA, seizures, focal neuro defects, increased ICP
What are the 3 types of gliomas?
Astrocytoma
Oligodendroglioma
Ependymoma
Which gliomas are diffuse (broad, pervasive)?
Astrocytoma
Oligodendroglioma
What are astrocytomas?
Diffuse: always malignant, 80% of adult gliomas, 30-60 years. Poorly circumscribed (more invasise, destructive), cerebral (frontal area MC location), seizures, HA, focal neuro defects
What is the behavior of astrocytomas in the brain?
Invasive, necrotic, distort brain tissue
What are three grades (A, B, and C) of astrocytomas?
A: well-differentiated
B: Anaplastic
C: Glioblastoma (nasty one)
What is the prognosis for astrocytomas?
Poor. 1-5 years.
What is the survival prognosis for gliobastomas?
15 months, avg.
What is a pilocytic category of astocytoma?
Benign, cystic (hence the name), affect children/young adults, cerebellum and spinal cord (rarely cerebral) Well circumscribed lesion.
What tends to happen with vessels in glioblastomas?
Possible crebral edema: “leaky” angiogenesis
What is the tx for glioblastomas?
Anticonvulsants, corticosteroids, surgical excision, radiation, chemo.
What is an oligodendroglioma?
Oligodendrocytes. Benign or malignant: depends on the grade. 5-15% of gliomas, age 30-50.
Where are oligodendrogliomas found?
Frontal, temporal
What predisposing characteristics can help identify oligodendrogliomas?
Hx. of neurologic symptom: years of seizures
What is the prognosis for oligodendrogliomas?
5-20 years (surgery, chemo, radiation).
What is an ependymoma?
Ependymal cells. MC in pediatrics: periventricular regions. Adults: spinal canal
NF2 (multiple schwannomas)
What are some histological features of oligodendrogliomas
Uniform, dark chromatin, clear halo
Whar are some histological features of ependymomas?
Fibrillary appearance, rosettes/canals
What are embryonal (primative) neoplasms?
Neuroectodermal cells, “small round cells” (upon biopsy). Possible Homer-Wright rosettes (central neutrophil pseudo rosettes).
What are medulloblastomas?
Malignant, 20% of pediatric brain tumors, well-circumscribed, hyperchromatic nuclei.
What areas are medulloblastomas found?
Exclusively cerebellar: midline, infratentorial
What is the tx for embryonal neoplasms?
Excision, radiation therapy, chemotherapy. Highly radiosensitive (responsive to chemo). 75% 5-year survival rate.
What is similar to medulloblastomas?
PNETs are similar, but located outside the CNS
What are primary CNS lymphomas?
Diffuse large B cell lymphoma, inside CNS. Aggressive, extranodal lymphoma. Rare: 1% of intracranial neoplasms
What is the MC CNS tumor in the immunosuppressed?
Primary CNS lymphoma (implicated in AIDS)
What will cause extensive necrosis in patients with primary CNS lymphomas?
EBV
What areas of the CNS are affected by primary CNS lymphomas?
Any brain tissue, multifocal. Spreads via ventricles. Possible at any age, increased with age (>60 years).
What is the prognosis for primary CNS lymphomas?
Very poor prognosis
What is a meningioma?
Benign, but invasive, transformed arachnoid cells. MC affects adult females
Where are meningiomas located?
Any surface of CNS, compression.
What are risks associated with meningiomas?
Hx of irradiation, NF2
What is the tx for meningiomas?
Most are able to be excised
What are some features of meningiomas that have mets to the CNS?
25-50% of intracranial tumors
From: Lung, breast, melanoma (skin), kidney, G.I.
Well-circumscribed, gray/white jxn,. edema, gliosis
What is a histological identifier of meningiomas?
Syncytial (whorled) cell clusters
