CNS Tumors Flashcards by Josh Durand

Which is MC, cranial or spinal CNS tumors?

Cranial are MC

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T/F

Most CNS tumors are secondary tumors

False,

Primary tumors from neuronal tissues

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What characterizes the premalignant (in situ) stages of CNS tumors?

None, there is none.

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What is associated with non-resectable CNS tumors (all CNS tumors)?

Poor prognosis

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How often do CNS tumors metastasize outside the CNS?

Rarely

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What are the features of CNS tumors?

HA, seizures, focal neuro defects, increased ICP

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What are the 3 types of gliomas?

Astrocytoma
Oligodendroglioma
Ependymoma

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Which gliomas are diffuse (broad, pervasive)?

Astrocytoma

Oligodendroglioma

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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

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What is the behavior of astrocytomas in the brain?

Invasive, necrotic, distort brain tissue

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What are three grades (A, B, and C) of astrocytomas?

A: well-differentiated
B: Anaplastic
C: Glioblastoma (nasty one)

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What is the prognosis for astrocytomas?

Poor. 1-5 years.

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What is the survival prognosis for gliobastomas?

15 months, avg.

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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.

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What tends to happen with vessels in glioblastomas?

Possible crebral edema: “leaky” angiogenesis

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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