CNS Tumors Flashcards
Where are the majority of tumors in adults?
Supratentorial
Where are the majority of tumors in children?
Posterior fossa tumor
How are gliomas classified?
based on resemblance to normal, non-neoplastic glial cells
How are gliomas graded?
By the type of glioma
What is pilocytic astrocytoma
Most common CNS neoplasm of childhood.
Usually found in cerebellum, optic pathway, hypothalamus, also thalamus, spinal cord, temporal lobe.
WHO Grade 1
Different genetic origins in different anatomical sites
Bipolar neoplastic cells, rosenthal bodies.
What is a mutation associated with pilocytic astrocytomas?
BRAF fusion associated with cerebellar tumor
What is diffuse astrocytoma?
Predominantly in cerebral hemispheres
Patternless, discoheseive, monotonous cellular infiltrate.
Ki67/MIB1
What is anaplastic astrocytoma?
WHO grade 3
Ki67/MIB1 5-15%
Malignant- requires radiation and chemotherapy
What is the earliest genetic mutation in diffuse
astrocytomas and oligodendrogliomas of both grades II and III?
Isocitrate dehydrogenase (IDH) - promotes HIF1 Only seen in tumors Found on immunohistochemistry with antibody to R132H
What does IDH1 have to do with prognosis
Without IDH mutation means worse prognosis, likely to progress to high grade glioma
What are oligodendrogliomas?
presence of IDH mutation and 1p and 19q codeletions
Does better than diffuse astrocytomas
Sensitive to chemotherapy
What are glioblastomas?
Not on IDH pathway.
What is Ganglioglioma
Grade 1
Temporal lobe- seizures and temporal lobe epilepsy
Usually
What is Ganglioglioma
Grade 1
Temporal lobe- seizures and temporal lobe epilepsy
Usually
What is Ganglioglioma
Grade 1
Temporal lobe- seizures and temporal lobe epilepsy
Usually
What is medulloblastoma?
Embryonic tumor- only seen in children under age 16
Confined in cerebellum
What are the symptoms of medulloblastoma?
Gait, truncal ataxia, lethargy, headache, morning vomiting
Grade 4- responds well to chemotherapy and radiation
What are some consequences of medulloblastoma?
can cause hydrocephalus and mass effect
What are some consequences of medulloblastoma?
can cause hydrocephalus and mass effect. Can also leave the brain and spreads to the spinal cord (only tumor that metastasizes and is staged)
Do brain tumors need to metastasize to become fatal?
This is one of the only types of cancer that does not require metastasis to be fatal.
What cancers are most likely to metastasize to the brain?
breast, lung, kidney, melanoma, and GI tract
Melanoma and lung will often show up to the ER with no knowledge of the primary tumor in extremis due to brain metastasis and bleeding into the brain.
What is a common gene mutation in patients with pediatric meningiomas or multiple meningiomas?
NF2- Neurofibromatosis
