CNS Tumours

Question 1

What are CNS tumours?

Answer 1

Primary tumours arising from any brain tissue type central nervous system.

Question 2

How are CNS tumours differentiated? Which types fall into each class?

Answer 2

High-Grade = grow rapidly + aggressively 
Glioma + glioblastoma multiforme 
Primary cerebral lymphoma  
Medulloblastoma  
Low-Grade = grow slowly + may/ may not be successfully treated  
Meningioma 
Acoustic neuroma  
Neurofibroma 
Pituitary tumour 
Craniopharyngeoma 
Pineal tumour

Question 3

Which cancers do brain metastases commonly arise from?

Answer 3

Lung 
Breast  
Stomach  
Prostate  
Thyroid  
Colorectal

Question 4

What is the aetiology of CNS tumours?

Answer 4

Can arise from any of the cells in the CNS (e.g. glial cells, ependymal cells, oligodendrocytes)

Question 5

Describe the epidemiology of CNS tumours

Answer 5

2 peaks of incidence (children + elderly)

Question 6

List 3 risk factors for CNS tumours

Answer 6

Ionising radiation
Immunosuppression (e.g. HIV)
Inherited syndromes (e.g. neurofibromatosis, tuberous sclerosis)

Question 7

What does CNS tumour presentation depend on?

Answer 7

Size + location of the tumour

Question 8

List 5 symptoms of CNS tumours

Answer 8

Headache (worse in the morning + when lying down)
N+V
Epilepsy
Focal neurological deficits (dysphagia, hemiparesis, agnosia, ataxia, visual field defects, cognitive impairment)
Personality change

Question 9

What investigations are performed for CNS tumours?

Answer 9

CT head
MRI brain
CXR/ CT TAP: to determine if lesion is secondary or primary
Bloods: CRP, ESR, HIV screen, toxoplasma serology
Brain Biopsy: Type + grading

Question 10

What signs may be seen in CNS tumours?

Answer 10

Papilloedema

Focal neurological deficits (visual field defects, dysphasia, agnosia, hemiparesis, ataxia, personality change)