CNS Tumours

Question 1

Define:

Answer 1

• Tumours of the central nervous system.

NOTE: brain tumours cannot be truly differentiated into benign and malignant because supposedly ‘benign’ tumours can cause significant morbidity and mortality
- Defined into high and low grade

Question 2

Aetiology:

Answer 2

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

Question 3

Risk factors:

Answer 3

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

Question 4

Where do brain metastases commonly arise from:

Answer 4

• Lung
• Breast
• Stomach
• Prostate
• Thyroid
• Colorectal

Question 5

Symptoms/Signs:

Answer 5

• Presentation depends on the size and location of the tumour
• Headache (worse in the morning and when lying down)
• Nausea and vomiting
• Seizures
• Progressive focal neurological deficits
• Cognitive and behavioural symptoms
• Papilloedema

Question 6

Epidemiology:

Answer 6

• Primary brain tumours = 2% of tumours diagnosed in the UK
• AIDS patients have an increased risk of developing CNS tumours
• Can develop at any age but are more common between 50-70 yrs

Question 7

Investigations:

Answer 7

• Bloods - check CRP/ESR to eliminate other causes (e.g. temporal arteritis)
• CT/MRI
• Biopsy and tumour removal
• Magnetic resonance angiography - define changing size and blood supply of the tumour
• PET
• NOTE: distant metastases are RARE with primary CNS tumours