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neuro > DISEASE- brain tumours > Flashcards

DISEASE- brain tumours Flashcards

1
Q

most common neuroepithelial tumour?

A

Astrocytoma

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2
Q

describe the shape of an astrocyte

A

star shaped
-multipolar

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3
Q

role of astrocyte?

A

-involved in BBB
-structural support
-involved in lots of disease process

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4
Q

are primary or secondary brain tumours more common?

A

secondary

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5
Q

features of a cancer headache?

A

Progressive neurological deficit (68%)
Usually motor weakness (45%)
Seizures (26%)
Headache (54%)
* May occur with/without raised ICP
* Worse in morning
* Worse when coughing/ leaning forward (30%)
* N+V
* Similar to migraine, difference: headache pattern erratic in cancer, tension like, vomiting Is prolonged and repetitive, new motor weakness common in cancer but not migraine
Worsens with valsalva in a cancer headache

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6
Q

what is the grading of an astrocytoma?

A

WHO GRADING
Grade I- pilocytic astrocytoma
Grade II- low grade astrocytoma
Grade III- anaplastic astrocytoma
Grade IV- glioblastoma multiforme

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7
Q

what grade of astrocytoma are benign?

A

Grade I- pilocytic astrocytoma
Grade II- low grade astrocytoma

Grade II is not considered malignant but it does not act benign

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8
Q

what is the most common brain tumour is children?

A

Grade I- pilocytic astrocytoma

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9
Q

describe the behaviour of a Grade I pilocytic astrocytoma

A

benign + slow growing

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10
Q

treatment of a Grade I pilocytic astrocytoma

A

surgery

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11
Q

where is a grade I pylocytic astrocytoma most commonly found?

A

-in the cerebellum or brainstem

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12
Q

where is a grade II low grade astrocytoma more commonly found?

A

-in the temporal lobe or around the central gyrus

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13
Q

describe a grade II low grade astrocytoma

A

not considered malignant but does not act benign (there is also a chance it can differentiate into higher grade)

-vascular proliferation and nuclear atypia

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14
Q

treatment of a grade II low grade astrocytoma?

A

surgery +/- radiation/ chemo (PVC)

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15
Q

is a grade III anaplastic astrocytoma benign or malignant?

A

malignant

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16
Q

describe a grade III anaplastic astrocytoma

A

Greater nuclear atypia and mitosis
-malignant

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17
Q

where do grade III anaplastic astrocytomas arise from?

A

can arise de novo or develop from a lower grade

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18
Q

what is the median survival or someone with anaplastic astrocytoma?

A

median survival is 2 years

19
Q

where do you normally find a grade IV glioblastoma multiforme?

A

-usually in frontal lobe and crosses the midline

20
Q

describe grade IV glioblastoma multiforme

A

-malignant
-butterfly appearance
-necrosis and neovascularisation

21
Q

how do grade IV glioblastoma multiformes spread?

A

through the white matter tracts/ CSF pathway

22
Q

median survival of someone with grade IV glioblastoma multiforme?

A

cant cure

median survival <1 year

23
Q

do grade IV glioblastoma multiforme metastasise?

A

grade IV glioblastoma multiforme rarely metastasize

24
Q

management of malignant astrocytomas?

A

Grade III anaplastic astrocytoma and grade IV glioblastoma multiforme are malignant

not curative

Post operative radiotherapy + chemo (tenozolamide + PVC)

25
Q

SE of radiotherapy (tanozolamide + PVC)?

A

cant drive post op- risk of seizures

SE: IQ drops by 10, skin + hair loss, tired

26
Q

what would multiple glioblastoma multiformes suggest?

A

-NF1
-TS (turcot syndrome)
-PML

27
Q

how does glioblastoma multiforme appear on ct?

A

On CT- peripherally enhancing lesion and hypodense centre (darker)

28
Q

where are oligodendrogliomas most commonly found?

A

in the frontal lobe

29
Q

who is typically affected by oligodendrogliomas?

A

adults (25-45)

30
Q

how do oligodendrocytes appear microscopically?

A

-greyish pink
-subarachnoid accumulations
-‘toothpaste’ appearance on morphology

31
Q

how do oligodendrocytes appear macroscopically?

A

-cysts
-calcification (usually peripheral)
-peritumoral haemorrhage

32
Q

Oligodendrocytes are collision tumours
-what does this mean?

A

it means that they are typically found with other tumours

33
Q

management of oligodendrocytes?

A

Treatment= surgery + chemotherapy + radiotherapy

34
Q

median survival of oligodendrocytes?

A

median survival 10 years (can have malignant conversion)

35
Q

what is the most common benign brain tumour?

A

meningioma

36
Q

where do meningiomas arise from?

A

meningiomas arise from arachnoid cap cells
-they are extra axial (outwith the brain parenchyma/ functional tissue)

37
Q

who is more likely to get a meningioma?

A

3F:2M

Can get radiation induced meningioma (think of this if midline tumour and patient had leukemia as a child)

38
Q

how do meningiomas usually present?

A

often asymptomatic- due to slow growing tumour

symptoms usually more due to compression than tumour itself:
-headache, regional anatomical disturbances
-if at skull base may have cranial nerve neuropathies

39
Q

what is meningioma en plaque?

A

morphological subgroup within meningiomas defined by a carpet/ sheet-like lesion that infiltrates the dura and sometimes invades the bone

40
Q

histology of meningioma?

A

Spindle cells in concentric whorls and calcified psammoma bodies

41
Q

MRI of meningioma?

A

dural tail and patent dural sinuses

42
Q

CT of meningioma?

A

homogenous, densely enhancing, oedema, hyperostosis/ skull ‘blistering’

43
Q

management and survival rate of meningioma?

A

Expectant if small enough.

Pre op embolisation, Surgery, radiotherapy
(Meningiomas are vascular- may help to do angiography +/- embolization before surgery)

Recurrence depends on grade
5 year survival 90%.

neuro (44 decks)

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