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Emma H&N II > Intracranial tumors > Flashcards

Intracranial tumors Flashcards

1
Q

most common glioma

A

glioblastoma

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2
Q

most common tumor in pediatric population

A

medulloblastoma

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3
Q

extra-axial means…

A

outside the brain (ex: from the dura)

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4
Q

intra-axial means…

A

in the brain substance

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5
Q

examples of extra-axial tumors

A
  • dural lesions: meningiomas, METS
  • Cranial nerve tumors: schwanommas, neurofibromas, MNST
  • sellar/parasellar: pituitary tumors
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6
Q

examples of intra-axial tumors

A
  • glioma
  • ependymoma
  • neuronal tumor
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7
Q

WHO classification of tumors

A
  • more appropriate for classification of GLIAL TUMORS
  • degree of malignancy INCREASES with grade

Low grade: I and II
Anaplastic: III
High grade: IV

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8
Q

types of gliomas

A
  • astrocytoma

- oligodendroglioma

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9
Q

astrocytomas (types/grades)

A

I: pilocytic astrocytoma
II: low grade astrocytoma
III: anaplastic astrocytoma
IV: high grade astrocytoma / GBM

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10
Q

pilocytic astrocytoma

A
  • grade I
  • BENIGN
  • slow growing
  • common in pediatrics
  • well defined, cystic mass in cerebellum
  • increased ICP due to obstruction of CSF in 4th ventricle (secondary hydrocephalus)
  • presentation: headache, nasuea, vomiting, cerebellar signs

Tx: surgical excision
Prognosis: excellent

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11
Q

pilocytic astrocytoma - histology

A
  • small oval nuclei with long cytoplasmic processes (horse hair)
  • biphasic pattern: cellular and myoxoid areas
  • rosenthal fibers
  • NO mitotic figures present
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12
Q

low grade/diffuse astrocytoma

A
  • MALIGNANT
  • will evolve to higher grades if not removed
  • poorly circumscribed
  • invades adjacent brain structures
  • no enhancement on MRI
  • presentation: seizures, headache, neurological deficit

Tx: excision, radiation
Prognosis: excellent

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13
Q

low grade/diffuse astrocytoma - histology

A
  • hypercellular
  • mitotic figures not present or rare
  • irregular nuclei
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14
Q

anaplastic astrocytoma

A
  • malignant tumor
  • diffuse infiltrating mass
  • MRI: iso- or hypo dense on T1, may/not enhance
  • presentation: seizures, headache, neurological deficit
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15
Q

glioblastoma multiforme

A
  • high grade tumor (IV)
  • diffuse infiltrating mass with cystic NECROTIC CENTER
  • MRI: cystic, necrotic, rim enhancing mass
  • presentation: seizures, headache, neurological deficit

Tx: surgical debulking, adjuvant radiation/chemo
Prognosis: dismal

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16
Q

GBM - histology

A
  • central cystic necrosis
  • rim enhancement after injection of contrast
  • densely cellular
  • nuclear pleomorphysm
  • vascular endothelial proliferation
17
Q

oligodendroglioma

A
  • slow growing
  • MRI: non-enhancing, often calcified
  • presentation: headaches, seizures

Tx: excision/debulking, adjuvant radiation/chemo
Prognosis: good; better if 1P,19Q chromosome deleted

18
Q

oligodendroglioma - histology

A
  • fried egg appearance

- fairly homogenous

19
Q

ependymoma

A
  • low grade (II)
  • intra ventricular mass
  • or in spinal cord
  • presentation: hydrocephalus, nausea/vomiting, motor/sensory spinal cord deficits

Tx: excision, radiation is curative
Prognosis: good

20
Q

ependymoma - histology

A
  • cellular
  • ovoid monomorphic nuclei
  • rosettes
21
Q

neuronal tumors

A
  • uncommon
  • occur in temporal lobe
  • associated with chronic seizure disorder

Tx: observation OR surgical excision

22
Q

meningiomas

A
  • slow growing
  • benign
  • from dura
  • symptoms based on location
  • MRI: enhancing mass with dural tail

Tx: excision (curative)

23
Q

meningiomas - histology

A

-whirl pattern

-

24
Q

hemangioblastoma

A
  • benign
  • highly vascular
  • sporadic or genetic (Von hippel syndrome: AD, chromosome 3)
  • VHL associated with hemangiomas of retina, brainstem, spinal cord, renal, liver
25
Q

sellar tumors

A
  • pituitary adenoma is most common
  • subtypes: functional and non functional (secreter vs non secreter)
  • functional tumors: prolactinoma, acromegly (GH), Cushings Disease (ACTH)
  • slow growing
  • benign
  • endocrine dysfunction, visual loss

Tx: surgical excision, or medical management

26
Q

sellar tumors - histology

A

-sheets of monotonous cells

27
Q

cranial nerve tumors

A
  • benign tumor of schwann cell most common
  • slow growing
  • MRI: enhancing mass in CPA extending to IAC
  • presentation: hearing loss, tinnitus, vertigo, facial numbness, weakness, ataxia

Tx: surgery, radiation, observation

Emma H&N II (49 decks)

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