Neoplasms Flashcards
What are the types of cancer?
Carcinoma, Sarcoma, and Blastoma
What is the most common cancer type?
Carcinoma
How does carcinoma arise?
Arise from epithelial cells
How does sarcoma arise?
Arise from connective tissue cells, including bone, cartilage, fat, tendon, or muscle
How does blastoma arise?
Arise from immature cells of the cell line, “-blasts”
What is angiogenesis?
Growth of new blood vessels to feed tumor, characteristic of malignant tumors
How is cancer named?
From the cell line they arise from
What are some characteristics of noncancerous/benign tumors?
Do not spread via blood or lymph, cells are well differentiated (look more like normal cells of that type) and grow slowly. Typically do not cause pain and less harmful than cancerous.
What are some characteristics of malignant/cancerous tumors?
Capacity to spread and form new tumors in other tissues/organs, spread via blood or lymph. Cells are poorly differentiated (appear abnormal). Often recur.
What are the primary brain tumors?
Glioblastoma
Meningioma
Astrocytoma
Oligodendroglioma
Ependymoma
Schwannoma
Pituitary Tumor
What are the characteristics of Grade 1 Brain Tumors?
Least malignant (benign)
Possibly curable via surgery alone
Non-infiltrative and slow growing
What tumor’s are Grade 1?
Pilocytic astrocytoma
Craniopharyngioma
Gangliocytoma
Ganglioglioma
What are the characteristics of Grade 2 Brain Tumors?
Relatively slow growing, somewhat infiltrative, and may recur
What are the characteristics of Grade 3 Brain Tumors?
Malignant and infiltrative
Tend to recur at higher rates
What are the characteristics of Grade 4 Brain Tumors?
Rapid malignant growth, agressive
Widely infililtrated
Rapid recurrance
Necrosis prone
What grade is glioblastoma multiforme?
Grade 4 (always)
How do work up a CNS neoplasm?
Imaging
Labs
Tissue sample
What imaging is helpful in diagnosing CNS neoplasms
CT (quick and dirty)
MRI (gold standard)
What does it mean if the tumor enhances with contrast on CT?
Chemo can also get through the BBB (can be helpful or harmful in treatment)
What is the approach to managing CNS neoplasms?
Control cerebral edema with steroids (Dex)
ASM (only if seizures are present)
CSF shunt for hydrocephalus
What is the administration route for chemo so that it can get directly into the CSF?
Intrathecally
What are risk factors for developing CNS neoplasms?
- Ionizing radiation exposure (prior malignancy, imaging, cell phones)
- Immune compromise
- Women more likely to have meningiomas
- Genetic syndromes
What symptoms would be seeing in an occipital lobe lesion?
Visual field cut (homonymous)
Alexia (w/o agraphia)
What symptoms would be seen in an cerebellum lesion?
Incoordination/imbalance/Ataxia
CN deficits
Coma
Hydrocephalus
What symptoms would be seen in a parietal lobe lesion?
Neglect
Sensory loss
Vision changes
Motor incoordination
What symptoms are more associated with gliomas?
headaches, seizures, personality changes, weakness, numbness, problems with speech, vision changes
What is the biggest risk factor for glioblastoma?
Age, median age of diagnosis is 64
Why does a glioblastoma tumor have a necrotic center?
The growth outpaces angiogenesis
Appears as ring-enhancing
What are the risk factors for meningioma?
Female, radiation therapy, prolonged use of hormones (progesterone, estrogen), neurofibromatosis type 2
Where are schwannoma (acoustic neuroma) typically found around?
CN 8, vestibulocochlear nerve
If diagnosed with cancer, what is the likelyhood of you developing at least one brain metastasis?
20-40%
What cancers are most likely to metastases to the brain?
Lung (45%)
Breast (20%)
Melanoma (15%)
What are the treatment options for brain metastases?
Surgical resection
Radiation
Chemo
Immunotherapy
