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Clin Neuro - SCI, PNS, Epilepsy, Neoplasms > Neoplasms: Types of tumors > Flashcards

Neoplasms: Types of tumors Flashcards

1
Q

Astrocytoma is a Glioma or Non-glioma

A

Glioma

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2
Q

Oligodendroglioma is a Glioma or Non-glioma

A

Glioma

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3
Q

Ependymoma is a Glioma or Non-glioma

A

Glioma

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4
Q

Medulloblastoma is a Glioma or Non-glioma

A

Non-glioma

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5
Q

Meningioma is a Glioma or Non-glioma

A

Non-glioma

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6
Q

Pituitary adenoma is a Glioma or Non-glioma

A

Non-glioma

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7
Q

Neurinoma (Schwannoma)

is a Glioma or Non-glioma

A

Non-glioma

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8
Q

Primary CNS lymphoma is a Glioma or Non-glioma

A

Non-glioma

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9
Q

Pediatric Brain Tumors are located and name 3 types

A

Predominant brain tumors in children are infratentorial in location

Cerebellar astrocytoma

Medulloblastoma

Fourth Ventricular ependymoma

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10
Q

Which type of tumor is most prevalent

A

Gliomas

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11
Q

Glial cells can be subdivided into and give rise to

A

Astrocytes – Have a nutritive role for neurons

Oligodendrocytes – Produce the myelin sheath

Ependymal cells – Line the ventricles

These cells can give rise to tumors called astrocytomas, oligodendrogliomas & ependymomas, respectively

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12
Q

Gliomas arise from and are found

A

Arise from glial cells, which are the cells that support, insulate, & metabolically assist neurons

Neurons are rarely the basis for neoplastic formation

Found mostly in cerebral hemispheres in adults, & in the cerebellum in pediatrics

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13
Q

Low-grade Astrocytoma

are, growth rate, location, WHO grade

A

Benign neoplasms that are slow growing and often cystic (encapsulated - Well differentiated)

Usually located in the frontal lobe, but can be anywhere in the cerebrum

Almost always infiltrative and progressive

WHO: 1-2

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14
Q

Can you have surgery to remove a low grade astrocytoma

A

With surgery, survivability is high; without surgery the prognosis is poor due to progressive nature

Damage is usually from compression so when tumor is removed you usually recover pretty well

Cystic (encapsulated) – damage will be compressive rather than infiltrative – easier to remove surgically

However it can come back and if it comes back it is usually more aggressive —> GBM

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15
Q

Do Low Grade Astrocytomas cause damage

A

Although benign, can still be catastrophic due to

  • Location
  • Conversion into higher grade tumor
  • ->Once this occurs, the tumor becomes more infiltrative
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16
Q

High Grade Astrocytomas are, growth rate, location, WHO grade

A

High grade astrocytomas (grade III & IV) are apt to invade the cerebral hemispheres via the corpus callosum

Very aggressive (esp Grade IV) & will eventually recur

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17
Q

Anaplastic Astrocytoma is a type of and WHO grade

A

High Grade Astrocytomas

Grade 3

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18
Q

What is the name of a (WHO) grade 4 high grade astrocytoma

A

Glioblastoma Multiforme (GBM)

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19
Q

Glioblastoma Multiforme
Grade
Location
Prognosis

A

Grade 5

Predominantly located in the deep white matter of cerebral hemispheres
50% are bilateral & occupies > 1 lobe

Highly malignant & fatal

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20
Q

What is the hallmark of an oligodendroglioma

A

Radiographic evidence of calcification

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21
Q

Why are oligodendrogliomas so well treated?

A

Because of the calcification and they are encapsulated so you can remove them and the brain will survive pretty well

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22
Q

Oligodendroglioma
Growth rate
Prognosis

A

Slow growing, solid calcified tumor

Can bleed spontaneously
-> stroke-like sx

After a long post-treatment inactive period, the probability of a more aggressive recurrence is high

23
Q

Ependymoma

Location
Prognosis

A

Derived from the ependymal cells lining the ventricular system & the central canal of the SC

More common in the fourth ventricle

Common in children & highly metastatic via CSF

24
Q

Why are ependymomas likely detected early

A

Because of the location it can block flow coming out and limit flow of CSF and increase ICP

Due to signs of ↑ ICP in the posterior fossa (HA, vomiting, papilledema)

25
Q

Ependymoblastomas (anaplastic ependymoma) commonly affects which population and how dangerous are they

A

common in children & highly metastatic via CSF

26
Q 
Medulloblastoma
Arises from
Growth rate
Common in
Results in
A

Rapidly growing malignant embryonal tumor that arises from the vermis of the Cb

Metastasizes to the surface of the remaining CNS via CSF pathways, more commonly into the spine

Most common malignant 1° tumor in children

Often results in hydrocephalus, ↑ ICP, and cerebellar signs

27
Q

Medulloblastoma
Typical location
Survival rate

A

Posterior fossa

Usually since kids are pretty resilient it has a high survival rate

28
Q

Meningioma
Growth
Location

A

Slow growing benign lesions that occur predominantly along the dural folds and cerebral convexities

May occur in the SC as well

May infiltrate the dura, dural sinuses and bone, but not the brain parenchyma

29
Q

What is the good thing about Meningiomas and what does this mean for the prognosis ?

A

They affect the meninges and not the brain
Prognosis is better because in order to remove it you do not have to go that deep into the parenchyma, these are usually pretty superficial

Better prognosis bc it is pretty superficial however close to the skull but that can lead to hyperostosis thickening of the skull

30
Q

What do you have to worry about with meningiomas

A

They can lead to hyperostosis which is a thickening of the skull because the meninges metastasized into the skull

31
Q

What is hyperostosis and what cancer can cause this

A

It’s an osteoblastic response leading to a thickening of the skull

seen with meningiomas

32
Q

clinical signs and meningiomas

A

They can become quite large before clinical signs and symptoms are evident

33
Q

Pituitary Adenoma is and results in

A

Benign epithelial tumor derived from the anterior pituitary gland

Frequently encroaches on the optic chiasm

Result in hyposecretion or hypersecretion of pituitary hormones

34
Q

Pituitary Hormones

A

Anterior Pituitary Gland – GH, TSH, ACTH, FSH, LH, Prolactin

Posterior Pituitary Gland – vasopressin (ADH) & oxytocin

35
Q

Associated syndromes due to a pituitary adenoma

A

Galactorrhea – excess prolactin (20 prolactinoma) - abnormal milk discharge

Amenorrhea – excess prolactin (20 prolactinoma)-(absents of menstrual cycle )

Gigantism – excess GH

Acromegaly – excess GH - bones thicken because growth plates are fused

Cushing’s disease – excess ACTH

36
Q

Hypopituitarism can lead to

A

Fatigue, weakness and hypogonadism

A 2nd presentation consists of suppression of 2° sex characteristics and hypothyroidism

A 3rd presentation consists of HA with visual loss

37
Q

Neurinomas are and originate from

A

Slow growing, encapsulated, benign tumors that originate from Schwann cells (Technically outside of the CNS)

38
Q

Neurinomas develop in

A

The vestibular portion of CN VIII (affects CN 7)
-Acoustic neuroma or vestibular schwannomas

-Typically located in the IAC, may extend into cerebellopontine angle

39
Q

Clinical presentation of neurinomas

A

Clinical presentation is sensorineural hearing loss, tinnitus & vertigo

Late features include dysphagia & facial muscle weakness

40
Q

Neurinoma treatment

A

Cure is achieved through surgical excision, although it may result in hearing loss.

The earlier the surgery, the greater likelihood of hearing preservation.

41
Q

Primary CNS lymphoma

Who is as risk and how fast

A

Aggressive Non-Hodgkin’s Lymphoma usually found in the immunosuppressed (ie. AIDS patients)

42
Q

Primary CNS lymphoma leads to what type of changes/deficits

A

Leads to behavior/cognitive changes in 2/3 patients

50% has HP, aphasia, & visual field deficits

15-20% present with seizures

43
Q

Diagnosis of Brain Tumors

A 
MRI *
CT *
PET scan
Angiography
Biopsy
Craniotomy (open)
Stereotactic needle biopsy
44
Q

Medical & Surgical Management of brain tumors

A

Traditional surgery

Chemotherapy

Radiation Therapy

Stereotactic Radiosurgery

45
Q

Stereotactic biopsy/surgery

A

Small needle inserted into skull
Direction of needle guided by MRI/CT
Cells “suctioned out” through needle

46
Q

Craniotomy

A

Resection of skull overlying tumor
Removal of tumor
Replacement of bone flap

47
Q

What do they do if the is an increase in CSF?

A

They put in a shunt to drain

VP Shunt Placement
To bypass blockage of CSF
To relieve pressure

48
Q

Indications for radiation

A

Inoperable tumors

Partial resection

49
Q

Methods of radiation

A

External Beam RT
Brachytherapy (GBM)
Whole Brain RT

50
Q

External Beam RT

A

It goes straight in and they try to aim at one specific point

51
Q

Brachytherapy is done by

A

They stick radioactive sources by the tumor because they do not want to get as close and the radiation helps reduce the size of the tumors. Done for different areas of the brain

52
Q

Chemotherapy can be done to enhance RT effects by

A

Ommaya Reservoir

Chemotherapy wafers
(Wafers are soaked with a chemotherapy drug (BCNU) and are implanted in the space where the tumor was. The wafers destroy the remaining tumor cells)

53
Q

Medications for brain tumors

A

Dexamethasone

  • Steroid
  • ↓ cerebral edema
  • Helps relieve headaches
  • Alleviate symptoms 24-48 hours
  • Maximum effect days 4-5
  • Gradually tapered

Anticonvulsants
-For patients with focal changes to prevent seizure activity

Clin Neuro - SCI, PNS, Epilepsy, Neoplasms (17 decks)

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