Neuro - Cancers

Question 1

What are the most common cancers that metastasise to the brain?

Answer 1

• Lung
• Breast
• Colorectal
• Prostate

Question 2

What are gliomas? Name three types from most to least malignant

Answer 2

• Tumours of glial cells in the brain and spinal cord
• Astrocytoma (most malignant) - glioblastoma multiforme
• Oligodendroglioma
• Ependymoma

Gliomas are graded from 1-4, 1 is most benign (possibly curable by surgery), grade 4 are most malignant (glioblastoma)

Question 3

What is a meningiomas?

Answer 3

• Tumours growing from the cells of the meninges in brain and spinal cord
• Are benign but take up space and this leads to raised ICP and neuro symptoms

Question 4

Name some consequences of pituitary tumours

Answer 4

• Tend to be benign but if large enough can compress optic chiasm, leading to bitemporal hemianopia
• Can cause growth hormone deficiencies (hypopituitarism) or excess
• Acromegaly, hyperprolactinaemia, cushing’s disease, thyrotoxicosis

Question 5

Give some treatment options for pituitary tumours (including treatment for prolactin secreting tumours and growth hormone secreting tumours

Answer 5

• Trans-sphenoid always surgery
• Radiotherapy
• Bromocriptine: blocks prolactin secreting tumours
• Somatostatin analogues (octreotide) - blocks growth hormone secreting tumours

Question 6

List some general management options for brain tumours

Answer 6

• There is a massive variation based on grade and presentation
• Surgery: dependent on grade and behaviour of the tumours
• Chemotherapy
• Radiotherapy
• Palliative care