Neuro: Neoplasms Flashcards
MC tumor in CNS?
-metastases from distant neoplasms (1/2 come from lungs)
Primary brain tumors
originate from CNS tissues and meninges
70% of primary tumors are located?
supratentorial
MC kind of tumors in adults?
MC: gliomas
second MC: meningiomas
**both are supratentorial
1/3 of PBT are_____
malignant
MC cancers of childhood?
PBTs
in children, 70% of tumors are located?
infratentorial
MC tumor in kids?
Medulloblastoma
*intatentorial
MC cell origin for neoplasms?
glial cell
Name the four different Gliomas:
- Astrocytoma
- Oligodendroglioma
- Ependymom
- Choroid plexsus papilloma
Astrocytoma
- derived from
- what is the role of the cell it originates from?
- MC occur in what age?
- location in brain?
- CM?
derived from astrocytes
star shaped cells that support endothelial cells of BBB and help repair brain post injury
- MC occur in PT 2-20 YO
- can appear in any part of brain
CM:
- focal symptoms dep on location of tumor
- incr ICP–HA (can often wake up PT at night), N/V, ataxia
- vision changes, weakness, cranial nerve deficits, AMS
Types of astrocytomas (4)
*which is benign? which is most aggressive? slow grower?
*which grades are MRI enhancing and which are non-enhacing
- Pilocytic Astrocytoma (grade I)—MC in children and young adults.. most benign
- Diffuse astrocytoma (grade II or low grade)–tend to grow and invade surround tissues.. but slow growing
- Anaplastic astrocytoma (grade III)—rare but aggressive
- Astrocytoma grade (IV)—aka Glioblastoma)
* most aggressive
grades I and II are non-enhancing
III and IV are enhancing
most common PBT in adults?
Astrocytoma grade IV—Glioblastoma
*aggressive
Astrocytoma grade IV---Glioblastoma -peak onset -RF -DX -CM TX prognosis
-most common PBT in adult
-most aggressive
-peak onset: 40-60 YO
-RF: male, >50, HHV-6 (herpes)
CM: same as other tumors… HA, seizures, focal neuro deficits and AMS
DX:
- MRI with contrast—-initial test of choice
- biopsy–confirm dx
TX:
- surgical excision when possible
- radiation and chemo
prognosis is poor
Oligodendroglioma
- arrise from?
- location of tumor?
- Peak incidence in what age group
- fast or slow growing
- CM
- Dx
- Tx
arrises from a type of glial cell–oligodendrocyte—role is to supp brain tissue
- can occur anywhere in brain
- slow growing
- Peak incidence: 35-45 YO
CM:
-dep on location….
MC s/s is seizures
DX:
- CT or brain MRI with contrast
- Brain biopsy/histology—will see calcifications are common—“fried egg shaped tumor”
TX
- surgical excision when poss
- rad
- chem
histology report: calcifications or “fried egg” shaped tumor
oligodendroglioma
Ependymoma
- age group?
- location in brain
- cm
- dx
- prognosis
CHILDREN: avg dx age is 5
MC seen in 4th ventricle or sc
CM:
- increase ICP: papilledema, CN palsies etc
- N/V HA
- infants: incr head size**, irritability, sleeplessness and vom
DX:
- CT or brain MRI with contrast
- Biopsy: shows perivascular pseudo rsettes
Prognosis: overall 10 year survival is 45-55%
-Biopsy: shows perivascular pseudo rsettes
Ependymoma
***children tumor
Meningioma
- arises?
- fast/slow growing?
- benign or malignant?
- MC in what gender
- CM
- DX
- TX
- prognosis
arises from meningothelial cells in dura matter
benign and slow growing
W>M
CM:
- often asympto until compression/displacement
- seizure
- HA
- weakness
- fixed dilated pupil (CNIII palsy) common
DX:
-MRI with contrast—initial test of choice
—-shows well defined lesion attached to the dura–often with calcification
Histology shows: spindle cells concentrically arranged in a whorled pattern
TX:
asymp: observe if tumor small
Sympto: surgical excision +/- radiation
Prognosis:
5 year survivial is 70-90%
*malignant transformation is RARE
MRI: shows well defined lesion attached to the dura–often with calcification
Meningioma
Histology shows: spindle cells concentrically arranged in a whorled pattern
meningioma
