Neuro-Oncology; Aetiology & Epidemiology

Question 1

What is the central nervous system made up of?

Answer 1

Brain
Spinal cord

Question 2

What is the peripheral nervous system made up of?

Answer 2

Somatic (conscious thought processes e.g. touch and feeling)
Autonomic (unconscious e.g. digestion)

Question 3

What do parasympathetic nerves stimulate?

Answer 3

Pupil constriction
Saliva stimulation
Airway constriction
Slows heartbeat
Stimulates stomach activity
Inhibits glucose release
Stimulates gallbladder
Stimulates intestine activity
Contracts bladder
Genital erection

Question 4

What do sympathetic nerves stimulate?

Answer 4

Pupil dilation
Saliva inhibition
Airways relaxed
Increases heartbeat
Inhibits stomach activity
Stimulates glucose release
Inhibits gallbladder
Inhibits intestine activity
Relaxes bladder
Genital ejaculation and vaginal contractions

Question 5

Epidemiology definition

Answer 5

Distribution of incidence, distribution of diseases or other factors relating to health

Application of knowledge for disease prevention and control

Question 6

Epidemiology statistics - Global

Answer 6

308,102 diagnosed in 2020

251,329 deaths in 2020

Question 7

Epidemiology statistics - Europe (EU-27)

Answer 7

43,567 diagnosed in 2020

Lithuania (13 cases per 100,000), Greece (11.9), Poland (11.9)

Question 8

Epidemiology statistics - England 2020

Answer 8

4,585 diagnosed (1995 3,538)

Meninges 21:35 M:F
Brain 2586:1810 M:F
Spinal cord, cranial nerves, CNS 63:70 M:F

Question 9

Incidence rates

Answer 9

Incidence related to age
Highest incidence in older people
23% cases diagnosed in 75+ (2018)

Question 10

Most common tumour location (gliomas)

Answer 10

Frontal

Question 11

Least common tumour location (gliomas)

Answer 11

Occipital

Question 12

Most to least common tumour location (gliomas)

Answer 12

Frontal
Temporal
Parietal
Occipital

Question 13

What is aetiology?

Answer 13

Risk factors

Question 14

What are risk factors for children (adolescents)?

Answer 14

Single gene inherited disorders
Ionising Radiation

Question 15

What are risk factors for adults?

Answer 15

Environment
Genetic
Syndromes/disorders
Genetic alterations

Question 16

What environmental risk factors are there for adults?

Answer 16

High dose ionising radiation risk factor
Power-lines (low frequency magnetic fields)

Question 17

What genetic risk factors are there for adults?

Answer 17

Inherited & sporadic brain tumour risk

Question 18

What syndromes/disorders risk factors are there for adults?

Answer 18

Lynch Syndrome
Mismatch repair deficiency
Ollier disease (IDH1 gene)
Li-Fraumeni syndrome*
Cowden syndrome
Gorlin’s syndrome*

Question 19

What genetic alteration risk factors are there for adults?

Answer 19

IDH
1p/19q codeletion
H3 LysMet
RELA-fusion

Question 20

What is the overall main risk factor?

Answer 20

Radiation

Question 21

What did Lynch syndrome used to be called?

Answer 21

Hereditary non-polyposis colorectal cancer (HNPCC)

Question 22

What is Ollier disease (IDH1 gene) characterised by?

Answer 22

Multiple enchondromas, which are noncancerous (benign) growths of cartilage that develop within the bones. These growths most commonly occur in the limb bones, especially in the bones of the hands and feet; however, they may also occur in the skull, ribs, and bones of the spine (vertebrae). Enchondromas may result in severe bone deformities, shortening of the limbs, and fractures.

Question 23

Genetic alterations (IDH, 1p/19q codeletion, RELA-fusion, H3 Lys27Met) + histology = ?

Answer 23

Improved diagnosis & grading
Improved management

2016 WHO Classification of CNS tumours

Question 24

What did a clinical trial regarding ‘In Vivo Molecular Mapping of Adult Primary Brain Tumour Activity Using Novel Magnetic Resonance Imaging (MRI): a Pilot Study’ conclude?

Answer 24

Correlation of the MRI signal intensity (advanced MRI sequence 1; arbitrary units) and glioma protein concentration (g/L) in a 1 x 1 x 1 cm region of interest (R value) [Time Frame: 5 years]