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Undeleted > Neurooncology > Flashcards

Neurooncology Flashcards

0
Q

In who are brain tumours most common?

A

Men under 45

Woman under 35

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1
Q

What is the prevalence of brain tumours

How many new cases each year

A

7 per 100,000
5000
1.6% of all cancers

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2
Q

How many types and groups of brain tumours are there?

A

150 types

7 main groups

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3
Q

Secondary brain tumours occur how?

A

Metastatic growth from a primary cancer ie lung breast, colorectal, testicular

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4
Q

What are gliomas?

A

Primary brain tumours of the glial cells

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5
Q

Describe the WHO Brain tumour scale

A

Malignancy scale 1-5

1 being least histologically malign and 5 being most

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6
Q

What are the known causes of primary brain tumours?

A

Mostly no cause is found
Ionising radiation
Family history 5%
Immunosuppressive (CNS Lymphoma)

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7
Q

What genetic syndromes are associated with brain tumours?

A

Neurofibromatosis,
tuberose sclerosis
Von hippel-landau disease

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8
Q

What are the the symptoms of brain tumours

A

Varied presentation dependant on tumour type, grade and site

Can include:
Headache 
Seizures
Focal neurological symptoms
Other non focal symptoms
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9
Q

What qualities of headache are associated with seizures

A

Woken by headache
Worse in morning
Worse lying down
Exacerbated by coughing, sneezing, drowsiness

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10
Q

What percentage of patients experience headache as first symptom and what percent at presentation

A

24%

46%

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11
Q

What percentage of first seizures are consequently found to be a brain tumour

A

2-6%

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12
Q

What percent of brain tumours present with seizures?

A

21%

80% low grade gliomas

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13
Q

How do focal deficits present ?

A 
Progressive over days-weeks
Weakness
Sensory loss
Visual/speech disturbances
Ataxia
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14
Q

Name three non focal symptoms

A

Personality change
Memory disturbances
Confusion

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15
Q

What is papillodema and what is it a sign of?

A

Optic disc swelling caused by increase intracranial pressure
Can be a sign of cancers such as gliomas

16
Q

Name four focal neurological deficits common in brain tumours

A

Hemiparesis
Hemisensory loss
Visual field defect
Dysphasia

17
Q

What are the red flags?

A

Headache (with increased intracranial pressure features)
Ie papillodema

New onset focal seizures
Rapidly progressive focal neurology (w/o headache)
Past history of other cancer

18
Q

If there is a long history of isolated headache is a brain tumour likely or unlikely?

A

Unlikely

19
Q

Describe the difference in presentation between low grade and high grade tumours

A

Low grade- Typically present with seizures (can be incidental finding)
High grade- rapidly progressive neurological deficit, symptoms of raised ICP

20
Q

Investigations for brain tumours

A

CT (with contrast)
MRI
Brain biopsy

21
Q

What would you find on the scan for a high grade tumour?

A

Irregular mass with vasogenic oedema. Enhancement often seen

22
Q

What are the histologically markers for tumour ?

A

MGMT methylation
IDH-1 mutation
Chromosome 1p19q loss (in oligodendroglial tumours)

23
Q

What treatments are available for high grade gliomas (HGG)

A 
Depends on type, grade and site
Steroids-reduce oedema 
Surgery-biopsy or resection 
Radiotherapy-mainstay. Radical vs palliative 
Chemotherapy - temozolamide, PCV
24
Q

What is the prognosis for HGG

A

6 months no treatment 18 months with

25
Q

What is the treatment for Low grade gliomas (LGG)

A

Surgery
Radiotherapy- delay the disease transformation
Chemotherapy- no evidence

26
Q

What is prognosis for LGG

A

Median survival 10 years

27
Q

Pituitary tumours are…..

A

Usually always benign and curable and can lead to
Excessive hormone production
,Local effects of tumour
Inadequate hormone production by remaining pituitary

28
Q

How are brain tumours classified

A

According to cell type and histological behaviour

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