Neurooncology

Question 1

Which three tumors are astrocytomas?

Answer 1

• Pilocytic Astrocytoma
• Anaplastic Astrocytoma
• Glioblastoma

Question 2

Pilocytic Astrocytoma: 
Benin/ malignant? 
Which age group is affected? 
Location in the brain (2)? 
Path feature?

Answer 2

• Benign cystic growths
• Children/ Young adults
• Ventricles + Cerebellum
• Rosenthal fibers (red worm-like)

Question 3

Anaplastic Astrocytoma:

• Benign/ malignant
• Prognosis

Answer 3

• Malignant: higher grade w/ mitotic figures, cytopathic change
• Aggressive, commonly morph into glioblastoma, death in 5 yrs

Question 4

Glioblastoma Multiforme:

• Benign or malignant?
• How does it present (2)? Age?
• Prognosis?
• What is seen pathologically?
• What is seen radiologically?

Answer 4

• Most malignant brain tumor
• Presents in 5th-7th decade with seizures or focal deficits
• Responds poorly to treatment; death in 1 year
• Pseudopalisading cells with necrotic center
• Contrast enhancing (ring appearance)

Question 5

Oligodendroglioma:

• Location and clinical presentation? Age?
• Prognosis?
• Pathological findings?

Answer 5

• Presents in 4th-5th decade of life as supratentoral tumor w/ seizures
• Responds well to resection, radiation, chemo–survive 5-10 years after dx
• “Fried egg” appearance of cells

Question 6

Ependymoma:

• Age? Location of tumor?
• Common clinical presentation?
• Pathologic appearance
• Radiologic appearance?

Answer 6

• Kids + YA; infra or supratentroal mass–> 4th ventricle (kids) or spinal cord (YA)
• Obstruction of 4th ventricle–> Hydrocephalus–> Morning HA, vision changes
• Perivascular pseudorosettes
• Radiologically, look for them in the fourth ventricle or in the spinal cord

Question 7

What is the most common spinal cord glioma?

Answer 7

Ependymoma = #1 CNS cell tumor of spinal cord

Question 8

What are the two primitive neuroectodermal tumors?

Answer 8

• Medulloblastoma

- Retinoblastoma

Question 9

Medulloblastoma:

• Most common location and age group
• Common complication?
• Prognosis?
• Pathological appearance?
• Radiological appearance?

Answer 9

• Commonly occur during childhood; found in cerebellum
• Drop metastasis to spinal cord due to CSF infiltration
• Responds well to radiation; 5 yr survival 75% w/ tx
• Homer-Wright Rosettes; small round blue cell tumor
• Midline cerebellum or spinal cord tumors on radio

Question 10

Retinoblastoma:

• Age and location + pathogenesis
• Clinical presentation
• Pathological findings

Answer 10

• Childhood, intraocular PNET
• Deletion Rb tumor suppressor–> tumor–> monocular vision loss w/ loss of red reflex
• TRUE rosettes

Question 11

Pituitary Tumors:

• Most common type + treatment (2)
• Clinical presentation (2)

Answer 11

• prolactinoma; bromocriptine + transnasal resection

- HA, vision impairment

Question 12

Meningioma:

• Type of cells + pathological finding (2)
• Clinical présentation
• How to ID on radiology

Answer 12

• Arachnoid cells + PSAMMOMA BODIES
• Can grow large without causing sx; commonly incidental finding
• ID on radio w dural tail

Question 13

Which brain mets are most likely to hemorrhage? (3)

Answer 13

• Renal
• Choriocarcinoma
• Melanoma