Tumors of the brain, spinal cord, peripheral nerves Flashcards
Classification of astrocitomas
Pilocytic
Diffuse
Anaplastic
Glioblastoma
Pilocytic astrocytoma tumor
children and young adults
infratentorially or allow the optic pathways and thalamic regions
Difusse astrocytoma localization
supratentorial within the temporal frontal lobe
Diffuse astrocytoma characteristics
Microscopically benign (infiltration of microcitis but no necrosis, no microvascular progeneration…)
Beiological malignant (infiltrative growth. Survival up to 10 years
Diffuse astrocytoma treatment
Surgery is the best but also chemo
Anaplastic astrocytoma characteristics
no haemorrage or necrosis but nucleus polymorphous, hyper cellular mitosis, microvascular proliferation, endothelial proliferation.
Survival up to 3 years
When does the patient has longer survival
when mutation of IDH is grade 2
Most frequent glioma
Glioblastoma
Glioblastoma age of presentation
50/60 years
Glioblastoma characteristics
Central necrosis, edema
Glioblastoma localization
white matter of hemisphere, basal and thalamus
Necrosis and microvascular proliferation
Oligodendroglioma localization
Supratentorial (more than 90%)
Ependymomamas age
All but more in children
Ependymomas localization
Arise in the region of 4th ventricle
Posterior fossa in children. In adults spinal ependymomas are commoner than intracranial
Types of Ependymomas
Mixopapillary (grade I)
Ependymoma (grade II)
Anaplastic ependymoma (grade III)
Rossette is characteristic in
Ependymomas
Diffuse midline glioma mutation
H3K27 mutation (histone mutation)
Diffuse midline glioma age
Children young adults
Schwannoma is it benign or malign?
Benign tumor of the Schwann cells that envelops cranial nerves, most commonly VIII and V
Schwannoma characteristic
VIII: Progressive unilateral hearing loss, tintinnus and vertigo
V, VII: facial sensory loss and facial weaknes. Hydrocephalus due to compression of brainstem
Meningioma age
Females after 50 years
Meningioma localization
parasagital region, sphenoid wing, spinal cord (thoracic segment). Rarely invade the brain
Meningioma characteristics
Intradural tumor, well-demarked, compressing the brain/spinal cord
Medulloblastoma age
Embrional tumor
Medulloblastoma localization
Cerebellum or posterior fosa
Medulloblastoma characteristic
Invasive, rapidly growing, metastasize
Drop metastasis
In medulloblastoma metastasis all the way down to cauda equina at the base of the spinal cord
Types of pineal gland tumors
Pinealocytoma (benign)
Pinealoblastoma (WHO IV)
Clinical presentation of intracranial tumor
headache which worsens with activity
Hemiparesis, cognitive disfunction, ataxia, aphasia, Cranial nerve involvement
Seizures
Increased intracranial pressure: headache, disturbance of consciousness, vomiting, visual problems
Bitemporal hemianopsia (if is compressing chiasma optic)
Hearing loss (acoustic neuroma)
Intractable epilepsy
most common brain tumor in pediatric
medulloblastoma
most common brain tumor in adults
metástasis and then hemangioblastoma or glioblastoma
Extramedulary tumours of the spinal cord
Schwannoma
Meningioma
Medullary tumors of the spinal cord
Ependymoma
Midline gliomas
Myxopapilary ependymoma of cauda equina
Neurofibromatosis type 1. Clinical
Skin: cafe-au-lait spots, multiple neurofibromas, axial and inguinal freckling
Eyes: Iris hamartomas-Lish nodules
Cranial nerve: optic nerve glima
Neurofibromatosis type 2. Clinical
Bilateral vestibular scwannomas
Bilateral acustic neurinoma
multiples meningiomas
Gliomas, neurofibromas, cataract
Glial hamartomas, meningioangiomatosis, intracranial calcifications
Meningioma common localization
Thoracic segment
Most common manifestation of low-grade pleomorphic xanthoastrocytoma
Epilepsy
Most common localisation of pilocytic astrocytoma in children
Little brains
Drug patient with malignant edematous tumor
Dexamethasone
Where are tumours most commonly found in children
Infratentorial
Where are brain metastases most commonly found
At the boundary (perímetro) between white and grey matter
Tumour in which calcifications are characteristic
Oligondendroglioma
Most common glioma
Glioblastoma
Ependymoma in adult is in
Conus medullaris and filum terminale
Spinal ,meningiomas are most commonly seen in (age)
Older women
Cranial nerve most affected by neurinoma
VIII
Pituitary adenoma is most commonly secreted by
Prolactin
Tumour in left brainstem presentation
Affected sensation of temperature and pain in the ipsilateral side of the face and contra lateral side of the body
Tumour characteristic of neurofibromatosis type 2
Bilateral VIII cranial nerve schwannoma
Tumour than commonly occludes nerves in the sphenoid sinus
Meningeom
76 years old cerebellum tumour is likely to be
Metastasis
Tumour causing hearing problems is likely to have arisen from
Schwann cells
Brain tumour and daily complex partial seizures. Which antiepileptic to use
Levetiracetam
Most favourable prognosis
Pilocytic astrocytoma
Worst prognosis
Pleomorphic xanthoastrocytoma
Bitemporal quadrantopsy of the upper quadrants causes
Pituitary adenoma
A tumor with hyperosteosis is likely to be
Meningiom
Which tumour is treated with radiotherapy and temozolomide
Glioblastoma
Tumour in cerebellum of 35 years old man is likely to be
Hemangioblastoma
The most common brainstem tumour is
Glioma
Cystic tumour in cerebellum of child is likely to be
Pilocytic astrocytoma
Vision problems for 3 weeks, limited upward vision, poor pupillary reactions, convergence nystagmus at rest
Parinaud syndrome
MRI Parinaud syndrome expansive process in
Epiphyses
Parinaud syndrome
Supranuclear vertical palsy
Pseudo-Argyll Robertson pupils
Nystagmus when convergence
Eyelid retraction
Hydrocephalus
Bilateral papilledema, skew deviation, III and IV palsy, Internuclear ophthalmoplegia
Treatments for epilepsy for brain tumors
Carbamazepine and levatiracetam
Kennedy-Foster syndrome
ipsilateral optic atrophy and anosmia, contralateral papiledema
Immunophenotype of adenocarcinoma of the lung
CK7+
CK20-
TTF1+
Napsn A+
CNS tumor expresses CK7+ CK20-, TTF-. Origin of metastasis
Breast carcinoma
Tumour with 1p/19q deletion
Oligodendroglioma
Radiotherapy dosis to give postoperative radiotherapy to the astrocytoma
50-60 Gy
Double images, hearing loss in the left ear, headache, paresis of the right abducens
Carcinosis of the meninges
progressive dysarthria, gait faltering, intention tremor. Fails the finger-nose test
hemangioblastoma
Acutely symptom of parasagital meningioma
epilepsy