Tumors of the Nervous System Flashcards
In general, most primary brain tumors are ___ in children and ___ in adults.
Infratentorial (eg, cerebellar medulloblastoma, astrocytoma); supratentorial
True or false - spread of primary brain tumors to other body organs virtually never occurs.
True
Presentation of brain tumors?
Slow onset (unless hemorrhage within tumor -> acute)
Focal neurological deficit if involving motor or sensory cortex
Seizures
ICP -> headache, N/V, somonlence, obtundation
Most common type of primary brain tumor?
Gliomas
4 major types of gliomas?
- Astrocytomas
- Ependymomas
- Medullbolastomas
- Oligodendrogliomas
Cell of origin and prognosis of astrocytomas?
Arise from astrocytes
Differing microscopic degrees of malignancy, most malignant is glioblastoma multiforme
Cell of origin, common location and population of ependymomas?
Arise from ependymal cells lining the ventricles
Children: posterior fossa, obstruct 4th ventricle
Adults: filum terminale of spinal cord
Cell of origin, location, population of medulloblastomas?
Arise from neuroepithelial roof of the 4th ventricle, children
Cell of origin, location, population of oligodendrogliomas?
Arise from oligodendrocytes, frontal lobes in adults
Imaging features of malignant primary brain tumors?
Irregular, non-homogenous, solitary mass with variable enhancement
Imaging features of benign primary brain tumors?
Spherical, homogenous, uniform enhancement
Management of primary brain tumors?
Rx depends on the type, location, extent
Need a biopsy (surgical procedure or CT-guided approach)
Excision if possible, combined radiation and chemo
Typical imaging appearance of metastatic brain tumors?
Multiple, spherical tumors at the gray-white junction of the cerebral cortex, often with surrounding edema
Mets are common in what 5 cancers?
Lung Breast Colon Kidney Melanoma
Also systemic lymphoma can spread to the brain and primary lymphoma can originate in the brain if immunocompromised
What is meningeal carcinomatosis?
Syndrome where cancer cells spread throughout the CSF and deposit over different areas of the cerebral cortex, CN or spinal nerve rots
Symptoms include mental status changes, headache, CN palsies, radiculopathies
CSF analysis - confirm dx
Inrathecal chemo may offer benefit