Tumors- SG Flashcards
Glial cells of brain & spinal cord
- star shaped glial cells, give support to endothelial cells of BBB
- Help w/ maintenance, repair, transporting nutrients
Astrocyte
(Astrocytoma)
(astro = stars)
- Support & insulation for neurons
- Help w/ homeostasis, myelin
- Include 4 cell types, what are they?
Glial Cells
- Oligodendrocytes
- Astrocytes
- Ependymal cells
- Microglial cells
What is the most common primary intra-axial brain tumor?
Astrocytoma
Which grade of astrocytoma?
- Special astrocytoma such as: pilocytic astrocytoma
Grade 1
Which grade of astrocytoma?
- Low-grade astrocytoma
Grade 1 and 2
Which grade of astrocytoma?
- Anaplastic astrocytoma (malignant)
Grade 3
Which grade of astrocytoma?
- Glioblastoma / Glioblastoma Multiforme / GBM
- (malignant)
Grade 4
- More common in children and young adults
- Low degree of cellularity w/ preservation of normal brain tissue within tumor
- They do not always behave benign, and can undergo malignant transformation over a period of years
Grade 2 & 3 Astrocytoma
What is the most common presenting symptoms of Grade 1 & 2 Astrocytoma?
*** on exam ***
Seizures (50%)
What tx for Low Grade 1 Astrocytoma can be currative?
Surgical resection
(Chemo and Radiation if non-operable)
Tx for seizures from Low grade (1&2) Astrocytomas
AEDs (anti epileptic drugs)
- Considered malignant gliomas (form of astrocytoma)
- Anaplastic astrocytoma
- slower growing / slower onset of sxs
- Prognosis ___ yrs, but varies depending on age at dx
- mean age at dx is ___ y/o
Astrocytoma grade 3 & 4
- 3 - 5
- 30
2 types of grade 3&4 astrocytomas
- Anaplastic astrocytoma
- Glioblastoma
Astrocytoma Grade 4
Glioblastoma
- Prognosis is ____ months, but varies depending on age at dx
- Mean age at dx is ___ yrs
- “tentacles” out to brain tissue, so hard to resect al of tumor
- 11 - 15
- 64
Most common primary brain tumor
Glioblastoma
(glioblastoma multiforme) / GBM
Most deadly tumor
GBM
Glioblastoma
- ___ and ___ often present
- Can spread throughout ____
- Rarely ever ___ spread***
- necrosis & edema
- CSF
- systemic
3 Tx for Malignant Astrocytoma
Surgery: (resection / lobectomy) NOT currative
Radiation: (focal or stereotactic) / Whole brain
Chemotherapy: Temozolomide (currently the only chemo which can tx glial tumors
Prognosis for Grade 1/2 Astrocytomas
7 - 10 years
Prognosis for GBM
18 months survival
50% for pts under 40 y/o
10-20% for patients 40+ yrs
- Slow growing, extra-axial, benign tumors arising from arachnoid matter (outside of brain)
- Resection is usually curative
- Usually non-infiltrating (no necrosis)
- Displaces brain tissue
- Considered non-malignant mostly, but malignant forms exist
Meningioma
- Meningiomas occur between age __ to ___
- More common in which sex?
- 30 - 70
- Women,
- unless malignant = males
Meningioma
- Sxs occur rapidly or slowly?
- What imaging?
- __ needed to confirm dx
- Location of tumor?
- Slowly, usually associated w/ normal signs of agin
- MRI
- Surgical biopsy
- Anywhere meningeal tissue is…. (arachnoid tissue = periphery)
Which tx offers best chance for cure of Meningioma?
Complete surgical resection
(should be offered in all SYMPTOMATIC pts, if feasible)
What tx is best for pts w/:
- Few sxs / little to no swelling in adjacent brain tissue
- Mild/minimal sxs w/ hx of tumors w/o negative effect on quality of life
- Older pts w/ very slow progressing sxs
- Those whom tx carries a significant risk
- Those who choose to not have surgery
Observation
Tx as adjunct therapy, esp for unresectable tumors
Radiation
What tx has NO ROLE in management of Meningiomas
Chemotherapy
