Tumours Flashcards
What are the general presenting complaints of someone with a brain tumour?
Progressive neurological deficit
Motor weakness
Headache
Seizures
Describe the headache related to a brain tumour
Worse in the morning or upon coughing
Linked with vomiting
Which cells are the most common cause of brain tumours?
Neurepithelial
How are astrocytic tumours graded?
I - Benign
II - Astrocytomall
III - Malignant
IV - V. Malignant
Describe a Grade I Astrocytic tumour.
Truly benign slow going
Well encapsulated
How can a Grade I Astrocytic tumour present?
Hydrocephalus
Tip Toe gate
Slow mental development
What is the most common Astrocytic tumour in children?
Pilocytic Astrocytoma - generally arising in the cerebellum.
Describe how a Pilocytic Astrocytoma may appear in radiology.
Well Circumscribed
Contrast enhancing
Often cystic mass
For Grade I Astrocytic tumours what is the treatment of choice?
Surgery is usually curative
What is the general presentation of someone with as Grade II Astrocytic Tumour?
Focal deficit
Raised ICP
Altered Consciousness
Short duration of symptoms
Give an example of a Grade II Astrocytic Tumour?
Astrocytoma
Describe an Atrocytoma.
Poorly defined Invasive
Appears histologically little different from normal.
No contrast enhancement
What is the prognosis for someone with an astrocytoma?
Generally poor in the longterm as will continue to grow even with surgical resection.
What is the treatment for Grade II Astrocytic tumours?
Surgery + Chemotherapy + Radiotherapy
Not curative the tumour will grow back slowly requires monitoring
What differentiates a Grade III from a Grade II Astrocytic tumour.
More invasive faster growing increased mitosis
Contrast enhancing on MRI
Give an example of a Grade III Astrocytic Tumour.
Anaplastic Astrocytoma
Describe an Anaplastic Astrocytoma
Poorly defined low density mass presenting with some contrast enhancement on MRI
Prognosis for an Anaplastic Astrocytoma
Median is 2 years
Treatment for Grade III Astrocytic Tumours.
Surgery + Chemotherapy + Radiotherapy
What is the most common Grade IV Astrocytic tumour?
Glioblastoma Multiforme
Describe a glioblastoma multiforme.
Very aggressive poorly differentiated tumour with evidence of new vessel growth brain tissue destruction and necrosis.
How do glioblastoma multiforme commonly appear on MRI?
Contrast enhancing - ring pattern is present
Surrounded by darker area of oedema
If multiple Glioblastoma multiforme are present what could be behind this?
Neurofibromatosis
Tuberose sclerosis
What is the prognosis for Glioblastoma Multiforme?
Very poor months at most
What is the treatment for Glioblastoma Multiforme?
Treatment is to improve quality of survival
Reducing the mass effect
Surgery Chemotherapy Radiotherapy
What is the medial survival of someone with a Oligodendroglial tumour?
10 years
If someone presents with a diffusely invasive tumour calcified cysts Microvascular growth and haemorrhage in the frontal lobes what is it likely to be?
Oligodendroglial tumour.
How does a oligodendroglial tumour present on imaging?
A well demarcated hypodense or isodense lesion
Possible calcification and cystic appearance
What is the treatment for an oligondedroglial tumour?
Chemotherapy
Surgery
What are the presenting symptoms of someone with a meningioma?
Headache
Cranial Nevre Neuropathies
Wha grade are most meningiomas?
Generally Benign Grade I
List some aggressive grade III meningiomas.
Chordoid
Rhabdoid
Papillary
If a tumour presents with hearing loss tinnitus and balance issues what could it be?
Acoustic neuroma
List some other tumours affecting the CNS and the brain.
Schwannomas
Neurofibromas
Malignant peripheral sheath tumour.
Secondary tumours are far more common than primary within the brain.
True
Where are the most common sites of origin for malignant secondary tumours?
Breast Bronchus Kidney Thyroid Colon Melanomas
Generally how are primary tumours graded?
Neovascularision Necrosis and Mitosis
Why are benign non invasive tumours still worrying?
As they can still kill via mass effect and oedema swell as the increased risk of haemorrhage.
What is the most common benign tumour in children?
Craniopharyngioma
What is the most common malignant tumour in children?
Medulloblastoma
Where do medulloblastomas usually present?
Often in the midline
If it occurs in the midline what can be a common presentation of a medulloblastoma?
Hydrocephalus as disrupts CSF flow
Upon observation what does a medulloblastoma appear like?
Poorly differentiated
What is the treatment for a medullablastoma?
Very radiosensitive so surgery + radiotherapy
