Neuro-Onc

Question 1

What is the differential for mass lesions in the brain?

Answer 1

1. Hemorrhage
2. Neoplasm
3. Inflammatory Mass (granuloma, abscess)
4. Demyelinating Plaques of MS

Question 2

Whare do children tend to get CNS neoplasms?

Answer 2

posterior cranial fossa and spinal cord

Question 3

Where do adults tend to get CNS neoplasms?

Answer 3

middle and anterior cranial fossa and metastatic tumors (breast and lung)

Question 4

What are the most common primary intracranial tumors?

Answer 4

Glioma, meningioma, extra-axial tumors

Question 5

What is the most aggressive primary intracranial tumor?

Answer 5

astrocytoma

Question 6

What are some of the general s/sx of CNS tumors?

Answer 6

Increased ICP, N/V, seizures onset depends on how fast the tumor is growing

Question 7

Meningiomas

Answer 7

almost always a benign, slow growing tumor, it presents with personality changes, optic nerve/muscle issues, or myelopathy depending on where it is. tx: monitot or resect it.
Path: psmmoma bodies, cellular whorls, nuclear psuedo-inclusions

Question 8

Glioma

Answer 8

Derived from oligodendroglia, astroglia or ependymal cells. Range in their degree of malignancy - astrocytomas are hard to remove bc they grow into the brain tissue and have no surgical boarder.

Question 9

Glioblastoma multiforme Astrocytoma

Answer 9

The most malignant glioma that are highly anaplastic and cause necrosis, pseudopalisading and proliferation of endothelial cells. It can metastisize via the CSF. Has “fried egg” tumor cells pathologically with delicate capillary networks.

Question 10

Oligodendroglioma

Answer 10

A less aggressive type of glioma that often presents with seizures, is slow growing, and may calcify. Not commonly curable, but can be abated with chemo and radiation.

Question 11

Neurolemoma

Answer 11

Tumor derived from the nerve coverings. Acoustic neuroma is the most common cause that presents with unilateral hearing loss and can be removed with resection.

Question 12

Ependymoma

Answer 12

Tumor derived from the cells lining the ventricles and central canal. Presents more in young people and is often resectable, but does recur. It can also cause drop metastases.

Question 13

Primitive Neuroectodermal tumors

Answer 13

Seen in children and young adults, these tumors are often found in the midline in the posterior fossa. They are sensitive to chemo and radiation though often not curable.

Question 14

Most common metastases to the CNS?

Answer 14

lung, breast, colon

Question 15

Most selectively metastasize in the CNS?

Answer 15

renal cancer, ovarian cancer, melanoma

Question 16

Tumor grading

Answer 16

1. benign, slow growing, unlikely to recur or spread
2. slow growing, but will come back
3. aggressive, requires therapy more than surgery alone
4. anaplastic, malignant, lethal

Question 17

Schwannoma

Answer 17

Spindle cell tumor that is associated with cranial and spinal nerves and present pathologically with verocay bodies

Question 18

Metastases

Answer 18

One of the most common types of tumors found in the brain. Are sharp edged and are made up of cells of a different lineage than CNS cells. This tumor type presents with the most edema around lesion.

Question 19

How do tumors produce neuro deficits?

Answer 19

1. ischemia
2. compression
3. edema