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Flashcards in brain tumors Deck (25):
1

7 main questions to ask self about brain tumors

1. in CNS: intracranial or extra cranial?
2. if intracranial: intra or extra axial
3. if intraxial: infra or supra tentorial
4. if spinal: eaxta or intra canallicular?
5. if intracanallicular: extra or intra dural
6. if intradural: extramedullary or intrameddulary
7 primary tumor or mets?

2

4 DDx for CNS mass lesions in adults

1. tumor
2. vascular
3. infectious
4. inflammatory

3

5 post. fossa tumors in kids

1. pilocytic astrocytoma
2. ependyoma
3. medualloblastoma
4. choroid plexus papilloma
5. choroid plexus carcinoma

4

what is pilocytic astrocytoma

- most common in children
- hydroceph or cellebellar dysfunction
- WHO gr1

5

what is imaging, path, goal of therapy, outcomes of pilocytic astrocytoma

imaging: cyctic lesion w mural node - may have strong contrast enhancement
path: biphasic appearance with comact fascicles
goals: surgery
outcome: 90% cure

6

**1 where are pediatric tumors

post. fossa

7

**2 signs of post. fossa tumors

cerebellar or hydroceph

8

**3 what are WHO gr1 tumors

non-infiltrative and curable

9

what are oligodendroglioma

- commonly present with seizure
- arise within cotex
- WHO gr.2

10

what is imaging, path, goal of therapy, outcomes of oligodendroglioma

imaging: ccalcification of cT, dark on T1, bright on T2
path: fried egg appearance
goals: prolongation of disease remission
outcome: 8-10 years with everything - will undergo malignancy

11

2 prognostic indicators of oligodendroglioma

1. 1p/19q status
2. IDH mutation

12

what is effect of 1p/19q status

those with this deletion tend to do better

13

what is IDH mutation

enzyme mutation
- less NADPH
- creation of 2-HG metabolite, an onco metabolite

14

**4 what is outcome of infiltrative gliomas (WHO 2-4)

incurable

15

**5 what is presentation of low grade tumor

siezure rather than neuro deficit

16

**6 how are tumors on CT, MRI

hypodense on CT
hypodense on T1 MRI
hyperdense on T2 MRI

17

**7 what do low grade tumors look like on CT

no enhancement, but calcification

18

what is secondary glioblastoma

- 20-30% of all glioblastoma
- present with HA, neuro def. or seizure
- WHO gr 4

19

what is imaging, path, goal of therapy, outcomes of glioblastoma

imaging: heterogeniously enhancing mass
path: areas of low grade tumor with pockets/sheet of malignant degenaration
goals: acheivment of disease control and neuro function
outcome: 12-14 month survival

20

what is def. of infiltating CA

CA that has spread beyond the layers of tissue in which it had developed

21

what is main treatment of gliobastoma

temezolamide

22

what predicts response to temezolamide

MGMT methylation
MGMT will not respond to temezolamide, but methylation shuts it off

23

**8 what happens to low grade glioma

will invariably progress to glioblastoma

24

***9 what do malignant tumors look like on CT

enhance

25

**10 what does rapid progression of Sx predict

increased malignancy

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