Brain Tumors

Question 1

difference between biological and cytological malignancy

Answer 1

Biological malignancy refers to the likelihood that a tumor will kill a patient

Cytological malignancy doesn’t always tell the whole story
Has to do with properties of anaplasia, invasiveness and metastasis
Is the tumor cancerous and how “aggressive” is it
Tumor that is cytologically benign does not necessarily mean a good prognosis
Some are inoperable, fast growing or high rate of reoccurrence
Sometimes cytologically malignant tumors have a better prognosis than benign tumors

Question 2

Where can tumors arise?

Answer 2

either from glial cells which are the most common primary brain tumors or from nerve cells

Question 3

What are metastatic tumors?

Answer 3

tumors that started somewhere else and are more common

Question 4

Two common ways that tumors may present

Answer 4

1. Acute/sudden changes

2. Steady, progressive declining presentation

Question 5

What does the growth of tumors cause and result in?

Answer 5

• obstruction of arteries
• obstruction of CSF flow with resultant acute hydrocephalus
• results in pressure in the brainstem
• hemorrhage of blood supply

Question 6

What are the 3 most common symptoms of tumors?

Answer 6

headaches similar to migraine or cluster headaches
seizures
altered mental status

Question 7

What do tumor symptoms depend on?

Answer 7

depends on location and whether or not it is obstructing the artery or CSF and the amount of edema present

Question 8

4 main types of tumors

Answer 8

Gliomas
Meningiomas
Pituitary Adenomas
Schwannoma

Question 9

Subcategory of Gliomas

Answer 9

oligodendrogliomas
medulloblastomas
astrogytomas
ependymomas

Question 10

Oligodedrogliomas

Answer 10

type of glioma

2 grades: low grade and anaplastic

Question 11

medullablastomas

Answer 11

type of glioma
highly malignant embryonal tumors
2nd most common childhood tumor
develop hyrdrocephalus due to blocking of CSF
treatment includes surgery, extensive radiation and chemo

Question 12

Astroycytomas

Answer 12

type of glioma
most common childhood tumor
 Gliobastoma multiforme is a highly malignant grade 3 astrocytoma
o Cerebellar benign the most common under age 10
o Tends to be cytologically benign; slow growing
 Good prognosis if slow growing
o Brainstem gliomas are present in late child hood and involve CN and long tract signs

Question 13

Ependymoma

Answer 13

type of glioma
third most common childhood tumor
found later as it grows into the 4th ventricle
difficult to resect
doesn’t respond well to treatment and has worse long term prognosis
can become cytologically malignant

Question 14

Meningioma

Answer 14

type of tumor that occurs in the meninges and is overall most common

Question 15

Pituitary adenomas

Answer 15

benign epithelial tumor

Question 16

Schwannoma

Answer 16

CN 8 acoustic neuromas are the most common of this type of tumor

Question 17

common symptoms of childhood tumors

Answer 17

	
	Present with hydrocephalus due to blockage of CSF
	Headache; especially in morning
	Early morning nausea and vomiting
	Ataxic gait
	Incoordination
	Later lethargy

Question 18

Where do most childhood tumors occur?

Answer 18

70% occur below the tentorium

Question 19

What is the most common primary adult tumor?

Answer 19

Meningioma
o Most are cytologically benign; slow growing
o May present with seizures due to tumor pushing on brain
o Often highly vascular
o Can often be successfully removed
o Good survival rate

Question 20

Where do most adult tumors occur?

Answer 20

70% of adult tumors are SUPRAtentorial

Question 21

general symptoms with adult brain tumors

Answer 21

• Headache
• Memory loss
• Personality changes
• CVA like symptoms
• Double vision
• Inability to speak
• Gait changes/ataxia
• Nausea, vomiting
• Papilledema
• Seizures
• Coma

Question 22

What do infratentorial tumors include?

Answer 22

Schwannomas of cranial nerves (esp. CN VIII) and cerebellar hemangioblastomas