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Flashcards in Brain tumour Deck (30):
1

Astrocytic tumour classifications

I: pilocytic astrocytoma
II: astrocytoma
III anaplastic astrocytoma
IV: glioblastoma

2

Oligodendricytic tumour classifications

II: oligodendroglioma
anaplastic oligodendroglioma

3

Classes of brain tumours

I: in-situ/localized
II: diffuse
III: undefied
IV: malignant

4

Neuron tumour classifications

I: gangliocytoma
II: neurocytoma

5

Ependymal tumour classifications

I: subependymoma
II; ependymoma
III: anaplastic ependymoma

6

Meningeal tumour classifications

I: meningioma
II: atypical meningioma
III: anaplastic meningioma

7

Neurononal stem cell tumour classification

IV: neuroblastoma (PNET) - named by location
Medulloblastoma
Neuroblastoma
Retinoblastoma
Pineoblastoma

8

Mixed brain tumour classification

I: ganglioglioma
II: mixed oligoastrocytoma
III: anaplastic oligoastrocytoma

9

PSNS tumour classifications

I:Schwannoma/neurofibroma
IV: malignant peripheral nerve sheath tumour

10

General principles of brain tumours

1/2 are "benign" but mass effect
cure rate for malignant brain tumours much lower than other cancers
lifetime risk: 1/200
leading cause of cancer deaths in children/teenagers
2nd leading cause of cancer deaths in males 20s-40s
40% primary CNS tumours: gliomas
80% of malignant CNS tumours: gliomas

11

CNS tumour etiology

majority are unknown
Irradiation --> meningoma, glioma, nerve sheath tumours
Genetic
Immunosuppression: CNS lymphoma
Experimental: SV40
Occupation: some risk
Trauma, diet- no convincing data

12

CNS tumour risk factors

Sex: gliomas Men. women
Meningiomas: women > men
Association with breast cancer and meningioma
Cell phone: of concern

13

Clinical features of CNS tumours

epilepsy
headache
raised ICP
focal neurologic deficit
short history: more aggressive

14

Intracranial CNS tumour distribution

adults: 70% supratentorial, 30% infra
children: 30% supra, 70% infra

15

CNS tumours common among adults

glioblastoma
metastasis
malignant astrocytoma
meningioma
pilocytic
Schwannoma

16

CNS tumours common among children

medulloblastoma
astrocytoma
ependymoma
craniopharyngioma
glioblastoma

17

Glioblastoma 5 year survival

3-4%

18

Anaplastic astrocytoma 5 year survival

30%

19

Oligodendroglioma 5 year survival

60%

20

Ependymoma 5 year survival

60%

21

Medulloblastoma 5 year survival

60%

22

Pilocytic astrocytoma 5 year survival

>80%

23

Meningioma 5 year survival

70-95%

24

Pilocytic astrocytoma features

predominantly in childhood
usually cerebellum, optic tract, hypothalamus
others: more guarded prognosis
often cystic (esp cerebellum)
potentially curable by complete excision

25

Pilocytic astrocytoma genetics

most common: gains on 7q34
Often associated with duplications of BRAF, HIPK2 genes
- not associated with clinical outcome for cerebellar tumours
- predict better clinical outcome for low grade gliomas in pediatric patients
- activation of MAP kinase signalling pathway

26

DIffuse gliomas

40% of all primary CNS tumours
78% of malignant CNS tumours
>80% of high grade gliomas

27

Tumour suppressor genes involved in CNS tumours

p53
Rb: retinoblastoma
p16
p19

28

Oncogenes involved in CNS tumours

Epidermal growth factor receptor: GBM
pltaelet-derived growth receptor alpha: low grade astrocytoma

29

CNS tumour metastasis

Lung (50%)
Breast (15%)
Skin (melanoma - 10%)
GI
GU
80-90% are in the brain, 10-20% spinal

30

CNS effects of cancer treatment

Radiotherapy:
encephalopathy
delayed myelopathy
hypothalamic/pituitary disturbance
oncogenesis

Chemo:
encephalopathy/myelopathy
cerebellar