Brain tumours

Question 1

most common form of brain tumour

Answer 1

metastases

Question 2

Cancers which commonly metastasise to brain

Answer 2

lung (most common)
breast
bowel
skin (melanoma)
kidney

Question 3

Most common primary tumour in adults
Poor prognosis (~ 1yr).

Imaging: solid tumours with central necrosis and a rim that enhances with contrast

Disruption of the blood-brain barrier and therefore are associated with vasogenic oedema.

Histology: Pleomorphic tumour cells border necrotic areas

Tx: surgical with postop chemo/radiotherapy
Dexamethasone is used to treat the oedema.

Answer 3

Glioblastoma multiforme

Question 4

Second most common primary brain tumour in adults

Benign, extrinsic tumours of the CNS.
Arise from the arachnoid cap cells of the meninges
Typically located next to the dura
Cause compression symptoms rather than invasion.

Typically are located at the falx cerebri, superior sagittal sinus, convexity or skull base.

Histology: Spindle cells in concentric whorls and calcified psammoma bodies

Tx: observation, radiotherapy or surgical resection.

Answer 4

meningioma

Question 5

Benign tumour arising from the eighth cranial nerve (vestibulocochlear nerve).
Often seen in the cerebellopontine angle.
Presents with hearing loss, facial nerve palsy and tinnitus.

Associated with Neurofibromatosis type 2 (presents bilaterally)

Histology: Antoni A or B patterns are seen. Verocay bodies (acellular areas surrounded by nuclear palisades)

Tx: observation, radiotherapy or surgery.

Answer 5

Vestibular schwannomas (Acoustic neuromas)

Question 6

• The most common primary brain tumour in children
• Histology: Rosenthal fibres (corkscrew eosinophilic bundle)

Answer 6

Pilocytic astrocytoma

Question 7

Aggressive paediatric brain tumour that arises within the infratentorial compartment.
It spreads through the CSF system.
Tx: surgical resection and chemotherapy.

Histology: Small, blue cells. Rosette pattern of cells with many mitotic figures

Answer 7

Medulloblastoma

Question 8

• Commonly seen in the 4th ventricle
• May cause hydrocephalus
• Histology: perivascular pseudorosettes

Answer 8

Ependymoma

Question 9

• Benign, slow-growing tumour common in the frontal lobes
• Histology: Calcifications with ‘fried-egg’ appearance

Answer 9

Oligodendroma

Question 10

• Vascular tumour of the cerebellum
• Associated with von Hippel-Lindau syndrome
• Histology: foam cells and high vascularity

Answer 10

Haemangioblastoma

Question 11

benign tumours of the pituitary gland
secretory or non-secretory
microadenomas (<1cm) or macroadenoma (>1cm).

Patients will present with the consequences of hormone excess Compression of the optic chiasm will cause a bitemporal hemianopia

Tx: Either hormonal or surgical (e.g. transphenoidal resection).

Answer 11

Pituitary adneoma

Question 12

Most common paediatric supratentorial tumour

solid/cystic tumour of the sellar region
derived from the remnants of Rathke’s pouch
Can present with hormonal disturbance, symptoms of hydrocephalus or bitemporal hemianopia.

Tx: typically surgical with or without postoperative radiotherapy

Answer 12

Craniopharyngioma