Brain Tumours

Question 1

Give examples of grade I astrocytic tumours

Answer 1

Pilocytic astrocytoma
Pleomorphic xanthoastrocytoma
Subependymal giant cell

Question 2

Give example of grade II astrocytic tumours

Answer 2

Low grade astrocytoma

Question 3

Give example of grade III astrocytic tumours

Answer 3

Anaplastic astrocytoma

Question 4

Give example of grade IV astrocytic tumours

Answer 4

Glioblastoma multiforme

Question 5

Appearance of pilocytic astrocytoma on contrast scan

Answer 5

Strong enhancement

Question 6

Low grade astrocytoma common locations.

Answer 6

Temporal lobe
Posterior frontal
Anterior parietal

Question 7

Common presentation of low grade astrocytoma

Answer 7

Seizures

Question 8

What is a poor prognostic sign on scan for low grade astrocytoma?

Answer 8

Contrast enhancement

Question 9

Will low grade astrocytomas remain benign of dedifferentiate to high grade malignancy?

Answer 9

Dedifferentiate

Question 10

Grade II (low grade) astrocytoma management

Answer 10

Surgery with maybe radio and/or chemo depending on molecular profile.

Question 11

Do anaplastic astrocytomas (grade 3) take up contrast?

Answer 11

No

Question 12

What is the most common primary brain tumour?

Answer 12

Glioblastoma multiforme

Question 13

Management of anaplastic astrocytoma and glioblastoma multiforme

Answer 13

Surgery and post operative EBRT and chemo (temozolomide, PCV, carmustine wafers)

Question 14

Where do oligodendogliomas present and where do they commonly affect?

Answer 14

Seizures

Frontal lobe

Question 15

Management of oligodendrocytomas

Answer 15

Surgery, chemo (PCV) and radiotherapy.

Question 16

What other conditions are associated with meningiomas?

Answer 16

Breast cancer

Neurofibromatosis type II

Question 17

What are the meningiomas that are most likely to recurr?

Answer 17

Clear cell 
Chordoid
Rhabdoid
Papillary
Radiation induced meningiomas (particularly childhood leukaemia)

Question 18

Describe CT findings of meningioma.

Answer 18

Homogenous
Densely enhacing
Hyperostosis (skull blistering)

Question 19

Describe MRI assessment of meningioma

Answer 19

Dural tail

Patency of dural sinuses

Question 20

What can interventional radiology do before operation on a meningioma?

Answer 20

Embolisation of external carotid artery feeders

Question 21

Management of meningiomas

Answer 21

Expectant
Preoperative embolisation
Surgery
Radiotherapy

Question 22

Name the grading for the extent of resection of tumour

Answer 22

Simpson’s grading

Question 23

What age group to germ cell tumours affect?

Answer 23

Under 20s

10-12

Question 24

What is the most common CNS germ cell tumour and how is it treated?

Answer 24

Germinoma

Radiotherapy

Question 25

What tumour markers are you looking for in midline brain tumour of children?

Answer 25

AFP HCG LDH (serum and csf)

Question 26

What is the management of medulloblastoma?

Answer 26

Radiotherapy (75% 5 year survival)