ch 8 neuro-oncology Flashcards Preview

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Flashcards in ch 8 neuro-oncology Deck (64)
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1

Patient presents with spontaneous rapid, irregular, and high-amplitude conjugate eye movements that occur in any direction, as well as diffuse myoclonic jerks, and ataxia. What is the syndrome?

opsoclonus myoclonus syndrome

2

opsoclonous myoclonus syndrome presents in adults with what types of cancer (3)?

breast, ovarian, and small cell lung cancer

3

opsoclonus myoclonus syndrome presents in children with what type of cancer (1)?

neuroblastoma

4

In adults with opsoclonus myoclonus syndrome, what antibody can be seen (especially in association with breast cancer?

anti-Ri (also known as ANNA-2) antibodies

5

txt for children with neuroblastoma and opsoclonus myoclonus syndrome?

ACTH; may have resolution of neurologic manifestations when neuroblatoma is resected

6

In opsoclonus myoclonus syndrome, who has worse prognosis: adults or children?

adults

7

Diffuse astrocytomas can be classified according to the histopathologic cell type into the following: (8)?

fibrillary, gemistocytic, protoplasmic, small cell, giant cell, epithelioid and granular cell, glioblastoma with oligodendroglioma component

8

What are fibrillary astrocytomas?

prototypical and more common, with elongated hyperchromati nuclei, scant cytoplasm, and presence of a fibrillary background

9

What are gemistocytic astrocytomas?

rounded cells with prominent eosinophilic cytoplasm

10

What are protoplasmic astrocytomas?

cells with oval-shaped nuclei and wispy cobweb-like processes

11

Clinical manifestations of leptomeningeal disease? (7)

headache, backache, polyradiculopathies, multiple cranial neuropathies, AMS, features of increased IP and hydrocephalus

12

How to diagnose leptomeningeal carcinomatosis?

MRI shows leptomeningeal enhancement. CSF cytology and flow cytometry (not sensitive, and sometimes biopsy is required)

13

Treatment and prognosis of leptomeningeal carcinomatosis?

whole-brain radiation plus intraventricular (or intrathecal) chemotherapy; prognosis is poor with survivals of < 6 months

14

Most common primary brain tumor?

Glioma

15

What is a well established risk factor known to be associated with the development of gliomas?

radiation exposure

16

Describe characteristic MRI findings of a astrocytoma WHO grade 4 (aka glioblastoma)? (4)

neoplasm that crosses corpus callosum, with prominent gad enhancement, hypointense areas that correlate with necrosis, edema on FLAIR

17

where do ependymomas localize to?

most commonly infratentorial, typically in the 4th ventricle. Can also occur supratentorial in the periventricular region Can also occur in the spinal cord, more commonly in adults

18

Where do oligodendrogliomas localize to?

hemispheric masses usually arising superficially and with cortical involvement

19

Histopathologic features of glioblastoma (astrocytoma WHO grade 4)? (5)

perinecrotic pseudopalisading, nuclear atypia, mitoses,endothelial hyperplasia, and necrosis

20

Histopathologic feature of oligodendrogliomas?

fried egg

21

Histopathologic feature of ependymomas?

perivascular pseudorosettes

22

Histopathologic feature of medulloblastoma?

Homer-Wright rosettes

23

Treatment and prognosis for glioblastoma?

median survival is about 15 months with radiotherapy plus temozolomide

24

What tumor does not commonly present with seizures?

ependymoma

25

anti-Yo antibodies are associated with what cancer?

ovarian cancer (and in a smaller percentage of patients with breast cancer)

26

anti-Hu antibodies are associated with what cancer?

small cell carcinoma of the lung

27

Anti-Tr antibody is associate with what cancer?

lymphomas (and seen more commonly in young men)

28

What is the treatment of glioblastoma?

surgical resection, radiation therapy and chemotherapy with temozolomide

29

txt of recurrent glioblastomas? How does it work?

Bevacizumab; mab that binds to VEGF --> decreases edema and need for steroids

30

What genetic mutation is seen in low grade gliomas and associated with better prognosis?

IDH1 (isocitrate dehydrogenase)