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Clin Med - NEURO > Neoplasms > Flashcards

Neoplasms Flashcards

1
Q

what is a tumor

A

abnormal mass of tissue resulting from a DNA mutation
OR
cells not dying when its the usual time (failure of apoptosis)

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2
Q

what are the types of cancers

A

Carcinoma
Sarcoma
Blastoma

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3
Q

what are carcinomas

A

arise from epithelial cells, most common type of cancer, 80-90% of cancers

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4
Q

what are examples of carcinomas

A

adenocarcinoma
squamous cell carcinoma
basal cell carcinoma

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5
Q

what is a sarcoma

A

arise from connective tissue cells, including bone cartilage, fat, tendon, muscle

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6
Q

what are examples of sarcomas

A

osteosarcoma
myosarcoma
chondrosarcoma
liposarcoma

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7
Q

what is a blastoma

A

arise from immature cells of the cell line, “-blast”

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8
Q

what are examples of blastoma

A

glioblastoma
hepatoblastoma
retinoblastoma

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9
Q

what are benign/noncancerous lesion

A

generally less harmful
do not locally invade other tissues or parts of the body
do not spread via blood or lymph
can grow very large
cells are well differentiated

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10
Q

what is malignant/cancerous lesions

A

capacity to spread and form new tumors in other tissues or organs
can locally invade surrounding tissue
can spread via blood or lymph
grow quickly
cells are poorly differentiated

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11
Q

what is angiogenesis

A

growth of new blood vessels to feed tumor

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12
Q

what are the primary brain tumors

A

glioblastoma
astrocytoma
oligodendroglioma
ependymoma
meningioma
schwannoma
pituitary tumor

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13
Q

what is the most common primary malignant brain tumor in adults

A

glioblastomas

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14
Q

what is the most common benign brain tumor in adults

A

meningioma

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15
Q

what is the most common neoplasm in kids

A

primary neoplasms which originate in the CNS

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16
Q

what is the most common neoplasm in adults

A

metastatic or secondary neoplasms

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17
Q

what is our brain primarily made up of

A

Glial cell and Neurons

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18
Q

what falls under WHO low grade

A

Grade 1 and 2

less aggressive

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19
Q

what falls under WHO high grade

A

Grade 3 and 4

more aggressive

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20
Q

what are WHO grade 1 tumors

A

low grade
non-infiltrative
least malignant (benign)
possibly curable via surgery alone
long-term survival
slow growing

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21
Q

what are WHO grade 2 tumors

A

low grade
relatively slow growing
somewhat infiltrative
may recur as higher grade

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22
Q

what are WHO grade 3 tumors

A

high grade
malignant
infiltrative
tend to recur as higher grade

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23
Q

what are WHO grade 4 tumors

A

most malignant
rapid growth, aggressive
widely infiltrative
rapid recurrence
Necrosis prone

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24
Q

what grade tumor is a meningioma

A

WHO grade 4

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25
what is important about the signs and symptoms of neoplasms
duration and intensity and progression
26
what are important imaging for neoplasms
CT is quick and dirty MRI is gold standard (shows edema) if tumor enhances with contrast on CT, that means chemo can also get through BBB
27
what is the gold standard for diagnosing a neoplasm
MRI - shows edema and lesions
28
what are treatment options dependent on for CNS neuroplasms
dependent on patients wishes, age, and type of tumor
29
what are the common symptoms of neoplasms
headaches N/V seizures (focal or localized depending on location) cranial nerve palsies neurocognitive disturbances psychiatric symptoms
30
what are the mechanisms that cause symptoms of neoplasms
compression and destruction of health brain tissue production of hormones tumor growth
31
if a patient presents with CN deficits, incorrdination/imbalance, ataxia, hydrocephalus and possible coma - what location is most likely for a tumor
Cerebellum
32
if a patient presents with sensory loss, motor incoordination, agniosia, visuospatial processing, apraxia, visual field cut - what location is most likely for a tumor
Parietal lobe
33
what are the common symptoms for a frontal lobe tumor
hemiparesis dysphasia abulia altered personality
34
what are the common symptoms with an occipital lobe tumor
visual field cut
35
if a patient presents with auditory/olfactory hallucinations, seizures, memory impairment, dysphasia and visual field cut - where is the most likely location for a tumor
temporal lobe
36
how are CNS neoplasms managed
control cerebral edema with steroid (dexamethasone) ASM (only if applicable) CSF shunt for hydrocephalus surgery, radiation, chemo, embolize and shrink tumor pre-operatively or if not surgical candidate
37
what are the risk factors with treatment of CNS neoplasms
inoizing radiation exposure (radiation therapy for prior malignancy, diagnostic imaging, ? cellhpone) immune compromise genetic syndromes
38
what population is more likely to develop a meningioma
women > men
39
what genetic syndromes increase your risk of neoplasm
NF1 and 2, Tuberous sclerosis, Turcot syndrome, Van-Hippel-Lindau
40
what is supratentorial
cerebral cortex
41
what is infratentorial
cerebellum, brain stem, pituitary
42
what are gliomas
glial cell tumors - 1/3 of all brain tumors
43
what are the different types of gliomas
astrocytomas brain stem gliomas ependymomas oligodendrogliomas
44
what is an ependymomas
rare, more common in kids. from ependymal cells lining ventricles and spinal cord. associated with hydrocephalus when they block the flow of CSF. associated with drop metastases
45
what type of tumor is associated with drop metastases
ependymomas
46
what is the presentation of oligodendrogliomas
better prognosis than other gliomas, commonly in men, commonly present with seizures (50-80%)
47
what are the common symptoms of gliomas
mainly from mass effect and compression of brain tissue or spinal cord - Headaches, seizures, personality changes, weakness, numbness, problems with speech, N/V, vision loss, dizziness
48
what is glioblastoma multiforme
supratentorial and is the most common form of glioma, can cross corpus collosum into other hemisphere (butterfly) WHO IV diffusely infiltrating astrocytoma (can occur anywhere in CNS but mostly cerebral) median age of diagnosis is 65 (age is biggest risk factor) INCURABLE median survival 15 months with maximal therapy
49
what are the treatment options for glioblastomas
Incurable surgery, chemotherapy, radiation therapies greater the extent of resection, the greater the survival benefit surgical techniques are progressing but still have very poor prognosis
50
where are meningiomas located
supratentorial
51
what are meningiomas
graded 1-3, usually slow growing and 85-90% are benign - often discovered incidentally
52
what population are meningiomas associated with
F>M (3:1), most frequently occur in people in 70s-80s
53
what are the risks of meningiomas
radiation therapy, prolonged use of certain hormones, neurofibromatosis type 2
54
what do meningiomas arise from
arachnoid mater of meninges, often occur on surface of brain under dura mater, attachment to dura via a dural "base" or "tail" right beneath skull, so irritated adjacent bone may proliferate - hyperostosis
55
what is hyperostosis
irritated adjacent bone may proliferate
56
how are meningiomas treated
for benign and slow growing - observation and regular imaging surgery and radiation for more aggressive tumors or ones that are causing symptoms
57
what is another name for schwannomas
acoustic neuroma
58
what are schwann cells
types of glial cell (myelin insulates axon) - electrical impulse/action potential propagation
59
where are schwannomas usually found
around peripheral nerves, usually benign and dont invade or metastasize usually around CN8 - vestibulocochlear
60
what is the growth pattern for Schwannomas
grow very slowly, but can compress nerves, obstruct arteries, veins or flow of CSF
61
what are typical symptoms of Schwannomas
relate mainly to nerve compression and depend on location acoustic neuroma -unilateral hearing loss, tinnitus, balance, facial weakness/paralysis if compressing facial nerve pain can also be a symptom
62
how are schwannomas diagnosed
CT or MRI - also checking auditory brainstem response test (measuring evoked action potential from sound)
63
what is the treatment for Schwannomas
surgery
64
what is a pituitary adenoma
formed by the hormone secreting cells of the anterior pituitary typically benign, do not invade neighboring tissues but can compress.
65
what are pituitary adenomas very close to
optic chiasm - can cause bitemporal hemianopsia (blindness in outer halves of both R&L visual fields)
66
how are Pituitary adenomas differentiated
by size Microadenoma < 1cm Macroadenoma > 1cm
67
what is the most common hormone associated with pituitary adenomas
Prolactinoma - functional adenoma
68
what is associated with growth hormone secreting adenomas
gigantism (kids) acromegaly (adults)
69
what is associated with adrenocorticotropic hormone secreting tumor
excess cortisol - cushing disease
70
what is seen with cushings syndrome caused by tumor
moon facies, buffalo hump, truncal obestiy
71
what is a gonadotroph derived adenomas
most frequent non-functional tumors, clinically silent
72
how are pituitary adenomas diagnosed
MRI
73
how are pituitary adenomas treatede
depends on type and size some managed medically others surgically transsphenoidal resection in nonfunctional, only treated if compressing
74
what are the primary 3 brain metastases from
lung cancer breast cancer melanoma
75
what are differential diagnosis of brain metastases
infection abscess demyelinating disease such as MS Primary brain tumor
76
what is the prognosis factors for brain metastases
patient age number and size of metastases site of primary tumor any other sites of metastases sensitivity of the tumor to radiation or chemotherapy presence of mass effect
77
what are potential complications of brain mets
mass effect brain herniation seizures hydrocephalus invasion of surrounding tissues neurological deficit death
78
what are the treatments for brain metastases
surgical resection radiation (whole brain vs stereotactic) chemotherapy immunotherapy

Clin Med - NEURO (13 decks)

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