Neuro oncology Flashcards
choroid plexus papilloma
enhancing in ventricle if kids, in 3rd or 4th ventricle in adults
-looks like normal choroid plexus on path
papilloma = grade 1
carcinoma. grade iii - Li-Fraumeni syndrome
-hydrocephalus Sx
colloid cyst
hyperdense on CT (protinaeous fluid)
-roof of 3rd ventricle
-ASx usually or transient LOC (obstructive hydrocephalus)
subependymal giant cell astrocytoma
tuberous sclerosis
central neurocytoma
off of broad attachment to septum pellucidum
SC tumors- extramedullary, intradural and extradural
intradural/outside SC: meningioma, nerve sheath tumors
Extradural: metastases
SC tumors -intramedullary
ependymoma - ovale/sausage shaped mass
astrocytoma - pilocytic astrocytoma, anaplastic astrocytoma, glioblastoma, H327K midline glioma
lymphoma
hemangioblastoma (multiple (think WHL)
-enhancing cystic massesblood vessels on path
Pineal tumors
1st -serum tumor markers - AFP, bhCP
-usually needs biopsy
Germ cell - germinoma - engulfed calcifications
-no surgery unless mature teratoma, use radiation
pineal cell tumors - peripheral calcifications (blast calcifications out of the way)
-pineocytoma/pineoblastoma (blastoma = grade IV tumors in kids)
grade 1 glioma
-pilocytic astrocytoma most common
-can enhance or having enhancing mural nodule, cyst; well circumscribed
-cerebellum
diffuse gliomas
Astrocytoma
-IDH mutant
Oligodendroglioma
-IDH mutation
-IDH/1p19q co-deletion best
-mass effect, variable enhancement
Tx: surgery then temozolomide/PCV and radiation therapy
glioblastoma
grade iv
heterogenous enhancing (vs lymphoma)
central necrosis, enhancing mass
-surgery, chemo (temozolamide), RT
diffuse midline glioma
grade iv
H3K27M mutant
CNS lymphoma
can be multifocal
homogenously enhancing
high dose methodexate induction then consolidation /
