neuro- oncology Flashcards by sophia carrasco

____ is benign or malignant expanding lesion whose constituent cells multiply without restraint and form a mass

neoplasm

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what is the difference between primary anf secondary tumors

primary arise from the CNS cells and secondary metastatic from other primary sites

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what are the most common cancer type in children

brain and CNS

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t/f: most CNS tumors are metastases

true

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Pilocytic astrocytoma, choroid plexus tumors, neuronal tumora, pineal region tumors, germ cell tumors… these tumors are common in who

children

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Meningioma and Glioblastoma… these 2 tumors are common in who

adults

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men have higher incidence for what kind of tumor ? what about women

brain tumor for mena and meningeal tumor for women

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where is the localization of CNS tumors for children adn adults

children’s is 70% in posteior fossa
adults is 70% in cerebral hemisphere

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symptoms of a tumor is produced by what 3 things and how do u categorizes symptoms

-tumor
-edema surrounding tumor
- injury to normla brian tissue

categorize them into focal or generalized

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what are symptoms of a brain tumor

• Focal Neurologic Symptoms – based on location.
• Seizures
• Headaches
• Symptoms of elevated ICP

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if a pateints has a brain tumor and presents with personality changes , nonfluent aphasia (dominant) , urinary frequency and urgency, seizures and hemiparesis where do u think the tumor is

frontal

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if a patient has a brain tumor anf they presents with hemiparesis , hemisenosry loss and non fluent aphasia where is the tumor site

frontoparietal

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if. a pateint has a brain tumor and presents with hemisneosry loss , nonfluent aphasia , hemineglect (non dominant) , anosognosia (non dom) , hemiparesis , and homonymous hemianopsia where do u think the tumor is

parietal

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what are symptoms of increase ICP

• Headache – Dull
– Worse in the am
– Worse if bending over
– Seen in 50% of pts with brain tumors
• Nausea
• Papilledema (swelling of optic disc)

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what is the herniation syndrome , monro kellie doctrine

-brian enclosed in hard skull
- sum of volume of CSF , blood and brain is constant

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what is the thing that divides the intracranial comparemtns and play a key roll in hernimation syndromes

dural septa

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• Expanding lesion presses cerebral hemisphere under falx to contralateral side
• Compression of branches of ACA that run along falx can cause infarction and further swelling

what herniation is this

subfalcine (cingulate) herniation

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what is uncal herniation

hippocampus and uncus of the temporal lob herniate down

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uncal herniation symptoms are due to pressure on ___ ____ and what are they

tentorial notch ( kernohans notch phenomenon)

• Ipsilateral fixed and dilated pupil (CN III)
• Impaired consciousness
• Hemiparesis
• PCA infarcts 16

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what is tonsillar herniation

cerebellar tonsils push down foramen magnum
compress 4th ventricle and medulla

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during th etonsillar herniation the Cerebellar tonsils pushed down foramen magnum and Compress 4th ventricle and medulla which leads to what

stiff neck progressing to decerebrate posturing and coma

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what does an MRI w/o contract see for CNS tumor

little study for postieor fossa

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what does a CT w/o contrast assessment for CNS tumors

assess cranial bones, vertebral column and hemorrhage

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what imagining for a CNS tumor determines blood supply and embolize

angiography

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what are the 2 brain locations for CNS tumors

• Supratentorial (above cerebellum) • Infratentorial

what are the 3 spinal locations for CNS tumors

• intradural, intramedullary • intradural, extramedullary • extradural

Ependymoma and astrocytoma are examples of what kind of spinal cord tumors

intramedullaruy -within the SC

meningioma and neurofibroma are what kind of spinal cord tumors

extramedullary intradural - lying on surface of cord arising from roots or meninges

metastases and lymphoma are what kind of SC tumors

extradural - in epidural space , bit able to compress upon SC

____ resemble glial cells (astrocytes, oligodendrocytes, and ependymal cells)

gliomas

Meningiomas arise from ___ cells

arachnoid

Neuroblastomas, neurocytomas: derived from ____

neurons

Medulloblastomas arise from ____ cells

primitive

what grade on the historical glioma classification is a **pilocytic astrocytoma** and what is its characteristics

grade 1 and benign , slow growing

what grade on the historical glioma classification is a **glioblastoma** and what is its characteristics

grad 4 (bas bas ) and vascular proliferation and necrosis

for a **Astrocytoma**: IDH mutation & 1p/19q intact.. where is its usual locations and what does it commonly present with | grade 1

location cerebral hemisphere present with seizures and HA

what is the treatment and prognosis for **astrocytoma**

* Treatment – Surgical resection – +/- radiation – +/- chemotherapy good his prognosis

what is a favorable prognosis for a Astrocytomas

– Younger age – Seizure as only symptom – Smaller tumor size

* Incidence 3:100,000 * Higher incidence in **men** * Median age at diagnosis is 59 * Median survival 1.5years *** Presenting symptom**–focal signs,cognitive changes, increased ICP *** Risk factors:** – ionizing radiation – genetic cancer syndromes what tumor do u think

glioblastoma

what symptoms and risk factors foes a glioblastoma presents with

focal sings cognitive changes increase CP RF: ionizing radiation , genetic cancer syndrome

treatment from glioblastoma

-steroids -sx - radiation -chemo -CT/MRI monitor

if you are > ___ then u have a poor prognosis for glioblastoma

what helps the prognosis for a glioblastoma

higher level functioning

* 23% of tumors in **children** * Peak incidence age 6 * Located in **cerebellum** * Tumor can cause CN deficits or obstruct 4th ventricle -> **hydrocephalus** * Drop metastases in CNS what tumor do u think

medulloblastoma

where is medulloblastoma located in and most common in

cerebellum and kid

medulloblastoma tumor can causes ___ deficits or obtrstuc ___ ventricles leading to ____

CN ‘4th ‘hydrocephalus

treatment for medulloblastoma

-sx -mod dos rad - chemo w ct or mri

where is recurrence come in for medulloblastoma

postioer fossa ## Footnote bc remeber most location of tumors for kids is in the postieor fossa and adults is cerebral hemisphers

how is the prognosis for medulloblastoma

good ish with sx and rad but extra cranial metastases is worse

* **Most common 1° brain tumor** * Incidence increases with age * **F**>M * Arise from **arachnoid cells** *** Benign, slow** growing tumors * Calcification common what thumor do u think

meningiomas

what is the most common primary brai tumor

meningiomas

what are the primary sites for metastases to CNS

• Lung (50%) • Breast (15%) • Melanoma (10%) • GI, prostate, ovary (10%)

what is seizures treated w for metastistc disease

antipeileptic drugs usually LEVTIRACATEM (keppra) or LACOSAMIDE (vimpat)

which SC region is most likely to metastases

thoracic then lumbar then cervical

what is the primary tumor site for SC metastases

lung , breast. , prostate , kidney , thyroid ,gut

what are the symptoms for SC metastases

back pain tenderness paraparesis incontinence

what do u treat SC metastases with

high dose steroid , radiation

what is the prognosis of spinal metastatic disease

if walking then will remain walking if not walking then 1 year to survive

what is the common primary cancers from leptomeningeal metastases

– Breast – Lung – Melanoma

what are the sites for-of invovlment for leptomeningela metastases and what does it show

– Basal cisterns • Ataxia • CN deficits – Cauda equina • polyradiculopathy

* **Heterogeneous** group of disorders associated with cancer * Mechanism thought related to autoimmunity – Antibodies to receptors/proteins on cell surface – Antibodies to intracellular tagets what disorder is this

Paraneoplastic Disorders

• Polyneuropathy • Polymyositis or dermatomyositis • Cerebellar degeneration • Limbic and brainstem encephalitis • Necrotizing myelopathy • Lambert Eaton myasthenic syndrome theses are examples of what disorder

Paraneoplastic Disorders

– Neuropathy – Delirium – Dementia – Seizures – Headaches – Visual Loss – Cerebellar dysfunction’ these are complications for what treatment for tumors

chemo

– Headache – Worsening of neurologic symptoms – Radiationnecrosis • Leukoencephalopathy • Corticalatrophy – Cognitive impairment – Neuropathy – Myelopathy – Vasculopathy – Endocrinopathy these are complications fot what treatment for brain tumors

rad

neuro- oncology Flashcards

(64 cards)