NeuroOnc Flashcards
(108 cards)
0
Q
primary brain tumor
A
tumor that develops from normal tissues of the brain
1
Q
Metastasis
A
spreading of malignant tumor to a remote part of body
2
Q
meningioma
A
usually benign; tumor that develops from covering of the brain
3
Q
glioma
A
tumor that develops from glial cells
4
Q
astrocytoma
A
glial tumor that develops from astrocytes
5
Q
anaplastic astrocytoma
A
high grade glial tumor that develops from astrocytes
6
Q
glioblastoma multiforme
A
maligant glial tumor that develops from astrocytes
7
Q
medulloblastoma
A
tumor that develops from primative neuroectodermal cells (usualyl in children)
8
Q
ependymoma
A
glial tumor that develops from ependymal cells
9
Q
drop metastasis
A
metastasis, usually from glioblastomas or ependymomas that occurs through cerebrospinal system
–typically occurs around lumbar nerve roots or lower spinal cord
10
Q
sensory level
A
line on the trunk below which sensation is lost
11
Q
myelopathy
A
damage to the spinal cord
12
Q
radiculopathy
A
damage to nerve root
13
Q
non-metastatic complications
A
those of cancer that dont result from direct invlvement of tumor
14
Q
paraneoplastic syndrome
A
syndrome usually from development of an autoimmune reaction, where there is damage to neural structures
15
Q
intracranial tumors/neoplasm classified by
A
cell of origin
16
Q
where do childhood tumors go?
A
posterior cranial fossa
spinal cord
17
Q
where do adult tumors commonly found
A
adults
18
Q
lung cancer and CNS mets
A
found in about 1/4th
19
Q
most common primary intracranial tumors
A
gliomas
20
Q
most aggressive tumor
A
atrocytoma (glioblastoma multiforme
21
Q
slow growing tumors- little dysfunction until very late in course
A
meningiomas
neurilemmomas
22
Q
rapidly enlaring neoplasm
A
metastatic tumors/glioblastomas
progressive loss of fx over short time interval
23
Q
edema mostly around
A
metastatic tumors
24
edema leads to
rapid apperance signs and symptoms
25
glioblastoma dysfunction
appears rapidly, but the tumor looks like it should cause more damage because the tumor infiltrates nerve tissue and leaves many neurons functional
26
surgical removal of glioblastoma
may increase patients neurological impairment, but it is usally necessary
27
intracranial space
closed chamber with ONE outlet (foramen magnum) and stiff dural membranes (falx verebri and tentorium) that divides into compartments
28
As herniation progresses
rostral-caudal deterioriation of neural functions
29
papilledema
swelling of optic nerve-->increased intracranial pressure
swelling of optic nerve head (associated with loss of retinal venous pulsations and nelargement of blind spot on visual field testing)
30
non-localizing manifestations of tumors are usually due to
expanding supratentorial masses
31
what are the non-localizing manifestations?
unilateral/bilateral sixth nerve palsies via rostral-cudal displacement of brainstem
third nerve dysfunction from compression of herniating temporal lobe (where the nerve passes forward at the edge of the tenortium)
compression of contralateral cerebral peduncle -->ipsuilateral to mass hemiparesis
posterior cerebral artery compression
hydrocephalus-occlusion of fourth ventricle
32
where are large meningiomas often found?
inferior to frontal lobe in olfactory groove
33
if meningiomas are producing symptoms, most are
surgically resectable
34
gliomas come from
supportive cells of NS- oligodendrogia, astroglia, ependyma cells
35
astrocytoma vs oligodendroglioma
astrocytoma more common
36
astrocytomas and removal
difficult to removal completely
37
most malignant and more common glioma
glioblastoma multiforme
38
what is special about glioblastoma multiforme
this tumor can met-- usually by spreading through CSF
39
aggressiveness of oligodendroglioma
somewhat less aggressive than the other two
40
what do oligodendrogliomas present with
seizures rather than mass effect
| can calcify!
41
prognosis of oligodendrocytes
better with chemo and radiation--but not completely curable
42
neurolemoma
dervied from coverings of nerves
43
most common neurolemoma
acoustic neuroma from vestibular nerve (but impinges on acoustic nerve, so gradual hearing loss)
MAY affect facial nerve-->facial weakness
44
why does acoustic neuroma cause vertigo?
slow growth so compensation
45
surgery on neurolemoma?
yes, usually resectable, but if large could still have deficit
46
ependymoma
derive from lining tissue of the ventricles and the central canal of spinal cord
47
who do we tend to see epndymoma in
younger individuals
48
treatment of ependyomoma
many are completely resectable, but most require adjuvant therapy
49
mets in ependymoma
can exceed the ventricular system and even subarachnoid space and so-called drop metastes are possible
50
deficits are from what in ependymoma
pressur eand local invasion
| or frm treatment
51
primitive neuroectodermal tumors
midline tumors- posterior fossa (cerebellum, 4th ventricle area of tectum)--small blue tumors
52
who are PNTs mostly seen in
children and young adults
53
prognosis in PNTs
sensitive to chemo and radiation, but not completley curable in most cases--can spread to other areas of brain and spinal cord through spinal fluid
54
particular types of priminitive neuroectoermal tumors
pineal tumors
| medulloblastomas
55
common cancers that met to brain and spine
```
lung cancer
breast cancer
colon cancer
ovarian
melanoma
```
56
less common
renal cancer
57
rare places to get mets from
prostate
58
radiation for mets is
usually only palliative
59
lymphoma
form of cancer that can either develop in brain (primary) or spread to brain
- -primary CNS lymphoma from patients with severe immunosuppression
- -secondary spready of lymphoma to NS-involvement of nerve roots and meninges (carcinomatous meningitis)
60
spinal tumors
most are metastatic, but some primary as well
61
what do spinal tumors often result in?
expanding extradural masses-->can compress cord or nerve roots
62
intradural, but extramedullary tumors
neurofibromas
meningiomas
schwanomas
63
intramedullary spinal cord tumors
gliomas
| ependymomas
64
intramedullary tumors can
met in spinal gluid and result in extraaxial mass
65
treatment for spinal tumors
steroids, surgery/radiation
66
cerebellar tumors commonly found
children
67
most common cerebellar tumor
cerebellar astrocytoma
68
cerebellar astrocytoma prognosis
often surgically curable
69
if cerebellar astrocytoma develops in pons
not curable because the surgical procedures can produce intolerable deficits
70
medulloblastoma
severe and devastating form of cancer that develops in cerebellar region of children
--may occasionally respond to chemotherapy and radiation, but typically progresses fast and is fATAL
71
pituitary tumors
neoplasms involving pit gland, hypothalamus, or both
72
if pituitary tumor encroaches on____ you get ___
neighboring optic chiasm
| visual field deficits (bitemporal hemianopia)
73
cranipharyngioma
benign cystic tumor that derives from remnants of rathke's pouch that encroaches on optic chiasm
74
anterior pit tumors
positive humoral effects via increased secretion of pituitary hormones
- -eosinophilic adenomas
- -basophilic adenomas
75
eosinophilic adenomas
secrete growth hormone
76
basophilic adenomas
cushing's hyperadrenal syndrome
77
routine procedure for all people suspected of having intracranial tumor
CT or MRI
78
MRI is more
sensitive! intracranial lesions that are the same radiographic density as brain can be missed with un enhanced CT scans
79
intravascular contrast helps
because many tumors have blood vessels that do not have normal BBB; excluded from normal brain, but often enhances apperance of tumor
80
MRI helps to
evaluation chemical constituents of mass; distinguish tumor frm other enhancing masses (abscesses)
81
PET
metabolic activity
82
CSF should be
negative
83
if test shows increased iCP
no LP because can cause rostralcaudal deterioration
84
LP only in prelim exam when
```
CNS infection (maningitis) is suspected
pt has severe acute heache or other symptom or a history that suggests subarachnoid hemorrhage in teh absence of positve CT becaus eCT can miss small sub arac
```
85
major finding
elevation of CSFs
86
adults tend to get tumors
supratentorial
87
children tend to get tumors
infratentorial
88
cortical signs
aphasia, hemiparesis, homonymous, hemianopsia, sensory loss
89
dysinhition is a
frontal lobe sihn
90
incoordination is a
cerebellar sign
91
unilateral loss of pin and temperature sense on face
lateral brainstem
92
loss of upward gaze
dorsal brainstem
| pineal region
93
bilateral hemianopsia
pituitary region tumor
94
paraplegia/sphnciter dysfunction
spinal cord
95
cushing response
increase BP with decrease pulse
96
symptoms and signs of increase ICP
awakened from sleep by headache
papilledema or loss of venous pulsations in fundus of eye
cushing response
97
transtentorial sign of herniation
dilating pupil (usually ipsilateral)
oculomotor palsy-III nerve (usually ipsilateral)
hemipareis (usually contralateral)
98
failure of upward gaze/parinaud's syndrome
pineal/tectal region
99
edema responds to
steroids
100
glioblastoma multiforme is a grade 4 (worst)
astrocytoma
101
childhood tumors and prognosis
cerebellar astrocytoma- good prognosis
pontine glioma- bad prognosis
medulloblastoma- bad prognosis
102
most tumors of the spine are
metastatic
103
good for spine tumors
steroids, radiation
| major surgery
104
rare tumors inside spinal cord
ependymoma
| glioma
105
bbb limits
type of chemo
106
other approaches to treatment
black angiogenesis
small targeted molecules
immune targeting
107
paraneoplastic
remote effect of cancer, probably autioimmune
| clinical manigestations vary according to nervous system structure affected
