Tumours

Question 1

What are the general presenting complaints of someone with a brain tumour?

Answer 1

Progressive neurological deficit
Motor weakness
Headache
Seizures

Question 2

Describe the headache related to a brain tumour

Answer 2

Worse in the morning or upon coughing

Linked with vomiting

Question 3

Which cells are the most common cause of brain tumours?

Answer 3

Neurepithelial

Question 4

How are astrocytic tumours graded?

Answer 4

I - Benign
II - Astrocytomall
III - Malignant
IV - V. Malignant

Question 5

Describe a Grade I Astrocytic tumour.

Answer 5

Truly benign slow going

Well encapsulated

Question 6

How can a Grade I Astrocytic tumour present?

Answer 6

Hydrocephalus
Tip Toe gate
Slow mental development

Question 7

What is the most common Astrocytic tumour in children?

Answer 7

Pilocytic Astrocytoma - generally arising in the cerebellum.

Question 8

Describe how a Pilocytic Astrocytoma may appear in radiology.

Answer 8

Well Circumscribed
Contrast enhancing
Often cystic mass

Question 9

For Grade I Astrocytic tumours what is the treatment of choice?

Answer 9

Surgery is usually curative

Question 10

What is the general presentation of someone with as Grade II Astrocytic Tumour?

Answer 10

Focal deficit
Raised ICP
Altered Consciousness
Short duration of symptoms

Question 11

Give an example of a Grade II Astrocytic Tumour?

Answer 11

Astrocytoma

Question 12

Describe an Atrocytoma.

Answer 12

Poorly defined Invasive
Appears histologically little different from normal.
No contrast enhancement

Question 13

What is the prognosis for someone with an astrocytoma?

Answer 13

Generally poor in the longterm as will continue to grow even with surgical resection.

Question 14

What is the treatment for Grade II Astrocytic tumours?

Answer 14

Surgery + Chemotherapy + Radiotherapy

Not curative the tumour will grow back slowly requires monitoring

Question 15

What differentiates a Grade III from a Grade II Astrocytic tumour.

Answer 15

More invasive faster growing increased mitosis

Contrast enhancing on MRI

Question 16

Give an example of a Grade III Astrocytic Tumour.

Answer 16

Anaplastic Astrocytoma

Question 17

Describe an Anaplastic Astrocytoma

Answer 17

Poorly defined low density mass presenting with some contrast enhancement on MRI

Question 18

Prognosis for an Anaplastic Astrocytoma

Answer 18

Median is 2 years

Question 19

Treatment for Grade III Astrocytic Tumours.

Answer 19

Surgery + Chemotherapy + Radiotherapy

Question 20

What is the most common Grade IV Astrocytic tumour?

Answer 20

Glioblastoma Multiforme

Question 21

Describe a glioblastoma multiforme.

Answer 21

Very aggressive poorly differentiated tumour with evidence of new vessel growth brain tissue destruction and necrosis.

Question 22

How do glioblastoma multiforme commonly appear on MRI?

Answer 22

Contrast enhancing - ring pattern is present

Surrounded by darker area of oedema

Question 23

If multiple Glioblastoma multiforme are present what could be behind this?

Answer 23

Neurofibromatosis

Tuberose sclerosis

Question 24

What is the prognosis for Glioblastoma Multiforme?

Answer 24

Very poor months at most

Question 25

What is the treatment for Glioblastoma Multiforme?

Answer 25

Treatment is to improve quality of survival Reducing the mass effect Surgery Chemotherapy Radiotherapy

Question 26

What is the medial survival of someone with a Oligodendroglial tumour?

Answer 26

10 years

Question 27

If someone presents with a diffusely invasive tumour calcified cysts Microvascular growth and haemorrhage in the frontal lobes what is it likely to be?

Answer 27

Oligodendroglial tumour.

Question 28

How does a oligodendroglial tumour present on imaging?

Answer 28

A well demarcated hypodense or isodense lesion | Possible calcification and cystic appearance

Question 29

What is the treatment for an oligondedroglial tumour?

Answer 29

Chemotherapy | Surgery

Question 30

What are the presenting symptoms of someone with a meningioma?

Answer 30

Headache | Cranial Nevre Neuropathies

Question 31

Wha grade are most meningiomas?

Answer 31

Generally Benign Grade I

Question 32

List some aggressive grade III meningiomas.

Answer 32

Chordoid Rhabdoid Papillary

Question 33

If a tumour presents with hearing loss tinnitus and balance issues what could it be?

Answer 33

Acoustic neuroma

Question 34

List some other tumours affecting the CNS and the brain.

Answer 34

Schwannomas Neurofibromas Malignant peripheral sheath tumour.

Question 35

Secondary tumours are far more common than primary within the brain.

Answer 35

True

Question 36

Where are the most common sites of origin for malignant secondary tumours?

Answer 36

``` Breast Bronchus Kidney Thyroid Colon Melanomas ```

Question 37

Generally how are primary tumours graded?

Answer 37

Neovascularision Necrosis and Mitosis

Question 38

Why are benign non invasive tumours still worrying?

Answer 38

As they can still kill via mass effect and oedema swell as the increased risk of haemorrhage.

Question 39

What is the most common benign tumour in children?

Answer 39

Craniopharyngioma

Question 40

What is the most common malignant tumour in children?

Answer 40

Medulloblastoma

Question 41

Where do medulloblastomas usually present?

Answer 41

Often in the midline

Question 42

If it occurs in the midline what can be a common presentation of a medulloblastoma?

Answer 42

Hydrocephalus as disrupts CSF flow

Question 43

Upon observation what does a medulloblastoma appear like?

Answer 43

Poorly differentiated

Question 44

What is the treatment for a medullablastoma?

Answer 44

Very radiosensitive so surgery + radiotherapy