Intracranial Tumours Flashcards Preview

S2.3 Neurology > Intracranial Tumours > Flashcards

Flashcards in Intracranial Tumours Deck (18)
Loading flashcards...
1
Q

What are some examples of primary intracranial tumour types?

A

Glioma - glioblastoma, astrocytoma, oligodendroglioma, ependymoma
Embryonic neural cell - medullablastoma
Arachnoidal cell - meningioma
Nerve sheath cell - schwannoma, neurofibroma
Pituitary gland - adenoma
Lymphoid cell - lymphoma
Capillary vessels - haemangioblastoma

2
Q

What are common origins of CNS metastases?

A
Breast
Lung
Kidney
Colon
Melanoma
3
Q

Which are the four most notable CNS tumours?

A

Glioma
Meningioma
Schwannoma
Adenoma

4
Q

How does the location of CNS tumours vary in children vs adults?

A

Mostly above tentorium in adults

Mostly below tentorium in children

5
Q

What are signs/symptoms of intracranial tumours?

A

As in raised ICP
Focal neurological deficit
Epileptic fits, focal/generalised and only if above tentorium
CSF obstruction

6
Q

What are some examples of focal neurological deficits?

A
Hemiparesis
Dysphasia
Hemianopia
Cognitive impairment (memory, sense of direction)
Cranial nerve palsy
Endocrine disorders
7
Q

What investigations might be done in suspected intracranial mass?

A

CT
MRI
PET
Angiography

If suspected metastases

  • CT chest/abdo/pelvis
  • mammography
  • biopsy skin lesions/lymph nodes

NEVER perform LP in suspected mass

8
Q

What are the goals in intracranial tumour management?

A
Accurate diagnosis
Improve QoL
- decreasing mass effect
- improve neurological deficit
Aid effect of adjuvant therapy
Prolong life expectancy
9
Q

What are various types of treatment in intracranial tumours?

A
Surgery
Radiotherapy
Chemotherapy
Endocrine replacementCorticosteroids - dexamethasone
Treat epilepsy - anticonvulsants
Analgaesics/anti-emetics
Counselling
10
Q

What are the treatments for glioblastoma multiforme?

A

Steroids/anticonvulsants
Radiotherapy
Chemotherapy (temazolamide)
Complete surgical excision impossible - biopsy or debulk

11
Q

What is the management in metastatic-origin CNS tumours?

A

Confirm diagnosis
11% with abnormal imaging and cancer history DO NOT have mets
Steroids/anticonvulsants
Radiotherapy (whole brain or stereotactic)
Surgery

12
Q

Features of gliomas?

A

Resemble cells of glial differentiation
Diffuse edges - not encapsulated
Malignant but don’t metastasise outside CNS

Low grade astrocytoma - bland cells on microscopy - similar to normal astrocytes, slow growth

Glioblastoma - cellular, atypical, with necrosis under microscope, grow quickly - often present as large tumours, spread through white matter and CSF

13
Q

Features of medullablastoma?

A

Tumour of primitive neuroectoderm (primitive neural cells)
Sheets of small undifferentiated cells
Children especially
Posterior fossa, especially brainstem

14
Q

Features of meningioma?

A

From arachnocytes
Benign but can be locally aggressive and can invade the skull
Slow growing
Often resectable
On miscroscopy, bland cells forming small groups, sometimes with calcification (psammoma)
Small groups of cells whorl around each other, resembling arachnoid granulation

15
Q

Features of nerve sheath tumours?

A

Around peripheral nerves - intracranial and extracranial

e. g. Schwannoma on CNVIII
- acoustic neuroma at angle between pons and cerebellum
- unilateral deafness
- benign lesion but removal technically difficult

16
Q

Pituitary adenoma features?

A

Benign tumour (99%) of pituitary in pituitary fossa
Often secrete pituitary hormone
Grow superiorly and impinge on optic chiasm - visual symptoms

17
Q

Features of CNS lymphoma?

A

High grade neoplasm
Usually diffuse large B-cell lymphoma
Often deep and central site in brain - difficult to biopsy
Difficult to treat as drugs do not cross BBB
Generally do not spread outside CNS

18
Q

Features of haemangioblastoma?

A

Tumour of blood vessels
Space occupying
May bleed
Most often in cerebellum