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26 Cards in this Set
- Front
- Back
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Glioma: a type (category) of tumor
These are ... tumors The most common primary intracranial tumor, comprising 60% of all primary CNS neoplasms -Astrocytoma -Anaplastic astrocytoma -... (the worst!!) -Oligodendroglioma |
infiltrative
Glioblastoma |
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Glioma grading system:
The higher the grade, the ... the tumor Grade I : ... (low-grade) Grade II : ... Grade III : ... |
worse
astrocytoma anaplastic astrocytoma glioblastoma multiforme |
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What is the difference between anaplastic astrocytoma (grade II) and Glioblastoma multiforme (grade III)?
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glioblastoma multiforme exhibits necrosis
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Astrocytoma: (grade I)
Clinical characteristics -Tend to occur in young children and adults -The best prognostic indicator is ... -Poorer prognosis with increased intracranial pressure, alteration in consciousness, personality change, severe neurological deficits (weak on one side of the body) |
young age
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Astrocytoma:
Treatment -Surgical excision is a reasonable initial approach (and watch patient) -In older patients (40s and 50s) high dose radiation may also be used -Follow-up imaging studies every ...-... months (slow growing tumors) -No definite role for ... at this time -Overall, prognosis is ... -However, these tumors can progress to higher grade neoplasms over time |
6-12
chemotherapy favorable |
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Anaplastic Astrocytoma: (grade II)
Clinical characteristics -Typically occur in the ... decade of life -Some difficulty with histologic grading *Up to 30% may actually be higher grade (due to sampling errors) -Best prognostic indicator is ... |
fifth
younger age |
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Anaplastic Astrocytoma:
Treatment -Surgery needs to be considered if diagnosis is uncertain -... will help reduce increased intracranial pressure (due to edema – white matter edema) -Radiation therapy (focal) -Chemotherapy Prognosis -Median survival rate is ... years -Typical time to tumor recurrence is 2.5 years (follow pts closely with imaging studies) -Individuals younger than 40 have the best prognosis |
Steroids
three |
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Glioblastoma multiforme:
Clinical characteristics -Unfortunately, the most ... diagnosed primary CNS tumor -Course of the disease is well-defined -Typically occur in the ... decade -Short history of neurological symptoms (less than six months) -A shorter duration of neurological symptoms before the diagnosis has been associated with ... survival period |
frequently
sixth longer |
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Glioblastoma multiforme:
Treatment -Maximum ... of the tumor, if possible -High-dose radiation therapy -Adjuvant ... -Monitor response with serial MRIs Prognosis -... survival rate *Surgery alone: 14-26 weeks *Surgery + radiation: 40 weeks *Surgery + radiation + chemotherapy: 50 weeks -Overall, median survival is less than ... year. Fewer than 15% survive two years |
debulking
chemotherapy Poor one |
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Oligodendroglioma:
Clinical characteristics -Presumed to arise from oligodendroglial precursors -Usually manifests in the ... or ... decades -Tend to occur in proportion to the volume of white matter (most common in ... lobes) |
fourth or fifth
frontal |
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Oligodendroglioma
Treatment -Surgical excision -Radiation therapy similar to anaplastic astrocytoma and glioblastoma -More poorly differentiated (higher grade) often treated with ... Prognosis -Median survival rate is greater than ... years -Ten year survival rate is about 25% |
chemotherapy
five |
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Primative Neuroectodermal Tumor (PNET):
Primarily neoplasms of ... (fewer than 1% of ...) The most common PNET is the ... -Typically occurs in the ... fossa -Can metastasize throughout the CNS and even outside the CNS (bone, lymph nodes, lung, pleura, liver, and breast) |
children
adults medulloblastoma posterior |
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in adults, the majority of tumors occur ... the tentorium
In children, the majority of tumors occur ... the tentorium (in the ... fossa) |
above
below posterior |
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Primitive Neuroectodermal Tumor (PNET)
Treatment -Maximal surgical resection (cerebellum, brainstem area) -... therapy (whole brain) -... for recurrent disease |
Radiation
Chemotherapy |
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Primitive Neuroectodermal Tumor (PNET):
Prognosis -... -year survival rate is 50-75% with radiation therapy -... -year survival rate is 30-60% -The prognosis is much ... if disease is metastatic outside the CNS |
Five
Ten poorer |
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...: (a more solid tumor)
Clinical characteristics -Primarily a tumor of the young -Commonly arises in the central canal of the spinal cord, the filum terminale, as well as the white matter adjacent to the ventricular surface (tumor inside ventricle or in spinal cord. Often diagnosed as MS) -Can spread throughout the CNS (like medulloblastoma) |
Ependymoma
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Ependymoma Treatment:
-Surgical resection and radiation therapy, if possible -Chemotherapy is reserved for ... Prognosis -...–year survival rate is 60-80% for lower grade tumors |
recurrance
Five |
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...:
Clinical characteristics -Very common CNS tumor -Peak age at diagnosis is 45 -Asymptomatic tumors are common in older adults -These tumors form slowly and usually exhibit benign behavior -Occur most frequently in the parasagittal and falx regions -Malignant forms are rare -very vascular tumors. Whirling pattern of calcification |
Meningioma
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Meningioma:
Treatment -... removal -Radiation and chemotherapies usually not considered unless the tumor shows ... characteristics -Imaging studies should be carried out periodically to monitor for ... Prognosis -Very good -...% recurrence rate even when tumor is totally removed |
Surgical
malignant recurrance 10 |
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...:
Clinical characteristics -Rare -Incidence is increased in immunocompromised patients -Typically looks like non-Hodgkin’s B-cell tumors -Check for HIV |
Primary CNS Lymphoma
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Primary CNS Lymphoma:
Treatment -... only, not resection -Chemotherapy administered ... -Steroids -Radiation therapy can be used for relapse Prognosis -Median survival is ... years |
Biopsy
intrathecally 3.5 |
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Metastases to the nervous system:
-20-40% of tumors in the CNS -... cancer metastasizes to brain most frequently, followed by breast and colon -Resection of solitary lesion followed by ... therapy can improve survival Metastases to spine can cause ... -Back pain -Sensory level -Paralysis -Change in bowel/bladder |
Lung
radiation cord compression |
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Metastases to the nervous system:
-Treat with ... initially -Radiation therapy -For individuals not a candidate for radiation, surgery may be indicated |
Decadron
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Metastases to the nervous system:
Leptomeningeal carcinomatosis -Also known as ... Can present in numerous ways: -Altered mental status -Seizures -Multiple cranial nerve abnormalities -Severe headache |
neoplastic meningitis
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Leptomeningeal carcinomatosis:
-In adults, ... cancer is the most common cause, followed by lung cancer and melanoma -In children, the most common cause is ... |
breast
leukemia |
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Leptomeningeal carcinomatosis:
Diagnosed by MRI or CT and lumbar puncture May need to do ... lumbar punctures -50% yield on first -85% yield by third -... will likely be elevated in addition to other findings Treated with ... Very ... prognosis |
serial
Protein chemotherapy poor |
