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13 Cards in this Set
- Front
- Back
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Brain mets occur in what percentage of patients with cancer?
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20-40%
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What is the most frequent source of primary tumor in brain mets?
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lung (48%), breast (15%), melanoma (9%), colon (5%), then other
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What is the most common neurologic symptom for someone with brain mets?
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Headache
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What is the mean survival time (MST) after diagnosis of brain mets depending on treatment type?
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1 month from diagnosis if untreated; 2 months if treated with steroids; 2-7 months if treated with whole brain radiation therapy (WBRT).
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What is the treatment of choice for brain mets?
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WBRT
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What is the recurrence rate for brain mets treated with surgical resection alone?
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31-70%; surgical resection does not provide adequate tumor control.
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What is stereotactic radiosurgery (SRS)?
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Newer radiation modality used for brain metastases. SRS is the delivery of a single dose of radiation to a small and critically located intracranial volume. It is typically delivered with a machine named the gamma knife.
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von Recklinghausen's disease
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Neurofibromatosis type 1; autosomal dominant
Affected patients may have intracranial astrocytomas of all grades (WHO I to IV), particularly pilocytic astrocytoma (WHO I) of the optic pathways or cerebellum. |
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Neurofibromatosis type 2
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Autosomal dominant
May have schwannoma, particularly acoustic schwannoma, which is often bilateral. |
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What is the treatment for low grade gliomas?
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The mainstay of treatment is maximum surgical resection. However, surgery often cannot remove the tumor in its entirety due to its infiltrative nature and location in critical areas of the brain. After subtotal resection or biopsy, treatment (radiation therapy) is either given upfront or deferred until the time of symptomatic imaging progression. Chemotherapy does not have a well defined role in the management of adult low grade glioma.
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What is the most common high grade glioma in adults?
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Grade 4 astrocytoma (glioblastoma multiforme)
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Medulloblastoma
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A highly malignant primary brain tumor that originates in the cerebellum or posterior fossa. Occurs in children and young adults. Symptoms are associated with obstruction of CSF flow (hydrocephalus) and include headache, nausea, vomiting, and ataxia.
Standard treatment is very intense and includes maximal surgical resection, craniospinal radiation therapy, as well as several months of chemotherapy. Survival rates are 60-75% at 5 years. |
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Pituitary tumors
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Occur in females more than males. Treatment includes transsphenoidal and other surgical approaches, pharmacologic management of hormonal dysfunctions as well as medical treatment of the adenoma, and the selective use of radiation therapy.
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