51 Questions
What is the most common type of glioma?
Astrocytomas
Where do 70% of childhood CNS tumors tend to arise?
Posterior fossa
What percentage of brain tumors are primary tumors?
50 – 75%
What can slow-growing, well-differentiated brain tumors in the brain cause?
Serious problems due to compression or destruction of critical brain areas
What is anaplasia in the context of brain tumors?
Abnormal cellular morphology and increased mitosis
Which grade of astrocytoma is commonly found in children and young adults?
Grade I
What is a common mutation associated with Grade II & III astrocytomas?
PTEN inactivation
Which type of astrocytoma has the worst prognosis?
Grade IV
What are common signs and symptoms of astrocytomas?
Headache, nausea, vomiting, focal changes
What is the median survival rate for Grade II astrocytomas?
5–6 years
Which imaging method is considered the best for diagnosing astrocytomas?
MRI
What are common treatments for astrocytomas?
Radiation, chemotherapy, surgery
What are signs/symptoms of increased intracranial pressure?
Headaches (especially if more severe in the morning), vomiting (more likely in the morning), blurred and/or double vision
What are worse prognostic factors associated with astrocytomas?
Infiltration of normal tissue, hemorrhage and necrosis, rapid cell division
Which cranial nerve palsy is commonly associated with astrocytomas?
6th cranial nerve palsy
What is the most common age range for oligodendrogliomas?
40s and 50s
Which gene mutation is commonly associated with oligodendrogliomas?
IDH gene mutation
Where do ependymomas frequently block in kids?
Spinal cord
What is a common pathological finding in meningiomas?
"Sheet-like" spreading through the brain
Where does medulloblastoma occur?
"Cerebellum"
"Brain metastases" are often found on/in which part of the brain?
Meninges
Which primary site is among the five most common sites that metastasize to the brain?
Lung
What is a common feature of ependymomas in adults?
Often found in the spinal cord
What is a common characteristic of meningiomas?
Slow growth rate during pregnancy
What is a typical prognosis for medulloblastomas?
Good due to responsiveness to radiation therapy
What are typical signs and symptoms of ependymomas if in the cranium?
Seizures and increased intracranial pressure
What is the typical location for childhood CNS tumors?
In the posterior fossa
What is a common consequence of slow-growing, well-differentiated brain tumors?
Compression or destruction of critical brain areas
What is the typical epidemiology for intracranial tumors?
10 - 17 per 100,000
Which type of brain tumor is among the deadliest of cancers?
Aggressive, poorly differentiated brain tumors
What is anaplasia in the context of brain tumors?
Abnormal cellular morphology and increased mitosis
What is a common mutation associated with Grade II & III astrocytomas?
PTEN inactivation leading to excessive PI3K pathway signaling
What is the most common age range for oligodendrogliomas?
30-50 years
Where does medulloblastoma occur?
Cerebellum
What are typical signs and symptoms of astrocytomas?
Headache (worse in morning), nausea, vomiting, focal changes caused by invasion/damage of normal brain tissue
Which gene mutation is commonly associated with oligodendrogliomas?
IDH mutations producing 2-hydroxyglutarate that dysregulates epigenetic signaling in glial cells
What can slow-growing, well-differentiated brain tumors cause?
Optic nerve atrophy due to papilledema and 6th cranial nerve palsy
What is the median survival rate for Grade II astrocytomas?
5-6 years
What percentage of brain tumors are primary tumors?
80%
Which cranial nerve palsy is commonly associated with astrocytomas?
6th cranial nerve palsy
What is a common characteristic of meningiomas?
Well-differentiated and relatively easy to separate from surrounding normal brain tissue
Which imaging method is considered the best for diagnosing astrocytomas?
MRI
What is a common genetic mutation associated with oligodendrogliomas?
IDH mutations
Where are ependymomas often found in adults?
In the spinal cord
What is a common pathological finding in meningiomas?
Extension into the overlying bone
Which of the following is a common primary site that metastasizes to the brain?
Lung
What is a characteristic feature of medulloblastomas?
"Primitive-looking" cells
What is a common location for meningiomas?
On the external surfaces of the brain
What is a typical prognosis for meningiomas?
Tends to be good as they grow slowly and do not usually invade adjacent tissue
What is a common consequence of ependymomas blocking the central canal or being near the 4th ventricle in kids?
Elevated intracranial pressure (hydrocephalus)
What is a typical location for medulloblastomas?
Near the 4th ventricle
Study Notes
Glioma Types and Characteristics
- The most common type of glioma is astrocytoma.
- 70% of childhood CNS tumors tend to arise in the cerebellum.
Astrocytomas
- Slow-growing, well-differentiated brain tumors can cause seizures and increased intracranial pressure.
- Anaplasia in the context of brain tumors refers to a loss of cellular differentiation.
- Grade I astrocytoma is commonly found in children and young adults.
- A common mutation associated with Grade II & III astrocytomas is IDH1/2.
- Glioblastoma (Grade IV) has the worst prognosis among astrocytomas.
- Common signs and symptoms of astrocytomas include seizures, headaches, and changes in mental status.
- The median survival rate for Grade II astrocytomas is 7-10 years.
- MRI is considered the best imaging method for diagnosing astrocytomas.
- Common treatments for astrocytomas include surgery, radiation, and chemotherapy.
Increased Intracranial Pressure
- Signs and symptoms of increased intracranial pressure include headache, vomiting, and changes in mental status.
Prognostic Factors
- Worse prognostic factors associated with astrocytomas include age, tumor location, and tumor grade.
- Cranial nerve palsy, particularly VI, is commonly associated with astrocytomas.
Oligodendrogliomas
- The most common age range for oligodendrogliomas is 40-50 years.
- A common genetic mutation associated with oligodendrogliomas is 1p/19q deletion.
Ependymomas
- Ependymomas frequently block the fourth ventricle and central canal in kids.
- In adults, ependymomas are often found in the spinal cord.
- Common signs and symptoms of ependymomas in the cranium include headache, vomiting, and seizures.
Meningiomas
- A common pathological finding in meningiomas is the presence of psammoma bodies.
- Meningiomas are commonly located in the dura mater.
- A common characteristic of meningiomas is that they are typically slow-growing and benign.
- The typical prognosis for meningiomas is good, with a 5-year survival rate of 95%.
Medulloblastomas
- Medulloblastomas occur in the cerebellum.
- The typical prognosis for medulloblastomas is poor, with a 5-year survival rate of 50-60%.
- A characteristic feature of medulloblastomas is their rapid growth and high aggressiveness.
Brain Metastases
- Brain metastases are often found in the cerebral cortex.
- The primary site that most commonly metastasizes to the brain is the lung.
General Brain Tumor Facts
- 80% of brain tumors are primary tumors.
- The typical epidemiology for intracranial tumors is that they are more common in adults than in children.
- Glioblastoma is among the deadliest of cancers.
- Slow-growing, well-differentiated brain tumors can cause seizures and increased intracranial pressure.
Test your knowledge on brain tumours and neuropathology with topics such as general considerations, types of primary CNS tumours, common metastases, and epidemiology. Explore the different types of brain tumours and their prevalence.
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