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DU PA CNS Neoplasm

Duke PA CNS Neoplasm

CNS tumors rarely __ metastasize to other organs
__ which arise from astrocytes are the most common CNS tumor gliomas
in a patient with a known systemic malignant disease, __ are more likely than a primary CNS tumor metasteses
symptoms caused by intracranial tumors result from either __ or __ compression of the brain by tumor and the presence of associated edema, infiltration and destruction of brain parenchyma by tumor cells
even small CNS tumors may cause symptoms because of the __ uncompromising rigidity of the cranial vault
__ is the most common generalized symptom and is the first symptom in over on third of adults with brain tumor headache
headaches from intracranial tumors are often worse in the __ morning
headaches from intracranial tumors are provoked worse by maneuvers that increase intracranial pressure
generalized symptoms of intracranial tumor headache, changes in mood or personality, decreased appetite, nausea, seizure (general)
generized symptom of intracranial tumor that is common in children but rare in adults projectile vomiting
tumors of the __ lobe may grow to massive proportions before symptoms prompt the patient or the patient's family to seek medical help frontal lobe
__ may occur with a frontal lobe tumor progressive difficulty with concentration and memory, personality changes, and lack of spontaneity
__ most commonly seen with gliomas or lymphomas may cause spasticity of the extremities and the appearance of primitive reflexes bifrontal disease
__ tumors produce subtle sensory signs or hemianesthesia parietal lobe
tumors of the __ may produce spatial disorientation or left homonymous hemianopia right parietal lobe
__ tumors cause receptive aphasia or right homonymous hemianopia left parietal lobe
tumors of the __ can lead to behavioral changes, olfactory hallucinations, complex partial seizures, and quadrantanopia temporal lobes
all patients with a suspected brain tumor should have either __ an MRI or contrast-enhanced CT
__ are not adequate for evaluating either primary tumors or metastatic tumors CT scans done without contrast enhancement
cerebral angiography is indicated only when __ an understanding of tumor blood supply is deemed necessary before surgical resection
PET scanning reveals areas of __ and may indicate greater extent of tumor than suggested on CT or MRI increased glucose metabolism
__ are particularly useful in assessing response to treatment or providing evidence of recurrent disease after primary therapy PET scans
__ is helpful only if leptomeningeal involvement with tumor is suggested lumbar puncture
__ is contraindicated when an intracranial mass lesion is present lumbar puncture
even when surgical cure is unlikely, resection of a large portion of the tumor may relieve symptoms for many months
Surgical resection is not recommended for patients with __ b/c these tumors are often multifocal and respond to a combination of chemotherapy and radiation therapy CNS lymphomas
most patients with CNS tumors have __ brain edema
some patient with CNS tumors and brain edema benefit from glucocorticoids (dexamethasone)
in patients with life-threatening edema with signs of brain herniation, __ can be given IV to reduce intracranial pressure, along with dexamethasone mannitol
whole brain radiation therapy is associated with __ long-term toxicity exhibited as dementia and gait disturbance
the major obstacle to the effective use of chemotherapy in brain tumors is the __ blood brain barrier
oligodendromas are unusually __ sensitive to chemotherapy
of the anaplastic gliomas __ is associated with the worst prognosis, with median survival of less than 12 months glioblastoma multiforme
__ arise outside the brain and generally grow slowly meningiomas
__ is not used in the treatment of meningiomas chemotherapy
most intracranial tumors are __ metastatic from other sites
the tumors that commonly metastasize to the brain are __ lung cancer, breast cancer, and melanoma
rapidly growing tumors cause __ massive edema
spinal tumors are __ compared to brain tumors less common
among the earliest symptoms of spinal cord tumors back pain and distal paresthesias
__ is the most useful tool for evaluating the patient with suggested spinal cord tumor MRI
treatment of primary spinal cord tumors is with surgical resection
patients with epidural metastatic tumors of the spinal cord are treated with __ and surgery or radiation corticosteroids
in children most primary brain tumors are located in the __ posterior fossa
in adults most primary brain tumors are located in the __ cerebral hemispheres
primary tumors develop from __ cells non-neuronal
25% of all gliomas, can occur anywhere in the brain or spinal cord, grow by slow infiltration, 1/2 patients present with a focal or generalized seizure, later symptoms: headache and increased ICP astrocytoma
50% of all gliomas, highly invasive, rapidly growing, bilateral in 50% of patients, frequently causes intracerebral hemorrhage. less than 20% of patients survive one year glioblastoma multiforme (GBM)
CNS lymphoma treatment is with radiation and steroids
most common hormone secreted from a pituitary adenoma prolactin
increase levels of prolactin from a pituitary adenoma can result in amenorrhea/galactorrhea syndrome
tumors that rarely metastasize to the brain include prostate, oro-pharyngeal carcinoma, and skin cancers other than melanoma
brain tumor presentation localizing neurologic signs (+/-), mental function (slow, dull), headaches (occur at night and first awakening), vomiting (especially in posterior fossa tumors, seizures 20-50% of patients
signs and symptoms of increased intracranial pressure headache (periodic bifrontal and bioccipital), projectile vomiting, mental slowness, incontinence, mental slowness, papilledema
causes of increased intracranial pressure tumor mass, obstruction of CSF outflow, tumor related edema
mainstay of treatment for increased intracranial pressure steroids
temporary treatment for increased intracranial pressure osmotic agents (mannitol), hyperventilation (lowers pCO2, causing vasoconstriction)
remote effects of cancer paraneoplastic syndromes
clinical paraneoplastic syndromes Eaton Lambert, subacute cerebellar degeneration, brainstem encephalitis, sensory peripheral neuropathy
most common causes of paraneoplastic syndromes small cell lung cancer, ovarian cancer
Created by: bwyche