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Brain Tumors

Mostly likely tumor in a patient with juvenile cataracts who was found to have a mutation in the merlin gene on chromosome 22 Schwannoma (most common tumor in neurofibromatosis type 2; they are usually bilateral; these patients are also at risk for meningiomas and ependymomas)
Frontal lobe tumor biopsy shows infiltrating cells with perinuclear halos and prominent delicate vasculature Oligodendroglioma (perinuclear halos describe the clear cytoplasm surrounding the round nuclei of oligodendrocytes, and are said to have a "fried egg" appearance; the vasculature is said to have a chicken-wire capillary pattern; calcification is common)
Adult with "head fullness" and headaches when standing; T2-MRI shows lobulated mass that enhances with contrast and crosses the midline; immunostain is positive for glial fibrillary acidic protein Glioblastoma multiforme (glial fibrillary acidic protein = GFAP = astrocyte stain)
Biopsy of a solid cerebellar brain tumor from a child shows gray matter with abundant fibrillary material surrounded by a wheel-shaped configuration of differentiated cells Medulloblastoma (these arise from the cerebellar external granular layer; the pattern described is a Homer-Wright "pseudo"-rosette, which is also found in neuroblastomas; in contrast, "true" rosettes have an empty lumen and are found in retinoblastomas)
Tumor at cerebellopontine angle that stains positive for a protein that is 100% soluble in ammonium sulfate at neutral pH Schwannoma (protein in question is S-100, the "S" actually stands for soluble and "100" for 100%; it is usually present in cells derived from neural crest, and may also be found in melanomas)
Most likely brain tumor in a patient with bilateral renal cell carcinoma and pheochromocytoma Cerebellar hemangioblastoma (these are classic findings of Von Hippel-Lindau disease, an autosomal dominant deletion of the VHL tumor suppressor gene on chromosome 3; these patients also get cavernous hemangiomas in their skin, mucosa, retina, and organs)
Adult female with new-onset focal seizures is found to have a firm, non-invasive, multilobular, parasagittal brain tumor that expresses estrogen receptors and infiltrates the overlying bone Meningioma (these arachnoid cell tumors are more common in females than males, and locations may include parasagittal, olfactory groove, or lesser wing of sphenoid; they may indent and compress the surface of the brain, but will not invade)
Biopsy of a solid tumor from the posterior fossa of a child on H&E stain shows eosinophilic and elongated corkscrew fiber bundles Pilocytic astrocytoma (the description is characteristic of Rosenthal fibers; this tumor would also stain positive for GFAP)
Resectable tumor often localized to CN VIII Schwannoma
Most common childhood supratentorial tumor Craniopharyngioma (most childhood brain tumors are below the tentorium cerebelli, while most adult primary brain tumors are above)
Most common cause of hypopituitarism in adults Nonfunctioning pituitary adenoma (I included this here, however, the pituitary gland is not actually part of the brain, anatomically speaking)
Most common cause of hypopituitarism in children Craniopharyngioma
Benign cystic childhood tumor of neuroectoderm origin, most commonly in the cerebellum Pilocytic astrocytoma
Cerebellar tumor in a patient which is found to have foamy cells and high vascularity; further workup demonstrates polycythemia and constitutive expression of HIF (hypoxia inducible transcription factor); his father suffered from a rare genetic disease Cerebellar hemangioblastoma (the genetic disease is Von Hippel-Lindau and the tumor is producing erythropoietin)
Most common primary childhood brain tumor Pilocytic astrocytoma
Most common primary malignant childhood brain tumor Medulloblastoma
2nd most common primary childhood brain tumor Medulloblastoma
Arachnoid tumor that is resectable and external to the brain; typically in convexities of hemispheres or parasagittal region Meningioma
A child with hydrocephalus is determined to have a solid tumor in the cerebellar vermis; biopsy shows primitive small blue cells Medulloblastoma (these are highly malignant)
Most common primary adult brain tumor Glioblastoma multiforme
2nd most common primary adult brain tumor Meningioma
Most common benign adult brain tumor Meningioma
Most common brain malignancy Metastasis
Most frequent metastatic brain tumor primary location Lung
Childhood brain tumor of cells lining the ventricles characterized by perivascular pseudorosettes and rod-shaped blepharoplasts (basal ciliary bodies) found near the nucleus Ependymoma (ependymomas & medulloblastomas both have rosette-like patterns; ependymomas are benign and of the ventricular lining, while medulloblastomas are malignant primitive small round blue cell cerebellar tumors and are more common)
Child with diabetes insipidus and bitemporal hemianopsia is found to have a cystic brain tumor with hemorrhage, calcification, and cholesterol crystals Craniopharyngioma (benign Rathke's pouch [surface ectoderm] tumor; do not confuse with pituitary adenoma)
Pseudopalisading pleomorphic tumor cells border central areas of necrosis and hemorrhage Glioblastoma multiforme
Spindle cells concentrically arranged in a whorled pattern with basophilic laminated calcifications Meningioma (basophilic laminated calcifications = psammoma bodies; these are also found in thyroid papillary adenocarcinoma, ovarian papillary serous cystadenocarcinoma, and malignant mesothelioma)
Brain tumor in a child with precocious puberty, obstructive hydrocephalus, and paralysis of upward gaze Germinoma of the pineal gland (this is the most common tumor of the pineal gland; they produce beta-hCG that causes precocious puberty, hydrocephalus due to acqueductal compression, and Parinaud's syndrome due to compression of the midbrain tectal area)
Tumor is usually benign and may present as a hemorrhagic mass; it arises in the fourth ventricle in children (causing hydrocephalus) or the cauda equina in adults (causing syringomyelia) Ependymoma
Created by: kesselmb
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