Types of Glioma?
- • Astrocytoma (MC)Q
- • OligodendrogliomaQ
- • EpendymomaQ
MC primary brain tumor in both children and adultsQ.
Astrocytoma - Glioblastoma multiforme is most common
Location of Astrocytoma in children and adults?
- Supratentorial in adults
- Infratentorial in childrenQ•
- Majority of astrocytomas are low-grade in children and high grade in adulthoodQ.
MC posterior fossa tumor in childrenQ•?
- In children, pilocytic astrocytoma is most commonQ.•
- In adults, diffuse astrocytoma is most commonQ.
Radiological features of Glioblastoma?
Glioblastoma is highly vascular, sometimes so vascular that it resembles an AV malformation on angiography
WHO Classification of Astrocytoma?
- Grade I or Pilocytic Astrocytoma
- Low-grade, or grade II astrocytomas
- Grade III or Anaplastic
- Grade IV or Glioblastoma multiforme
Radiological featues of pilocytic astrocytoma?
Discrete appearing, contrast enhancing and often cystic with a mural noduleQ
Treatment of astrocytoma?
- Pilocytic - Curable by radical resectionQ (no infiltration of surrounding brain), Radiation therapy and chemotherapy have no role
- Low-grade - Observation and follow-up, radiation with or without chemotherapy, and surgery. Surgery is not curative because most of these tumors are infiltrative with no clear marginsQ
- Anaplastic and GBM - Cytoreductive surgery followed by EBRTQ.
Histology of Glioblastoma multiforme?
Endothelial proliferation or necrosisQ on histology makes the tumor grade IV.
Chemotherapy for GBM?
- Carmustine and cisplatin
MC astrocytomas in childhood?
Juvenile Pilocytic Astrocytoma (JPA)
Most common site of subependymal giant cell astrocytoma?
- Ependymal wall of lateral ventricle near the foramen of MonroQ -
- Causes obstruction at the foramen of Monro leading to ventricular enlargement and raised ICT.
Common locaton of Medulloblastoma?
- Highly malignant tumor found in cerebellumQ and infratentorial location
- Occur predominantly in childrenQ (peak incidence at 3-4 yearsQ) •
Most radiosensitive brain tumor?
Most radiosensitive brain tumorQ
Treatment of medulloblastoma?
- Despite of extreme radiosensitivity, it should be surgically excisedQ.
- • Surgical excision should be followed by radiotherapy and chemotherapyQ
Side effects of Craniospinal Irradiation (CSI)?
- GH disturbance – MC side effect
- Hypothyroidism: One of the earliest late side effects
- and after GH disturbanceQ
- Prevalence of hypothyroidism is 40–80% after CSIQ
- Significantly increased risk of development of benign thyroid nodules and papillary carcinoma of the thyroid many years laterQ..