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Medicine Notes Oncology Notes

Cns Malignancy Notes

Updated Cns Malignancy Notes

Oncology Notes

Oncology

Approximately 27 pages

Concise notes on Oncology, including palliative care. These notes cover the most common cancers and all of the oncology emergencies. Very clinically relevant - great for written and practical exams for medical finals. Colour coded by topic including diagrams and tables where relevant...

Available here

The following is a more accessible plain text extract of the PDF sample above, taken from our Oncology Notes. Due to the challenges of extracting text from PDFs, it will have odd formatting:

CNS Malignancy

Primary Brain Tumours

Epidemiology

  • 2 peaks of incidence

    • Childhood

    • Late middle age (>50 years)

Aetiology

  • Most sporadic with no proven risk factors

  • Li-Fraumeni and Turcot’s syndromes = increased risk

  • AIDS – increased risk of CNS lymphoma

  • Radiation – increased risk of glioma and meningioma (proven on follow up from children who received treatment for ALL)

Pathology

WHO classification is the most commonly used system for categorizing brain tumours

  • Incorporates histological type and grade (histological grades 1-4)

Types

  • ‘Gliomas’

    • Most common

    • E.g astrocytoma, oligodendrocytoma – derived from glial cells in brain parenchyma

    • Glioblastoma multiforme (grade 4) and anaplastic astrocytoma (grade 3) = high grade gliomas.

    • Vary hugely

Clinical features

  • Huge variation

    • Depends on location of the tumour and associated oedema

  • Most present due to features of raised intracranial pressure or loss of neurological function

  • Common symptoms include

    • Headache (worse in the morning)

    • Epilepsy

    • Disturbance of cognition, speech or motor function

    • Clouding of consciousness

    • Visual disturbances

Location Signs
Frontal lobe Personality change, anosmia, leg weakness, incontinence, apraxia
Parietal lobe Dysphasia, Gerstman’s syndrome (occurs when tumour is in dominant parietal lobe – left/right disorientation)
Occipital lobe Homonymous hemianopia
Temporal lobe Dysphasia, memory loss
Cerebellum Ataxia, intention tremor, dysdiardokokynesis, nystagmus, abnormal heel-toe walking

Investigations

  • CT head with contrast

  • MRI + gadolinium = gold standard

  • MRI of spine also indicated when CSF dissemination is a risk

Management

  • Of symptoms

    • Dexamethasone 10mg loading dose IV/PO plus 4mg QDS (+PPI)

    • If no response, dexamethasone can be increased

    • Mannitol (doesn’t cross BBB but creates osmotic gradient) IV in 20% solution, 100ml dose

    • Standard...

Buy the full version of these notes or essay plans and more in our Oncology Notes.

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