Info
🌱 來自: Huppert’s Notes
Neuro-oncology🚧 施工中
Neuro-oncology
Metastatic brain tumors
• Radiographic findings: Multifocal lesions at the gray-white junction, ring enhancement with contrast
• Common malignancies that metastasize to the brain: Lung cancer, breast cancer, melanoma, GI malignancies, GU malignancies
Primary CNS tumors
• See Hematology/Oncology Chapter 7
Paraneoplastic neurologic syndromes
• Clinical presentation: Consider paraneoplastic (or autoimmune) encephalitis in patients with subacute onset neurologic symptoms including limbic encephalitis (memory loss, behavior changes, seizures), movement disorders, myelopathy, and/or neuropathy. Higher risk if the patient has a known history of malignancy. Typically, CSF is acellular (though often have abnormal IgG index and oligoclonal bands). MRI brain/spine may show abnormal findings in the limbic system, brainstem, or spinal cord.
• Diagnosis: MRI, lumbar puncture with IgG index and oligoclonal bands, serum and CSF autoimmune encephalitis panel, CT chest/abdomen/pelvis, testicular/vaginal ultrasound and/or PET if unknown primary site of malignancy
TABLE 12.6 • Key Medications Used in Neurology
• Treatment: Treat underlying malignancy, may require immunosuppression