LGG BASICS & EPIDEMIOLOGY
These three types of glial cells give rise to LGGs
What is Astrocytes, oligodendrocytes, and ependymal cells
This percentage of intracranial schwannomas are vestibular schwannomas
what is 90%
This is the genetic profile that confirms an adult Astrocytoma
IDH mutation and a lack of 1p/19q codeletion
This is the primary treatment gold standard goal for LGG surgery
What is maximal safe resection (Accept: What is gross total resection)
This is the gold standard imaging modality for LGG diagnosis
what is MRI with gadolinium contrast (T1-weighted and T2/FLAIR sequences) (Accept: What is MRI)
This percentage of pediatric brain tumors are low grade gliomas
what is 30%
Schwannomas arise from this type of cell
What is a schwann cell
This genetic syndrome involves a mutation on chromosome 22 leading to a loss of the merlin protein.
What is Neurofibromatosis Type 2? (Accept: What is NF2?)
This chemotherapy regimen was proven beneficial in the RTOG 9802 trial
What is PCV (Procarbazine, Lomustine/CCNU, and Vincristine) chemotherapy?
The Pignatti (EORTC) risk criteria consider patients high-risk if they have this many or more risk factors
what is 3 or more, (age >=40, astrocytoma histology, tumor >=6 cm, midline crossing, pre-operative neurological deficit)
The peak age range for astrocytoma diagnosis
what is 30-40 years old
Schwannomas are almost universally classified as this WHO grade
what is 1
This mutation is considered an "early event" in most adult LGGs and produces 2-hydroxyglutarate
IDH mutation
For vestibular schwannoma, this treatment achieves 92-97% tumor control rates
What is stereotactic radiosurgery
This histological pattern in schwannomas consists of dense spindle cells
what is Antoni A
These are the 2 mutations that must be present in order to be considered an oligodendroglioma
What is IDH mutation and 1p/19q codeletion
what is CPA, where the 8th CN originates.
In the 2021 WHO classification, finding this deletion in an IDH-mutant astrocytoma automatically makes it Grade 4.
what is CDKN2A/B homozygous deletion, which automatically upgrades an IDH-mutant astrocytoma to WHO Grade 4.
This is the technique, standard radiation dose range and preferred fractionation for LGG RT in Gy.
What is IMRT/VMAT Standard Dose: 45 Gy to 54 Gy Delivered in small daily increments of 1.8 Gy, once a day, 5 days a week, for about 5 to 6 weeks
This is a pediatric LGG that arises from Astrocytes
Diffuse astrocytoma, MYB- or MYBL1-altered = Grade 1. Pilocytic Astrocytoma, BRAF-KIAA1549 fusion = Grade 1. Pleomorphic Xanthoastrocytoma (PXA), BRAF V600E mutation =Grade 2
These three genetic syndromes are linked to LGGs
What is (only need 3 of these)
NF1=low-grade astrocytomas. NF2=spinal ependymomas. Tuberous Sclerosis=subependymal giant cell astrocytomas. Li-Fraumeni Syndrome (Tp53). Turcot Syndrome.
These two cranial nerves do NOT have Schwann cells and therefore cannot develop schwannomas
What is 2 (optic) and 1 (olfactory)
In IDH-wildtype tumors, these markers (along with gaining parts or an extra copy of chromosome 7 and losing parts or the entirety of chromosome 10) automatically make the tumor a WHO Grade 4, even if the tissue sample looks like a Grade 2.
What is EGFR amplification or TERT promoter mutation?
This surgical resection technique for schwannomas aims to preserve the nerve of origin
What is Intracapsular Enucleation
This FDA-approved oral targeted therapy, approved in August 2024, is an IDH-inhibitor used for Grade 2 IDH-mutant gliomas to delay tumor growth and postpone the need for radiation and chemotherapy.
What is Vorasidenib?