| 1: AJNR
Am J Neuroradiol. 2005 May;26(5):1122-7. |
|
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Different Signal Intensities between Intra- and
Extracranial Components in Jugular Foramen Meningioma: An Enigma.
Shimono T, Akai F, Yamamoto A, Kanagaki M, Fushimi Y, Maeda M, Miki Y.
Department of Radiology, Kinki University School of Medicine, Osaka, Japan.
BACKGROUND AND PURPOSE: The purpose of this study was to evaluate
retrospectively differences in MR signal intensity and contrast enhancement
between intra- and extracranial components of jugular foramen meningioma
(JFM). METHODS: MR studies of eight patients who underwent surgery for
histologically confirmed JFM were reviewed retrospectively. Signal intensity
differences between intra- and extracranial components of all eight JFMs on
axial T1-, T2-, and postcontrast T1-weighted images were evaluated visually.
In six of the eight JFMs, quantitative signal intensity evaluations were
also performed by using relative signal intensity ratios of the intra- and
extracranial components of JFM to CNS tissue at the same level. Paired t
tests were used to evaluate differences in relative signal intensity ratios
in each JFM between intra- and extracranial components. RESULTS: Both visual
and quantitative signal intensity evaluations revealed that signal
intensities of the intracranial component of JFM were significantly higher
than those of the extracranial component on T1-, T2-, and postcontrast
T1-weighted images. Results of relative signal intensity ratios were 0.89
+/- 0.04 versus 0.77 +/- 0.02 on T1-weighted images (P = .002); 1.66 +/-
0.28 versus 0.88 +/- 0.14 on T2-weighted images (P = .003); and 2.16 +/-
0.29 versus 1.77 +/- 0.26 on postcontrast T1-weighted images (P = .01).
CONCLUSION: Intra- and extracranial components of JFM display different
signal intensity and enhancement patterns. These differences may be related
to histologic composition, and in particular, collagen content.
PMID: 15891170 [PubMed - in process]
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| 2: AJNR
Am J Neuroradiol. 2005 May;26(5):1084-8. |
|
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Single-Dose Contrast Agent for Intraoperative MR Imaging
of Intrinsic Brain Tumors by Using Ferumoxtran-10.
Hunt MA, Bago AG, Neuwelt EA.
Department of Neurosurgery, Oregon Health and Science University, Portland,
OR.
BACKGROUND AND PURPOSE: Intraoperative MR imaging (IMRI) has advantages over
conventional framed and frameless techniques. IMRI, however, also has some
drawbacks, especially related to interpretation of gadolinium-enhanced
intraoperative imaging resulting from surgically induced blood brain barrier
injury, vascular changes, and hemorrhage. Ultra-small superparamagnetic iron
particles like ferumoxtran-10 have a long plasma half-life and are trapped
by reactive cells within the tumor. These trapped particles provide a method
to demonstrate enhancing lesions without the artifact of repeat gadolinium
administration in the face of blood brain barrier and vascular injury.
METHODS: We present a review of the literature and the cases of two patients
who underwent surgery in which IMRI with ferumoxtran-10 was used. RESULTS:
Ultra-small superparamagnetic iron particles represent a method to
demonstrate enhancing intrinsic brain tumors without the drawbacks of
intraoperative gadolinium enhancement. These lesions appear even on
low-field strength IMRI. Ferumoxtran-10, administered preoperatively,
provides a stable imaging marker, even after surgical manipulation of the
brain. CONCLUSION: Fermumoxtran-10 provides a way to lessen artifactual
enhancement during IMRI related to the administration of gadolinium.
PMID: 15891164 [PubMed - in process]
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| 3: Cancer. 2005 Apr
25;105(2):65-70. |
|
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Atypical teratoid/rhabdoid tumor of the brain:
cytopathologic characteristics and differential diagnosis.
Parwani AV, Stelow EB, Pambuccian SE, Burger PC, Ali SZ.
Department of Pathology, The Johns Hopkins Hospital, Baltimore, Maryland
21287, USA.
BACKGROUND: Atypical teratoid/rhabdoid tumor (AT/RT) is a highly aggressive
neoplasm with a unique cytogenetic profile. Although the clinicopathologic
and radiologic features of AT/RT have been described previously, to the
authors' knowledge the cytomorphologic profile of this tumor has not been
studied well. METHODS: Nine samples of AT/RT from 8 patients were analyzed
from the pathology files of 2 large institutions in a 10-year period
(1993-2002). Material consisted of slides made from scraping and smearing
(SS) or squash preparation (SP) of the tissue cores (six slides),
fine-needle aspiration (FNA) (two slides), and cerebrospinal fluid (one
slide). Smears were stained with Diff-Quik, Papanicolaou, and hematoxylin
and eosin stains. RESULTS: There were 4 males and 4 females who ranged in
age from 1-16 years (mean age, 7.1 years). Cytomorphologic features
consisted of hypercellularity (eight of eight tumors); predominantly large
tissue fragments with tumor cells surrounding proliferating capillaries
depicting a "papillary-like" appearance (five of eight tumors);
large, round, "plasmacytoid" cells and characteristic
"rhabdoid" cells (i.e., intermediate-sized cells with granular to
fibrillary, brightly eosinophilic cytoplasm with or without globoid
"inclusions"; large, eccentrically located, round-to-reniform
nuclei with single prominent nucleoli; eight of eight tumors); small, round,
primitive "neuronal-appearing" cells with a high nuclear to
cytoplasmic ratio (five of eight patients); and bizarre, multinucleated
giant cells (two of eight tumors). Also seen were numerous apoptotic bodies,
mitoses, and significant necrosis (seven of eight tumors), and prominent
dystrophic calcification (four of eight tumors). CONCLUSIONS: AT/RT is
extremely rare. Cytologic examination by SS, SP, or FNA offers a useful
alternative to frozen section during intraoperative consultation.
Cytomorphologic features are unique and lead to an accurate diagnosis in the
right clinicoradiologic context. The differential diagnosis includes
medulloblastoma (in cerebellar tumors), primitive neuroectodermal tumor (in
suprasellar tumors), choroid plexus carcinoma, and malignant glioma. 2005
American Cancer Society.
PMID: 15690353 [PubMed - indexed for MEDLINE]
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| 4: Cancer. 2005 Apr
25;105(2):80-6. |
|
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Pineal gland lesions: a cytopathologic study of 20
specimens.
Parwani AV, Baisden BL, Erozan YS, Burger PC, Ali SZ.
Department of Pathology, The Johns Hopkins Hospital, Baltimore, Maryland.
BACKGROUND: Pineal gland lesions are rare, with only a few cytologic
descriptions occurring in the literature, according to the authors'
knowledge. The current article describes the cytopathologic characteristics
of 20 such lesions with discussion of differential diagnoses. METHODS:
Cytologic material was obtained either by fine-needle aspiration biopsy
(FNAB) under stearotactic radiologic guidance or by touch imprinting (TI) at
the time of frozen sectioning. The 20 specimens include pineoblastoma (five
specimens), pineocytoma (four specimens), astrocytoma (three specimens),
germ cell tumor (three specimens), meningioma (one specimen), epidermoid
cyst (three specimens), and pineal cyst (one specimen). Smears were stained
with Diff-Quik and with Papanicolaou and hematoxylin and eosin stains. In
selected specimens, immunoperoxidase (IPOX) stains were performed on cell
block sections using synaptophysin, neuron-specific enolase, placental
alkaline phosphatase, glial fibrillary acidic protein, leukocyte common
antigen, cytokeratins, and human chorionic gonadotropin antibodies. RESULTS:
Several cytomorphologic characteristics unique to each lesional category
with occasional overlapping features were observed. The unique features
included the following: small, hyperchromatic, round to oval cells with
frequent rosetting (pineocytoma), with a few specimens in addition showing
hypercellularity, crowding, mitoses, and necrosis (pineoblastoma);
pleomorphic round cells in a fibrillary background (astrocytoma); large
polygonal cells with prominent nucleoli and clear cytoplasm (germ cell
tumor); spindled fibroblastic cells (meningioma); anucleate squames and
mature squamous cells (epidermoid cyst); and small uniform polygonal cells
(pineal cyst). When necessary, IPOX studies supported the morphologic
diagnoses. CONCLUSIONS: FNAB and TI cytology were found to provide a rapid
and reliable diagnosis of pineal lesions. This is particularly important
when dealing with minute amounts of tissue material. Both techniques
appeared to provide equally good cytomorphology on smears. IPOX studies
played an important complementary role in difficult cases when performed on
cell blocks. 2005 American Cancer Society.
PMID: 15662708 [PubMed - indexed for MEDLINE]
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| 5: Cancer Res. 2005 May
15;65(10):4368-75. |
|
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Inhibition of the DNA-dependent protein kinase catalytic
subunit radiosensitizes malignant glioma cells by inducing autophagy.
Daido S, Yamamoto A, Fujiwara K, Sawaya R, Kondo S, Kondo Y.
Department of Neurosurgery, University of Texas M. D. Anderson Cancer
Center, Houston, Texas 77030, USA.
DNA-dependent protein kinase (DNA-PK) plays a major role in the repair of
DNA double-strand breaks induced by ionizing radiation (IR). Lack of DNA-PK
causes defective DNA double-strand break repair and radiosensitization. In
general, the cell death induced by IR is considered to be apoptotic. On the
other hand, nonapoptotic cell death, autophagy, has recently attracted
attention as a novel response of cancer cells to chemotherapy and IR.
Autophagy is a protein degradation system characterized by a prominent
formation of double-membrane vesicles in the cytoplasm. Little is known,
however, regarding the relationship between DNA-PK and IR-induced autophagy.
In the present study, we used human malignant glioma M059J and M059K cells
to investigate the role of DNA-PK in IR-induced apoptotic and autophagic
cell death. Low-dose IR induced massive autophagic cell death in M059J cells
that lack the catalytic subunit of DNA-PK (DNA-PKcs). Most M059K cells, the
counterpart of M059J cells in which DNA-PKcs are expressed at normal levels,
survived, and proliferated although a small portion of the cells underwent
apoptosis. Low-dose IR inhibited the phosphorylation of p70(S6K), a molecule
downstream of the mammalian target of rapamycin associated with autophagy in
M059J cells but not in M059K cells. The treatment of M059K cells with
antisense oligonucleotides against DNA-PKcs caused radiation-induced
autophagy and radiosensitized the cells. Furthermore, antisense
oligonucleotides against DNA-PKcs radiosensitized other malignant glioma
cell lines with DNA-PK activity, U373-MG and T98G, by inducing autophagy.
The specific inhibition of DNA-PKcs may be promising as a new therapy to
radiosensitize malignant glioma cells by inducing autophagy.
PMID: 15899829 [PubMed - in process]
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| 6: Cancer Res. 2005 May
15;65(10):4088-96. |
|
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High-resolution genome-wide mapping of genetic
alterations in human glial brain tumors.
Bredel M, Bredel C, Juric D, Harsh GR, Vogel H, Recht LD, Sikic BI.
Division of Oncology, Center for Clinical Sciences Research, Stanford
University School of Medicine, Stanford, California 94305-5151, USA.
mbredel@stanford.edu
High-resolution genome-wide mapping of exact boundaries of chromosomal
alterations should facilitate the localization and identification of genes
involved in gliomagenesis and may characterize genetic subgroups of glial
brain tumors. We have done such mapping using cDNA microarray-based
comparative genomic hybridization technology to profile copy number
alterations across 42,000 mapped human cDNA clones, in a series of 54
gliomas of varying histogenesis and tumor grade. This gene-by-gene approach
permitted the precise sizing of critical amplicons and deletions and the
detection of multiple new genetic aberrations. It has also revealed
recurrent patterns of occurrence of distinct chromosomal aberrations as well
as their interrelationships and showed that gliomas can be clustered into
distinct genetic subgroups. A subset of detected alterations was shown
predominantly associated with either astrocytic or oligodendrocytic tumor
phenotype. Finally, five novel minimally deleted regions were identified in
a subset of tumors, containing putative candidate tumor suppressor genes
(TOPORS, FANCG, RAD51, TP53BP1, and BIK) that could have a role in
gliomagenesis.
PMID: 15899798 [PubMed - in process]
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| 7: Cancer Res. 2005 May
15;65(10):4051-8. |
|
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Gene expression profiling and genetic markers in
glioblastoma survival.
Rich JN, Hans C, Jones B, Iversen ES, McLendon RE, Rasheed BK, Dobra A,
Dressman HK, Bigner DD, Nevins JR, West M.
Department of Medicine, W.M. Keck Center for Neuro-Oncogenomics, Institute
of Statistics and Decision Sciences, Duke University Medical Center, Durham,
North Carolina 27710, USA. rich0001@mc.duke.edu
Despite the strikingly grave prognosis for older patients with
glioblastomas, significant variability in patient outcome is experienced. To
explore the potential for developing improved prognostic capabilities based
on the elucidation of potential biological relationships, we did analyses of
genes commonly mutated, amplified, or deleted in glioblastomas and DNA
microarray gene expression data from tumors of glioblastoma patients of age
>50 for whom survival is known. No prognostic significance was associated
with genetic changes in epidermal growth factor receptor (amplified in 17 of
41 patients), TP53 (mutated in 11 of 41 patients), p16INK4A (deleted in 15
of 33 patients), or phosphatase and tensin homologue (mutated in 15 of 41
patients). Statistical analysis of the gene expression data in connection
with survival involved exploration of regression models on small subsets of
genes, based on computational search over multiple regression models with
cross-validation to assess predictive validity. The analysis generated a set
of regression models that, when weighted and combined according to posterior
probabilities implied by the statistical analysis, identify patterns in
expression of a small subset of genes that are associated with survival and
have value in assessing survival risks. The dominant genes across such
multiple regression models involve three key genes-SPARC (Osteonectin),
Doublecortex, and Semaphorin3B-which play key roles in cellular migration
processes. Additional analysis, based on statistical graphical association
models constructed using similar computational analysis methods, reveals
other genes which support the view that multiple mediators of tumor invasion
may be important prognostic factor in glioblastomas in older patients.
PMID: 15899794 [PubMed - in process]
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| 8: Childs
Nerv Syst. 2005 May 14; [Epub ahead of print] |
|
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Recurrence in pediatric craniopharyngiomas: analysis of
clinical and histological features.
Gupta DK, Ojha BK, Sarkar C, Mahapatra AK, Sharma BS, Mehta VS.
Department of Neurosurgery, All India Institute of Medical Sciences, Ansari
Nagar, New Delhi, 110029, India, drdeepakkumargupta@yahoo.com.
OBJECTIVE: The purpose of this study was to investigate the recurrence
pattern and significance of various clinical and histological features as
predictors of recurrence in pediatric craniopharyngiomas. METHODS: A series
of 116 pediatric craniopharyngiomas (68 boys and 48 girls; age range, 1.6-18
years) was reviewed. Mean follow-up period was 18.53 months. Tumors recurred
in 15 patients within 96 months [mean recurrence-free survival (RFS), 12.67
months]. Of the recurrence cases, 2 had complete (mean RFS, 16 months) and
13 had subtotal tumor excision (mean RFS, 9.03 months). Histologically, an
adamantinous pattern was seen in 95% of cases, whereas a papillary pattern
was noted in 5%. Brain tissue was included in 41 cases. In 32 of 41 cases,
brain invasion was noted, and all were of adamantinous histology. No
correlation was noted of histopathological subtyping or brain invasion with
recurrence. CONCLUSIONS: The significant clinical factors associated with
recurrence included extent of resection, tumor size >4 cm, and cystic
tumors.
PMID: 15895298 [PubMed - as supplied by publisher]
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| 9: Clin
Cancer Res. 2005 May 15;11(10):3821-7. |
|
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Recombinant Sendai virus vector induces complete
remission of established brain tumors through efficient interleukin-2 gene
transfer in vaccinated rats.
Iwadate Y, Inoue M, Saegusa T, Tokusumi Y, Kinoh H, Hasegawa M, Tagawa M,
Yamaura A, Shimada H.
Department of Neurological Surgery, Graduate School of Medicine, Chiba
University, Japan. iwadatey@faulty.chiba-u.jp
PURPOSE: Sendai virus (SeV), a murine parainfluenza virus type I, replicates
independent of cellular genome and directs high-level gene expressions when
used as a viral vector. We constructed a nontransmissible recombinant SeV
vector by deleting the matrix (M) and fusion (F) genes from its genome
(SeV/DeltaMDeltaF) to enhance its safety. We also estimated the therapeutic
efficacy of the novel vector system against a rat glioblastoma model.
EXPERIMENTAL DESIGN: We administered the recombinant SeV vector carrying the
lacZ gene or the human interleukin-2 (hIL-2) gene into established 9L brain
tumors in vivo simultaneous with peripheral vaccination using irradiated 9L
cells. Sequential monitoring with magnetic resonance imaging was used to
evaluate the therapeutic efficacy. RESULTS: We found extensive transduction
of the lacZ gene into the brain tumors and confirmed sufficient amounts of
interleukin 2 (IL-2) production by hIL2-SeV/DeltaMDeltaF both in vitro and
in vivo. The magnetic resonance imaging study showed that the intracerebral
injection of hIL2-SeV/DeltaMDeltaF brought about significant reduction of
the tumor growth, including complete elimination of the established brain
tumors. The (51)Cr release assay showed that significant amounts of
9L-specific cytotoxic T cells were induced by the peripheral vaccination.
Immunohistochemical analysis revealed that CD4(+) T cells and CD8(+) T cells
were abundantly infiltrated in the target tumors. CONCLUSION: The present
results show that the recombinant nontransmissible SeV vector provides
efficient in vivo gene transfer that induces significant regression of the
established brain tumors and suggest that it will be a safe and useful viral
vector for the clinical practice of glioma gene therapy.
PMID: 15897582 [PubMed - in process]
-
| 10: Clin
Cancer Res. 2005 May 15;11(10):3624-32. |
|
-
Proteins and protein pattern differences between glioma
cell lines and glioblastoma multiforme.
Vogel TW, Zhuang Z, Li J, Okamoto H, Furuta M, Lee YS, Zeng W, Oldfield
EH, Vortmeyer AO, Weil RJ.
Surgical Neurology Branch, National Institutes of Neurological Disorders and
Stroke, NIH, Bethesda, Maryland, USA.
INTRODUCTION: Research into the pathogenesis, molecular signaling, and
treatment of glioblastoma multiforme (GBM) has traditionally been conducted
using cell lines derived from malignant gliomas. We compared protein
expression patterns between solid primary GBMs and GBM cell lines to
identify proteins whose expression may be altered in cell culture. METHODS:
We cultured cell lines U87, U118, U251, and A172 and used tissue-selective
microdissection of eight primary GBMs to obtain pure populations of tumor
cells, which we studied using two-dimensional gel electrophoresis (2DGE) and
examined using differential expression software. Select protein targets
expressed differentially between GBM tumors and GBM cell lines were
sequenced using tandem mass spectrometry. RESULTS: Analysis of the primary
GBM tumor samples (n = 8) and the GBM cell lines revealed reproducibly
similar proteomic patterns for each group, which distinguished tumors from
the cell lines. Gels contained up to 500 proteins that were consistently
identified in the pH 4 to 7 range. Comparison of proteins identified in the
GBM tumors and in the cell lines showed approximately 160 proteins that were
gained and 60 proteins that were lost on culture. Using normalized intensity
patterns from the 2DGE images, ANOVA tests were done and statistically
significant spots were identified. Seven proteins found in the cell lines
were significantly increased when compared with the GBM tumors (P <
0.05), whereas 10 proteins were significantly decreased from cell lines
compared with the GBM tumors. Proteins identified included transcription
factors, tumor suppressor genes, cytoskeletal proteins, and cellular
metabolic proteins. CONCLUSION: Global protein and proteomic differences
were identified between primary GBM tumor samples and GBM cell lines. The
proteins identified by 2DGE analysis elucidate some of the selection
pressures of in vitro culture, help accentuate the advantages and
limitations of cell culture, and may aid comprehension of gliomagenesis and
enhance development of new therapeutics.
PMID: 15897557 [PubMed - in process]
-
| 11: Clin Neuropathol.
2005 Mar-Apr;24(2):56-63. |
|
Pituitary adenoma: a DNA flow cytometric study of 192
clinicopathologically characterized tumors.
Gaffey TA Jr, Scheithauer BW, Leech RW, Blick K, Kovacs K, Horvath E,
Weaver AL, Lloyd RV, Ebersold M, Laws ER Jr, DeBault LE.
Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
55905, USA.
A clinically, immunohistochemically and ultrastructurally characterized
series of 192 pituitary adenomas was analyzed for DNA content by flow
cytometry. Results were assessed not only relative to tumor immunotype,
size, and invasiveness, but also with frequency of recurrence. Case
selection was non-random; males predominated (1.8:1) and the ratio of
macro-to-microadenomas was 4.2:1. Female patients were slightly younger and,
in all adenoma categories, less often had invasive tumors: PRL (15%/30%),
ACTH (17%/44%), LH/FSH (8%/27%) and null cell adenomas (0%/27%). With the
exception of prolactin cell adenomas, similar proportions of macroadenomas
and invasive tumors in all tumor subtypes were diploid and non-diploid.
Prolactin adenomas differed in that tumors of males showed a high rate of
non-diploidy (65%); such tumors were predominantly macroadenomas, but only
28% were invasive. Among GH-containing tumors 78% were macroadenomas, 40%
were nondiploid, and the frequency of invasive macroadenomas was higher
(49%) than in PRL tumors (21%). ACTH adenomas were mainly microadenomas
(81%), their rate invasion (29%) and of non-diploidy being low (14%). Among
"non-functioning" (LH/FSH, null cell adenomas), LH/FSH-producing
tumors were all macroadenomas, but with low rates of invasion (23%) and
non-diploidy (9%). Null cell adenomas, nearly all macroadenomas, had similar
low invasion rate (21%), but were more often non-diploid (39%). In all
adenoma subgroups S-phase fractions were higher in non-diploid adenomas by
an overall ratio of 2.1:1. Prolactin adenomas showed the highest (15.2%) and
LH/FSH adenomas the lowest (5.6%) mean S-phase fraction. When compared to
long-term follow-up, neither this parameter nor ploidy correlated with tumor
size or invasiveness. Lastly, long-term follow-up showed ploidy to be an
unreliable predictor of tumor persistence or recurrence.
PMID: 15803804 [PubMed - indexed for MEDLINE]
| 12: Int
J Radiat Oncol Biol Phys. 2005 Jun 1;62(2):328-32. |
|
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Evaluating changes in tumor volume using magnetic
resonance imaging during the course of radiotherapy treatment of high-grade
gliomas: Implications for conformal dose-escalation studies.
Tsien C, Gomez-Hassan D, Ten Haken RK, Tatro D, Junck L, Chenevert TL,
Lawrence T.
Department of Radiation Oncology, University of Michigan, Ann Arbor, MI,
USA.
Objective: To determine whether changes in tumor volume occur during the
course of conformal 3D radiotherapy of high-grade gliomas by use of magnetic
resonance imaging (MRI) during treatment and whether these changes had an
impact on tumor coverage. Methods and Materials: Between December 2000 and
January 2004, 21 patients with WHO Grades 3 to 4 supratentorial malignant
gliomas treated with 3D conformal radiotherapy (median dose, 70 Gy) were
enrolled in a prospective clinical study. All patients underwent T1-weighted
contrast-enhancing and T2-weighted and fluid-attenuated inversion recovery
(FLAIR) imaging at approximately 1 to 2 weeks before radiotherapy, during
radiotherapy (Weeks 1 and 3), and at routine intervals thereafter. All MRI
scans were coregistered to the treatment-planning CT. Gross tumor volume
(GTV Pre-Rx) was defined from a postoperative T1-weighted contrast-enhancing
MRI performed 1 to 2 weeks before start of radiotherapy. A second GTV (GTV
Week 3) was defined by use of an MRI performed during Week 3 of
radiotherapy. A uniform 0.5 cm expansion of the respective GTV, PTV
(Pre-Rx), and PTV (Week 3) was applied to the final boost plan. Dose-volume
histograms (DVH) were used to analyze any potential adverse changes in tumor
coverage based on Week 3 MRI. Results: All MRI scans were reviewed
independently by a neuroradiologist (DGH). Two patients were noted to have
multifocal disease at presentation and were excluded from analysis. In 19
cases, changes in the GTV based on MRI at Week 3 during radiotherapy were as
follows: 2 cases had an objective decrease in GTV (>/=50%); 12 cases
revealed a slight decrease in the rim enhancement or changes in cystic
appearance of the GTV; 2 cases showed no change in GTV; and 3 cases
demonstrated an increase in tumor volume. Both cases with objective
decreases in GTV during treatment were Grade 3 tumors. No cases of tumor
progression were noted in Grade 3 tumors during treatment. In comparison,
three of 12 Grade 4 tumors had tumor progression, based on MRI obtained
during Week 3 of radiotherapy. Median increase in GTV (Week 3) was 11.7 cc
(range, 9.8-21.3). Retrospective DVH analysis of PTV (Pre-Rx) and PTV (Week
3) demonstrated a decrease in V(95%)(PTV volume receiving 95% of the
prescribed dose) in those 3 cases. Conclusions: Routine MR imaging during
radiotherapy may be essential in ensuring tumor coverage if highly conformal
radiotherapy techniques such as stereotactic boost and intensity-modulated
radiotherapy are used in dose-escalation trials that utilize smaller
treatment margins.
PMID: 15890571 [PubMed - in process]
-
| 13: Int
J Radiat Oncol Biol Phys. 2005 Jun 1;62(2):318-27. |
|
-
Immunohistochemically determined total epidermal growth
factor receptor levels not of prognostic value in newly diagnosed
glioblastoma multiforme: Report from the Radiation Therapy Oncology Group.
Chakravarti A, Seiferheld W, Tu X, Wang H, Zhang HZ, Ang KK, Hammond E,
Curran W Jr, Mehta M.
Department of Radiation Oncology, Massachusetts General Hospital/Harvard
Medical School, Boston, MA.
Purpose: The Radiation Therapy Oncology Group (RTOG) performed an analysis
of patterns of immunohistochemically detected total epidermal growth factor
receptor (EGFR) protein expression levels and their prognostic significance
on archival tissue in newly diagnosed glioblastoma multiforme (GBM) patients
from prior prospective RTOG clinical trials. Methods and materials: Patients
in this study had been treated on previous RTOG GBM trials (RTOG 7401, 7918,
8302, 8409, 9006, 9305, 9602, and 9806). Tissue microarrays were prepared
from 155 patients enrolled in these trials. These specimens were stained
using a mouse monoclonal antibody specific for the extracellular binding
domain of EGFR to detect total EGFR (including both wild-type phosphorylated
and wild-type unphosphorylated isoforms with some cross-reactivity with
EGFRvIII). The intensity of total EGFR protein expression was measured by
computerized quantitative image analysis using the SAMBA 4000 Cell Image
Analysis System. The parameters measured were the mean optical densities
over the labeled areas and the staining index, which represents the
proportion of stained area relative to the mean stain concentration. Both
parameters were correlated with the clinical outcome. Results: No
differences in either overall or progression-free survival could be
demonstrated by the mean optical density class or mean optical density
quartile or the staining index of total EGFR immunostaining among the
representative RTOG GBM cases. Conclusion: Total EGFR protein expression
levels, as measured immunohistochemically, do not appear to be of prognostic
value in newly diagnosed GBM patients. Given the accumulating clinical
evidence of the activity of anti-EGFR agents in GBM and the preclinical data
suggesting the important role of downstream mediators as effectors of EGFR
signaling, the RTOG is conducting additional investigations into the
prognostic value of activation patterns of EGFR signaling, both at the level
of the receptor (e.g., EGFRvIII, phospho-EGFR) and at the level of
downstream signal transduction pathways (e.g., PI3K, Ras/MAPK pathways).
PMID: 15890570 [PubMed - in process]
-
| 14: J
Neurol Neurosurg Psychiatry. 2005 Jun;76(6):845-851. |
|
-
Contribution of intraoperative electrical stimulations in
surgery of low grade gliomas: a comparative study between two series without
(1985-96) and with (1996-2003) functional mapping in the same institution.
Duffau H, Lopes M, Arthuis F, Bitar A, Sichez JP, Van Effenterre R,
Capelle L.
Service de Neurochirurgie, Hopital de la Salpetriere, 47-83 Bd de l'hopital,
75651 Paris, Cedex 13, France. hugues.duffau@psl.ap-hop-paris.fr.
OBJECTIVES: Despite the growing use of intraoperative functional mapping in
supratentorial low grade glioma (LGG) surgery, few studies have compared
series of patients operated on without and with direct electrical
stimulation (DES) by the same team. The present study compared the rate of
LGG surgery performed in eloquent areas, the rate of postoperative sequelae,
and the quality of resection during two consecutive periods in the same
department-the first without and the second with the use of intraoperative
electrophysiology. METHODS: Between 1985 and 1996, 100 patients harbouring a
supratentorial LGG underwent surgery with no functional mapping (S1).
Between 1996 and 2003, 122 patients were operated on in the same department
for a supratentorial LGG using intraoperative cortico-subcortical DES (S2).
RESULTS: Comparison between the two series showed that 35% of LGGs were
operated on in eloquent areas in S1 versus 62% in S2 (p<0.0001), with 17%
severe permanent deficits in S1 versus 6.5% in S2 (p<0.019). On
postoperative MRI, 37% of resections were subtotal and 6% total in S1 versus
50.8% and 25.4%, respectively, in S2 (p<0.001). In both groups, survival
was significantly related to the quality of resection. CONCLUSIONS: The
results of the present study allow, for the first time, quantification of
the contribution of intraoperative DES in LGG resection. Indeed, the use of
this method leads to the extension of indications of LGG surgery within
eloquent areas; to a decrease in the risk of sequelae; and to improvement of
the quality of tumour resection, with an impact on survival.
PMID: 15897509 [PubMed - as supplied by publisher]
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| 15: Neuroradiology. 2005
Jan;47(1):18-26. Epub 2005 Jan 4. |
|
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Value of 123I-IMT SPECT for diagnosis of recurrent
non-astrocytic intracranial tumours.
Plotkin M, Amthauer H, Eisenacher J, Wurm R, Michel R, Wust P,
Stockhammer F, Rottgen R, Gutberlet M, Ruf J, Felix R.
Department of Radiology, Nuclear Medicine and Radio-oncology, Klinik fur
Strahlenheilkunde, Campus Virchow-Klinikum, Charite Universitatsmedizin,
13353 Berlin, Germany. michail.plotkin@charite.de
The value of single-photon emission tomography (SPECT) using
iodine-123-alpha-methyl-tyrosine (IMT) for the diagnosis of recurrent or
residual gliomas is well established. In the current study we investigated
whether IMT-SPECT could also be useful in the follow-up of brain metastases
and other intracranial tumours of non-astrocytic origin. The study included
22 patients with suspected recurrent intracranial tumours of non-astrocytic
origin (12 brain metastases, one supratentorial primitive neuroendocrine
tumour (PNET), one rhabdoid tumour, two clivus chordomas, three ependymomas,
two pituitary tumours, one anaplastic meningioma) who had previously been
treated by surgery and/or radio/chemotherapy. SPECT results were correlated
with clinical and MRI follow-up data. The study was true positive in 13
patients, true negative in five, false positive in one and false negative in
three patients. Notably, all false negative findings were <13 mm. The
resulting sensitivity of the IMT-SPECT was 81%. We concluded that the
IMT-SPECT is a promising complementary imaging tool for the detection of
recurrences of non-astrocytic intracranial tumours and their distinguishing
from treatment-induced changes. The limitation of the IMT-SPECT is its low
sensitivity for the detection of small lesions.
PMID: 15630586 [PubMed - indexed for MEDLINE]
-
| 16: Neuroradiology. 2004
Sep;46(9):770-80. |
|
-
Choroid plexus carcinomas in children: MRI features and
patient outcomes.
Meyers SP, Khademian ZP, Chuang SH, Pollack IF, Korones DN, Zimmerman RA.
Department of Radiology, University of Rochester School of Medicine, Strong
Memorial Hospital, Rochester, NY, USA. steven_meyers@urmc.rochester.edu
Choroid plexus carcinomas (CPC) are rare malignant intracranial neoplasms
usually occurring in young children. The objectives of this study were to
characterize the preoperative MRI features of CPC, determine the frequency
of disseminated disease in the CNS at diagnosis, and assess patient
outcomes. The preoperative cranial MR images of 11 patients with CPC were
retrospectively reviewed for lesion location, lesion size, un-enhanced and
enhanced MRI signal characteristics, and presence of disseminated
intracranial tumor. Postoperative cranial and spinal MRI images were
reviewed for residual, recurrent, and/or disseminated tumor. The study group
included six male and five female patients ranging in age from 5 months to
5.3 years (median= 1.8 years). CPC were located in the lateral (n = 8),
fourth (n = 1), and third (n = 1) ventricles, and foramen of Luschka (n =
1). Mean tumor size was 5.2 cm x 4.9 cm x 5.0 cm. On short-TR images, CPC
had heterogeneous, predominantly intermediate signal with foci of high
signal in 45% of lesions from areas of hemorrhage. On long-TR/long-TE
images, solid portions of CPC typically had heterogeneous,
intermediate-to-slightly-high signal. Small zones of low signal on
long-TR/long-TE images were seen in 55% of the lesions secondary to areas of
hemorrhage and/or calcifications. Tubular flow voids representing blood
vessels were seen in 55% of the lesions. Zones of high signal comparable to
CSF were seen in 64% of CPC secondary to cystic/necrotic zones. All CPC
showed prominent contrast enhancement. Irregular enhancing margins
suggesting subependymal invasion were seen in 73% of the lesions. Findings
consistent with edema in the brain adjacent to the enhancing lesions were
seen in 73% of CPC. CPC caused hydrocephalus in 82% of patients at
diagnosis. Two patients died from hemorrhagic complications from surgical
biopsies. Disseminated tumor in the leptomeninges was present in 45% of
patients at diagnosis and was associated with a poor prognosis. The 1-year
and 5-year survival probabilities were 55% and 45%, respectively. In
conclusion, MRI features commonly associated with CPC include large
intraventricular lesions with irregular enhancing margins; heterogeneous
signal on long TR/long TE images and short-TR images; edema in adjacent
brain; hydrocephalus; and presence of disseminated tumor. MRI evidence of
disseminated tumor at diagnosis is associated with a poor prognosis.
PMID: 15309348 [PubMed - indexed for MEDLINE]
-
| 17: Neuroradiology. 2004
Sep;46(9):744-54. |
|
-
Intrathecal gadolinium (gadopentetate
dimeglumine)-enhanced MR cisternography used to determine potential
communication between the cerebrospinal fluid pathways and intracranial
arachnoid cysts.
Tali ET, Ercan N, Kaymaz M, Pasaoglu A, Jinkins JR.
Department of Radiology, Division of Neuroradiology, Gazi University School
of Medicine, 06510 Ankara, Turkey. turgut.tali@med.gazi.edu.tr
This study was designed to assess the feasibility of intrathecal
gadolinium-enhanced magnetic resonance cisternography (MRC) for the
evaluation of the presence or absence of communication of cranial arachnoid
cysts with the cerebrospinal fluid (CSF) pathways of the central nervous
system (CNS). This prospective study included 20 patients (12 males and 8
females) with a mean age of 37 years, who had, as a group, 22 intracranial
arachnoid cysts identified on prior CT and/or MR examinations. Routine
pre-contrast cranial MR imaging was followed by the intrathecal
administration of 0.5 cc gadopentetate dimeglumine (GD) (Magnevist,
Schering, Germany). Immediate and delayed (24 h) MR cisternography was then
carried out. Eleven of 22 arachnoid cysts showed immediate CSF communication
by the demonstration GD-contrast enhancement of the cyst fluid on the
immediate post-injection scan. Contrast enhancement of the cyst was observed
only on delayed MRC in six patients. MR imaging in five patients
demonstrated no contrast enhancement of the arachnoid cysts on either
immediate or delayed imaging. Six patients had mild transient post-procedure
headache that was relieved by oral analgesics within 24 h. No serious
immediate or chronic adverse effects or complications relating to the
intrathecal contrast administration were observed. This study showed the
relative safety, feasibility and reliability of low-dose intrathecal GD MR
imaging in the demonstration of the communication or non-communication of
intracranial arachnoid cysts with the CSF pathways of the CNS. In the
future, this may have bearing on the selection for surgery of patients with
intracranial arachnoid cysts presenting with clinical signs and symptoms
potentially related to the location and mass effect of the cyst.
Publication Types:
PMID: 15289956 [PubMed - indexed for MEDLINE]
-
| 18: Neurosurgery. 2005
Mar;56(3):E627; discussion E627. |
|
-
Repair of intractable cerebrospinal fluid rhinorrhea with
mucosal flaps and recombinant human basic fibroblast growth factor:
technical case report.
Kubo S, Inui T, Hasegawa H, Yoshimine T.
Department of Neurosurgery, Tominaga Hospital, Osaka, Japan.
sig-kubo@momo.so-net.ne.jp
OBJECTIVE AND IMPORTANCE: Repair of a cerebrospinal fluid leak is not always
easy, especially when a large fistula, with concomitant infection and
injured mucosa, has developed from repeated transsphenoidal operations. We
repaired such a sellar floor defect with mucosal flaps via the endonasal
endoscopic approach and finally obliterated the fistula by promoting
granulation-like tissue formation with recombinant human basic fibroblast
growth factor (bFGF). CLINICAL PRESENTATION: A 27-year-old woman with
intractable cerebrospinal fluid rhinorrhea was referred to our department
after repeated operations for a relapsing Rathke's cleft cyst. Endonasal
endoscopic examination revealed a large bone defect on the sellar floor
through which previously packed fat and fascia were exposed to the nasal
cavity. INTERVENTION: Mucosal flaps were harvested endoscopically from the
nasal septum and the superior and middle turbinates. These pedicled flaps
were transposed to the sellar defect. The flaps survived but did not cover
the whole area, resulting in gaps between the flaps through which
cerebrospinal fluid still leaked. Recombinant bFGF was repeatedly applied
endoscopically to the mucosal flaps. The flaps turned into granulation-like
tissue, and complete mucosal covering was finally achieved. CONCLUSION: bFGF
has a wide range of biological effects, including stimulation of fibroblast
growth and promotion of angiogenesis. It accelerates wound healing and is
used clinically to treat dermal ulcers. The method presented here to treat
an intractable fistula with mucosal flap and recombinant bFGF may suggest a
new clinical application of bFGF. This possibility should be examined in a
large number of patients in the future.
Publication Types:
PMID: 15730594 [PubMed - indexed for MEDLINE]
-
| 19: Neurosurgery. 2005
Mar;56(3):E625; discussion E625. |
|
-
Cervical dumbbell intra-extradural hemangioblastoma:
total removal through the lateral approach: technical case report.
Barrey C, Kalamarides M, Polivka M, George B.
Department of Neurosurgery, Hopital Neurologique P. Wertheimer, Lyon,
France. c.barrey@wanadoo.fr
OBJECTIVE AND IMPORTANCE: Extradural hemangioblastomas account for 8 to 12%
of all spinal hemangioblastomas. Among them, intra-extradural forms with a
dumbbell extension are extremely rare. We report a case of intra-extradural
hemangioblastoma involving the C6 cervical nerve root. CLINICAL
PRESENTATION: The patient was a 31-year-old woman presenting with signs of
myelopathy and C6 radiculopathy on the right side. A computed tomographic
scan and magnetic resonance imaging demonstrated a dumbbell tumor that had
developed through the C5-C6 intervertebral foramen. Angiography revealed a
well-circumscribed mass with feeders from the vertebral artery and the deep
cervical artery. INTERVENTION: The tumor was totally removed through the
lateral approach, with control of the vertebral artery and sacrifice of the
C6 cervical nerve root. Limited bone drilling to enlarge the foramen
permitted us to reach and resect the intradural component. Histopathological
examination confirmed the diagnosis of hemangioblastoma. Follow-up was
uneventful. CONCLUSION: This is the sixth reported case of a cervical
dumbbell hemangioblastoma investigated by computed tomographic scanning and
MRI but the first one resected via the lateral approach. The lateral
approach seems appropriate for surgical resection because it provides
primary control of the vascular feeders and access to the extradural and
intradural components.
Publication Types:
- Case Reports
- Review
- Review of Reported Cases
PMID: 15730592 [PubMed - indexed for MEDLINE]
-
| 20: Neurosurgery. 2005
Mar;56(3):510-5; discussion 510-5. |
|
-
Clinical characteristics of spinal nerve sheath tumors:
analysis of 149 cases.
Jinnai T, Koyama T.
Department of Neurosurgery, Ohtsu Municipal Hospital, Ohtsu, Japan.
OBJECTIVE: Spinal nerve sheath tumors arise from the spinal nerve root and
grow along it. There are two sites at which the growth of a tumor is
restricted: the dural aperture for the spinal nerve root and the
intervertebral foramen. This article describes the growth pattern of a
spinal nerve sheath tumor along the spinal nerve root at various spinal
levels. METHODS: We retrospectively reviewed the records for 149 patients
with spinal nerve sheath tumors who were treated between 1980 and 2001. Of
these, 176 resected tumors were classified into five groups according to the
relationship to the dura mater and/or the intervertebral foramen. RESULTS:
Strictly intradural tumors compose 8% of nerve sheath tumors of the first
two cervical nerve roots. The percentage of these tumors increased gradually
from the high cervical region to the thoracolumbar region, where it was more
than 80%. In contrast, the percentage of strictly extradural tumors
gradually decreased from the rostral portion to the caudal portion.
Similarly, a percentage of tumors extending outside the spinal canal
decreased from the rostral portion to the caudal portion. These changes of
the growth pattern may be explained by the anatomic features of the spinal
nerve roots, which have a longer intradural component at the more caudal
portion of the spinal axis. CONCLUSION: The anatomic relationship of a nerve
sheath tumor with the dura mater and the intervertebral foramen varies
depending on the level of the tumor. This knowledge may help us to create a
strategy for total resection of a nerve sheath tumor.
Publication Types:
PMID: 15730576 [PubMed - indexed for MEDLINE]
-
| 21: Neurosurgery. 2005
Mar;56(3):503-9; discussion 503-9. |
|
-
Characterization of hemangioblastomas of spinal nerves.
Glasker S, Berlis A, Pagenstecher A, Vougioukas VI, Van Velthoven V.
Department of Neurosurgery, Albert-Ludwigs-University, Freiburg, Germany.
OBJECTIVE: Hemangioblastoma is classified as a benign tumor of the central
nervous system. Peripheral nervous system hemangioblastomas to date have
been described only in a few case reports. Experience in treating patients
with these rare lesions, which harbor diagnostic and therapeutic pitfalls,
is limited. METHODS: To characterize these lesions better, we reviewed our
hemangioblastoma database for patients who underwent surgery for extradural
hemangioblastoma of the spinal nerve. RESULTS: Between 1983 and 2003, six
patients underwent surgery for spinal nerve hemangioblastomas at our
institution. These tumors occurred in 2% of all patients with
hemangioblastomas of the central nervous system, or 6% of all patients with
spinal hemangioblastomas. The occurrence did not differ in von Hippel-Lindau
disease cases versus sporadic cases. Radiographically, the tumors easily
could be mistaken for schwannomas or metastases; however, they did have some
typical features. If a hemangioblastoma was not suspected primarily, profuse
bleeding could complicate surgery. Most of the tumors arose from the dorsal
sensory fascicles. The vascular supply was from extradural circulation. In
general, the surgical outcome of these lesions was good, and permanent
neurological deficit was rare. However, local recurrence was observed in
three of six patients. CONCLUSION: These tumors harbor diagnostic and
therapeutic pitfalls. In general, the tumors are surgically more
challenging, and clinically significant bleeding as well as local tumor
recurrence is more common than in intradural hemangioblastomas, mostly
because of the frequency of incorrect initial radiographic diagnosis. We
suggest that because of the surgical consequences, hemangioblastoma should
always be considered to be an important radiological differential diagnosis
for nerve sheath tumors. Angiography can bring clarification to ambiguous
cases.
Publication Types:
PMID: 15730575 [PubMed - indexed for MEDLINE]
-
| 22: Neurosurgery. 2005
Mar;56(3):434-40; discussion 434-40. |
|
-
Robotic long-distance telementoring in neurosurgery.
Mendez I, Hill R, Clarke D, Kolyvas G.
Division of Neurosurgery, Dalhousie University and Queen Elizabeth II Health
Sciences Centre, Halifax, Nova Scotia, Canada. mendez@dal.ca
OBJECTIVE: To test the feasibility of long-distance telementoring in
neurosurgery by providing subspecialized expertise in real time to another
neurosurgeon performing a surgical procedure in a remote location. METHODS:
A robotic telecollaboration system (Socrates; Computer Motion, Inc., Santa
Barbara, CA) capable of controlling the movements of a robotic arm, of
handling two-way video, and of audio communication as well as transmission
of neuronavigational data from the remote operating room was used for the
telementoring procedures. Four integrated services digital network lines
with a total speed of transmission of 512 kilobytes per second provided
telecommunications between a large academic center (Halifax, Nova Scotia)
and a community-based center (Saint John, New Brunswick) located 400 km
away. RESULTS: Long-distance telementoring was used in three craniotomies
for brain tumors, a craniotomy for an arteriovenous malformation, a carotid
endarterectomy, and a lumbar laminectomy. There were no surgical
complications during the procedures, and all patients had uneventful
outcomes. The neurosurgeons in the remote location believed that the input
from the mentors was useful in all of the cases and was crucial in the
removal of a mesial temporal lobe glioma and resection of an occipital
arteriovenous malformation. CONCLUSION: Our initial experience with
long-distance robotic-assisted telementoring in six cases indicates that
telementoring is feasible, reliable, and safe. Although still in its
infancy, telementoring has the potential to improve surgical care, to
enhance neurosurgical training, and to have a major impact on the delivery
of neurosurgical services throughout the world.
Publication Types:
PMID: 15730568 [PubMed - indexed for MEDLINE]
-
| 23: Oncogene. 2005 May 16;
[Epub ahead of print] |
|
-
Cytotoxic T cell targeting of TRP-2 sensitizes human
malignant glioma to chemotherapy.
Liu G, Akasaki Y, Khong HT, Wheeler CJ, Das A, Black KL, Yu JS.
1Maxine Dunitz Neurosurgical Institute, Cedars-Sinai Medical Center, Los
Angeles, CA 90048, USA.
Tyrosinase-related protein (TRP)-2 is not only expressed on glioma cells,
but is naturally processed and presented by their surface MHC molecules and
is recognized by TRP-2-specific cytotoxic T cells. After active
immunotherapy, we detected TRP-2-specific cytotoxic T lymphocyte (CTL)
activity in patients' peripheral blood mononuclear cells (PBMC). Tumor cells
from postvaccination resections showed significantly lower TRP-2 expression
and higher sensitivity to carboplatin and temozolomide than those autologous
cell lines from prevaccination resections in two patients who demonstrated
CTL response to TRP-2. One of two patients underwent treatment with
temozolomide after recurrence and responded dramatically. TRP-2-transfected
cell line (TRP-2-U373) resulted in significant drug resistance to
carboplatin and temozolomide compared to wild-type U-373 (W-U373). There was
no significant difference, however, in the mRNA expression of other common
drug resistance related proteins, such as BCRP-1, MGMT, MDR-1, MRP-1 and
MRP-3, after TRP-2 transfection. TRP-2-U373 tumor cells were immunoselected
by a TRP-2-specific CTL line. The immunoselected cells (IS-TRP-2-U373)
demonstrated significantly increased sensitivity to carboplatin and
temozolomide compared to TRP-2-U373. For the first time, we provide evidence
that immunological targeting of tumor-associated antigen TRP-2 significantly
increases sensitivity to chemotherapy.Oncogene advance online publication,
16 May 2005; doi:10.1038/sj.onc.1208519.
PMID: 15897911 [PubMed - as supplied by publisher]
-
| 24: Pediatr Neurosurg.
2004 Nov-Dec;40(6):306-11. |
|
-
Germinoma of the basal ganglia. An 8-year asymptomatic
history after detection of abnormality on CT.
Takeda N, Fujita K, Katayama S, Uchihashi Y, Okamura Y, Nigami H,
Hashimoto K, Kohmura E.
Department of Neurosurgery, Nishi-Kobe Medical Center, Kobe, Japan.
takedake@kk.iij4u.or.jp
We describe a case of germinoma of the left basal ganglia. An 11-year-old
boy, who demonstrated calcification of the left basal ganglia on CT scan
following a head injury at the age of 3 years, presented with a weakness of
the right upper extremity for 2 months. MRI demonstrated high intensity in
the left basal ganglia on a T1-weighted image without enhancement as well as
high intensity on a T2-weighted image. Ipsilateral hemiatrophy of the
hemisphere and midbrain was also noted. In addition, high intensity in the
left internal capsule and cerebral peduncle was demonstrated on T2-weighted
image. Surgical specimens obtained by stereotactic biopsy showed germinoma
with a two-cell pattern. The patient had remained asymptomatic for 8 years
after abnormal calcification was initially detected on CT scan. Ipsilateral
hemiatrophy of the hemisphere and midbrain was demonstrated before the onset
of weakness.
Publication Types:
- Case Reports
- Review
- Review of Reported Cases
PMID: 15821363 [PubMed - indexed for MEDLINE]
-
| 25: Pediatr Neurosurg.
2004 Nov-Dec;40(6):301-5. |
|
-
Synchronous optic and pineal pilocytic astrocytomas in a
paediatric patient with neurofibromatosis type 1.
Ogura T, Adachi J, Nishikawa R, Hirose T, Matsutani M.
Department of Neurosurgery, Saitama Medical School, Saitama, Japan.
takeshi-ogura@nifty.com
A 12-year-old girl with neurofibromatosis type 1 presented with headache,
visual acuity and visual field disturbance. Computed tomography and magnetic
resonance imaging revealed an enhanced solid mass involving her right optic
nerve and optic chiasm, and a cystic lesion in the pineal region that had
resulted in obstructive hydrocephalus. An open biopsy of the right optic
nerve tumour was performed, and it was histologically identified as a
pilocytic astrocytoma. Local irradiation of 50 Gy to the optic pathway
tumour was performed, and the tumour has remained stable for more than 29
months. On the contrary, the pineal cystic mass that was also histologically
identified as a pilocytic astrocytoma showed marked enlargement within 5
months after a subtotal resection. Chemotherapy with cisplatin and
vincristine was performed after a second surgery, and the pineal tumour has
not re-grown in 18 months. To our knowledge, this is the first case report
to describe synchronous optic and pineal pilocytic astrocytomas associated
with neurofibromatosis type 1.
Publication Types:
PMID: 15821362 [PubMed - indexed for MEDLINE]
-
| 26: Pediatr Neurosurg.
2004 Nov-Dec;40(6):297-300. |
|
-
Congenital peripheral facial palsy associated with
cerebellopontine angle arachnoid cyst.
Erman T, Demirhindi H, Gocer AI, Akgul E, Ildan F, Boyar B.
Department of Neurosurgery, Cukurova University, School of Medicine, Adana,
Turkey. ermant@cu.edu.tr
OBJECTS: A rare case of cerebellopontine angle arachnoid cyst leading to
congenital peripheral facial palsy was presented. CLINICAL PRESENTATION: A
1-year-old girl presented with peripheral facial paralysis since birth.
Computed tomography and magnetic resonance imaging revealed left
cerebellopontine angle arachnoid cyst causing moderate displacement of the
brain stem. INTERVENTION: Retrosigmoid suboccipital craniotomy was performed
and microsurgical resection of the cyst wall and fenestration of the cyst to
the basal cisterns were achieved. CONCLUSIONS: Cerebellopontine angle
arachnoid cyst should be considered as a potential cause of congenital
peripheral facial palsy.
Publication Types:
PMID: 15821361 [PubMed - indexed for MEDLINE]
-
| 27: Pediatr Neurosurg.
2004 Nov-Dec;40(6):293-6. |
|
-
Spinal rhabdomyosarcoma in a child with
lipomyelomeningocele.
Wagner W, Koch D.
Department of Neurosurgery, Section of Pediatric Neurosurgery, University
Hospitals, Mainz, Germany. wagner@nc.klinik.uni-mainz.de
Malignant tumors arising within dysrhaphic malformations are very rare and
are mostly teratomas; so far, only one rhabdomyosarcoma has been reported in
this context. We report another case of a girl with lipomyelomeningocele who
developed a lumbar rhabdomyosarcoma 2 years after birth and primary closure
of the neural tube defect. We present clinical, radiological and
pathological findings, discuss possible mechanisms of malignant
transformation and review the literature.
Publication Types:
- Case Reports
- Review
- Review of Reported Cases
PMID: 15821360 [PubMed - indexed for MEDLINE]
-
| 28: Pediatr Neurosurg.
2004 Nov-Dec;40(6):277-83. |
|
-
Choroid plexus and aquaporin-1: a novel explanation of
cerebrospinal fluid production.
Longatti PL, Basaldella L, Orvieto E, Fiorindi A, Carteri A.
Department of Neurosurgery, Treviso Hospital, University of Padua, Italy.
plongatti@ulss.tv.it
Aquaporins are selective water channel proteins that play a central role in
the homeostasis of human body water. The choroid plexus (CP) is considered
to be the main cerebrospinal fluid (CSF)-producing structure. In this study,
six specimens of normal human CP obtained during surgery were analyzed by
immunohistochemistry techniques for aquaporin-1 (AQP1) expression and
distribution. Intense, uniformly distributed AQP1 immunostaining was
observable in the apical but not the basolateral side of cuboid cells of the
CP. Moreover, this polarized expression of AQP1 was weakly detectable in the
endothelial cells of choroid microvessels and, with a different pattern, in
the cells lining the tubules shaped into crypts. Selective AQP1 expression
on the surface of the normal human CP might explain the role of CSF
production by this complex structure.
PMID: 15821358 [PubMed - indexed for MEDLINE]
|
Volume 4, Number 22 - 25 May 2005