| 1: AJNR
Am J Neuroradiol. 2005 Sep;26(8):2157-60. |
|
-
Glioblastoma multiforme of the conus medullaris in a
child: description of a case and literature review.
Stecco
A, Quirico
C, Giampietro
A, Sessa
G, Boldorini
R, Carriero
A.
SCDU Radiologia, AO Maggiore della Carita, Novara, Italy.
We describe a case of glioblastoma multiforme of the conus medullaris in a
child. MR imaging showed at the T12-L1 level an intramedullary mass with
signal alteration, with only two nodules of contrast enhancement. The
finding was consistent with astrocytoma. Pathologic evaluation was
consistent with glioblastoma multiforme. Nine months after the surgical
treatment, the patient showed leptomeningeal recurrence. This case appears
to be unusual for both the hysto-type and the nonspecific MR imaging
features.
PMID: 16155176 [PubMed - in process]
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| 2: AJNR
Am J Neuroradiol. 2005 Sep;26(8):2053-6. |
|
-
Primary Intraosseous Meningioma: CT and MRI Appearance.
Tokgoz
N, Oner
YA, Kaymaz
M, Ucar
M, Yilmaz
G, Tali
TE.
Department of Radiology, Division of Neuroradiology, Gazi University School
of Medicine, Ankara, Turkey.
Benign primary intraosseous meningioma presenting with osteolytic skull
lesion and soft-tissue component is rare. CT and MR imaging of a patient
with frontoparietal scalp swelling showed an osteolytic intracalvarial
lesion with an extradural soft-tissue component. Following wide surgical
resection, the histological examination revealed an intraosseous chordoid
meningioma. The clinical and radiological findings of primary intraosseous
meningioma are discussed and the relevant literature is reviewed.
PMID: 16155159 [PubMed - in process]
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| 3: AJNR
Am J Neuroradiol. 2005 Sep;26(8):1980-5. |
|
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The Effect of Prior Surgery on Blood Oxygen
Level-Dependent Functional MR Imaging in the Preoperative Assessment of
Brain Tumors.
Kim
MJ, Holodny
AI, Hou
BL, Peck
KK, Moskowitz
CS, Bogomolny
DL, Gutin
PH.
Department of Radiology, Functional MRI Laboratory, Memorial Sloan-Kettering
Cancer Center, New York, NY.
BACKGROUND AND PURPOSE: Blood oxygen level-dependent functional MR imaging
(BOLD fMRI) is a clinically useful technique for preoperative mapping of
eloquent cortices in patients with brain tumors. The purpose of this study
was to determine the effect on BOLD fMRI accuracy of susceptibility
artifacts caused by prior surgery by comparing volumes of activation in the
primary motor cortex (PMC) of patients with and without prior brain surgery.
METHODS: The volumes of fMRI activation of the PMC were measured for the
tumor and nontumor sides in patients with (n = 13) and without (n = 30)
prior neurosurgery. Statistical comparisons of the volumes were performed by
using paired t tests and linear regression analysis. The location and degree
of susceptibility artifact were subjectively assessed. RESULTS: No
significant difference was found between the mean tumor and nontumor volumes
of fMRI activations in patients without prior surgery (P = .51). In patients
who had prior surgery, the volume of activation was significantly smaller on
the side of the prior operation when compared with the contralateral side (P
= .001). The volume of activation on the side of the tumor was also
significantly smaller in the patients with prior surgery compared with those
without prior surgery (P < .001). Nevertheless, the PMC was identified in
all cases, and its location was confirmed intraoperatively. CONCLUSION:
Prior surgery is associated with a decrease in the volume of fMRI activation
in patients with prior surgery; however, by examining the T2 images, an
astute radiologist can recognize this phenomenon, draw the appropriate
conclusions, and correctly identify the PMC.
PMID: 16155146 [PubMed - in process]
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| 4: AJNR
Am J Neuroradiol. 2005 Sep;26(8):1967-72. |
|
-
Radiation Necrosis Versus Glioma Recurrence: Conventional
MR Imaging Clues to Diagnosis.
Mullins
ME, Barest
GD, Schaefer
PW, Hochberg
FH, Gonzalez
RG, Lev
MH.
Department of Radiology, Massachusetts General Hospital, Boston, MA.
BACKGROUND AND PURPOSE: Conventional MR imaging findings are considered to
be inadequate for reliably distinguishing radiation necrosis from tumor
recurrence in patients with glioma. Despite this belief, we hypothesized
that certain conventional MR imaging findings, alone or in combination,
though not definitive, may favor one or another of these diagnoses in proton
beam-treated patients with new enhancing lesions on serial scanning.
METHODS: MR imaging findings (axial T1-, T2-, and post-gadolinium
T1-weighted) of 27 proton beam radiation therapy patients with high-grade
gliomas were retrospectively reviewed. Entry criteria included new MR
imaging enhancing lesions after treatment and histologically unequivocal
biopsy proof of diagnosis. Readers rated corpus callosum involvement,
midline spread, subependymal spread, new discrete multiple enhancing foci, a
"spreading wavefront" appearance, and septum pellucidum
involvement. Statistical analysis was by the Fisher exact test. RESULTS:
Corpus callosum involvement in combination with multiple other findings was
highly associated with progressive glioma. These combinations included
involvement of the corpus callosum with multiple enhancing foci (P = .02),
involvement of the corpus callosum with crossing the midline and multiple
enhancing lesions (P = .04), and involvement of the corpus callosum with
subependymal spread and multiple enhancing lesions (P = .01). CONCLUSIONS:
In proton beam-treated patients with glioma, corpus callosum involvement, in
conjunction with multiple enhancing lesions with or without crossing of the
midline and subependymal spread, favors predominant glioma progression.
Overall, combinations of enhancement patterns were more likely than
individual patterns to distinguish necrosis from predominant tumor
progression. Together with clinical and functional imaging findings, these
results may assist in determining the need for biopsy.
PMID: 16155144 [PubMed - in process]
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| 5: AJNR
Am J Neuroradiol. 2005 Aug;26(7):1858-61. |
|
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Posterior pituitary astrocytoma: a rare tumor of the
neurohypophysis: a case report.
Shah
B, Lipper
MH, Laws
ER, Lopes
MB, Spellman
MJ Jr.
Department of Radiology, Division of Neuroradiology, University of Virginia
Health Systems, Charlottesville, VA 22908, USA.
Astrocytoma, or pituicytoma, of the posterior pituitary is a relatively rare
entity consisting of poorly characterized glial tumor cells. We report two
cases of posterior pituitary astrocytomas in middle-aged women presenting as
focal lesions of the neurohypophysis. A review of the literature reveals
only a few reports of this tumor, and there has been scanty discussion of
the imaging findings of posterior pituitary astrocytomas compared with
lesions of the anterior pituitary gland. This report reviews the clinical
characteristics and imaging findings and discusses the differential
diagnosis of these two cases.
Publication Types:
- Case Reports
- Review
- Review of Reported Cases
PMID: 16091544 [PubMed - indexed for MEDLINE]
-
| 6: Cancer
Genet Cytogenet. 2005 Oct 1;162(1):63-7. |
|
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GADD45A and EPB41 as tumor suppressor genes in meningioma
pathogenesis.
Piaskowski
S, Rieske
P, Szybka
M, Wozniak
K, Bednarek
A, Pluciennik
E, Jaskolski
D, Sikorska
B, Liberski
PP.
Department of Molecular Pathology and Neuropathology, Chair of Oncology,
Medical University, Czechoslowacka st. 8/10, 92-216 Lodz, Poland.
Deletions of 1p occur in approximately 30% of meningiomas. Based on loss of
heterozygosity (LOH) analysis, two regions on 1p have been suspected to be
carriers of tumor suppressor genes. We chose the GADD45A and EPB41 genes as
tumor suppressor candidates based on their function and chromosomal
localization. We analyzed 19 cases of meningioma with LOH of 1p by means of
sequencing of the GADD45A gene and Western blotting of the GADD45a protein.
Twenty cases of meningioma without 1p LOH were also analyzed by Western
blotting to find out if changes of the GADD45a protein expression occurred.
Nineteen samples with 1p LOH (12 grade I; 7 grade II, WHO classification)
and 20 samples without 1p LOH (18 grade I; 2 grade II) were also analyzed by
means of real-time polymerase chain reaction to find abnormalities in EPB41
mRNA levels in meningioma. LOH analysis was performed using seven
microsatellite markers: D1S508 (1p36.2), D1S199 (1p36.1) D1S2734 (1p36.1),
D1S2720 (1p34), D1S197 (1p32), D1S162 (1p32), D1S429 (1p11). LOH analysis
confirmed previously described localization of putative tumor suppressor
genes on 1p and involvement in meningioma pathogenesis (1p36 and 1p32). The
open reading frame of GADD45A and intron splicing sites showed neither
mutations nor polymorphisms. GADD45a protein molecular weight and expression
level were unaltered in meningiomas with and without 1p LOH. We conclude
that the GADD45A gene is not involved in meningioma tumorigenesis. EPB41
gene expression was unchanged in all analyzed meningiomas. This suggests
that involvement of the EPB41 gene (4.1R protein) in meningioma pathogenesis
should be reconsidered.
PMID: 16157202 [PubMed - in process]
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| 7: Cancer Res. 2005 Sep
15;65(18):8359-65. |
|
-
Plasminogen kringle 5-engineered glioma cells block
migration of tumor-associated macrophages and suppress tumor vascularization
and progression.
Perri
SR, Nalbantoglu
J, Annabi
B, Koty
Z, Lejeune
L, Francois
M, Di
Falco MR, Beliveau
R, Galipeau
J.
Division of Experimental Medicine, Lady Davis Institute for Medical
Research.
Angiostatin, a well-characterized angiostatic agent, is a proteolytic
cleavage product of human plasminogen encompassing the first four kringle
structures. The fifth kringle domain (K5) of human plasminogen is distinct
from angiostatin and has been shown, on its own, to act as a potent
endothelial cell inhibitor. We propose that tumor-targeted K5 cDNA
expression may act as an effective therapeutic intervention as part of a
cancer gene therapy strategy. In this study, we provide evidence that
eukaryotically expressed His-tagged human K5 cDNA (hK5His) is exported
extracellularly and maintains predicted disulfide bridging conformation in
solution. Functionally, hK5His protein produced by retrovirally engineered
human U87MG glioma cells suppresses in vitro migration of both human
umbilical vein endothelial cells and human macrophages. Subcutaneous
implantation of Matrigel-embedded hK5His-producing glioma cells in nonobese
diabetic/severe combined immunodeficient mice reveals that hK5His induces a
marked reduction in blood vessel formation and significantly suppresses the
recruitment of tumor-infiltrating CD45(+)Mac3(+)Gr1(-) macrophages.
Therapeutically, we show in a nude mouse orthotopic brain cancer model that
tumor-targeted K5 expression is capable of effectively suppressing glioma
growth and promotes significant long-term survival (>120 days) of test
animals. These data suggest that plasminogen K5 acts as a novel two-pronged
anticancer agent, mediating its inhibitory effect via its action on
host-derived endothelial cells and tumor-associated macrophages, resulting
in a potent, clinically relevant antitumor effect.
PMID: 16166313 [PubMed - in process]
-
| 8: Cancer Res. 2005 Sep
15;65(18):8250-5. |
|
-
Essential role for ras signaling in glioblastoma
maintenance.
Holmen
SL, Williams
BO.
Molecular Medicine and Virology Group and Laboratory of Cell Signaling and
Carcinogenesis, Van Andel Research Institute, Grand Rapids, Michigan.
Malignant gliomas can be induced in mice through the combined expression of
activated forms of both KRas and Akt in glial progenitor cells. To determine
the reliance of these tumors on continued KRas signaling in vivo, we
generated a viral vector that allows the expression of KRas to be controlled
post-delivery. Tumor-free survival rates were compared between those animals
with continued KRas expression and animals in which KRas expression was
suppressed. KRas signaling was found to be required for the maintenance of
these tumors in vivo; inhibition of KRas expression resulted in apoptotic
tumor regression and increased survival. Subsequent reexpression of KRas
reinitiated tumor growth, indicating that a percentage of the progenitor
cells survived and retained tumorigenic properties.
PMID: 16166301 [PubMed - in process]
-
| 9: Cancer Res. 2005 Jul
15;65(14):6178-88. |
|
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Stromal cell-derived factor-1alpha and CXCR4 expression
in hemangioblastoma and clear cell-renal cell carcinoma: von Hippel-Lindau
loss-of-function induces expression of a ligand and its receptor.
Zagzag
D, Krishnamachary
B, Yee
H, Okuyama
H, Chiriboga
L, Ali
MA, Melamed
J, Semenza
GL.
Microvascular and Molecular Neuro-oncology Laboratory, New York, New York,
USA. dz4@nyu.edu
The genetic hallmark of hemangioblastomas and clear cell-renal cell
carcinomas (CC-RCCs) is loss-of-function of the von Hippel-Lindau (VHL)
tumor suppressor protein. VHL is required for oxygen-dependent degradation
of hypoxia-inducible factor-1alpha (HIF-1alpha). In hemangioblastomas and
CC-RCCs, HIF-1alpha is constitutively overexpressed leading to increased
transcription of HIF-1-regulated genes, including vascular endothelial
growth factor (VEGF). Because loss of VHL function is associated with
increased expression of the chemokine receptor CXCR4 in CC-RCCs, we
investigated the expression of HIF-1alpha, CXCR4, and its ligand stromal
cell-derived factor-1alpha (SDF-1alpha) in hemangioblastomas and CC-RCCs.
Immunohistochemistry revealed overexpression of both CXCR4 and SDF-1alpha
within tumor cells and endothelial cells of hemangioblastomas and CC-RCCs.
HIF-1alpha was detected in tumor cell nuclei of both hemangioblastomas and
CC-RCCs. A specific ELISA showed that hemangioblastomas and CC-RCCs
expressed SDF-1alpha protein at levels that were significantly higher than
those found in normal tissue. Analysis of the VHL-null RCC line 786-0
revealed that SDF-1alpha mRNA levels were 100-fold higher than in a subclone
transfected with the wild-type VHL gene. Expression of CXCR4 and SDF-1alpha
mRNA was significantly decreased in HIF-1alpha-null compared with wild-type
mouse embryo fibroblasts (MEFs). ELISA and Western blot studies for
SDF-1alpha and CXCR4 protein expression confirmed the RNA findings in RCC
lines and MEFs. These results suggest that loss-of-function of a single
tumor suppressor gene can up-regulate the expression of both a ligand and
its receptor, which may establish an autocrine signaling pathway with
important roles in the pathogenesis of hemangioblastoma and CC-RCC.
PMID: 16024619 [PubMed - indexed for MEDLINE]
-
| 10: Childs
Nerv Syst. 2005 Sep 10; [Epub ahead of print] |
|
-
Long-term effects of transient cerebellar mutism after
cerebellar astrocytoma or medulloblastoma tumor resection in childhood.
Huber
JF, Bradley
K, Spiegler
BJ, Dennis
M.
Department of Pediatrics, University of Toronto, Toronto, Canada.
BACKGROUND: Following cerebellar tumor resection, some patients develop
transient cerebellar mutism (TCM). Although the mutism resolves, it is not
known whether there are long-term motor speech deficits in patients with TCM
that are in excess of those in individuals with cerebellar tumors who had
not developed postoperative TCM. METHODS: Long-term survivors of cerebellar
tumors resected in childhood who developed TCM were matched to survivors
without TCM and to controls. Speech samples were formally analyzed by two
speech pathologists. RESULTS: Tumor survivors who had TCM had significantly
more ataxic dysarthric speech and slower speech than either those without
TCM or controls and were more dysfluent than controls. Tumor survivors
without TCM did not differ from controls on ataxic dysarthria or speech
rate. CONCLUSIONS: Survivors who had TCM showed more speech deficits than
controls or survivors without TCM. The data suggest that speech deficits are
chronic if not permanent sequelae of TCM.
PMID: 16155765 [PubMed - as supplied by publisher]
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| 11: Int
J Cancer. 2005 Sep 13; [Epub ahead of print] |
|
-
Maternal medication use and the risk of brain tumors in
the offspring: The SEARCH international case-control study.
Cardy
AH, Little
J, McKean-Cowdin
R, Lijinsky
W, Choi
NW, Cordier
S, Filippini
G, Holly
EA, Lubin
F, McCredie
M, Mueller
BA, Peris-Bonet
R, Arslan
A, Preston-Martin
S.
Department of Public Health, University of Aberdeen, Aberdeen, United
Kingdom.
N-nitroso compounds (NOC) have been associated with carcinogenesis in a wide
range of species, including humans. There is strong experimental data
showing that nitrosamides (R(1)NNO.COR(2)), a type of NOC, are potent
neuro-carcinogens when administered transplacentally. Some medications are a
concentrated source of amides or amines, which in the presence of nitrites
under normal acidic conditions of the stomach can form NOC. Therefore, these
compounds, when ingested by women during pregnancy, may be important risk
factors for tumors of the central nervous system in the offspring. The aim
of the present study was to test the association between maternal use of
medications that contain nitrosatable amines or amides and risk of primary
childhood brain tumors (CBT). A case-control study was conducted, which
included 1,218 cases and 2,223 population controls, recruited from 9 centers
across North America, Europe and Australia. Analysis was conducted for all
participants combined, by tumor type (astroglial, primitive neuroectodermal
tumors and other glioma), and by age at diagnosis (</=5 years; >5
years). There were no significant associations between maternal intake of
medication containing nitrosatable amines or amides and CBT, for all
participants combined and after stratification by age at diagnosis and
histological subtype. This is the largest case-control study of CBT and
maternal medications to date. Our data provide little support for an
association between maternal use of medications that may form NOC and
subsequent development of CBT in the offspring. (c) 2005 Wiley-Liss, Inc.
PMID: 16161045 [PubMed - as supplied by publisher]
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| 12: J
Clin Oncol. 2005 Aug 1;23(22):5198-204. |
|
-
Cognitive and adaptive outcome in low-grade pediatric
cerebellar astrocytomas: evidence of diminished cognitive and adaptive
functioning in National Collaborative Research Studies (CCG 9891/POG 9130).
Beebe
DW, Ris
MD, Armstrong
FD, Fontanesi
J, Mulhern
R, Holmes
E, Wisoff
JH.
Cincinnati Children's Hospital Medical Center, The University of Cincinnati
School of Medicine, Cincinnati, OH 45229-3039, USA. dean.beebe@cchmc.org
PURPOSE: Clinicians often assume that children with posterior fossa tumors
are at minimal risk for cognitive or adaptive deficits if they do not
undergo cranial irradiation. However, small case series have called that
assumption into question, and have also suggested that nonirradiated
cerebellar tumors can cause location-specific cognitive and adaptive
impairment. This study (1) assessed whether resected but not irradiated
pediatric cerebellar tumors are associated with cognitive and adaptive
functioning deficits, and (2) examined the effect of tumor location and
medical complications on cognitive and adaptive functioning. PATIENTS AND
METHODS: The sample was composed of 103 children aged 3 to 18 years with
low-grade cerebellar astrocytomas, who underwent only surgical treatment as
part of Children's Cancer Group protocol 9891 or Pediatric Oncology Group
protocol 9130. The sample was divided into three groups based on primary
tumor location: vermis, left hemisphere, or right hemisphere. Data were
collected prospectively on intelligence, academic achievement, adaptive
skills, behavioral functioning, and pre-, peri-, and postsurgical medical
complications. RESULTS: The sample as a whole displayed an elevated risk for
cognitive and adaptive impairment that was not associated consistently with
medical complications. Within this group of children with cerebellar tumors,
tumor location had little effect on cognitive, adaptive, or medical outcome.
CONCLUSION: We did not replicate previous findings of location-specific
effects on cognitive or adaptive outcome. However, the elevated risk of
deficits in this population runs contrary to clinical lore, and suggests
that clinicians should attend to the functional outcomes of children who
undergo only surgical treatment for cerebellar tumors.
PMID: 16051961 [PubMed - indexed for MEDLINE]
-
| 13: J
Clin Oncol. 2005 Aug 1;23(22):5034-43. Epub 2005 Jun 13. |
|
-
Report of an international workshop to standardize
baseline evaluation and response criteria for primary CNS lymphoma.
Abrey
LE, Batchelor
TT, Ferreri
AJ, Gospodarowicz
M, Pulczynski
EJ, Zucca
E, Smith
JR, Korfel
A, Soussain
C, DeAngelis
LM, Neuwelt
EA, O'Neill
BP, Thiel
E, Shenkier
T, Graus
F, van
den Bent M, Seymour
JF, Poortmans
P, Armitage
JO, Cavalli
F; International
Primary CNS Lymphoma Collaborative Group.
Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York,
NY 10021, USA. abreyl@mskcc.org
Standardized guidelines for the baseline evaluation and response assessment
of primary CNS lymphoma (PCNSL) are critical to ensure comparability among
clinical trials for newly diagnosed patients. The relative rarity of this
tumor precludes rapid completion of large-scale phase III trials and,
therefore, our reliance on the results of well-designed phase II trials is
critical. To formulate this recommendation, an international group of
experts representing hematologic oncology, medical oncology, neuro-oncology,
neurology, radiation oncology, neurosurgery, and ophthalmology met to review
current standards of reporting and to formulate a consensus opinion
regarding minimum baseline evaluation and common standards for assessing
response to therapy. The response guidelines were based on the results of
neuroimaging, corticosteroid use, ophthalmologic examination, and CSF
cytology. A critical issue that requires additional study is the optimal
method to assess the neurocognitive impact of therapy and address the
quality of life of PCNSL survivors. We hope that these guidelines will
improve communication among investigators and comparability among clinical
trials in a way that will allow us to develop better therapies for patients.
PMID: 15955902 [PubMed - indexed for MEDLINE]
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| 14: J Neurooncol.
2005 Sep 5; [Epub ahead of print] |
|
-
Prospective study of quality of life in adults with newly
diagnosed high-grade gliomas.
Brown
PD, Ballman
KV, Rummans
TA, Maurer
MJ, Sloan
JA, Boeve
BF, Gupta
L, Tang-Wai
DF, Arusell
RM, Clark
MM, Buckner
JC.
Division of Radiation Oncology, Mayo Clinic, Rochester, Minnesota,
brown.paul@mayo.edu, lovejoy.margery@mayo.edu.
OBJECTIVE: To assess baseline quality of life (QOL) and its prognostic
importance for adults with newly diagnosed high-grade gliomas, we analyzed
QOL and outcome data prospectively collected in three phase II high-grade
glioma protocols. METHODS: At study entry, patients completed five
self-administered forms to assess overall QOL (linear analogue scale
assessment [LASA] and Functional Assessment of Cancer Therapy-Brain
[FACT-Br]); fatigue (Symptom Distress Scale [SDS]); excessive daytime
somnolence (Epworth Sleepiness Scale [ESS]); and depression (POMS-SF).
Folstein Mini-Mental State Examination (MMSE) and Eastern Cooperative
Oncology Group (ECOG) performance scores (PS) were obtained by the health
care provider. RESULTS: Baseline QOL data were available for 194 of 220
patients (88%) enrolled in the three protocols. Differences in baseline QOL
among the three studies were not statistically significant. One-third of
patients had clinically significant fatigue at baseline. Increased fatigue
(P = 0.003), excessive daytime somnolence (P = 0.01), and lower overall QOL
scores (LASA, P = 0.001; FACT-Br, P = 0.0001) correlated with worse ECOG PS.
No relation was found between QOL and corticosteroid or anticonvulsant
therapy, extent of resection, tumor grade, or sex. Multivariate analyses
found worse ECOG PS (PS 2, P = 0.007) associated with increased fatigue.
Worse ECOG PS (PS 2, P = 0.002) was also associated with worse overall QOL
(LASA). On multivariate analyses of survival, increased fatigue (P = 0.003)
predicted poorer overall survival. CONCLUSIONS: Performance status is
related to QOL in patients with newly diagnosed high-grade brain tumors.
Increased fatigue is an independent predictor of overall survival.
Interventional studies directed at improving QOL, especially fatigue, may
have important benefits for these patients.
PMID: 16163448 [PubMed - as supplied by publisher]
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| 15: J Neurooncol.
2005 Sep 1; [Epub ahead of print] |
|
-
Radiation-induced Spinal Cord Glioma Subsequent to
Treatment of Hodgkin's Disease:Case Report and Review.
Riffaud
L, Bernard
M, Lesimple
T, Morandi
X.
Departments of Neurosurgery, Rennes University, Rennes, France,
laurent.riffaud@chu-rennes.fr.
Radiation-induced neoplasms of the central nervous system generally present
as meningioma or sarcoma. Spinal cord glioma after radiation therapy is rare
and half of the cases documented occurred after treatment of Hodgkin's
disease.A 39-year-old male presented with a 1-month history of gradually
worsening neck ache and paraparesis. The patient had been treated for stage
IB Hodgkin's disease 9 years previously with combined therapy: MOPP-ABV and
a 40-Gray mediastinal radiotherapy from T1 to T10. Magnetic resonance
imaging disclosed an intramedullary lesion from C6 to T2 and
histopathological examination from biopsy demonstrated a malignant glioma.
Despite chemotherapy and additional radiotherapy, the patient's neurological
status worsened and he died 11 months after initial presentation.We suggest
a strategy aimed solely at obtaining a tissue diagnosis to differentiate
myelitis from tumor, and, in the event of tumor, confirming the strong
likelihood of a high histopathological grade. The very limited survival
associated with these tumors regardless of therapy advocates palliative
therapies without attempting complete resection.
PMID: 16158216 [PubMed - as supplied by publisher]
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| 16: J Neurooncol.
2005 Sep 2; [Epub ahead of print] |
|
-
Possible pathophysiological role of vascular endothelial
growth factor (VEGF) and matrix metalloproteinases (MMPs) in metastatic
brain tumor-associated intracerebral hemorrhage.
Jung
S, Moon
KS, Jung
TY, Kim
IY, Lee
YH, Rhu
HH, Sun
HS, Jeong
YI, Kim
KK, Kang
SS.
Department of Neurosurgery, Chonnam National University Hwasun Hospital
& Medical School, Gwangju, Republic of Korea.
BACKGROUND: Intratumoral hemorrhage, as one of the cerebrovascular
complications in various tumor-related conditions, occurs mainly in
malignant brain tumors. Recent studies have shown that the overexpression of
vascular endothelial growth factor (VEGF) and metalloproteinase (MMP) may
play a role for the loss of vascular integrity and the subsequent hemorrhage
in several instances, in addition to their well-known properties in tumor
development and metastasis. METHODS: To investigate the potential role of
VEGF and MMP in hemorrhagic complication of metastatic brain tumor, we
estimated the expression of VEGF, MMP-2 & -9 by immunohistochemical
studies in pathological specimens of metastatic brain tumors obtained from
16 patients, 7 in hemorrhagic and 9 in non-hemorrhagic group. We also
examined the expression of collagen type IV, CD34, Factor VIII in order to
evaluate the status of tumor vasculature. RESULTS: Patients in hemorrhagic
group showed a higher VEGF expression with neovascularization than those in
non-hemorrhagic group. The basement membranes of newly formed vessels were
disrupted in cases with high expression in both MMP-2 and -9. These results
indicate that rapid growing nascent blood vessels, responding vigorously to
VEGF, are concentrated around the hemorrhagic tumors. Besides, these results
suggest a possibility that the basement membranes of these nascent vessels
could be disrupted proteolytically by MMP. CONCLUSION: We conclude that
overexpression of VEGF and MMP may play a role in metastatic brain
tumor-associated hemorrhage. Presumably, the underlying pathophysiological
mechanisms are through rapid growth and breakdown of vessels around the
tumors caused by overexpression of VEGF and MMP of tumor cells.
PMID: 16158215 [PubMed - as supplied by publisher]
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| 17: J Neurooncol.
2005 Sep 2; [Epub ahead of print] |
|
-
Identification of EGFRvIII-derived CTL Epitopes
Restricted by HLA A0201 for Dendritic Cell Based Immunotherapy of Gliomas.
Wu
AH, Xiao
J, Anker
L, Hall
WA, Gregerson
DS, Cavenee
WK, Chen
W, Low
WC.
Department of Neurosurgery, University of Minnesota Medical School, 2001
Sixth Street, SE, Minneapolis, MN, 55455.
The type III variant of the epidermal growth factor receptor (EGFRvIII)
mutation is present in 20-25% of patients with glioblastoma multiforme
(GBM). EGFRvIII is not expressed in normal tissue and is therefore a
suitable candidate antigen for dendritic cell (DC) based immunotherapy of
GBM. To identify the antigenic epitope(s) that may serve as targets for
EGFRvIII-specific cytotoxic T lymphocytes (CTLs), the peptide sequence of
EGFRvIII was screened with two software programs to predict candidate
epitopes restricted by the major histocompatibility complex class I subtype
HLA-A0201, which is the predominant subtype in most ethnic groups. Three
predicted peptides were constructed and loaded to mature human DCs generated
from peripheral blood monocytes. Autologous CD8(+) T cells were stimulated
in vitro with the EGFRvIII peptide-pulsed DCs. One of the three peptides was
found to induce EGFRvIII-specific CTLs as demonstrated by IFN-gamma
production and cytotoxicity against HLA-A0201(+) EGFRvIII transfected U87
glioma cells. These results suggest that vaccination with EGFRvIII
peptide-pulsed DCs or adoptive transfer of in vitro elicited
EGFRvIII-specific CTLs by EGFRvIII peptide-pulsed DCs are potential
approaches to the treatment of glioma patients.
PMID: 16155724 [PubMed - as supplied by publisher]
-
| 18: J Neurooncol.
2005 Sep 2; [Epub ahead of print] |
|
-
Isolation and Culture of Microvascular Endothelial Cells
from Gliomas of Different WHO Grades.
Miebach
S, Grau
S, Hummel
V, Rieckmann
P, Tonn
JC, Goldbrunner
RH.
Department of Neurosurgery, Klinikum Grosshadern,
Ludwig-Maximilians-University Munich, Munich, Germany.
Gliomas are the most common intrinsic brain tumors. The degree of
vascularization corresponds to malignancy and is related to prognosis. In
order to retrieve information about tumor behavior in situ, the use of
primary tissue material for experiments is advantageous. With increasing
evidence for the importance of microenvironment and vascularization in tumor
biology, we concentrated on the isolation of endothelial cells (EC) from
primary tumor material to investigate the role of endothelium within tumor
tissue.We developed a method for isolation and purification of tumor-derived
endothelial cells. EC were isolated and cultivated from normal brain using
tissue digestion and Percoll density gradient centrifugation resulting in a
>95% of EC culture. For isolation of EC from gliomas of different
malignancy grades a combination of tissue digestion, Percoll gradient
centrifugation and magnetic bead sorting by anti-CD31, -VE-Cadherin and -CD
105 was employed. This approach provided a purity of >98%. Cells were
classified and characterized by testing expression of CD105, CD31,
VE-Cadherin, vWF, UEA-1 and measuring DiI-Ac-LDL-uptake. To exclude
contamination, staining and negative selection with anti-SMA, -GFAP, and
-CD68 was performed. Tumors were histopathologically diagnosed according to
WHO classification. We isolated EC from normal brain (NBEC, n = 11),
low-grade gliomas WHO II (LGEC, n = 22), and high-grade gliomas WHO III
& IV (HGEC, n = 11). There were no clear differences in EC morphology
between the different tumor grades. However, a significantly higher
proliferation rate of HGEC compared to LGEC was observed as well as
distinctive antigen expression. Already in early passages isolated EC showed
a rapid change in antigen expression indicating a phenotypic shift under
culture conditions.We could establish a protocol for reliable and
reproducible isolation and culture of EC from gliomas with different WHO
grading. In first phenotypical and functional analyses, NBEC, LGEC and HGEC
show remarkable differences. EC from all tumors could be grown in culture.
However, passage related changes of EC phenotype demand very early passages
to work with.
PMID: 16155723 [PubMed - as supplied by publisher]
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| 19: J Neurosurg.
2005 Mar;102(2 Suppl):224-7. |
|
Atypical external hydrocephalus with visual failure due
to occult leptomeningeal dissemination of a pontine glioma. Case report.
Tarnaris
A, Edwards
RJ, Lowis
SP, Pople
IK.
Department of Neurosurgery, Frenchay Hospital, Bristol; and Department of
Paediatric Oncology, Bristol Royal Hospital for Sick Children, Bristol,
United Kingdom.
The authors report on the case of a diffuse pontine glioma in a 5-year-old
boy in whom radiologically and cytologically occult leptomeningeal
metastases led to the development of an atypical "external"
hydrocephalus, associated with grossly elevated intracranial pressure (ICP).
Initial neuroimaging demonstrated only mild communicating ventricular
dilation associated with a noticeable enlargement of the subarachnoid space,
particularly over the surface of the frontal lobes; these features are not
usually associated with significantly elevated ICP. Possible
pathophysiological mechanisms resulting in this unusual clinical
presentation are discussed. Early recognition of the severity of the raised
ICP despite the paucity of clinical and radiological signs may have averted
the development of blindness due to optic atrophy.
PMID: 16156235 [PubMed - in process]
-
| 20: J Neurosurg.
2005 Mar;102(2 Suppl):197-206. |
|
Correlation of gamma-catenin expression with good
prognosis in medulloblastomas.
Misaki
K, Marukawa
K, Hayashi
Y, Fukusato
T, Minamoto
T, Hasegawa
M, Yamashita
J, Fujisawa
H.
Department of Neurosurgery, Graduate School of Medical Science, Division of
Diagnostic Molecular Oncology, Cancer Research Institute, Kanazawa
University, Kanazawa, Japan.
OBJECT: Medulloblastoma is a malignant cerebellar tumor of childhood and is
difficult to cure due to frequent cerebrospinal fluid dissemination.
Amplification of the c-myc gene (4%) and messenger (mRNA) overexpression
(50%) are known to be adverse prognostic indicators. Because mRNA
overexpression cannot be explained by gene amplification alone, mechanisms
other than gene amplification are postulated. Molecules on the Wnt signal
pathway in primary tumors were examined. METHODS: Immunohistochemical and
cytogenetic examinations of beta- and gamma-catenin, c-myc, N-myc, and
cyclin D1 in 24 primary medulloblastomas were conducted, and their clinical
relevance was evaluated. Cytoplasmic/membranous staining of beta- and
gamma-catenin was detected in 19 (79%) and nine (37%) cases, respectively,
and nuclear expression of cyclin D1 and c-myc was detected in six (25%) and
21 (83%) cases, respectively. The expression levels of gamma-catenin in
Western blot analysis and immunohistochemistry were similar. By differential
polymerase chain reaction, c-myc and N-myc were amplified separately in two
large cell/anaplastic medulloblastomas. No cyclin D1 amplification, or beta-
or gamma-catenin mutations were found. Kaplan-Meier analysis revealed no
dissemination at diagnosis (Chang Grade M0) and gamma-catenin expression was
correlated with good prognosis (p = 0.0002 and 0.003, respectively).
Expression of gamma-catenin was also significant in the M0 group (p =
0.022). Expression of cyclin D1 showed a trend toward adverse outcome (p =
0.057) and all patients in whom cyclin D1 expression was found died of
disease. CONCLUSIONS: Expression of gamma-catenin is of great prognostic
value and its immunohistochemistry may be useful for further stratification
of treatment. Cyclin D expression may have the potential to be an adverse
prognostic indicator.
PMID: 16156230 [PubMed - in process]
-
| 21: J Neurosurg.
2005 Mar;102(2 Suppl):179-86. |
|
Neuroimaging-detected late transient treatment-induced
lesions in pediatric patients with brain tumors.
Helton
KJ, Edwards
M, Steen
RG, Merchant
TE, Sapp
MV, Boop
FA, Langston
J.
Department of Radiological Sciences, St. Jude Children's Research Hospital,
Memphis, Tennesee 38105-2794, USA. kathleen.helton@stjude.org
OBJECT: After the resection of brain tumors in pediatric patients, it can be
difficult to differentiate recurrent tumor from treatment effects. Although
late-delayed reactions are thought to be permanent, in this study the
authors sought to characterize transient brain lesions (TBLs) in the
late-delayed period that completely resolved without imaging or neurological
sequelae. METHODS: In a retrospective review of an institutional
neuroimaging brain tumor database, 11 patients were identified who met the
imaging criteria (transient T2-weighted hyperintense enhancing lesions
outside of the tumor bed, which occurred after radiation and/or
chemotherapy) and had undergone three-dimensional dosimetry; their
radiographic, clinical, and radiation-dosimetry results were analyzed. In
the 11 patients who had been treated with multiple protocols 17 loci of
abnormality, including 43 discrete, asymptomatic TBLs, were detected. The
median TBL diameter was 1 cm or smaller, without mass effect or necrosis,
and occurred 10 months after radiation therapy, 11 months after
chemotherapy, resolved by 3 months, and occurred within the high-dose
radiation treatment volume (median 55.8 Gy). The findings from extended
follow up revealed the development of additional permanent complications of
radiation therapy within the radiation port in five of the 11 patients.
CONCLUSIONS: A benign form of treatment-induced brain injury in children,
TBLs should be treated using short-interval follow up. When these lesions
are identified as a result of their characteristic imaging features,
location, and temporal course, TBLs may be clearly distinguished from
recurrent tumor or radiation necrosis and do not require biopsy. Further
studies are needed to determine whether patients with TBLs are at an
increased risk of developing more severe treatment-related brain injury.
PMID: 16156228 [PubMed - in process]
-
| 22: Neurology. 2004 Nov
9;63(9):1759-60; author reply 1759-60. |
|
Comment on:
Brainstem involvement in hypertensive encephalopathy:
clinical and radiological findings.
Biousse
V, Newman
NJ, Chang
GY.
Publication Types:
- Case Reports
- Comment
- Letter
PMID: 15534284 [PubMed - indexed for MEDLINE]-
|
Volume 4, Number 39 - 20 September
2005