-
Origin of chordoid glioma of the third ventricle.
Leeds
NE, Lang
FF, Ribalta
T, Sawaya
R, Fuller
GN.
Department of Radiology, Mount Sinai School of Medicine and Hospital, New
York, NY, USA.
CONTEXT: Chordoid glioma is a relatively recently described unique glial
neoplasm that has been formally codified by the World Health Organization in
Pathology and Genetics of Tumours of the Nervous System, in which it is
included along with astroblastoma and gliomatosis cerebri under the rubric
"Tumors of Uncertain Origin." Many examples of chordoid glioma
come to clinical attention only at a relatively large size and occupy a
large portion of the third ventricle. Accordingly, the anatomic origin of
chordoid glioma has been unclear and debated. OBJECTIVE: To examine the
regional anatomic origin of chordoid glioma. DATA SOURCES: The clinical,
imaging, histologic, immunophenotypic, and ultrastructural data in
previously published case series and individual case reports of chordoid
glioma were reviewed in conjunction with the study of a new case of chordoid
glioma that presented at a relatively small size, thereby facilitating
neuroanatomic localization. CONCLUSIONS: Chordoid glioma exhibits features
of specialized ependymal differentiation on ultrastructural examination, and
all examples reported in the literature to date have displayed a highly
stereotypical suprasellar anatomic localization and an ovoid shape, as seen
on neuroimaging studies and gross anatomy. Neuroanatomic, radiologic, and
clinical evidence supports an anatomic origin for chordoid glioma from the
vicinity of the lamina terminalis.
PMID: 16594739 [PubMed - in process]
 http://arpa.allenpress.com/arpaonline/?request=get-abstract&issn=1543-2165&volume=130&page=460
 http://arpa.allenpress.com/arpaonline/?request=get-document&doi=10.1043%2F1543-2165(2006)130%5B460:OOCGOT%5D2.0.CO%3B2
 http://arpa.allenpress.com/pdfserv/10.1043/1543-2165(2006)130[460:OOCGOT]2.0.CO;2
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The elusive origin of chordoid glioma.
Brat
DJ.
Publication Types:
PMID: 16594734 [PubMed - in process]
 http://arpa.allenpress.com/arpaonline/?request=get-abstract&issn=1543-2165&volume=130&page=437
http://arpa.allenpress.com/arpaonline/?request=get-document&doi=10.1043%2F1543-2165(2006)130%5B437:TEOOCG%5D2.0.CO%3B2
http://arpa.allenpress.com/pdfserv/10.1043/1543-2165(2006)130[437:TEOOCG]2.0.CO;2
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A 70-year-old man with diplopia, nausea, and vomiting.
Rathke cleft cyst concomitant with pituitary adenoma.
Vancura
RW, Jacob
KM, Damjanov
I.
Department of Pathology and Laboratory Medicine, University of Kansas
Hospital, Kansas City, KS 66160, USA.
Publication Types:
PMID: 16519575 [PubMed - indexed for MEDLINE]
http://arpa.allenpress.com/arpaonline/?request=get-abstract&issn=1543-2165&volume=130&page=403
http://arpa.allenpress.com/arpaonline/?request=get-document&doi=10.1043%2F1543-2165(2006)130%5B403:AYMWDN%5D2.0.CO%3B2
http://arpa.allenpress.com/pdfserv/10.1043/1543-2165(2006)130[403:AYMWDN]2.0.CO;2
-
| 4: Cancer.
2006 Apr 3; [Epub ahead of print] |
|
-
Patterns of exercise across the cancer trajectory in
brain tumor patients.
Jones
LW, Guill
B, Keir
ST, Carter
B S K, Friedman
HS, Bigner
DD, Reardon
DA.
Duke University Medical Center, Durham, North Carolina.
BACKGROUND: Exercise may represent a supportive intervention that may
complement existing neurooncologic therapies and address a multitude of
therapy-induced debilitating side effects in patients with brain tumors.
Given the limited evidence, the authors conducted a survey to examine the
exercise patterns of brain tumor patients across the cancer trajectory.
METHODS: Using a cross-sectional design, 386 brain tumor patients who
received treatment at the Brain Tumor Center at Duke University were sent a
questionnaire that assessed self-reported exercise behavior prior to
diagnosis, during adjuvant therapy, and after the completion of therapy.
RESULTS: The response rate was 28% (106 of 383 patients). Descriptive
analyses indicated that 42%, 38%, and 41% of participants, respectively, met
national exercise prescription guidelines prior to diagnosis, during
treatment, and after the completion of adjuvant therapy. Repeated measures
analyses indicated no significant changes in the majority of exercise
behavior outcomes over the cancer trajectory. However, exploratory analyses
indicated that males and younger participants may be at the greatest risk of
reducing exercise levels after a brain tumor diagnosis. These analyses
remained unchanged after controlling for relevant demographic and medical
covariates. CONCLUSIONS: A relatively high percentage of brain tumor
patients are exercising at recommended levels across the cancer trajectory.
Moreover, these patients have unique exercise patterns that may be modified
by select demographic variables. This preliminary study provides important
informative data for future studies examining the potential role of exercise
in patients diagnosed with neurologic malignancies. Cancer 2006. (c) 2006
American Cancer Society.
PMID: 16586497 [PubMed - as supplied by publisher]
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| 5: Cancer.
2006 Mar 29; [Epub ahead of print] |
|
-
Nonsmall cell lung cancer presenting with synchronous
solitary brain metastasis.
Hu
C, Chang
EL, Hassenbusch
SJ 3rd, Allen
PK, Woo
SY, Mahajan
A, Komaki
R, Liao
Z.
Department of Radiation Oncology, Cancer Hospital, Fudan University,
Shanghai, People's Republic of China.
BACKGROUND: Solitary brain metastases occur in about 50% of patients with
brain metastases from nonsmall cell lung cancer (NSCLC). The standard of
care is surgical resection of solitary brain metastases, or stereotactic
radiosurgery (SRS) plus whole brain radiation therapy (WBRT). However, the
optimal treatment for the primary site of newly diagnosed NSCLC with a
solitary brain metastasis is not well defined. The goal was to distinguish
which patients might benefit from aggressive treatment of their lung primary
in patients whose solitary brain metastasis was treated with surgery or SRS.
METHODS: The cases of 84 newly diagnosed NSCLC patients presenting with a
solitary brain metastasis and treated from December 1993 through June 2004
were retrospectively reviewed at The University of Texas M. D. Anderson
Cancer Center. All patients had undergone either craniotomy (n = 53) or SRS
(n = 31) for management of the solitary brain metastasis. Forty-four
patients received treatment of their primary lung cancer using thoracic
radiation therapy (median dose 45 Gy; n = 8), chemotherapy (n = 23), or both
(n = 13). RESULTS: The median Karnofsky performance status score was 80
(range, 60-100). Excluding the presence of the brain metastasis, 12 patients
had AJCC Stage I primary cancer, 27 had Stage II disease, and 45 had Stage
III disease. The median follow-up was 9.7 months (range, 1-86 months). The
1-, 2-, 3-, and 5-year overall survival rates from time of lung cancer
diagnosis were 49.8%, 16.3%, 12.7%, and 7.6%, respectively. The median
survival times for patients by thoracic stage (I, II, and III) were 25.6,
9.5, and 9.9 months, respectively (P = .006). CONCLUSIONS: By applying
American Joint Committee on Cancer staging to only the primary site, the
thoracic Stage I patients in our study with solitary brain metastases had a
more favorable outcome than would be expected and was comparable to Stage I
NSCLC without brain metastases. Aggressive treatment to the lung may be
justified for newly diagnosed thoracic Stage I NSCLC patients with a
solitary brain metastasis, but not for locally advanced NSCLC patients with
a solitary brain metastasis. Cancer 2006. (c) 2006 American Cancer Society.
PMID: 16572401 [PubMed - as supplied by publisher]
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Regeneration and tolerance factor: a novel mediator of
glioblastoma-associated immunosuppression.
Roth
P, Aulwurm
S, Gekel
I, Beier
D, Sperry
RG, Mittelbronn
M, Meyermann
R, Beaman
KD, Weller
M, Wischhusen
J.
Laboratory of Molecular Neuro-Oncology, Department of General Neurology,
Hertie Institute for Clinical Brain Research, University of Tubingen,
Medical School, Hoppe-Seyler-Strasse 3, 72076 Tubingen, Germany.
patrick.roth@uni-tuebingen.de
Regeneration and tolerance factor (RTF) was originally identified in
placenta where it is thought to be essential for fetal allograft survival.
Here we report that RTF mRNA and protein are also expressed in human glioma
cells in vitro and in vivo. Suppression of RTF expression by RNA
interference promotes the lysis of glioma cells by natural killer (NK) and T
cells in vitro. Moreover, RTF-depleted glioma cells are less tumorigenic
than control cells in nude mice in vivo. Depletion of NK cells in these
animals abolished this effect. RTF is thus a novel aberrantly expressed
molecule which confers immune privilege to human malignant gliomas.
PMID: 16585213 [PubMed - in process]
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FoxM1B is overexpressed in human glioblastomas and
critically regulates the tumorigenicity of glioma cells.
Liu
M, Dai
B, Kang
SH, Ban
K, Huang
FJ, Lang
FF, Aldape
KD, Xie
TX, Pelloski
CE, Xie
K, Sawaya
R, Huang
S.
Department of Neurosurgery, The University of Texas M.D. Anderson Cancer
Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA.
The transcription factor Forkhead box M1 (FoxM1) is overexpressed in
malignant glioma. However, the functional importance of this factor in human
glioma is not known. In the present study, we found that FoxM1B was the
predominant FoxM1 isoform expressed in human glioma but not in normal brain
tissue. The level of FoxM1 protein expression in human glioma tissues was
directly correlated with the glioma grade. The level of FoxM1 protein
expression in human glioblastoma tissues was inversely correlated with
patient survival. Enforced FoxM1B expression caused SW1783 and Hs683 glioma
cells, which do not form tumor xenografts, to regain tumorigenicity in nude
mouse model systems. Moreover, gliomas that arose from FoxM1B-transfected
anaplastic astrocytoma SW1783 cells displayed glioblastoma multiforme
phenotypes. Inhibition of FoxM1 expression in glioblastoma U-87MG cells
suppressed their anchorage-independent growth in vitro and tumorigenicity in
vivo. Furthermore, we found that FoxM1 regulates the expression of Skp2
protein, which is known to promote degradation of the cell cycle regulator
p27(Kip1). These results showed that FoxM1 is overexpressed in human
glioblastomas and contributes to glioma tumorigenicity. Therefore, FoxM1
might be a new potential target of therapy for human malignant gliomas.
PMID: 16585184 [PubMed - in process]
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-
IRS-1-Rad51 nuclear interaction sensitizes JCV T-antigen
positive medulloblastoma cells to genotoxic treatment.
Trojanek
J, Ho
T, Croul
S, Wang
JY, Chintapalli
J, Koptyra
M, Giordano
A, Khalili
K, Reiss
K.
Center for Neurovirology, Department of Neuroscience, Temple University,
Philadelphia, PA, USA.
The large T-antigen from human polyomavirus JC (JCV T-antigen) is suspected
to play a role in malignant transformation. Previously, we reported that JCV
T-antigen requires the presence of a functional insulin-like growth factor I
receptor (IGF-IR) for transformation of fibroblasts and for survival of
medulloblastoma cell lines; that IGF-IR is phosphorylated in medulloblastoma
biopsies and that JCV T-antigen inhibits homologous recombination-directed
DNA repair, causing accumulation of mutations. Here we are evaluating
whether JCV T-antigen positive and negative mouse medulloblastoma cell
lines, which significantly differ in their tumorigenic properties, are also
different in their abilities to repair double strand breaks of DNA (DSBs).
Our results show that despite much stronger tumorigenic potential, JCV
T-antigen positive medulloblastoma cells are more sensitive to genotoxic
agents (cisplatin and gamma-irradiation). Subsequent analysis of DNA repair
of DSBs indicated that homologous recombination-directed DNA repair (HRR)
was selectively attenuated in JCV T-antigen positive medulloblastoma cells.
JCV T-antigen did not affect HRR directly. In the presence of JCV T-antigen,
insulin receptor substrate 1 (IRS-1) translocated to the nucleus where it
co-localized with Rad51, possibly attenuating HRR. (c) 2006 Wiley-Liss, Inc.
PMID: 16572421 [PubMed - as supplied by publisher]
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Phase I study of intraoperative radiotherapy with photon
radiosurgery system in children with recurrent brain tumors: Preliminary
report of first dose level (10 Gy).
Kalapurakal
JA, Goldman
S, Stellpflug
W, Curran
J, Sathiaseelan
V, Marymont
MH, Tomita
T.
Division of Radiation, Oncology Northwestern University, Chicago, IL.
PURPOSE: To describe the preliminary results after intraoperative
radiotherapy (IORT) with the photon radiosurgery system in children with
recurrent brain tumors treated at the first dose level (10 Gy) of a Phase I
protocol. METHODS AND MATERIALS: A Phase I IORT dose escalation protocol was
initiated at Children's Memorial Hospital to determine the maximal tolerated
IORT dose in children with recurrent brain tumors. RESULTS: Fourteen
children have received IORT thus far. Eight had been previously irradiated.
Thirteen children had ependymoma. The median follow-up was 16 months. Three
patients (21%) developed radiation necrosis on follow-up MRI scans 6 to 12
months after IORT. They had not been previously irradiated and had received
10 Gy to a depth of 5 mm. One required surgery and the other two had
resolution of their lesions without treatment. All 3 patients were
asymptomatic at the last follow-up. No other late toxicity was observed at
the last follow-up visit. Eight patients (57%) had tumor control within the
surgical bed after IORT. CONCLUSION: Our findings have demonstrated the
safety and feasibility of IORT to a dose of 10 Gy to 2 mm in children with
previously irradiated brain tumors. IORT to a dose of 10 Gy at 5 mm was
associated with a greater complication rate.
PMID: 16580791 [PubMed - as supplied by publisher]
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-
An estimation of radiobiologic parameters from clinical
outcomes for radiation treatment planning of brain tumor.
Qi
XS, Schultz
CJ, Li
XA.
Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee,
WI, USA.
Purpose: To estimate a plausible set of radiobiologic parameters such as
alpha, alpha/beta values, from clinical outcomes for biologically based
radiation treatment planning of brain tumors. Methods and Materials:
Linear-quadratic (LQ) formalism and the concept of equivalent uniform dose
were used to analyze a series of published clinical data for malignant
gliomas involving different forms of radiation therapy. Results: A plausible
set of LQ parameters was obtained for gliomas: alpha = 0.06 +/- 0.05 Gy(-1),
alpha/beta = 10.0 +/- 15.1 Gy, the tumor cell doubling time T(d) = 50 +/- 30
days, with the repair half-time of 0.5 h. The present estimated biologic
parameters can reasonably predict the effectiveness of most of the recently
reported clinical results employing either single or combined radiation
therapy modalities. Different LQ parameters between Grade 3 and Grade 4
astrocytomas were found, implying the radiosensitivity for different grade
tumors may be different. Smaller alpha, beta from in vivo was observed,
indicating lower radiosensitivity occurred in vivo as compared with in
vitro. Conclusions: A plausible set of radiobiologic parameters for gliomas
was estimated based on clinical data. These parameters can reasonably
predict most of the clinical results. They may be used to design new
treatment fractionation schemes and to evaluate and optimize treatment
plans.
PMID: 16580506 [PubMed - in process]
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-
Combined proton and photon irradiation for
craniopharyngioma: Long-term results of the early cohort of patients treated
at Harvard Cyclotron Laboratory and Massachusetts General Hospital.
Fitzek
MM, Linggood
RM, Adams
J, Munzenrider
JE.
Department of Radiation Oncology, Massachusetts General Hospital, Harvard
Medical School, Boston, MA; Radiation Oncology Center, Tufts-New England
Medical Center, Tufts University School of Medicine, Boston, MA.
Purpose: We report the results of the early cohort of patients treated for
craniopharyngioma with combined proton-photon irradiation at the
Massachusetts General Hospital and the Harvard Cyclotron Laboratory. Methods
and Materials: Between 1981 and 1988, 15 patients with craniopharyngioma
were treated in part or entirely with fractionated 160 MeV proton beam
therapy. The group consisted of 5 children (median age, 15.9 years) and 10
adults (median age, 36.2 years). Median dose prescribed to the tumor was
56.9 cobalt Gray equivalent (CGE; 1 proton Gray = 1.1 CGE). The median
proton component was 26.9 CGE. Patients were treated after documented
recurrence after initial surgery (n = 6) or after subtotal resection or
biopsy (n = 9). None had had prior radiation therapy. Results: Median
observation period of surviving patients (n = 11) was 13.1 years from
radiotherapy. One patient was lost to follow-up with tumor control after 5.2
years. Actuarial 10-year survival rate was 72%. Four patients have died
5-9.1 years after treatment, two from local failure. Actuarial 5- and
10-year local control rates were 93% and 85%, respectively. The functional
status of the living adult patients is unaltered from their preradiotherapy
status; all of them continued leading normal or near normal working lives.
None of the patients treated as a child had experienced recurrence of tumor.
One child shows learning difficulties and slight retardation, comparable to
his preradiotherapy status. The others have professional achievements within
the normal range. Conclusion: Results in terms of survival and local control
are comparable with other contemporary series. Although no formal
neuropsychological testing was performed, the surrogate measures of
lifestyle and professional accomplishments appear to be satisfactory.
PMID: 16580494 [PubMed - in process]
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Survival prediction in patients with glioblastoma
multiforme by human telomerase genetic variation.
Wang
L, Wei
Q, Wang
LE, Aldape
KD, Cao
Y, Okcu
MF, Hess
KR, El-Zein
R, Gilbert
MR, Woo
SY, Prabhu
SS, Fuller
GN, Bondy
ML.
Department of Epidemiology, The University of Texas M.D. Anderson Cancer
Center, Houston, TX 77230-1439, USA.
PURPOSE: Glioblastoma multiforme (GBM) is the most common and aggressive
glioma with the poorest survival. Use of biomarkers for screening patients
with GBM may be used to modify treatments and improve outcomes. The level of
human telomerase (hTERT) expression is an independent predictor of outcome
of many cancers, and a functional variant of hTERT MNS16A (shorter tandem
repeats or short [S] allele) is associated with increased hTERT mRNA
expression. We investigated whether hTERT MNS16A variant genotype predicted
survival in GBM patients. PATIENTS AND METHODS: We genotyped hTERT MNS16A in
299 GBM patients using polymerase chain reaction and determined hTERT
genotype by classifying the DNA band of 243 or 272 base pairs (bp) as S
allele and 302 or 333 bp as long (L) allele. We compared overall survival
using Kaplan-Meier estimates and equality of survival distributions using
the log-rank test, and we computed univariate and multivariate Cox
proportional hazards models to estimate the effects of selected variables.
RESULTS: Overall survival differed significantly by hTERT MNS16A genotype,
with median survivals of 25.1, 14.7, and 14.6 months for the SS, SL, and LL
genotypes, respectively. Compared with the SS genotype, the hazard ratios
for the SL and LL genotypes were 1.69 and 1.87, respectively, after
adjustment for other factors. Multivariate Cox regression analysis showed an
independent statistically significant association between the hTERT MNS16A
variant genotype and outcome. CONCLUSION: A functional hTERT MNS16A genotype
is a potential biomarker for assessment of survival outcome of GBM. Larger
studies are needed to verify these findings.
PMID: 16575014 [PubMed - in process]
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The efficacy of alginate encapsulated CHO-K1 single
chain-TRAIL producer cells in the treatment of brain tumors.
Kuijlen
JM, de
Haan BJ, Helfrich
W, de
Boer JF, Samplonius
D, Mooij
JJ, de
Vos P.
Department of Neurosurgery , University Medical Centre Groningen, University
of Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 , RB, Groningen, The
Netherlands.
OBJECT: Patients with astrocytic tumors in the central nervous system (CNS)
have low survival rates despite surgery and radiotherapy. Innovative
therapies and strategies must be developed to prolong survival of these
patients. The alginate microencapsulation method, used to continuously
release a certain cytotoxic agent in the vicinity of the tumor, is such a
novel therapeutic strategy. The biological functionality of the apoptosis
inducing scFv425:sTRAIL protein, which was released through the
microencapsulation method, was studied in vitro. Analysis of the
intracerebral biocompatibility of alginate capsules was performed by
implantation of empty alginate capsules in the brain of mice. METHOD:
Chinese Hamster Ovary cells (CHO-K1) were recombinantly engineered to
produce the single chain anti-EGFR-sTRAIL protein (scFv425:sTRAIL). The
CHO-K1 producer cells were encapsulated in an alginate capsule with a
semi-permeable membrane through which the scFv425:sTRAIL protein could be
released. RESULTS: In vitro studies show maintained biological functionality
of the released scFv425:sTRAIL protein. There was no immunological tissue
response detectable after intracerebral implantation of the alginate
capsules in mice brains. CONCLUSION: Biological functionality of the
produced scFv425:sTRAIL protein is maintained and intracerebral
biocompatibility of the capsules is warranted. Alginate encapsulation of
CHO-K1 - scFv425:sTRAIL - producer cells and subsequently their
intracerebral implantation is technically feasible. This study justifies
further in vivo experiments.
PMID: 16598433 [PubMed - as supplied by publisher]
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Extraneural metastatic medulloblastoma in an adult.
Wendland
MM, Shrieve
DC, Watson
GA, S
Chin S, Blumenthal
DT.
Department of Radiation Oncology, Huntsman Cancer Hospital, University of
Utah, Salt Lake City, UT, USA.
Medulloblastoma is a rare malignancy in adults, accounting for approximately
1% of all primary brain tumors. Extraneural metastases have been reported in
10-30% of cases and most commonly involve bone; rarely lymph nodes, visceral
organs and bone marrow may be involved with disease. We report here our
experience with a 26 year-old woman with medulloblastoma treated with gross
total resection followed by radiation therapy to her craniospinal axis. She
subsequently developed widespread metastatic disease involving bone
exclusive of the calvarium and spine for which multi-agent salvage
chemotherapy was utilized with initial good clinical response. She later
relapsed within the lymph nodes and soft tissues of the pelvis and
eventually suffered a local recurrence within the posterior fossa. The
treatment of medulloblastoma, particularly salvage therapy following disease
recurrence, is reviewed.
PMID: 16598430 [PubMed - as supplied by publisher]
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-
Glioma-produced extracellular matrix influences brain
tumor tropism of human neural stem cells.
Ziu
M, Schmidt
NO, Cargioli
TG, Aboody
KS, Black
PM, Carroll
RS.
Neurosurgical Oncology Laboratory, Department of Neurosurgery, Brigham and
Women's Hospital & Children's Hospital, Harvard Medical School, Boston,
MA, USA.
A major obstacle in the treatment of gliomas is the invasive capacity of the
tumor cells. Previous studies have demonstrated the capability of neural
stem cells (NSCs) to target these disseminated tumor cells and to serve as
therapeutic delivery vehicles. Less is known about the factors involved in
brain tumor tropism of NSCs and their interactions within the tumor
environment. As gliomas progress and invade, an extensive modulation of the
extracellular matrix (ECM) occurs. Tumor-ECM derived from six glioblastoma
cell lines, ECM produced by normal human astrocytes and purified ECM
compounds known to be upregulated in the glioma environment were analyzed
for their effects on NSCs motility in vitro. We found that tumor-produced
ECM was highly permissive for NSC migration. Laminin was the most permissive
substrate for human NSC migration, and tenascin-C the strongest inducer of a
directed human NSC migration (haptotaxis). A positive correlation between
the degree of adhesion and migration of NSCs on different ECM compounds
exists, as for glioma cells. Our in vitro data suggest that the ECM of
malignant gliomas is a modulator of NSC migration. ECM proteins
preferentially expressed in areas of glioma cell invasion may provide a
permissive environment for NSC tropism to disseminated tumor cells.
PMID: 16598423 [PubMed - as supplied by publisher]
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Atypical meningioma in Werner syndrome: a case report.
Marton
E, Bonaldi
L, Busato
S, Longatti
P.
Neurosurgery Department, Regional Hospital, Padova University, Treviso,
Italy.
Introduction: Werner Syndrome, or adult progeria, is a rare autosomal
recessive disorder caused by a mutation in the Werner Syndrome Gene
belonging to the family of RecQ helicase. Malignant mesenchymal tumours and
atherosclerosis are typical causes of death. Intracranial meningiomas are
frequently described in these patients. Clinical Presentation: We present
the case of a 46-year-old man with Werner Syndrome and a convexity
meningioma. The patient had a 2-year history of paresthesia and paresis in
his right leg, which had worsened in recent months. He underwent surgery
with Simpson grade II removal, with improvement of the slight paresis and no
other neurological defects. The patient then underwent radiotherapy (60
Gy).Histological examination revealed an atypical meningioma. Cytogenetic
analysis showed a hypodiploid clone with a complex karyotype characterized
by monosomy 22 and deletion 1p. After 3 years' follow-up no relapses had
occurred. Conclusion: 1p deletion correlates with meningioma progression and
in this case correlates with histological examination. The chromosomal
instability underlying Werner Syndrome could have fostered the complex
karyotype.
PMID: 16598422 [PubMed - as supplied by publisher]
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Inhibition of matrix degrading enzymes and invasion in
human glioblastoma (U87MG) Cells by isoflavones.
Puli
S, Lai
JC, Bhushan
A.
Department of Pharmaceutical Sciences, College of Pharmacy and Biomedical
Research Institute, Idaho State University, Pocatello, ID, 83209, USA.
Glioblastoma multiforme is a primary brain tumor associated with extensive
invasion into surrounding brain tissue. Matrix metalloproteinases (MMPs) and
urokinase plasminogen activation (uPA) system are shown to be involved in
tumor invasion as they help in degradation of extracellular matrix (ECM)
proteins and thus assist in the movement of cells. MMP-2 and 9 were shown to
be upregulated in gliomas, suggesting their involvement in invasion.
Genistein and biochanin A are isoflavones commonly known as phytoestrogens
and have some anticancer properties. We hypothesize that these two
isoflavones can induce a lowering of tumor invasion by decreasing the
activity of matrix degrading enzymes. In this study we investigated the
effects of genistein and biochanin A on invasive activity of U87MG cells
using the Calbiochem in vitro invasion assay system. Our results suggest
that genistein and biochanin A induced a decrease in invasive activity of
U87MG cells in a dose-related manner. Genistein also induced a decrease in
EGF-stimulated invasion thereby implicating an involvement of EGF-mediated
signaling in invasion. Our results also show that treatment of U87MG cells
with the two isoflavones induced decreases in the enzymatic activity of
MMP-9 and the protein levels of MT1-MMP and uPAR.
PMID: 16598420 [PubMed - as supplied by publisher]
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Expression of Notch and Wnt pathway components and
activation of Notch signaling in medulloblastomas from heterozygous patched
mice.
Dakubo
GD, Mazerolle
CJ, Wallace
VA.
Molecular Medicine Program, Ottawa Health Research Institute, 501 Smyth
Road, K1H 8L6, Ottawa, ON, Canada.
Hedgehog (Hh), Notch, and Wingless (Wnt) signaling control normal
development of the cerebellum, and dysregulation of these signaling pathways
are associated with medulloblastoma (MB). As an initial step in the study of
the role of interacting signaling pathways in MB pathogenesis, we
demonstrate the expression of several components of the Notch and Wnt
signaling pathways, and activation of Notch signaling in MB from Ptch ( +/-
) mice that have elevated Hh signaling. We also show a marked downregulation
in the expression of Notch2, Jagged1, Hes1, mSfrp1, and mFrz7 in cerebella
of developing mice with reduced Hh signaling, suggesting that Hh signaling
regulates the expression of these genes. Together with recent published
data, these findings indicate that Hh signaling might synergize
simultaneously with Notch and Wnt signaling in MB development by controlling
Notch and Wnt pathway ligand, receptor and/or target gene expression.
PMID: 16598417 [PubMed - as supplied by publisher]
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Treatment options in childhood pontine gliomas.
Wagner
S, Warmuth-Metz
M, Emser
A, Gnekow
AK, Strater
R, Rutkowski
S, Jorch
N, Schmid
HJ, Berthold
F, Graf
N, Kortmann
RD, Pietsch
T, Sorensen
N, Peters
O, Wolff
JE.
Department of Pediatric Oncology, Krankenhaus der Barmherzigen Bruder Klinik
St. Hedwig, Regensburg, Germany.
BACKGROUND: Pontine gliomas are the subgroup of brainstem gliomas with the
worst prognosis. Controversial treatment approaches are discussed. PATIENTS
AND METHODS: Data of children with pontine gliomas treated in different
prospective multi-center studies who were registered in the HIT-GBM database
were pooled and analyzed addressing prognostic factors and the relevance of
intensive treatment using contingency tables, Kaplan-Meier curves and Cox
regression analyses. RESULTS: From 1983 to 2001, 153 patients (74 males, 79
females, mean age: 8.1 years) with pontine gliomas were registered.
Twenty-one tumors were low-grade and 60 were high-grade gliomas (72
undefined histology: 67 no surgery, 5 incomplete data). Sixteen tumors were
partially resected, and 125 were irradiated. Ninety children received
chemotherapy according to the "HIT-GBM" protocols ("Hirntumor-Glioblastoma
multiforme"). The one-year overall survival rate (1YOS) of all patients
with pontine glioma was 39.9+/-4.3%. None of the surviving patients had an
observation time longer than 3.9 years. Favorable prognostic factors seemed
to be age younger than 4 years, low-grade histology and smaller tumor. All
three major treatment modalities including resection, irradiation and
chemotherapy had prognostic relevance in univariable analysis. Chemotherapy
remained beneficial, even if the analysis was restricted to the subgroup of
irradiated tumors (1YOS 45.8+/-5.4% vs. 34.4+/-13.5%, P=0.030). CONCLUSION:
Irradiation is an effective element for the treatment of pontine gliomas.
Intensive chemotherapy seems to be important in achieving a better OS.
PMID: 16598416 [PubMed - as supplied by publisher]
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-
Validation of the M.D. Anderson Symptom Inventory Brain
Tumor Module (MDASI-BT).
Armstrong
TS, Mendoza
T, Gring
I, Coco
C, Cohen
MZ, Eriksen
L, Hsu
MA, Gilbert
MR, Cleeland
C.
The University of Texas Health Science Center at Houston, School of Nursing,
Houston, Texas, USA.
BACKGROUND: Symptom occurrence has been shown to predict treatment course
and survival in patients with solid tumors. Primary brain tumor (PBT)
patients are unique in the occurrence of neurologic symptoms. Currently, no
instrument exists that measures both neurologic and cancer-related symptoms.
METHODS: Patients diagnosed with PBT participated in this study. Data was
collected at one point in time and included demographic and clinical
factors, and the M.D. Anderson Symptom Inventory-Brain Tumor Module (MDASI-BT).
The study evaluated the reliability and validity of the MDASI-BT in primary
brain tumor patients. RESULTS: Two hundred and one patients participated in
this study. Mean symptom severity of items as well as cluster analysis was
used to reduce the number of total items to 22 (13 core, 9 brain tumor
items). Regression analysis showed more than half (56%) of the variability
in symptom severity was explained by brain module items. The MDASI-BT
measures six underlying constructs including affective, cognitive, focal
neurologic deficit, constitutional, generalized symptom, and a
gastrointestinal related factor. The internal consistency (reliability) of
the instrument was 0.91. The MDASI-BT was sensitive to disease severity
based on performance status (P<0.001), tumor recurrence (P<0.01), and
mean symptom interference (P<0.001). CONCLUSIONS: The 22 item MDASI-BT
demonstrated validity and reliability in patients with PBT. This instrument
can be used to identify symptom occurrence throughout the disease trajectory
and to evaluate interventions designed for symptom management.
PMID: 16598415 [PubMed - as supplied by publisher]
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-
Synthetic Smac peptide enhances the effect of etoposide-induced
apoptosis in human glioblastoma cell lines.
Mizukawa
K, Kawamura
A, Sasayama
T, Tanaka
K, Kamei
M, Sasaki
M, Kohmura
E.
Department of Neurosurgery, Kobe University Graduate School of Medicine,
Chuo-ku, Kobe, Japan.
Smac/DIABLO is a mitochondrial protein released into cytosol during the
progression of apoptosis. Smac/DIABLO promotes apoptosis by neutralizing the
inhibitory effect of the inhibitor of apoptosis proteins (IAPs) on the
processing and activity of the effecter of caspase. Here, we generated
synthetic Smac peptide which possesses an IAP-binding domain and Drosophila
antennapaedia penetration sequence, and examined whether it enhances the
effect of the chemotherapeutic agent etoposide in the human glioblastoma
cell line. Cellular uptake of Smac peptide in several glioma cell lines was
most prominent at 6-12 h after addition. Caspase activity assay showed that
our peptide successfully increased the activity of caspase-3 and caspase-9
in etoposide-induced apoptosis. In addition, Smac peptide increased the
amount of cleaved PARP (poly ADP-ribose polymerase), but control peptides
did not. Moreover, the addition of z-VAD-fmk, a caspase inhibitor,
counterbalanced the effect of Smac peptide. Finally, we demonstrated that
Smac peptide could enhance the growth inhibition effect of etoposide
compared with control peptides. These results suggest that synthetic Smac
peptide may be a new molecular targeting anti-tumor therapy for human
glioblastoma.
PMID: 16575541 [PubMed - as supplied by publisher]
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-
Posterior third ventricular meningioma masquerading a
pineal tumour.
Kasliwal
MK, Srinivas
M, Vaishya
S, Atri
S, Sharma
MC.
All India Institute of Medical Science, New Delhi, 110029, India, m_kasliwal@yahoo.com.
PMID: 16575539 [PubMed - as supplied by publisher]
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-
Tc-99m Tetrofosmin SPECT for the differentiation of a
cerebellar hemorrhage mimicking a brain metastasis from a renal cell
carcinoma.
Alexiou
GA, Bokharhii
JA, Kyritsis
AP, Polyzoidis
KS, Fotopoulos
AD.
Department of Neurosurgery, University of Ioannina School of Medicine,
Ioannina, Greece.
PMID: 16575536 [PubMed - as supplied by publisher]
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-
Cystemustine in recurrent high grade glioma.
Durando
X, Thivat
E, Roche
H, Bay
JO, Lemaire
JJ, Verrelle
P, Lentz
MA, Chazal
J, Cure
H, Chollet
P.
Centre Jean Perrin, 63011, Clermont-Ferrand Cedex, France.
In this study, we have assessed the efficacy of a nitrosourea, cystemustine,
in treating patients with recurrent high grade glioma with overall survival
analysis as primary end-point. Forty-eight patients with recurrent high
grade glioma (24 glioblastomas, 17 astrocytomas and 5 oligodendrogliomas)
were treated every 2 weeks with 60 mg/m(2) cystemustine by a 15
min-infusion. The median number of treatment cycles was 4 (range 1-17). The
median overall survival was 8.3 months (range 1-97) and the 6- and 12-month
overall survival rates were 55.3% (95% CI, 41.3-68.6%) and 29.8% (95% CI,
18.6-44.0%), respectively. The objective response rate was 18.8% (95% CI,
7.7-29.9%), and 54.2% of patients had stable disease (95% CI, 40.1-68.3%).
Multivariate analysis showed that WHO performance status, histology and
response to cystemustine were significant prognostic factors for survival of
patients with recurrent glioma.In conclusion, cystemustine has encouraging
activity for patients with recurrent high grade glioma.
PMID: 16575534 [PubMed - as supplied by publisher]
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-
Effects of syngeneic cellular vaccinations alone or in
combination with GM-CSF on the weakly immunogenic F98 glioma model.
Clavreul
A, Delhaye
M, Jadaud
E, Menei
P.
Departement de Neurochirurgie, CHU, 49033, Angers Cedex 01, France.
Cancer vaccines are one approach for the treatment of brain tumors. Most
experimental studies are performed on so-called "immunogenic"
brain tumor models such as the rat 9L glioma which does not reflect
characteristics of human glioblastoma. In the present study, we tested
syngeneic cellular vaccinations alone or in combination with granulocyte-macrophage
colony-stimulating factor (GM-CSF) on the weakly immunogenic F98 glioma
model. Previous studies have shown the efficacy of this treatment on the 9L
glioma model. Fisher rats received an intracerebral implantation of F98
cells. Three days later, two subcutaneous vaccinations with irradiated F98
cells were realized in presence or absence of GM-CSF. This scheme of
vaccination induced a systemic cellular and humoral immune response capable
of in vitro cytolytic activity against F98 cells. However, no significant
differences in survival times were noted between vaccinated and untreated
animals. Animals vaccinated with GM-CSF or without GM-CSF had respectively a
survival time of 26 +/- 2.1 and 25 +/- 4.4 days following tumor challenge
versus 26.5 +/- 2.4 days for untreated rats. Fourteen days after the
intracerebral tumor implantation, the tumors of vaccinated animals showed a
robust infiltration by T lymphocytes, NK cells, dendritic cells,
granulocytes and CD11b/c(+) myeloid cells. This infiltration was nearly
absent in untreated animals except for CD11b/c(+) myeloid cells. This study
shows that, contrary to the 9L glioma model, the F98 glioma model is
resistant to syngeneic cellular vaccinations although a strong peripheral
and intratumoral immune response can be induced. These results suggest that
the F98 glioma is an attractive model to understand the mechanisms of glioma
immunotherapy resistance.
PMID: 16575532 [PubMed - as supplied by publisher]
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-
Atypical teratoid/rhabdoid tumor of the spinal canal.
Bannykh
S, Duncan
C, Ogle
E, Baehring
JM.
Department of Pathology, Yale University School of Medicine, New Haven, CT,
USA.
Publication Types:
PMID: 16411024 [PubMed - indexed for MEDLINE]
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-
Carcinomatous meningitis from urachal carcinoma: the
first reported case.
McClelland
S 3rd, Garcia
RE, Monaco
SE, Goldman
JE, Olson
TJ, Kim
GH, Petrylak
DP, Goodman
RR.
Department of Neurological Surgery, Neurological Institute of New York, New
York, NY 10032, USA.
Carcinomatous meningitis (CM) occurs in less than 10% of cancer patients.
Although patients frequently present with a focal complaint, multifocal
signs are often found following careful neurological examination. The gold
standard for diagnosis remains the demonstration of neoplastic cells in the
cerebrospinal fluid. Despite the discouraging prognosis, palliative
treatment may improve quality of life and lengthen lifespan. We report a
patient with known primary carcinoma of the urachus who presented with
headaches, nausea, vomiting and ataxia 1 week following resection of a
nodular arachnoidal metastasis (indenting the cerebellum). Lumbar
cerebrospinal fluid subsequently confirmed carcinomatous meningitis. This is
the first reported case of carcinomatous meningitis resulting from
metastatic urachal carcinoma.
Publication Types:
PMID: 16307300 [PubMed - indexed for MEDLINE]
-
-
Metastatic osteosarcoma to the brain in adult patient.
Elkiran
ET, Aygen
B, Karaoglu
A, Altundag
K.
Publication Types:
PMID: 16283439 [PubMed - indexed for MEDLINE]
-
-
LINAC radiosurgery as single treatment in cerebral
metastases.
Deinsberger
R, Tidstrand
J.
Department of Neurosurgery, Landesklinikum St. Poelten, Propst Fuhrerstrasse
4, A-3100, St. Poelten, Austria. r.deinsberger@kh-st-poelten.at
OBJECTIVE: Stereotactic radiosurgery is a radiation technique of high
radiation dose focused on a stereotactic intracranial target in a single
fraction with high precision. LINAC Radiosurgery has gained increasing
relevance in the treatment of brain metastases since it was introduced by
Sturm (1987). METHOD AND PATIENT SELECTION: From January 1996 to August 2003
110 patients were treated with LINAC Radiosurgery. A combination of the
University of Florida system and the X Knife System developed by Radionics
was used in all patients. Seventy patients had a single and 40 patients
multiple metastatic lesions at the time of diagnosis and treatment. Overall
161 intracerebral metastases were treated. Median tumor volume was 3.1 ccm
(0.3-15 ccm). Median radiation dose to the tumor margin was 1830 cGy (range
1100-2200 cGy) prescribed to the 80% isodose line. Whole brain radiation
therapy with a total dose of 30 Gy in 10 fractions was performed in 35
patients because of multiple metastases and LINAC Radiosurgery was used as
boost for recurrences. In 75 patients LINAC Radiosurgery was used as single
treatment. RESULTS: The follow-up period was between 6 and 72 months. Local
tumor control rate was 89.4%. Seventeen out of 161 metastases treated showed
local recurrence. Eleven out of 75 patients treated with radiosurgery as
single treatment developed distant recurrence and 3 out of 35 patients who
were treated with whole brain radiation therapy (WBRT) and radiosurgery as
boost. The 1-year survival rate is 54.9% with a median survival of 54 weeks.
CONCLUSION: LINAC Radiosurgery is an effective and safe treatment modality
in patients with cerebral metastases located in any area of the brain. WBRT
should be preserved for patients with multiple metastases or be delayed
until multiple recurrence occurs. Surgery is still the treatment of choice
in metastases with mass effect and surgical accessible location.
Publication Types:
PMID: 16244795 [PubMed - indexed for MEDLINE]
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-
Preferential recurrence of a sarcomatous component of a
gliosarcoma after boron neutron capture therapy: case report.
Miyatake
S, Kuwabara
H, Kajimoto
Y, Kawabata
S, Yokoyama
K, Doi
A, Tsuji
M, Mori
H, Ono
K, Kuroiwa
T.
Department of Neurosurgery, Osaka Medical College and Kyoto University
Research Reactor Institute, Osaka, Japan. neu070@poh.osaka-med.ac.jp
Gliosarcoma, a rare pathological entity composed of 2-8% malignant gliomas,
is characterized by a biphasic tissue pattern with alternating areas
displaying glial and mesenchymal differentiation. Here we report the
preferential recurrence of a sarcomatous component in gliosarcoma after
boron neutron capture therapy (BNCT), while a gliomatous component
disappeared as a result of the treatment. A 56-year-old woman with a left
frontal tumor was introduced to our clinic. After stereotactic biopsy,
craniotomy was applied and 90% of the mass was resected. The histological
diagnosis was glioblastoma with small amounts of sarcomatous component, that
is, gliosarcoma. BNCT was applied 30 days after craniotomy. Two weeks after
BNCT, almost all of the contrast-enhanced mass had disappeared on magnetic
resonance images; however, a half year later, the mass recurred just below
the original site and extended posteriorly. Irrespective of repetitive
salvage surgeries, the patient died of the recurrent tumor. At autopsy,
tumor cells of the frontal lobe were absent. A well-circumscribed mass of
the parietal and occipital lobes was composed of sarcomatous material, with
very little glial fibrillary acid protein-positive glial material. We found
in this patient the preferential recurrence of the sarcomatous component of
a gliosarcoma after potent radiotherapeutics in the form of BNCT.
Publication Types:
PMID: 16234987 [PubMed - indexed for MEDLINE]
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-
Obstructive hydrocephalus and intracranial hypertension
caused by a giant macroprolactinoma. Prompt response to medical treatment.
Scarone
P, Losa
M, Mortini
P, Giovanelli
M.
The Pituitary Unit, Department of Neurosurgery, Istituto Scientifico San
Raffaele, Universita Vita-Salute, Milano, Italy.
Patients with large prolactin (PRL)-secreting pituitary adenoma often have
symptoms due to varying degree of hypopituitarism and/or mass effect on
visual structures, while presentation with hydrocephalus is extremely
uncommon. Even more exceptional is the development of the syndrome of
intracranial hypertension as a consequence of tumor obstruction of the
cerebrospinal fluid circulation. In this report, we describe a 26-year-old
man who was referred to the emergency department of our hospital because of
headache, nausea, and vomiting. Clinical and radiological assessment led to
the diagnosis of obstructive hydrocephalus caused by a giant
macroprolactinoma. The patient received a temporary external ventricular
drainage to relieve the symptoms of intracranial hypertension. The same day,
after we received the result of the basal PRL level, medical treatment with
cabergoline was initiated. A prompt response to the drug ensued with
resolution of the obstructive hydrocephalus, which allowed removal of the
external ventricular drainage. Initial shrinkage of the mass was already
noted on a magnetic resonance imaging performed 12 days thereafter.
Subsequent medical treatment led to progressive and marked shrinkage of the
tumor. Eighteen months after presentation the patient was well while on
cabergoline treatment and showed no symptom attributable to compression of
the surrounding nervous structures. Our report confirms that, even in cases
of giant sellar mass with neurological symptoms, a rapid hormonal evaluation
is mandatory. If a macroprolactinoma is diagnosed, treatment with dopamine
agonists can lead to prompt clinical amelioration and shrinkage of the
tumor, with eventual resolution of neurological symptoms.
Publication Types:
PMID: 16205966 [PubMed - indexed for MEDLINE]
-
-
The efficacy of radiation therapy in the management of
grade I astrocytomas.
Kidd
EA, Mansur
DB, Leonard
JR, Michalski
JM, Simpson
JR, Perry
A.
Department of Radiation Oncology and Mallinckrodt Institute of Radiology,
St. Louis, MO, USA.
INTRODUCTION: The purpose of this study was to analyze the outcome of
patients with grade I astrocytomas treated with radiation therapy,
specifically looking at the prognostic significance of age, timing of
radiation therapy (immediately after surgery or delayed until progression)
and tumor location. MATERIALS AND METHODS: The records of patients with
grade I astrocytomas treated at Washington University Medical Center between
1982 and 2002 were reviewed. Twenty patients with grade I pilocytic
astrocytoma (n=19) or subependymal giant cell astrocytoma (n=1) were treated
with radiation therapy with curative intent. RESULTS: The median follow-up
was 6.4 years. The 5-year overall survival for all patients was 100%. The
5-year progression-free survival (PFS) following radiation therapy for all
patients was 68%. Patients who received radiation therapy immediately after
biopsy or surgery had a 5-year PFS of 77% versus 50% for patients who
received radiation therapy after initial disease progression (P=0.013).
Patients with infratentorial tumors had an improved outcome with a 5-year
PFS of 80% versus 59% for those with supratentorial tumors (P=0.0076).
Patient age did not significantly influence outcome. All tumor recurrences
were local. CONCLUSIONS: While this study reports an excellent overall
survival, approximately one third of patients with grade I astrocytomas had
progressive disease following radiation therapy. In particular, patients
with supratentorial tumors and delayed radiation therapy had a worse PFS.
Additional investigation is needed to improve the outcome in these patients.
PMID: 16132503 [PubMed - indexed for MEDLINE]
-
-
Mixed germinoma and choriocarcinoma in the intramedullary
spinal cord: case report and review of the literature.
Takahashi
M, Koyama
H, Matsubara
T, Murata
H, Miura
K, Nagano
A.
Department of Orthopedic Surgery, Hamamatsu University School of Medicine,
Hamamatsu, 432-3192, Japan. taka1m@hama-med.ac.jp
Primary germinomas in the spinal cord are very rare with only 15 cases
published previously. In this case a 22-year-old woman with urinary
incontinence, lumbago, and bilateral leg pain and weakness was found to have
a solid tumor in the conus medullaris between the L1 and L2 vertebral
bodies. Serum HCG was elevated without pregnancy. The pathological diagnosis
was mixed germinoma and choriocarcinoma of the intramedullary spinal cord.
She received craninospinal irradiation and three courses of chemotherapy and
is currently asymptomatic with no evidence of recurrence and metastasis 22
months after surgery. To our knowledge, this is the first case report of a
patient with a primary mixed germinoma and choriocarcinoma of the
intramedullary spinal cord. The previous 15 cases of primary spinal cord
germinoma have been reviewed for comparison.
Publication Types:
PMID: 16132500 [PubMed - indexed for MEDLINE]
-
-
Targeted tumor cell death induced by autologous
tumor-specific T lymphocyte recognition of wild-type p53-derived peptides.
Tsurushima
H, Yoshii
Y, Leong
KW, Ohno
T.
Faculty of Medicine, Department of Neuro Surgery, University of the Ryukyus,
Okinawa, Japan. hideo-tsurushima@aist.go.jp
Autologous tumor-specific T lymphocyte (ATTL) lines were derived from the
peripheral blood mononuclear cells (PBMC) of a healthy volunteer with human
leukocyte antigen (HLA) -A*0201. These lines were achieved using
interleukins -1beta, -2, -4, and -6 and the p53-based peptide from the
264-272 sequence of the wild-type p53 protein with a strong affinity against
HLA-A*0201.;The frequencies of CD3+, CD4+, and CD8+ lymphocytes were 94-96%,
30-34%, and 69-74%, respectively. ATTLs killed most of the T2 cells pulsed
with p53-derived peptide, but not against the T2 cells non-pulsed or pulsed
with an irrelevant peptide. ATTLs also killed TKB-14 cells, which have been
derived from human glioblastoma multiforme, and exhibited HLA-A*0201
molecule and immunohistochemical accumulation of p53 protein. These
cytotoxic activities were inhibited by anti-CD3, anti-CD8, and anti-class I
antibodies.These findings suggested that these ATTL lines might include CTL
populations, which could recognize p53-derived peptide on HLA-A*0201 and the
p53-based peptide may play as an antigen on HLA-A*0201. When tumor antigens
would be more analyzed in the future, ATTL could be induced without the
primary-cultured cells from tumor tissue and could be applied for cancer
therapy.
PMID: 16132498 [PubMed - indexed for MEDLINE]
-
-
Olfactory ensheathing cell tumor: a case report.
Yasuda
M, Higuchi
O, Takano
S, Matsumura
A.
Department of Neurosurgery, Hitachi Ltd., Mito General Hospital, and
Department of Neurosurgery, Institute of Clinical Medicine, Graduate School
of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan.
ymune@par.odn.ne.jp
A 31-year-old Japanese woman was referred to our hospital after experiencing
a convulsion. Upon radiological examination, a heterogeneously enhanced
tumor was found on the anterior skull base. The tumor was surgically
removed. On light microscopy, the tumor cells appeared spindle-shaped,
forming an interwoven pattern. The nuclei were arranged partially parallel
mimicking a palisading pattern. At first, the tumor was thought to be
schwannoma. However, it was positive for S-100 and negative for both
epithelial membrane antigen (EMA) and Leu7. The final diagnosis was
olfactory ensheathing cell (OEC) tumor. OECs are similar to Schwann cells in
microscopic appearance and upon immunohistochemical staining. However, the
OECs are negative for CD57 (Leu7), while the Schwann cells are positive for
it. Our patient's tumor had immunological characteristics identical to those
of OEC. In the English and Japanese literature, 21 cases of solitary
schwannoma on the anterior skull base have been reported. Although several
theories have been suggested, the pathogenesis of subfrontal schwannoma has
not been clarified. Also, OECs have never been considered as their origin.
However, as in our case, OECs, rather than Schwann cells, are suspected as
the origin in some of the cases.
Publication Types:
PMID: 16132493 [PubMed - indexed for MEDLINE]
-
-
Management of a sporadic malignant subfrontal peripheral
nerve sheath tumor.
Sanchez-Mejia
RO, Pham
DN, Prados
M, Tihan
T, Cha
S, El-Sayed
I, McDermott
MW.
Department of Neurological Surgery, University of California, M-779, Box
0112, San Francisco, CA 94143, USA. sanchezr@neurosurg.ucsf.edu
Malignant subfrontal (olfactory) peripheral nerve sheath tumors (MPNSTs) are
exceedingly rare. Although meningiomas are the most common subfrontal
extra-axial lesions, it is important to recognize that MPNSTs, which are
radiographically similar to meningiomas, can also be present in this
location. MPNSTs require more aggressive surgical and postoperative
management than meningiomas. In this paper, we describe a patient with a
subfrontal MPNST with unusual histological characteristics and present a
review of the literature. A 49-year-old woman presented with chronic
sinusitis and progressive headaches. A neurological examination revealed
left-sided anosmia. Brain-imaging studies revealed a large left subfrontal
mass with extension into the frontal and ethmoid sinuses and the nasal
cavity. The patient underwent both a bifrontal transbasal craniotomy and a
transnasal approach for an attempt at total resection of both the intradural
and extradural components of the MPNST. The patient was treated
postoperatively with radiation therapy, and had no evidence of recurrence at
her follow-up examination 1-year after treatment. Subfrontal PNSTs are
extremely rare and usually benign. The specific cell and nerve of origin for
these tumors remains unknown. Our case shows that these rare lesions can
present as a malignant variant and thus require aggressive surgical and
postoperative management to provide long-term tumor control.
Publication Types:
PMID: 16132491 [PubMed - indexed for MEDLINE]
-
-
Definition and diagnostic implications of gemistocytic
astrocytomas: a pathological perspective.
Tihan
T, Vohra
P, Berger
MS, Keles
GE.
Department of Pathology, UCSF School of Medicine, San Francisco, CA
94143-0511, USA. tihan@itsa.ucsf.edu
Gemistocytic astrocytoma still continues to be enigmatic; both in terms of
definition and prognostic implications. The major issue of contention has
been the clinical relevance of this pathological entity. The currently
accepted definition of gemistocytic astrocytoma requires 20% or more
gemistocytes, and considers the neoplasm as a diffuse astrocytoma, which is
a WHO grade II tumor. Some suggest that gemistocytic morphology should be
considered as evidence of a higher grade astrocytoma. However, there is no
consensus on the percentage of gemistocytes associated with a worse
prognosis than otherwise expected. Given the reported cases and series, it
is not clear that this morphology portends a more aggressive biology when
all else is equal. There is still a need for studies with sufficient numbers
of well-matched gemistocytic and non-gemistocytic astrocytic neoplasms to
decide whether upgrading a tumor with 'significant' number of gemistocytes
is justifiable. This article presents a critical review of the existing
studies and a brief mention of our experience from a pathological
perspective.
Publication Types:
PMID: 16132490 [PubMed - indexed for MEDLINE]
-
Episodic nocturnal wandering in a patient with epilepsy
due to a right temporoinsular low-grade glioma: relief following resection.
Case report.
Duffau
H, Kujas
M, Taillandier
L.
Department of Neurosurgery, Hopital Salpetriere, Paris, France.
hugues.duffau@psl.ap-hop-paris.fr
Although controversial, episodic nocturnal wandering (ENW) is thought to be
a rare and atypical form of nocturnal epilepsy, originating in the frontal
lobe and responsive to antiepileptic drugs (AEDs). The authors report the
case of a patient harboring a right temporoinsular low-grade glioma, who
presented with a 3-year history of agitated somnambulen |
Volume 5, Number 15 - 10 April
2006