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Shibata A, Yamaguchi F, Sasaki K, Yokobori S, Morita A. Primary Central Nervous System Lymphoma in a Patient with Down Syndrome. J NIPPON MED SCH 2023; 90:346-350. [PMID: 35644559 DOI: 10.1272/jnms.jnms.2023_90-502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Intracranial tumors are rare in persons with Down syndrome. Although germ cell tumors and gliomas have been reported in Down syndrome, primary central nervous system lymphoma (PCNSL) has not. We report a case of PCNSL in a 48-year-old man with Down syndrome and no history of malignant tumors. He visited our hospital for evaluation of left hemiparesis and gait disturbance. A thorough examination revealed brain tumors, and analysis of a biopsy specimen of the tumor confirmed a diagnosis of PCNSL. The final pathological diagnosis was diffuse large B-cell lymphoma of the central nervous system. Chemotherapy with rituximab, methotrexate, procarbazine, and vincristine was administered, and whole-brain irradiation was planned in conjunction with chemotherapy. It is unclear whether chromosomal abnormalities related to Down syndrome were involved in the development of PCNSL. Further molecular biological analysis may clarify the mechanism of combined Down syndrome and PCNSL.
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Affiliation(s)
- Ami Shibata
- Department of Emergency and Critical Care Medicine, Nippon Medical School Tama Nagayama Hospital
- Department of Emergency and Critical Care Medicine, Nippon Medical School
| | - Fumio Yamaguchi
- Department of Neurosurgical Surgery, Nippon Medical School
- Department of Neurosurgery for Community Health, Nippon Medical School
| | - Kazuma Sasaki
- Department of Emergency and Critical Care Medicine, Nippon Medical School
| | - Shoji Yokobori
- Department of Emergency and Critical Care Medicine, Nippon Medical School
| | - Akio Morita
- Department of Neurosurgical Surgery, Nippon Medical School
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2
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Klotz S, Ricken G, Preusser M, Dieckmann K, Widhalm G, Rössler K, Fischer P, Kalev O, Wöhrer A, Kovacs GG, Gelpi E. Enhanced expression of autophagy-related p62 without increased deposits of neurodegeneration-associated proteins in glioblastoma and surrounding tissue - An autopsy-based study. Brain Pathol 2022; 32:e13058. [PMID: 35229396 PMCID: PMC9425004 DOI: 10.1111/bpa.13058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 01/17/2022] [Accepted: 02/14/2022] [Indexed: 11/27/2022] Open
Abstract
Neurodegenerative diseases are a major health burden. The underlying causes are not yet fully understood, but different mechanisms such as cell stress and chronic inflammation have been described as contributing factors. Neurodegenerative changes have been observed in the vicinity of brain tumors, typically around slowly growing benign lesions. Moreover, in‐vitro data suggest a potential induction of pathological tau deposits also in glioblastoma, a highly malignant and proliferative brain cancer. The aim of this study was to evaluate neurodegeneration‐associated protein deposition and autophagy as well as microglial activation within and surrounding glioblastoma. Post‐mortem brain tissue of 22 patients with glioblastoma was evaluated immunohistochemically for phosphorylated tau, beta‐amyloid, alpha‐synuclein and phosphorylated TDP‐43. Additionally, the autophagy marker p62 and the microglial marker HLA‐DR were investigated. The data was compared to 22 control cases and ten cases with other space occupying brain lesions. An increase of p62‐immunoreactivity was observed within and adjacent to the glioblastoma tumor tissue. Moreover, dense microglial infiltration in the tumor tissue and the immediate surrounding brain tissue was a constant feature. Deposition of neurodegeneration‐associated proteins was found in the majority of cases (86.4%) but in distant sites. These findings suggested a preexisting neurodegenerative pathology, which followed a typical distributional pattern: ten cases with Alzheimer disease neuropathological changes, including two severe cases, eight cases with primary age‐related tauopathy, six cases with aging‐related tau astrogliopathy and one case with progressive supranuclear palsy. Collectively, our data suggests enhanced autophagy in glioblastoma tumor cells and the surrounding brain. The variety and distribution of distant neurodegeneration‐associated protein aggregates observed in the majority of cases, suggest a preexisting rather than a tumor‐induced neurodegenerative condition.
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Affiliation(s)
- Sigrid Klotz
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Vienna, Austria.,Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Gerda Ricken
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Matthias Preusser
- Division of Oncology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Karin Dieckmann
- Department of Radiation Oncology, Medical University of Vienna, Vienna, Austria
| | - Georg Widhalm
- Department of Neurosurgery, Medical University of Vienna, Vienna, Austria
| | - Karl Rössler
- Department of Neurosurgery, Medical University of Vienna, Vienna, Austria
| | - Peter Fischer
- Medical Research Society Vienna D.C., Head of Department of Psychiatry, Danube Hospital, Vienna, Austria
| | - Ognian Kalev
- Department of Neuropathology, Kepler University Hospital, Linz, Austria
| | - Adelheid Wöhrer
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Gabor G Kovacs
- Tanz Centre for Research in Neurodegenerative Disease, University of Toronto, Toronto, Ontario, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.,Department of Medicine, University of Toronto, Toronto, Ontario, Canada.,Laboratory Medicine Program & Krembil Brain Institute, University Health Network, Toronto, Ontario, Canada
| | - Ellen Gelpi
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Vienna, Austria.,Department of Neurology, Medical University of Vienna, Vienna, Austria
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3
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Adams JW, Malicki D, Levy M, Crawford JR. Low-grade glioma with novel mutations in KRAS and PMS2 in an adolescent with Down syndrome. BMJ Case Rep 2021; 14:e245456. [PMID: 34376426 PMCID: PMC8356180 DOI: 10.1136/bcr-2021-245456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2021] [Indexed: 11/04/2022] Open
Affiliation(s)
- Jason W Adams
- Neurosciences, University of California San Diego, La Jolla, California, USA
| | - Denise Malicki
- Pathology, Rady Children's Hospital University of California San Diego, San Diego, California, USA
| | - Michael Levy
- Neurosurgery, University of California San Diego, San Diego, California, USA
| | - John Ross Crawford
- Neurosciences and Pediatrics, University of California San Diego, San Diego, California, USA
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Mangum R, Varga E, Boué DR, Capper D, Benesch M, Leonard J, Osorio DS, Pierson CR, Zumberge N, Sahm F, Schrimpf D, Pfister SM, Finlay JL. SHH desmoplastic/nodular medulloblastoma and Gorlin syndrome in the setting of Down syndrome: case report, molecular profiling, and review of the literature. Childs Nerv Syst 2016; 32:2439-2446. [PMID: 27444290 DOI: 10.1007/s00381-016-3185-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Accepted: 07/07/2016] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Individuals with Down syndrome (DS) have an increased risk of acute leukemia compared to a markedly decreased incidence of solid tumors. Medulloblastoma, the most common malignant brain tumor of childhood, is particularly rare in the DS population, with only one published case. As demonstrated in a mouse model, DS is associated with cerebellar hypoplasia and a decreased number of cerebellar granule neuron progenitor cells (CGNPs) in the external granule cell layer (EGL). Treatment of these mice with sonic hedgehog signaling pathway (Shh) agonists promote normalization of CGNPs and improved cognitive functioning. CASE REPORT We describe a 21-month-old male with DS and concurrent desmoplastic/nodular medulloblastoma (DNMB)-a tumor derived from Shh dysregulation and over-activation of CGNPs. Molecular profiling further classified the tumor into the new consensus SHH molecular subgroup. Additional testing revealed a de novo heterozygous germ line mutation in the PTCH1 gene encoding a tumor suppressor protein in the Shh pathway. DISCUSSION The developmental failure of CGNPs in DS patients offers a plausible explanation for the rarity of medulloblastoma in this population. Conversely, patients with PTCH1 germline mutations experience Shh overstimulation resulting in Gorlin (Nevoid Basal Cell Carcinoma) syndrome and an increased incidence of malignant transformation of CGNPs leading to medulloblastoma formation. This represents the first documented report of an individual with DS simultaneously carrying PTCH1 germline mutation. CONCLUSION We have observed a highly unusual circumstance in which the PTCH1 mutation appears to "trump" the effects of DS in causation of Shh-activated medulloblastoma.
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Affiliation(s)
- Ross Mangum
- The Divisions of Hematology/Oncology/BMT, Neurosurgery and Neuropathology, the Departments of Pediatrics, Surgery and Pathology, Nationwide Children's Hospital and The Ohio State University, Columbus, OH, USA.
| | - Elizabeth Varga
- The Divisions of Hematology/Oncology/BMT, Neurosurgery and Neuropathology, the Departments of Pediatrics, Surgery and Pathology, Nationwide Children's Hospital and The Ohio State University, Columbus, OH, USA
| | - Daniel R Boué
- The Divisions of Hematology/Oncology/BMT, Neurosurgery and Neuropathology, the Departments of Pediatrics, Surgery and Pathology, Nationwide Children's Hospital and The Ohio State University, Columbus, OH, USA
| | - David Capper
- German Cancer Consortium (DKTK), Core Center Heidelberg, Heidelberg, Germany.,Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Martin Benesch
- Division of Pediatric Hematology/Oncology, Medical University of Graz, Graz, Austria
| | - Jeffrey Leonard
- The Divisions of Hematology/Oncology/BMT, Neurosurgery and Neuropathology, the Departments of Pediatrics, Surgery and Pathology, Nationwide Children's Hospital and The Ohio State University, Columbus, OH, USA
| | - Diana S Osorio
- The Divisions of Hematology/Oncology/BMT, Neurosurgery and Neuropathology, the Departments of Pediatrics, Surgery and Pathology, Nationwide Children's Hospital and The Ohio State University, Columbus, OH, USA
| | - Christopher R Pierson
- The Divisions of Hematology/Oncology/BMT, Neurosurgery and Neuropathology, the Departments of Pediatrics, Surgery and Pathology, Nationwide Children's Hospital and The Ohio State University, Columbus, OH, USA
| | - Nicholas Zumberge
- The Divisions of Hematology/Oncology/BMT, Neurosurgery and Neuropathology, the Departments of Pediatrics, Surgery and Pathology, Nationwide Children's Hospital and The Ohio State University, Columbus, OH, USA
| | - Felix Sahm
- German Cancer Consortium (DKTK), Core Center Heidelberg, Heidelberg, Germany.,Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Daniel Schrimpf
- German Cancer Consortium (DKTK), Core Center Heidelberg, Heidelberg, Germany.,Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Stefan M Pfister
- German Cancer Consortium (DKTK), Core Center Heidelberg, Heidelberg, Germany.,Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jonathan L Finlay
- The Divisions of Hematology/Oncology/BMT, Neurosurgery and Neuropathology, the Departments of Pediatrics, Surgery and Pathology, Nationwide Children's Hospital and The Ohio State University, Columbus, OH, USA
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Yamamoto T, Shinojima N, Todaka T, Nishikawa S, Yano S, Kuratsu JI. Meningioma in Down Syndrome. World Neurosurg 2015; 84:866.e1-6. [PMID: 25862935 DOI: 10.1016/j.wneu.2015.03.065] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Revised: 03/10/2015] [Accepted: 03/11/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Down syndrome comprises multiple malformations and is due to trisomy of chromosome 21. There is epidemiologic evidence that individuals with Down syndrome are at decreased risk for solid tumors including brain tumors. It has been suggested that some genes expressed on the extra copy of chromosome 21 act as tumor suppressor genes and contribute to protection against tumorigenesis. CASE DESCRIPTION We report the first case to our knowledge of a patient with Down syndrome, an 8-year-old boy, with an intracranial meningioma, in which the status of chromosome 21 was examined. The diagnosis was based on histologic examination of the surgically resected tumor. Postoperatively, the patient's neurologic status improved, and there was no tumor regrowth in the next 2 years. Fluorescence in situ hybridization for chromosome 22 confirmed high allele loss involving the neurofibromin 2 gene locus, a finding typical in meningiomas. Fluorescence in situ hybridization also revealed chromosome 21 heterogeneity in tumor cells; not only cells with trisomy 21 but also cells with disomy and monosomy 21 were present. All blood cells from the patient manifested trisomy 21. CONCLUSIONS Deletion of the chromosome 21 allele may be associated with tumorigenesis of meningioma in Down syndrome. This supports the hypothesis that some genes whose expression is increased on the extra copy of chromosome 21 function as tumor suppressor genes and that they contribute to the reduced tumor incidence in individuals with Down syndrome.
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Affiliation(s)
- Takahiro Yamamoto
- Division of Neurosurgery, Nobeoka Hospital, Miyazaki, Japan; Department of Neurosurgery, Kumamoto University Hospital, Kumamoto, Japan
| | - Naoki Shinojima
- Department of Neurosurgery, Kumamoto University Hospital, Kumamoto, Japan.
| | - Tatemi Todaka
- Division of Neurosurgery, Nobeoka Hospital, Miyazaki, Japan
| | | | - Shigetoshi Yano
- Department of Neurosurgery, Kumamoto University Hospital, Kumamoto, Japan
| | - Jun-ichi Kuratsu
- Department of Neurosurgery, Kumamoto University Hospital, Kumamoto, Japan
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Endo S, Kobayashi H, Terasaka S, Iguchi A, Cho Y, Ohshima J, Kubota K, Houkin K. Primary intracranial yolk sac tumor in the posterior fossa: Case report of a child with Down syndrome. Clin Neurol Neurosurg 2013; 115:811-3. [DOI: 10.1016/j.clineuro.2012.07.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Revised: 07/10/2012] [Accepted: 07/19/2012] [Indexed: 10/28/2022]
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A very rare cancer in Down syndrome: medulloblastoma. Epidemiological data from 13 countries. J Neurooncol 2013; 112:107-14. [PMID: 23307327 DOI: 10.1007/s11060-012-1041-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2012] [Accepted: 12/28/2012] [Indexed: 10/27/2022]
Abstract
Persons with Down syndrome (DS) uniquely have an increased frequency of leukemias but a decreased total frequency of solid tumors. The distribution and frequency of specific types of brain tumors have never been studied in DS. We evaluated the frequency of primary neural cell embryonal tumors and gliomas in a large international data set. The observed number of children with DS having a medulloblastoma, central nervous system primitive neuroectodermal tumor (CNS-PNET) or glial tumor was compared to the expected number. Data were collected from cancer registries or brain tumor registries in 13 countries of Europe, America, Asia and Oceania. The number of DS children with each category of tumor was treated as a Poisson variable with mean equal to 0.000884 times the total number of registrations in that category. Among 8,043 neural cell embryonal tumors (6,882 medulloblastomas and 1,161 CNS-PNETs), only one patient with medulloblastoma had DS, while 7.11 children in total and 6.08 with medulloblastoma were expected to have DS. (p 0.016 and 0.0066 respectively). Among 13,797 children with glioma, 10 had DS, whereas 12.2 were expected. Children with DS appear to be specifically protected against primary neural cell embryonal tumors of the CNS, whereas gliomas occur at the same frequency as in the general population. A similar protection against neuroblastoma, the principal extracranial neural cell embryonal tumor, has been observed in children with DS. Additional genetic material on the supernumerary chromosome 21 may protect against embryonal neural cell tumor development.
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8
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Tan C, Scotting PJ. Stem cell research points the way to the cell of origin for intracranial germ cell tumours. J Pathol 2012; 229:4-11. [DOI: 10.1002/path.4098] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2012] [Revised: 08/15/2012] [Accepted: 08/22/2012] [Indexed: 12/12/2022]
Affiliation(s)
- Chris Tan
- Children's Brain Tumour Research Centre, School of Biology; University of Nottingham, Queen's Medical Centre; Nottingham UK
| | - Paul J Scotting
- Children's Brain Tumour Research Centre, School of Biology; University of Nottingham, Queen's Medical Centre; Nottingham UK
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Ehara H, Ohno K, Ito H. Benign and malignant tumors in Down syndrome: analysis of the 1514 autopsied cases in Japan. Pediatr Int 2011; 53:72-7. [PMID: 20573041 DOI: 10.1111/j.1442-200x.2010.03189.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Down syndrome is known for its association with neoplasms. The aim of this study was to examine this association. METHODS We surveyed the association with benign and malignant neoplasms in Down syndrome patients registered in the Annual of Pathological Autopsy Cases of Japan (1974-2000), a database of autopsied cases operated by the Japanese Society of Pathology. RESULTS In a total of 1514 cases with Down syndrome, there were eight cases with 10 benign tumors (four male and four female) and 104 cases with malignant disorders (61 male, 42 female and one case with unrecorded sex), in which 87 cases with hematopoietic malignancies (83.7%) and 17 cases with solid tumors (16.3%), were identified. The association of gallbladder adenocarcinoma with a benign tumor of the colon was noted in one case, while a further two cases with double benign tumors were confirmed as well. No case with a double malignancy was found. Hematopoietic malignancies (87 cases) included 31 cases (35.6%) with acute myelocytic leukemia, 10 (11.4%) with acute lymphocytic leukemia and two (2.3%) with chronic myelocytic leukemia. The ratio of acute myelocytic leukemia to acute lymphocytic leukemia was 3.1 in the present study. A peak in the age distribution was at 0 years in our data in contrast to the previous data (at 1 year) for myelocytic leukemia. The 17 solid tumors identified included three hepatocellular carcinomas, three extrahepatic cholangiocarcinomas, two gallbladder adenocarcinomas, three brain tumors, and three seminomas. CONCLUSION We present new associations of benign and malignant tumors with Down syndrome.
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Affiliation(s)
- Hiroaki Ehara
- Department of Special Education, Faculty of Education, Shiga University, Otsu, Shiga, Japan.
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Abstract
In patients with Down syndrome, cancers like leukemia and testicular tumors are frequent, but association with central nervous system tumors is rare. Only 1 case of ependymoma has been observed as an incidental autopsy finding in a 19-week-old female fetus. We herein report the second case of ependymoma and the fifth case of spinal tumor occurring in association with Down syndrome. We have also attempted to elucidate the various mechanisms of tumorigenesis implicated in this multiple malformation syndrome. A 13-year-old girl with Down syndrome presented with progressively increasing paraparesis and neurogenic bladder. Magnetic resonance imaging of dorsolumbar spine revealed an intramedullary mass (L1 to L5 level). The patient underwent near total excision of tumor with postoperative histopathology showing myxopapillary ependymoma. Karyotyping showed classic Down syndrome with trisomy 21. Postoperative irradiation (45 Gy in 25 fractions over 5 wk followed by boost up to 55 Gy) was subsequently delivered. One year after the completion of the tumor-directed therapy, the patient is in radiologic complete remission, with improved power in both lower limbs. Association of ependymoma with Down syndrome is a rarity, which at best, can be explained as a chance phenomenon.
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Hamlat A, Saikali S, Diabira S, Messerer M, Riffaud L. Diagnosis of childhood astrocytomas. EXPERT OPINION ON MEDICAL DIAGNOSTICS 2009; 3:501-522. [PMID: 23495981 DOI: 10.1517/17530050903032679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Astrocytomas are the most common brain tumours, accounting for 28 - 50% of all primary CNS tumours. Diagnosis of CNS tumours remains difficult because the varied and nonspecific presentations of CNS tumours in childhood. Objectives/method: The clinical presentations of CNS astrocytomas vary with their sites of location; therefore, a period of uncertainty often precedes diagnosis, and approximately 42% of patients with an intracranial process make several visits to various physicians between the onset and diagnosis. However, on clinical suspicion of a brain tumour, a wide range of neuroimaging techniques may be used to assess the diagnosis of paediatric brain lesions. In this review the authors, for ease of presentation, describe the clinical presentations of supratentorial, infratentorial and spinal cord astrocytomas as well as their radiological and pathological features, and discuss their differential diagnoses. RESULTS/CONCLUSIONS Understanding and mastering the numerous imaging features of several subtypes of primary brain tumours affecting children, in addition to radiological features of non-tumoural disorders, remains a significant challenge and demands increased awareness of the paediatric brain diseases.
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Affiliation(s)
- Abderrahmane Hamlat
- Department of Neurosurgery, CHU Pontchaillou, 2 Rue Henri Le Guilloux, 35000 Rennes Cedex 2, France +33 2 99 28 43 21 ; +33 2 99 28 41 80 ;
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12
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Satgé D, Bénard J. Carcinogenesis in Down syndrome: What can be learned from trisomy 21? Semin Cancer Biol 2008; 18:365-71. [DOI: 10.1016/j.semcancer.2008.03.020] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2008] [Accepted: 03/25/2008] [Indexed: 11/26/2022]
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13
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Nakamura H, Takeshima H, Makino K, Kuratsu JI. Evaluation of residual tissues after adjuvant therapy in germ cell tumors. Pediatr Neurosurg 2007; 43:82-91. [PMID: 17337917 DOI: 10.1159/000098378] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2006] [Accepted: 07/19/2006] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Germ cell tumors are the tumors sensitive for adjuvant therapy such as radiotherapy and chemotherapy. We evaluated the pathological findings of these heterogeneous tumors to determine the persistence of residual viable tumor cells after adjuvant therapy. PATIENTS AND METHODS Between 1988 and 2005, we treated 31 patients with germinoma or germinoma with syncytiotrophoblastic giant cells (STGC) and 15 patients with non-germinomatous malignant germ cell tumors (NGMGCTs). All 46 patients received a combination of chemo- and radiotherapy. A second-look operation was performed in 3 of 31 patients with germinomas or germinomas with STGC and 12 of 15 patients with NGMGCTs. The follow-up period was 2-139 months (median 95) in patients with germinomas or germinomas with STGC (group 1) and 10-202 months (median 65) in NGMGCT patients (group 2). RESULTS Post-treatment, 3 group 1 and 12 group 2 patients manifested residual tumors. The pathological diagnosis in group 1 patients was mature teratoma, pineal cyst, and fibrous tissue with calcification; in group 2 it was yolk sac tumor (n = 1), immature teratoma (n = 3), mature teratoma (n = 4), and necrosis or fibrous tissue (n = 4). While no group 1 patients manifested tumor cells, MIB-1-positive viable tumor cells were present in resected tissues from one-third of the group 2 patients (3 immature teratomas and 1 yolk sac tumor). CONCLUSION The absence of viable tumor cells in residual tissue indicates that the combination of cisplatin-based chemo- and radiotherapy was effective in our germinoma patients. On the other hand, in patients with NGMGCTs, these cells persisted despite this combination therapy.
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MESH Headings
- Adolescent
- Adult
- Antineoplastic Protocols
- Biopsy
- Brain Neoplasms/diagnosis
- Brain Neoplasms/mortality
- Brain Neoplasms/pathology
- Brain Neoplasms/therapy
- Chemotherapy, Adjuvant
- Child
- Child, Preschool
- Combined Modality Therapy
- Female
- Follow-Up Studies
- Giant Cells/pathology
- Humans
- Magnetic Resonance Imaging
- Male
- Middle Aged
- Neoplasm, Residual/diagnosis
- Neoplasm, Residual/mortality
- Neoplasm, Residual/pathology
- Neoplasms, Germ Cell and Embryonal/diagnosis
- Neoplasms, Germ Cell and Embryonal/mortality
- Neoplasms, Germ Cell and Embryonal/pathology
- Neoplasms, Germ Cell and Embryonal/therapy
- Radiotherapy, Adjuvant
- Survival Rate
- Trophoblasts/pathology
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Affiliation(s)
- Hideo Nakamura
- Department of Neurosurgery, Graduate School of Medical Science, Kumamoto University, Kumamoto, Japan.
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14
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Engidawork E, Gulesserian T, Fountoulakis M, Lubec G. Aberrant protein expression in cerebral cortex of fetus with Down syndrome. Neuroscience 2004; 122:145-54. [PMID: 14596856 DOI: 10.1016/s0306-4522(03)00605-5] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Down syndrome is the most common birth defect associated with mental retardation. Identifying proteins that are aberrantly expressed therefore helps to understand how chromosomal imbalance leads to subnormal intelligence in Down syndrome. In the present study, we generated a fetal brain map with the use of an analytical method based on two-dimensional electrophoresis coupled with mass spectrometry and searched the proteome for differential protein expression. Among 49 proteins analyzed in seven control and nine Down syndrome fetuses, we found 11 proteins that have been deregulated in cerebral cortex of fetal Down syndrome. While double-strand break repair protein rad 21 homologue, eukaryotic translation initiation factor 3 subunit 5, mixed lineage leukemia septin-like fusion protein-B and heat shock protein 75 were increased; beta-amyloid precursor-like protein 1, tropomyosin 4-anaplastic lymphoma kinase fusion oncoprotein type 2, Nck adaptor protein 2, Src homology domain growth factor receptor bound 2-like endophilin B2, beta tubulin, septin 7 and hematopoietic stem/progenitor cells 140 were decreased. The current data suggest that misexpression of proteins that have functions ranging from signaling to cellular structural organization could contribute to or reflect brain dysgenesis in Down syndrome.
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Affiliation(s)
- E Engidawork
- Department of Neonatology, University of Vienna, Vienna, Austria
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