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Shobeiri P, Seyedmirzaei H, Kalantari A, Mohammadi E, Rezaei N, Hanaei S. The Epidemiology of Brain and Spinal Cord Tumors. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1394:19-39. [PMID: 36587379 DOI: 10.1007/978-3-031-14732-6_2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
CNS tumors are a diverse group of neoplasms that emerge from a variety of different CNS cell types. These tumors may be benign, malignant, or borderline in nature. The majority of high grade glial tumors are fatal, with the exception of pilocytic astrocytoma. Primary malignant CNS tumors occur at a global annual rate of 2.1 to 5.8 per 100,000 persons. Males are more likely to develop malignant brain tumors than females, whereas benign meningiomas are more common in adult females. Additionally, gender inequalities in non-malignant tumors peak between the ages of 25 and 29 years. Only a small number of genetic variants have been associated with survival and prognosis. Notably, central nervous system (CNS) tumors exhibit significant age, gender, and race variation. Race is another factor that affects the incidence of brain and spinal cord tumors. Different races exhibit variation in terms of the prevalence of brain and CNS malignancies. This chapter discusses ongoing research on brain and spinal cord tumor epidemiology, as well as the associated risks and accompanied disorders.
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Affiliation(s)
- Parnian Shobeiri
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Homa Seyedmirzaei
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Amirali Kalantari
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Esmaeil Mohammadi
- Department of Pediatric Neurosurgery, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Nima Rezaei
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
- Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Sara Hanaei
- Department of Neurosurgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
- Universal Scientific Education and Research Network (USERN), Tehran, Iran.
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Primary Neuroendocrine Carcinoma of Pineal Gland With Extensive Meningeal Metastasis Detected by 18F-NOTATATE PET/CT. Clin Nucl Med 2022; 47:1105-1107. [PMID: 36342798 DOI: 10.1097/rlu.0000000000004368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
ABSTRACT Primary neuroendocrine tumor of the pineal gland is a rare disease. A 44-year-old woman with right cerebellopontine angle metastatic small cell neuroendocrine carcinoma underwent 18F-FDG and 18F-NOTATATE PET/CT scans. 18F-NOTATATE PET/CT showed intense uptake in the pineal gland lesions and multiple foci of intense focus of uptake in the intracranial leptomeningeal and whole spinal canal. However, the lesions are less impressive on 18F-FDG PET/CT.
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Caro-Osorio E, Perez-Ruano LA, Martinez HR, Rodriguez-Armendariz AG, Lopez-Sotomayor DM. Primary Neuroendocrine Carcinoma of the Cerebellopontine Angle: A Case Report and Literature Review. Cureus 2022; 14:e27564. [PMID: 36059346 PMCID: PMC9431898 DOI: 10.7759/cureus.27564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/30/2022] [Indexed: 11/25/2022] Open
Abstract
Primary intracranial neuroendocrine tumors are extremely rare malignancies with very few cases reported in the world literature. We describe a primary neuroendocrine carcinoma arising from the right cerebellopontine angle, the second case that has been described in this location. The possible origin in this place and treatment are described. A 29-year-old male patient, diagnosed with schwannoma of the right cerebellopontine angle, and treated with radiosurgery at another institution, came to our hospital six months later, The patient presented with a history of rapid progression of numbness on the right side of the face, diplopia, dizziness, vomiting, and facial palsy. On examination, the right cranial nerves V, VI, VII, VIII, and IX were affected. The MRI showed tumor growth occupying the right cerebellopontine angle, with compression of the brain stem and cerebellum. A right retromastoid craniectomy removed the tumor partially and the histopathological examination revealed a high-grade neuroendocrine carcinoma. We describe a primary neuroendocrine tumor of the brain that, despite its rarity, must be considered in the differential diagnosis. There are currently no guidelines for the management of these tumors. According to previously reported cases, surgery is the first line of treatment, followed by radiotherapy or chemotherapy. We consider that such a rare case is needed to be reported for a better understanding of the disease and its neurobiology.
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Diefenbach C, Lorenz C, Weidauer S. Toxic Spongiform Leukoencephalopathy After Intravenous Heroin Abuse: Unusual But Important Differential Diagnosis of Acute Impairment of Consciousness. FORTSCHRITTE DER NEUROLOGIE-PSYCHIATRIE 2022; 90:523-528. [PMID: 35584766 DOI: 10.1055/a-1778-3662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Abuse of heroin vapour inhalation known as "chasing the dragon" is associated with toxic spongiform leukoencephalopathy. However, similar clinical and imaging findings may occur also after intravenous heroin abuse. We report on a 32-year-old male suffering from extensive toxic spongiform leukoencephalopathy after intravenous heroin abuse resulting in acute impairment of consciousness and a global state of confusion. MRI disclosed broad and nearly symmetrical diffusion restriction of the supratentorial white matter indicating cytotoxic oedema. In an emergency setting, differential diagnosis of acute impairment of consciousness and broad symmetrical white matter lesions in neuroimaging should also include toxic leukoencephalopathy due to intravenous heroin application.
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Affiliation(s)
- Camilla Diefenbach
- Sankt Katharinen Krankenhaus, Neurologie, Goethe-Universität Frankfurt am Main, Fachbereich 16 Medizin, Frankfurt am Main, Germany
| | - Christine Lorenz
- Abteilung der Radiologie, Sankt Katharinen Krankenhaus, Frankfurt am Main, Germany
| | - Stefan Weidauer
- Sankt Katharinen Krankenhaus, Neurologie, Goethe-Universität Frankfurt am Main, Fachbereich 16 Medizin, Frankfurt am Main, Germany
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Stepien N, Haberler C, Theurer S, Schmook MT, Lütgendorf-Caucig C, Müllauer L, Gojo J, Azizi AA, Czech T, Slavc I, Peyrl A. Unique Finding of a Primary Central Nervous System Neuroendocrine Carcinoma in a 5-Year-Old Child: A Case Report. Front Neurosci 2022; 16:810645. [PMID: 35401087 PMCID: PMC8984181 DOI: 10.3389/fnins.2022.810645] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 03/03/2022] [Indexed: 11/13/2022] Open
Abstract
Neuroendocrine tumors (NETs) are rare neoplasms predominantly arising in the gastrointestinal-tract or the lungs of adults. To date, only ten cases of primary central nervous system (CNS) NETs have been reported, with just three of them describing a neuroendocrine carcinoma (NECA) and none occurring in a child. We report on a previously healthy 5-year-old boy, who presented with headaches, nausea and vomiting, and was diagnosed with a left cerebellar solid mass with a cystic component. After gross-total resection, histology revealed a neuroendocrine carcinoma. Molecular analysis of the tumor tissue showed a KRAS-splice-site mutation (c451-3C > T). The KRAS-mutation was discovered to be a maternal germline mutation, previously described as likely benign. After extensive search for an extracranial primary tumor, including Ga-68 DOTANOC-PET-CT, the diagnosis of a primary CNS NECA was established, and proton irradiation was performed. Unfortunately, the patient developed an in-field recurrence just 5 weeks after the end of radiotherapy. The tumor was re-resected with vital tumor tissue. Six cycles of chemotherapy were initiated, consisting of cisplatin, carboplatin, etoposide and ifosfamide. The patient remains disease free 22 months after the end of treatment, supporting the beneficial effect of platinum- and etoposide-based chemotherapy for this tumor entity.
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Affiliation(s)
- Natalia Stepien
- Department of Pediatric and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
- Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Christine Haberler
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Vienna, Austria
- Christine Haberler,
| | - Sarah Theurer
- Institute of Pathology, University of Duisburg-Essen, Essen, Germany
| | - Maria-Theresa Schmook
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | | | - Leonhard Müllauer
- Department of Pathology, Medical University of Vienna, Vienna, Austria
| | - Johannes Gojo
- Department of Pediatric and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
- Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Amedeo A. Azizi
- Department of Pediatric and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
- Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Thomas Czech
- Department of Neurosurgery, Medical University of Vienna, Vienna, Austria
| | - Irene Slavc
- Department of Pediatric and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
- Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Andreas Peyrl
- Department of Pediatric and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
- Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
- *Correspondence: Andreas Peyrl, , orcid.org/0000-0002-5736-8231
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Cheng A, Barron J, Holmes O, Bartlett P, Jenkins G, Seal M. Primary neuroendocrine tumor of the pineal gland: a case report. BMC Neurol 2021; 21:323. [PMID: 34416869 PMCID: PMC8377818 DOI: 10.1186/s12883-021-02351-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 08/12/2021] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Primary intracranial neuroendocrine tumors are exceedingly rare, with few cases in the literature. We present a case of a primary neuroendocrine carcinoma of the pineal gland, which is the second that has ever been reported. CASE PRESENTATION A 53-year-old male patient presented with vomiting, weakness, and headaches. Imaging revealed a lesion in the pineal region, which was surgically resected. This mass was characterized by histology as a neuroendocrine carcinoma, given the presence of neuroendocrine markers and cytokeratin markers with absence of a primary lesion elsewhere on imaging. CONCLUSIONS There are currently no guidelines on the management of primary intracranial neuroendocrine tumors. In this case, the patient underwent surgical resection and craniospinal radiotherapy. He subsequently received one cycle of chemotherapy with temozolomide, an alkylating agent, but he unfortunately did not tolerate treatment. A multidisciplinary decision was made along with the patient and his family to focus on palliative care. Eighteen months after the initial presentation, disease recurred in the patient's neck. The patient underwent resection to control the metastases, with a plan to follow with radiotherapy and chemotherapy. Unfortunately, the patient became unwell and died at 21 months after initial diagnosis. This demonstrates a need for continued research and reporting on this uncommon disease entity.
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Affiliation(s)
- Angela Cheng
- Faculty of Medicine, Memorial University, 105-78 Thorburn Road, St. John's, NL, A1B3T4, Canada.
| | - Jane Barron
- Discipline of Laboratory Medicine (Neuropathology), Memorial University Faculty of Medicine, St. John's, Canada
| | - Oliver Holmes
- Discipline of Oncology (Radiation Oncology), Memorial University Faculty of Medicine, St. John's, Canada
| | - Peter Bartlett
- Department of Radiology, Memorial University Faculty of Medicine, St. John's, Canada
| | - Gregory Jenkins
- Department of Surgery (Neurosurgery), Memorial University Faculty of Medicine, St. John's, Canada
| | - Melanie Seal
- Discipline of Oncology (Medical Oncology), Memorial University Faculty of Medicine, St. John's, Canada
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Abstract
Neuroendocrine neoplasms (NENs) are malignancies with rare reports of central nervous system development. A 34-year-old woman was found to have a primary NEN of the brain, and she had recurrence with identical histology 10 years later. Extracranial NENs were excluded. She had routine surveillance for the first 5 years with MRIs and positron emission tomography/CTs after the initial presentation which was treated with radiation followed by cisplatin and etoposide. This case highlights the difference in primary NENs versus NEN metastases to the brain, and that longer periods of surveillance are likely required for primary NENs. This is important because the prognosis between primary NENs and metastatic NENs to the brain are vastly different and should not be treated as equal diseases. The patient eventually died of her recurrence secondary to complications of a ventriculoperitoneal shunt placed for treatment of hydrocephalus from the disease.
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Affiliation(s)
- Clay T Reed
- Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Narjust Duma
- Medical Oncology, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Jan Buckner
- Medical Oncology, Mayo Clinic, Rochester, Minnesota, USA
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Wick MR. Primary lesions that may imitate metastatic tumors histologically: A selective review. Semin Diagn Pathol 2018; 35:123-142. [DOI: 10.1053/j.semdp.2017.11.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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