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George E, Settler A, Connors S, Greenfield JP. Pediatric Gliomatosis Cerebri: A Review of 15 Years. J Child Neurol 2016; 31:378-87. [PMID: 26239491 DOI: 10.1177/0883073815596612] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Accepted: 06/17/2015] [Indexed: 01/22/2023]
Abstract
Gliomatosis cerebri is a rare glial tumor that carries a poor prognosis. Seen in both adults and children, gliomatosis cerebri appears to differ in these populations as with adult versus pediatric glioblastoma. We present 10 children who either presented to the Weill Cornell Medical College or enrolled in the institution's Gliomatosis Cerebri International Registry alongside a cohort of 89 pediatric patients reported in the literature between 2000 and 2014. Age ranged from 4 months to 21 years, with a male to female ratio of 1.71. Median overall survival for patients in the registry cohort was 17 months (n = 10) and for the historic cohort was 13 months (n = 52). Overall survival was analyzed for the combined cohort and was significantly longer when presenting at age ≥ 10 (20 vs 10 months), for boys (18 vs 11 months), and with low-grade pathology (26.5 vs 12 months) but did not vary significantly by treatment approach.
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Affiliation(s)
- Emilie George
- Department of Neurological Surgery, Weill Cornell Medical College, New York, New York, USA
| | - Allison Settler
- Department of Neurological Surgery, Weill Cornell Medical College, New York, New York, USA
| | - Scott Connors
- Department of Neurological Surgery, Weill Cornell Medical College, New York, New York, USA
| | - Jeffrey P Greenfield
- Department of Neurological Surgery, Weill Cornell Medical College, New York, New York, USA
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Plattner BL, Kent M, Summers B, Platt SR, Freeman AC, Blas-Machado U, Clemans J, Cheville NF, Garcia-Tapia D. Gliomatosis Cerebri in Two Dogs. J Am Anim Hosp Assoc 2012; 48:359-65. [DOI: 10.5326/jaaha-ms-5796] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A 3.5 yr old Saint Bernard was evaluated for nonambulatory tetraparesis and cranial nerve dysfunction, and a 7 yr old rottweiler was evaluated for progressive paraparesis. Clinical signs of left-sided vestibular and general proprioceptive ataxia and cranial nerve VII dysfunction in the Saint Bernard suggested a lesion affecting the brain stem. Signs in the rottweiler consisted of general proprioceptive/upper motor neuron paraparesis, suggesting a lesion involving the third thoracic (T3) to third lumbar (L3) spinal cord segments. MRI was normal in the Saint Bernard, but an intra-axial lesion involving the T13–L2 spinal cord segments was observed in the rottweiler. In both dogs, the central nervous system (CNS) contained neoplastic cells with features consistent with gliomatosis cerebri (GC). In the Saint Bernard, neoplastic cells were present in the medulla oblongata and cranial cervical spinal cord. In the rottweiler, neoplastic cells were only present in the spinal cord. Immunohistochemistry disclosed two distinct patterns of CD18, nestin, and vimentin staining. GC is a rarely reported tumor of the CNS. Although GC typically involves the cerebrum, clinical signs in these two dogs reflected caudal brainstem and spinal cord involvement.
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Affiliation(s)
- Brandon L. Plattner
- Department of Veterinary Pathology (B.P., N.C., D. G-T.), Department of Veterinary Clinical Sciences (J.C.), College of Veterinary Medicine, Iowa State University, Ames, IA; Department of Small Animal Medicine and Surgery (M.K., S.P., A.F.), Diagnostic Laboratory (U.B-M.), College of Veterinary Medicine, University of Georgia, Athens, GA; and Pathology & Infectious Diseases, The Royal Veterinary College, Herts, United Kingdom (B.S.)
| | - Marc Kent
- Department of Veterinary Pathology (B.P., N.C., D. G-T.), Department of Veterinary Clinical Sciences (J.C.), College of Veterinary Medicine, Iowa State University, Ames, IA; Department of Small Animal Medicine and Surgery (M.K., S.P., A.F.), Diagnostic Laboratory (U.B-M.), College of Veterinary Medicine, University of Georgia, Athens, GA; and Pathology & Infectious Diseases, The Royal Veterinary College, Herts, United Kingdom (B.S.)
| | - Brian Summers
- Department of Veterinary Pathology (B.P., N.C., D. G-T.), Department of Veterinary Clinical Sciences (J.C.), College of Veterinary Medicine, Iowa State University, Ames, IA; Department of Small Animal Medicine and Surgery (M.K., S.P., A.F.), Diagnostic Laboratory (U.B-M.), College of Veterinary Medicine, University of Georgia, Athens, GA; and Pathology & Infectious Diseases, The Royal Veterinary College, Herts, United Kingdom (B.S.)
| | - Simon R. Platt
- Department of Veterinary Pathology (B.P., N.C., D. G-T.), Department of Veterinary Clinical Sciences (J.C.), College of Veterinary Medicine, Iowa State University, Ames, IA; Department of Small Animal Medicine and Surgery (M.K., S.P., A.F.), Diagnostic Laboratory (U.B-M.), College of Veterinary Medicine, University of Georgia, Athens, GA; and Pathology & Infectious Diseases, The Royal Veterinary College, Herts, United Kingdom (B.S.)
| | - A. Courtenay Freeman
- Department of Veterinary Pathology (B.P., N.C., D. G-T.), Department of Veterinary Clinical Sciences (J.C.), College of Veterinary Medicine, Iowa State University, Ames, IA; Department of Small Animal Medicine and Surgery (M.K., S.P., A.F.), Diagnostic Laboratory (U.B-M.), College of Veterinary Medicine, University of Georgia, Athens, GA; and Pathology & Infectious Diseases, The Royal Veterinary College, Herts, United Kingdom (B.S.)
| | - Uriel Blas-Machado
- Department of Veterinary Pathology (B.P., N.C., D. G-T.), Department of Veterinary Clinical Sciences (J.C.), College of Veterinary Medicine, Iowa State University, Ames, IA; Department of Small Animal Medicine and Surgery (M.K., S.P., A.F.), Diagnostic Laboratory (U.B-M.), College of Veterinary Medicine, University of Georgia, Athens, GA; and Pathology & Infectious Diseases, The Royal Veterinary College, Herts, United Kingdom (B.S.)
| | - Jessie Clemans
- Department of Veterinary Pathology (B.P., N.C., D. G-T.), Department of Veterinary Clinical Sciences (J.C.), College of Veterinary Medicine, Iowa State University, Ames, IA; Department of Small Animal Medicine and Surgery (M.K., S.P., A.F.), Diagnostic Laboratory (U.B-M.), College of Veterinary Medicine, University of Georgia, Athens, GA; and Pathology & Infectious Diseases, The Royal Veterinary College, Herts, United Kingdom (B.S.)
| | - Norman F. Cheville
- Department of Veterinary Pathology (B.P., N.C., D. G-T.), Department of Veterinary Clinical Sciences (J.C.), College of Veterinary Medicine, Iowa State University, Ames, IA; Department of Small Animal Medicine and Surgery (M.K., S.P., A.F.), Diagnostic Laboratory (U.B-M.), College of Veterinary Medicine, University of Georgia, Athens, GA; and Pathology & Infectious Diseases, The Royal Veterinary College, Herts, United Kingdom (B.S.)
| | - David Garcia-Tapia
- Department of Veterinary Pathology (B.P., N.C., D. G-T.), Department of Veterinary Clinical Sciences (J.C.), College of Veterinary Medicine, Iowa State University, Ames, IA; Department of Small Animal Medicine and Surgery (M.K., S.P., A.F.), Diagnostic Laboratory (U.B-M.), College of Veterinary Medicine, University of Georgia, Athens, GA; and Pathology & Infectious Diseases, The Royal Veterinary College, Herts, United Kingdom (B.S.)
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6
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Landi A, Piccirilli M, Mancarella C, Giangaspero F, Salvati M. Gliomatosis cerebri in young patients' report of three cases and review of the literature. Childs Nerv Syst 2011; 27:19-25. [PMID: 20376465 DOI: 10.1007/s00381-010-1137-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2010] [Accepted: 03/22/2010] [Indexed: 11/28/2022]
Abstract
UNLABELLED Gliomatosis cerebri (GC) is a rare disease, defined as a diffuse neoplastic glial cell infiltration of the brain. Diagnosis and management of GC are difficult. METHOD The authors report a literature review and their experience based on three patients, two male, and one female, all younger than 10 years, who were treated for GC. RESULTS Our series of three patients were combined for the purposes of survival assessment together with the 22 patients from the literature review yielding 25 evaluable patients with diagnosis of GC. We compared the patients treated (16) with chemo, RT, or both combined, with untreated patients (7) to evaluate the median survival. Even though, as expected, the number is too small to show a statistically significant increase of survival (p = 0.08 log rank test), we still demonstrated a slight increase in survival in the group of patients treated (26.6 vs 14.8 months). We also compared the overall survival according to treatment. The comparison between the group of five patients treated with radiotherapy only, ten treated with chemotherapy with TMZ and ten with chemo and RT combined, showed a slight increase in mean survival, although not statistically significant, in the second and third groups (p = 0.6 log rank test). CONCLUSION The optimal treatment in children under 10 years with GC is still obscure and absolutely not clear because total surgical resection is impossible to perform for the diffuse nature of the disease; CHT with TMZ seems to be the best treatment for children because it demonstrates a little reduction of the extension tumoral mass, but the responsivity of this treatment is extremely variable from case to case.
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Affiliation(s)
- Alessandro Landi
- Department of Neurosurgical Sciences, Neurosurgery, University of Rome Sapienza, Via Ostiense 121, Rome, Italy.
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Taillibert S, Chodkiewicz C, Laigle-Donadey F, Napolitano M, Cartalat-Carel S, Sanson M. Gliomatosis Cerebri: A Review of 296 Cases from the ANOCEF Database and the Literature. J Neurooncol 2005; 76:201-5. [PMID: 16200347 DOI: 10.1007/s11060-005-5263-0] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Gliomatosis cerebri (GC) is a rare disease, defined as a diffuse neoplastic glial cell infiltration of the brain. Diagnosis and management of GC are difficult. This study analyzed 296 individual cases (90 patients followed through the ANOCEF network, and 206 cases from the literature), aged 1 month to 85 years (median 42), sex ratio=1.31. Median survival was 14.5 months. It was higher for patients younger than 42 years (17 months vs. 13 months), with performance status>or=80 (27 months vs. 9 months), low grade gliomatosis (grade 2=20 months, grade 3=11.5 months, grade 4=8.5 months), oligodendroglial subtype (36 months compared to 14 months for mixed GC and 11 months for astrocytic GC). Male population was younger (median 39 years vs. 45), had a higher incidence of oligodendroglial GC (22% vs. 13%), which may explain their better prognosis (median survival 17 months vs. 11.5 months) than female population. Despite a high rate of stabilization, the impact on survival of whole brain radiotherapy, which carries the risk of severe toxicity, is still unclear. Up-front chemotherapy benefit to some patients and may be preferred to whole brain radiotherapy. However, the many bias of such retrospective heterogeneous data claim for multicentric clinical trials in this rare disease.
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Affiliation(s)
- Sophie Taillibert
- Fédération de Neurologie, Groupe hospitalier Pitié-Salpétrière, 47-83 bd de l'hôpital, 75651, Paris, cedex 13, France
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