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Elbeltagy M, Abbassy M. Neurofibromatosis type1, type 2, tuberous sclerosis and Von Hippel-Lindau disease. Childs Nerv Syst 2023; 39:2791-2806. [PMID: 37819506 DOI: 10.1007/s00381-023-06160-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 09/16/2023] [Indexed: 10/13/2023]
Abstract
Neurocutaneous syndromes (also known as phakomatoses) are heterogenous group of disorders that involve derivatives of the neuroectoderm. Each disease has diagnostic and pathognomonic criteria, once identified, thorough clinical examination to the patient and the family members should be done. Magnetic resonance imaging (MRI) is used to study the pathognomonic findings withing the CNS (Evans et al. in Am J Med Genet A 152A:327-332, 2010). This chapter includes the 4 most common syndromes faced by neurosurgeons and neurologists; neurofibromatosis types 1 and 2, tuberous sclerosis and Von Hippel-Lindau disease. Each syndrome has specific genetic anomaly that involves a tumor suppressor gene and the loss of inhibition of specific pathways. The result is a spectrum of cutaneous manifestations and neoplasms.
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Affiliation(s)
- M Elbeltagy
- Department of Neurosurgery, Cairo University, 1 University Street, Giza Governorate, 12613, Egypt.
- Department of Neurosurgery, Children's Cancer Hospital Egypt, Sekat Hadid Al Mahger, Zeinhom, El Sayeda Zeinab, Cairo Governorate, 4260102, Egypt.
| | - M Abbassy
- Department of Neurosurgery, Children's Cancer Hospital Egypt, Sekat Hadid Al Mahger, Zeinhom, El Sayeda Zeinab, Cairo Governorate, 4260102, Egypt
- Department of Neurosurgery, Alexandria University, 22 El-Gaish Rd, Al Azaritah WA Ash Shatebi, Bab Sharqi, Alexandria Governorate, 5424041, Egypt
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2
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Noureldine MHA, Shimony N, Jallo GI. Benign Spinal Tumors. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1405:583-606. [PMID: 37452955 DOI: 10.1007/978-3-031-23705-8_23] [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: 07/18/2023]
Abstract
Benign spinal intradural tumors are relatively rare and include intramedullary tumors with a favorable histology such as low-grade astrocytomas and ependymomas, as well as intradural extramedullary tumors such as meningiomas and schwannomas. The effect on the neural tissue is usually a combination of mass effect and neuronal involvement in cases of infiltrative tumors. The new understanding of molecular profiling of different tumors allowed us to better define central nervous system tumors and tailor treatment accordingly. The mainstay of management of many intradural spinal tumors is maximal safe surgical resection. This goal is more achievable with intradural extramedullary tumors; yet, with a meticulous surgical approach, many of the intramedullary tumors are amenable for safe gross-total or near-total resection. The nature of these tumors is benign; hence, a different way to measure outcome success is pursued and usually depends on functional rather than oncological or survival outcomes.
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Affiliation(s)
- Mohammad Hassan A Noureldine
- Department of Neurosurgery and Brain Repair, University of South Florida Morsani College of Medicine, Tampa, FL, USA
- Institute for Brain Protection Sciences, Johns Hopkins University School of Medicine, Johns Hopkins All Children's Hospital, Saint Petersburg, FL, USA
| | - Nir Shimony
- Institute of Neuroscience, Geisinger Medical Center, Geisinger Commonwealth School of Medicine, Danville, PA, USA
- Institute for Brain Protections Sciences, Johns Hopkins All Children's Hospital, Saint Petersburg, FL, USA
- Department of Surgery, St Jude Children's Research Hospital, Memphis, USA
| | - George I Jallo
- Institute for Brain Protections Sciences, Johns Hopkins All Children's Hospital, Saint Petersburg, FL, USA.
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3
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Bi WL, Santagata S. Skull Base Tumors: Neuropathology and Clinical Implications. Neurosurgery 2022; 90:243-261. [PMID: 34164689 DOI: 10.1093/neuros/nyab209] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 04/06/2021] [Indexed: 11/13/2022] Open
Abstract
Tumors that arise in and around the skull base comprise a wide range of common and rare entities. Recent studies have advanced our understanding of their pathogenesis, which in some cases, have significantly influenced clinical practice. The genotype of meningiomas is strongly associated with their phenotype, including histologic subtype and tumor location, and clinical outcome. A single molecular alteration, NAB2-STAT6 fusion, has redefined the category of solitary fibrous tumors to include the previous entity hemangiopericytomas. Schwannomas, both sporadic and familial, are characterized by near ubiquitous alterations in NF2 , with additional mutations in SMARCB1 or LZTR1 in schwannomatosis. In pituitary adenohypophyseal tumors, cell lineage transcription factors such as SF-1, T-PIT, and PIT-1 are now essential for classification, providing a more rigorous taxonomy for tumors that were previously considered null cell adenomas. The pituicyte lineage transcription factor TTF-1 defines neurohypophyseal tumors, which may represent a single nosological entity with a spectrum of morphologic manifestations (ie, granular cell tumor, pituicytoma, and spindle cell oncocytoma). Likewise, the notochord cell lineage transcription factor brachyury defines chordoma, discriminating them from chondrosarcomas. The identification of nonoverlapping genetic drivers of adamantinomatous craniopharyngiomas and papillary craniopharyngiomas indicates that these are distinct tumor entities and has led to successful targeted treatment of papillary craniopharyngiomas using BRAF and/or mitogen-activated protein kinase inhibitors. Similarly, dramatic therapeutic responses have been achieved in patients with Langerhans cell histiocytosis, both with BRAF -mutant and BRAF -wildtype tumors. Familiarity with the pathology of skull base tumors, their natural history, and molecular features is essential for optimizing patient care.
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Affiliation(s)
- Wenya Linda Bi
- Center for Skull Base and Pituitary Surgery, Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School , Boston , Massachusetts , USA
| | - Sandro Santagata
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School , Boston , Massachusetts , USA
- Laboratory of Systems Pharmacology, Harvard Medical School , Boston , Massachusetts , USA
- Ludwig Center at Harvard, Harvard Medical School , Boston , Massachusetts , USA
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4
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Zheng Y, Luo Y, Chen X, Li H, Huang B, Zhou B, Zhu L, Kang X, Geng W. The role of mRNA in the development, diagnosis, treatment and prognosis of neural tumors. Mol Cancer 2021; 20:49. [PMID: 33673851 PMCID: PMC7934508 DOI: 10.1186/s12943-021-01341-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 02/23/2021] [Indexed: 12/24/2022] Open
Abstract
Neural tumors can generally be divided into central nervous system tumors and peripheral nervous tumors. Because this type of tumor is located in the nerve, even benign tumors are often difficult to remove by surgery. In addition, the majority of neural tumors are malignant, and it is particular the same for the central nervous system tumors. Even treated with the means such as chemotherapy and radiotherapy, they are also difficult to completely cure. In recent years, an increasingly number of studies have focused on the use of mRNA to treat tumors, representing an emerging gene therapy. The use of mRNA can use the expression of some functional proteins for the treatment of genetic disorders or tissue repair, and it can also be applied to immunotherapy through the expression of antigens, antibodies or receptors. Therefore, although these therapies are not fully-fledged enough, they have a broad research prospect. In addition, there are many ways to treat tumors using mRNA vaccines and exosomes carrying mRNA, which have drawn much attention. In this study, we reviewed the current research on the role of mRNA in the development, diagnosis, treatment and prognosis of neural tumors, and examine the future research prospects of mRNA in neural tumors and the opportunities and challenges that will arise in the future application of clinical treatment.
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Affiliation(s)
- Yiyang Zheng
- Department of Anesthesiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, People's Republic of China.,School & Hospital of Stomatology, Wenzhou Medical University, Wenzhou, 325000, People's Republic of China
| | - Yanyan Luo
- Department of Anesthesiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, People's Republic of China
| | - Xixi Chen
- Department of Anesthesiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, People's Republic of China
| | - Huiting Li
- Department of Anesthesiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, People's Republic of China
| | - Baojun Huang
- Department of Anesthesiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, People's Republic of China
| | - Baofeng Zhou
- Department of Anesthesiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, People's Republic of China
| | - Liqing Zhu
- Department of clinical laboratory, Wenzhou Medical University, Wenzhou, 325000, People's Republic of China.
| | - Xianhui Kang
- Department of Anesthesiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
| | - Wujun Geng
- Department of Anesthesiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, People's Republic of China.
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5
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Du HG, Phuoc VX, Hoang ND, Tan LD, Van Trung N. Triad of meningothelial meningioma, rhabdoid meningioma and ependymoma: successful management of an extremely rare case. J Surg Case Rep 2020; 2020:rjaa267. [PMID: 32855801 PMCID: PMC7444614 DOI: 10.1093/jscr/rjaa267] [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: 03/30/2020] [Revised: 06/16/2020] [Accepted: 06/30/2020] [Indexed: 11/12/2022] Open
Abstract
An 8-year-old girl was admitted with four limb weakness for 2 months. Hyperactive reflexes were observed in all four limbs, and positive Hoffmann's signs were revealed. An MRI spine with the coronal slide detected two tumors, first in the intradural and intramedullary space at the C2-C4 level and the second in the intradural and extramedullary space at the C5-C7 level. Axial T1W contrast MRI brain showed a tumor in the left parietal region. The patient underwent spine surgery first and following by brain surgery. No invasive lesions were remarked during surgery. Histological findings showed meningothelial meningioma and ependymoma from the spine and rhabdoid meningioma from the brain. Two months after the second surgery, the patient recovered fully with no symptoms and was able to participate in all regular activities in life. This work is the first report of a mixed tumor with distinct spinal meningioma and ependymoma components occurring in the cervical spinal cord at the C2-C7 level and coexisting with cranial meningioma. The remarkable result was that the patient fully recovered without any symptoms after receiving two surgeries.
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Affiliation(s)
- Hoang Gia Du
- Department of Orthopedic and Spine Surgery, Bach Mai Hospital, Hanoi, Vietnam
| | - Vu Xuan Phuoc
- Department of Orthopedic and Spine Surgery, Bach Mai Hospital, Hanoi, Vietnam
| | - Nguyen Duc Hoang
- Department of Orthopedic and Spine Surgery, Bach Mai Hospital, Hanoi, Vietnam
| | - Le Dang Tan
- Department of Orthopedic and Spine Surgery, Bach Mai Hospital, Hanoi, Vietnam
| | - Nguyen Van Trung
- Department of Orthopedic and Spine Surgery, Bach Mai Hospital, Hanoi, Vietnam
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6
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Georgescu MM, Nanda A, Li Y, Mobley BC, Faust PL, Raisanen JM, Olar A. Mutation Status and Epithelial Differentiation Stratify Recurrence Risk in Chordoid Meningioma-A Multicenter Study with High Prognostic Relevance. Cancers (Basel) 2020; 12:E225. [PMID: 31963394 PMCID: PMC7016786 DOI: 10.3390/cancers12010225] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Revised: 01/13/2020] [Accepted: 01/14/2020] [Indexed: 02/06/2023] Open
Abstract
Chordoid meningioma is a rare WHO grade II histologic variant. Its molecular alterations or their impact on patient risk stratification have not been fully explored. We performed a multicenter, clinical, histological, and genomic analysis of chordoid meningiomas from 30 patients (34 tumors), representing the largest integrated study to date. By NHERF1 microlumen immunohistochemical detection, three epithelial differentiation (ED) groups emerged: #1/fibroblastic-like, #2/epithelial-poorly-differentiated and #3/epithelial-well-differentiated. These ED groups correlated with tumor location and genetic profiling, with NF2 and chromatin remodeling gene mutations clustering in ED group #2, and TRAF7 mutations segregating in ED group #3. Mutations in LRP1B were found in the largest number of cases (36%) across ED groups #2 and #3. Pathogenic ATM and VHL germline mutations occurred in ED group #3 patients, conferring an aggressive or benign course, respectively. The recurrence rate significantly correlated with mutations in NF2, as single gene, and with mutations in chromatin remodeling and DNA damage response genes, as groups. The recurrence rate was very high in ED group #2, moderate in ED group #3, and absent in ED group #1. This study proposes guidelines for tumor recurrence risk stratification and practical considerations for patient management.
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Affiliation(s)
- Maria-Magdalena Georgescu
- Department of Pathology, Louisiana State University, Shreveport, LA 71103, USA;
- Feist-Weiller Cancer Center, Shreveport, LA 71103, USA
- NeuroMarkers Professional Limited Liability Company, Houston, TX 77025, USA
| | - Anil Nanda
- Department of Neurosurgery, Rutgers University, Camden, NJ 08901, USA;
| | - Yan Li
- Department of Pathology, Louisiana State University, Shreveport, LA 71103, USA;
| | - Bret C. Mobley
- Department of Pathology, Vanderbilt University Medical Center, Nashville, TN 37232, USA;
| | - Phyllis L. Faust
- Department of Pathology and Cell Biology, Columbia University, New York, NY 10032, USA;
| | - Jack M. Raisanen
- Department of Pathology, the University of Texas Southwestern Medical Center, Dallas, TX 75390, USA;
| | - Adriana Olar
- Department of Pathology and Laboratory Medicine and Neurosurgery, Medical University of South Carolina and Hollings Cancer Center, Charleston, SC 29425, USA;
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7
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King AT, Rutherford SA, Hammerbeck-Ward C, Lloyd SK, Freeman SM, Pathmanaban ON, Rodriguez-Valero M, Thomas OM, Laitt RD, Stivaros S, Kellett M, Evans DG. High-Grade Glioma is not a Feature of Neurofibromatosis Type 2 in the Unirradiated Patient. Neurosurgery 2019; 83:193-196. [PMID: 28973691 DOI: 10.1093/neuros/nyx374] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Accepted: 06/25/2017] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The Manchester criteria for neurofibromatosis type 2 (NF2) include a range of tumors, and gliomas were incorporated in the original description. The gliomas are now widely accepted to be predominantly spinal cord ependymomas. OBJECTIVE To determine whether these gliomas include any cases of malignant glioma (WHO grade III and IV) through a database review. METHODS The prospective database consists of 1253 patients with NF2. 1009 are known to be alive at last follow-up. RESULTS There was a single case of glioblastoma multiforme (GBM; World Health Organization grade IV) in the series and no WHO grade III gliomas. The GBM was in a patient who had previously undergone stereotactic radiosurgery for a vestibular schwannoma. CONCLUSION High-grade gliomas are not a feature of NF2 in the unirradiated patient and should be excluded from the diagnostic criteria.
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Affiliation(s)
- Andrew T King
- Department of Neurosurgery, Manche-ster Academic Health Science Centre, Sal-ford Royal NHS Foundation Trust, Man-chester, United Kingdom
| | - Scott A Rutherford
- Department of Neurosurgery, Manche-ster Academic Health Science Centre, Sal-ford Royal NHS Foundation Trust, Man-chester, United Kingdom
| | - Charlotte Hammerbeck-Ward
- Department of Neurosurgery, Manche-ster Academic Health Science Centre, Sal-ford Royal NHS Foundation Trust, Man-chester, United Kingdom
| | - Simon K Lloyd
- Department of Otolaryngology, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, Manchester, United Kingdom
| | - Simon M Freeman
- Department of Otolaryngology, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, Manchester, United Kingdom
| | - Omar N Pathmanaban
- Department of Neurosurgery, Manche-ster Academic Health Science Centre, Sal-ford Royal NHS Foundation Trust, Man-chester, United Kingdom
| | - Monica Rodriguez-Valero
- Department of Otolaryngology, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, Manchester, United Kingdom
| | - Owen M Thomas
- Department of Neuroradiology, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, Manchester, United Kingdom
| | - Roger D Laitt
- Department of Neuroradiology, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, Manchester, United Kingdom
| | - Stavros Stivaros
- Department of Neuroradiology, Manchester Academic Health Science Centre, Central Manchester NHS Foundation Trust, Manchester, United Kingdom
| | - Mark Kellett
- Department of Neurology, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, Manchester, United Kingdom
| | - D Gareth Evans
- Department of Manchester Centre for Genomic Medicine, Manchester Academic Health Science Centre, Central Manchester NHS Foundation Trust, Manchester, United Kingdom
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8
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Romiyo P, Ng E, Dejam D, Ding K, Sheppard JP, Duong C, Franks A, Ong V, Udawatta M, Phillips HW, Gopen Q, Yang I. Radiosurgery treatment is associated with improved facial nerve preservation versus repeat resection in recurrent vestibular schwannomas. Acta Neurochir (Wien) 2019; 161:1449-1456. [PMID: 31129783 DOI: 10.1007/s00701-019-03940-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 05/03/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Vestibular schwannomas (VSs) are benign neoplasms of the Schwann cells of cranial nerve VIII, and treatment of VS typically involves surgical resection. However, tumor recurrence may necessitate reintervention, and secondary treatment modalities include repeat surgical resection or adjuvant radiosurgery. The purpose of this study is to examine the scientific literature in order to determine whether surgical resection or radiosurgery for recurrent VS results in better tumor control, hearing preservation, and preservation of facial nerve function. METHODS The PubMed, Scopus, Embase, Cochrane, and Web of Science databases were searched for studies reporting on patients undergoing either radiosurgery or repeat surgical resection after primary surgical resection for recurrent VS. Statistical analyses were performed on the compiled data, primarily outcome data involving tumor control, hearing preservation, and preservation of facial nerve function. RESULTS We analyzed the data of 15 individual studies involving 359 total patients, and our results reveal that tumor control rates are comparable between adjuvant radiosurgery (91%, CI: 88-94%) and secondary resection (92%, CI 75-98%). However, adjuvant radiosurgery was shown to preserve good facial nerve function better (94%, CI 84-98%) compared to secondary surgical resection (56%, CI 41-69%). CONCLUSION With comparable tumor control rates and better preservation of good facial nerve function, this study suggests that secondary radiosurgery for recurrent VS is associated with both optimal tumor control and preservation of good facial nerve function.
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Affiliation(s)
- Prasanth Romiyo
- Department of Neurosurgery, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Edwin Ng
- Department of Neurosurgery, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Dillon Dejam
- Department of Neurosurgery, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Kevin Ding
- Department of Neurosurgery, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - John P Sheppard
- Department of Neurosurgery, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Courtney Duong
- Department of Neurosurgery, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Alyssa Franks
- Department of Neurosurgery, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Vera Ong
- Department of Neurosurgery, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Methma Udawatta
- Department of Neurosurgery, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - H Westley Phillips
- Department of Neurosurgery, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Quinton Gopen
- Department of Radiation Oncology, Harbor-UCLA Medical Center, Torrance, CA, USA
- Department of Head and Neck Surgery, Harbor-UCLA Medical Center, Torrance, CA, USA
- UCLA Jonsson Comprehensive Cancer Center, Ronald Reagan UCLA Medical Center, Los Angeles, CA, USA
| | - Isaac Yang
- Department of Neurosurgery, Harbor-UCLA Medical Center, Torrance, CA, USA.
- Department of Head and Neck Surgery, Harbor-UCLA Medical Center, Torrance, CA, USA.
- UCLA Jonsson Comprehensive Cancer Center, Ronald Reagan UCLA Medical Center, Los Angeles, CA, USA.
- Los Angeles Biomedical Research Institute (LA BioMed) at Harbor-UCLA Medical Center, Torrance, CA, USA.
- Office of the Patient Experience, Harbor-UCLA Medical Center, Torrance, CA, USA.
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Zhang Z, Yang Y, Zhang K, Zhuang J, Shao F, Liu H, Xing Y, Xu S. Collision Tumor of Glioblastoma and Meningioma: Case Report and Literature Review. World Neurosurg 2018; 117:137-141. [PMID: 29890277 DOI: 10.1016/j.wneu.2018.05.246] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 05/30/2018] [Accepted: 05/31/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND Intracranial primary collision tumors of different histologic types are rare, and their occurrence is still unclear. CASE DESCRIPTION We describe a 66-year-old female who presented with headache, nausea, and vomiting. Magnetic resonance imaging scan showed that there were 2 primary intracranial tumors occurring simultaneously at adjacent sites of the right cerebral hemisphere. Tumor pathology showed 2 distinct tumors: meningioma (World Health Organization I) and glioblastoma. This is a rare case in which 2 different intracranial primary tumors occurred at adjacent sites, but the patient had no history of head trauma, neurologic surgery, or radiation therapy. CONCLUSIONS According to previous and present reports, the most common type of intracranial primary collision tumor is composed of a benign meningioma and a glioblastoma. During the occurrence of collision tumors, 1 tumor can play a role in the formation and growth of the other.
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Affiliation(s)
- Zhen Zhang
- Department of Neurosurgery, Shandong Provincial Hospital Affiliated to Shandong University, Shandong, China
| | - Yihang Yang
- Department of Neurosurgery, Shandong Provincial Hospital Affiliated to Shandong University, Shandong, China
| | - Keke Zhang
- Department of Otolaryngology, Shandong Provincial Hospital Affiliated to Shandong University, Shandong, China
| | - Jianfeng Zhuang
- Department of Neurosurgery, Shandong Provincial Hospital Affiliated to Shandong University, Shandong, China
| | - Fangchen Shao
- Department of Neurosurgery, Shandong Provincial Hospital Affiliated to Shandong University, Shandong, China
| | - Huajie Liu
- Department of Neurosurgery, Shandong Provincial Hospital Affiliated to Shandong University, Shandong, China
| | - Yi Xing
- Department of Neurosurgery, Shandong Provincial Hospital Affiliated to Shandong University, Shandong, China
| | - Shangchen Xu
- Department of Neurosurgery, Shandong Provincial Hospital Affiliated to Shandong University, Shandong, China.
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10
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Haddadi N, Lin Y, Travis G, Simpson AM, McGowan EM, Nassif NT. PTEN/PTENP1: 'Regulating the regulator of RTK-dependent PI3K/Akt signalling', new targets for cancer therapy. Mol Cancer 2018; 17:37. [PMID: 29455665 PMCID: PMC5817727 DOI: 10.1186/s12943-018-0803-3] [Citation(s) in RCA: 179] [Impact Index Per Article: 29.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Accepted: 02/01/2018] [Indexed: 12/14/2022] Open
Abstract
Regulation of the PI-3 kinase (PI3K)/Akt signalling pathway is essential for maintaining the integrity of fundamental cellular processes, cell growth, survival, death and metabolism, and dysregulation of this pathway is implicated in the development and progression of cancers. Receptor tyrosine kinases (RTKs) are major upstream regulators of PI3K/Akt signalling. The phosphatase and tensin homologue (PTEN), a well characterised tumour suppressor, is a prime antagonist of PI3K and therefore a negative regulator of this pathway. Loss or inactivation of PTEN, which occurs in many tumour types, leads to overactivation of RTK/PI3K/Akt signalling driving tumourigenesis. Cellular PTEN levels are tightly regulated by a number of transcriptional, post-transcriptional and post-translational regulatory mechanisms. Of particular interest, transcription of the PTEN pseudogene, PTENP1, produces sense and antisense transcripts that exhibit post-transcriptional and transcriptional modulation of PTEN expression respectively. These additional levels of regulatory complexity governing PTEN expression add to the overall intricacies of the regulation of RTK/PI-3 K/Akt signalling. This review will discuss the regulation of oncogenic PI3K signalling by PTEN (the regulator) with a focus on the modulatory effects of the sense and antisense transcripts of PTENP1 on PTEN expression, and will further explore the potential for new therapeutic opportunities in cancer treatment.
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Affiliation(s)
- Nahal Haddadi
- School of Life Sciences, Faculty of Science, University of Technology Sydney, 15 Broadway, Ultimo, Sydney, NSW 2007 Australia
| | - Yiguang Lin
- School of Life Sciences, Faculty of Science, University of Technology Sydney, 15 Broadway, Ultimo, Sydney, NSW 2007 Australia
| | - Glena Travis
- School of Life Sciences, Faculty of Science, University of Technology Sydney, 15 Broadway, Ultimo, Sydney, NSW 2007 Australia
| | - Ann M. Simpson
- School of Life Sciences, Faculty of Science, University of Technology Sydney, 15 Broadway, Ultimo, Sydney, NSW 2007 Australia
| | - Eileen M. McGowan
- School of Life Sciences, Faculty of Science, University of Technology Sydney, 15 Broadway, Ultimo, Sydney, NSW 2007 Australia
- Central Laboratory, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, 510080 China
| | - Najah T. Nassif
- School of Life Sciences, Faculty of Science, University of Technology Sydney, 15 Broadway, Ultimo, Sydney, NSW 2007 Australia
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11
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Grossbach AJ, Mahaney KB, Menezes AH. Pediatric meningiomas: 65-year experience at a single institution. J Neurosurg Pediatr 2017; 20:42-50. [PMID: 28474981 DOI: 10.3171/2017.2.peds16497] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Meningiomas are relatively common, typically benign neoplasms in adults; however, they are relatively rare in the pediatric population. Pediatric meningiomas behave very differently from their adult counterparts, tending to have more malignant histological subtypes and recur more frequently. The authors of this paper investigate the risk factors, pathological subtypes, and recurrence rates of pediatric meningiomas. METHODS A retrospective chart review was conducted at the University of Iowa to identify patients 20 years old and younger with meningiomas in the period from 1948 to 2015. RESULTS Sixty-seven meningiomas in 39 patients were identified. Eight patients had neurofibromatosis, 2 had a family history of meningioma, and 3 had prior radiation exposure. Twelve (31%) of the 39 patients had WHO Grade II or III lesions, and 15 (38%) had recurrent lesions after resection. CONCLUSIONS Pediatric meningiomas should be considered for early treatment and diligent follow-up.
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Affiliation(s)
- Andrew J Grossbach
- Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa; and
| | - Kelly B Mahaney
- Department of Neurosurgery, University of Virginia, Charlottesville, Virginia
| | - Arnold H Menezes
- Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa; and
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12
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Tauziede-Espariat A, Parfait B, Besnard A, Lacombe J, Pallud J, Tazi S, Puget S, Lot G, Terris B, Cohen J, Vidaud M, Figarella-Branger D, Monnien F, Polivka M, Adle-Biassette H, Varlet P. Loss of SMARCE1 expression is a specific diagnostic marker of clear cell meningioma: a comprehensive immunophenotypical and molecular analysis. Brain Pathol 2017; 28:466-474. [PMID: 28474749 DOI: 10.1111/bpa.12524] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 04/28/2017] [Indexed: 01/01/2023] Open
Abstract
Clear cell meningioma (CCM) is a rare grade II histopathological subtype that usually occurs in young patients and displays high recurrence rate. Germline SMARCE1 mutations have been described in hereditary forms of this disease and more recently in small syndromic and sporadic CCM series. The diagnostic value of SMARCE1 in distinguishing between CCM and other meningioma variants has not been yet established. The aim of our study was to investigate the status of SMARCE1 in a series of CCMs and its morphological mimickers. We compared the performance of an anti-SMARCE1 antibody and the molecular analysis of the SMARCE1 gene in a retrospective multicenter series of CCMs. All CCMs lossed SMARCE1 immunoexpression. Bi-allelic inactivating events were found by NGS-based sequencing in all of these cases, except for one, which was incompletely explored, but had a wild-type sequence. We then validated the anti-SMARCE1 antibody specificity by analyzing additional 305 pediatric and adult meningiomas of various subtypes and 15 non-meningioma clear cell tumors by SMARCE1 immunohistochemistry. A nuclear immunostaining was preserved in all other meningioma variants, as well as non-meningioma clear cell tumors. In conclusion, our series showed, for the first time, that SMARCE1 immunostaining is a highly sensitive biomarker for CCM, useful as a routine diagnostic biomarker.
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Affiliation(s)
| | - Béatrice Parfait
- Department of Genetic and Molecular Biology, Cochin Hospital, AP-HP, 75014, Paris, France
| | - Aurore Besnard
- Department of Neuropathology, Sainte-Anne Hospital, 75014, Paris, France
| | - Joëlle Lacombe
- Department of Neuropathology, Sainte-Anne Hospital, 75014, Paris, France
| | - Johan Pallud
- Department of Neurosurgery, Sainte-Anne Hospital, 75014, Paris, France
| | - Sanaa Tazi
- Department of Neurosurgery, Mondor Hospital, 94010, Créteil, France
| | - Stéphanie Puget
- Department of Pediatric Neurosurgery, Necker University Hospital, University Paris Descartes, Sorbonne Paris Cité, 75015, Paris, France
| | - Guillaume Lot
- Department of Neurosurgery, Rothschild Foundation, 75019, Paris, France
| | - Benoît Terris
- Department of Pathology, Cochin Hospital, AP-HP, 75014, Paris, France
| | - Joëlle Cohen
- Department of Genetic and Molecular Biology, Cochin Hospital, AP-HP, 75014, Paris, France
| | - Michel Vidaud
- Department of Genetic and Molecular Biology, Cochin Hospital, AP-HP, 75014, Paris, France
| | - Dominique Figarella-Branger
- INSERM, CRO2, La Timone Hospital, Department of Anatomopathology and Neuropathology, Aix-Marseille Univ, APHM, 13385, Marseille, France
| | - Franck Monnien
- Department of Pathology, Jean Minjoz Hospital, 25000, Besançon, France
| | - Marc Polivka
- Department of Pathology, Lariboisière Hospital, APHP, 75475, Paris, France
| | | | - Pascale Varlet
- Department of Neuropathology, Sainte-Anne Hospital, 75014, Paris, France
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Abstract
Neoplasms in the central (CNS) and peripheral nervous system (PNS) in hereditary tumor syndromes play an important role in the neuropathological diagnostics. The benign and malignant PNS and CNS tumors that occur in the frequent neurofibromatosis type 1 (NF1) and type 2 (NF2) often represent essential factors for the course of the disease in those affected. Furthermore, certain clinical constellations (e.g. bilateral schwannomas of the auditory nerve, schwannomas at a young age and multiple meningiomas) can be important indications for a previously undiagnosed hereditary tumor disease. Other tumors occur practically regularly in association with certain germline defects, e.g. subependymal giant cell astrocytoma (SEGA) in tuberous sclerosis and dysplastic gangliocytoma of the cerebellum in Cowden's syndrome and can be indications in the diagnostics for an extended genetic counselling. This is not only important because many germline defects are based on new mutations, but also for the now established targeted therapy of certain tumors, e.g. inhibition of the mammalian target of rapamycin (mTOR) signaling pathway using temsirolimus for SEGA. Furthermore, knowledge about the possible constellations of genetic mosaics in hereditary tumor syndromes with the resulting (incomplete) syndrome manifestations is useful. This review article summarizes the most important hereditary tumor syndromes with involvement of the PNS and CNS.
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Affiliation(s)
- C Mawrin
- Institut für Neuropathologie, Otto-von-Guericke-Universität Magdeburg, Leipziger Straße 44, 39120, Magdeburg, Deutschland.
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14
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Abbassy M, Woodard TD, Sindwani R, Recinos PF. An Overview of Anterior Skull Base Meningiomas and the Endoscopic Endonasal Approach. Otolaryngol Clin North Am 2016; 49:141-52. [PMID: 26614834 DOI: 10.1016/j.otc.2015.08.002] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Meningiomas represent 30% of all primary brain tumors. Anterior skull base meningiomas represent 8.8% of all meningiomas. Surgical resection is a main treatment option for tumors that are symptomatic and/or growing. Recurrence is directly related to the extent of resection of the tumor, the dural attachment, and pathologic bone. Endoscopic endonasal approaches represent an important addition to the treatment armamentarium for skull base meningiomas. This article provides an overview of meningiomas, with a focus on those of the anterior skull base and their management.
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Affiliation(s)
- Mahmoud Abbassy
- Minimally Invasive Cranial Base and Pituitary Surgery Program, Rose Ella Burkhardt Brain Tumor & Neuro-Oncology Center, Cleveland Clinic, 9500 Euclid Ave, S73, Cleveland, OH 44143, USA; Department of Neurosurgery, Faculty of Medicine, Alexandria University, Champlion Street, El-Azareeta, Alexandria, Egypt
| | - Troy D Woodard
- Minimally Invasive Cranial Base and Pituitary Surgery Program, Rose Ella Burkhardt Brain Tumor & Neuro-Oncology Center, Cleveland Clinic, 9500 Euclid Ave, S73, Cleveland, OH 44143, USA; Section of Rhinology, Sinus and Skull Base Surgery, Head and Neck Institute, Cleveland Clinic, 9500 Euclid Ave, A71, Cleveland, OH 44143, USA
| | - Raj Sindwani
- Minimally Invasive Cranial Base and Pituitary Surgery Program, Rose Ella Burkhardt Brain Tumor & Neuro-Oncology Center, Cleveland Clinic, 9500 Euclid Ave, S73, Cleveland, OH 44143, USA; Section of Rhinology, Sinus and Skull Base Surgery, Head and Neck Institute, Cleveland Clinic, 9500 Euclid Ave, A71, Cleveland, OH 44143, USA
| | - Pablo F Recinos
- Minimally Invasive Cranial Base and Pituitary Surgery Program, Rose Ella Burkhardt Brain Tumor & Neuro-Oncology Center, Cleveland Clinic, 9500 Euclid Ave, S73, Cleveland, OH 44143, USA; Section of Rhinology, Sinus and Skull Base Surgery, Head and Neck Institute, Cleveland Clinic, 9500 Euclid Ave, A71, Cleveland, OH 44143, USA.
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15
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Begnami MD, Rushing EJ, Santi M, Quezado M. Evaluation of NF2 Gene Deletion in Pediatric Meningiomas Using Chromogenic In Situ Hybridization. Int J Surg Pathol 2016; 15:110-5. [PMID: 17478763 DOI: 10.1177/1066896906299128] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Meningiomas are uncommon childhood tumors. They could be of significant size at presentation, which has been associated with difficult surgical excision, high recurrence rate, and possibly aggressive clinical behavior. Monosomy 22 is a common molecular event in this neoplasm. Additionally, losses on chromosomes 1,7,10, and 14 have been identified in clinically aggressive meningiomas. Using chromogenic in situ hybridization, we studied a group of pediatric meningiomas, including neurofibromatosis type II—associated, sporadic, and radiation-induced cases. We found NF2 gene deletion in about 72% of the cases, with corresponding absent or minimal merlin protein expression by immunohistochemistry. Our findings confirm that the NF2 gene plays a role in the tumorigenesis of pediatric meningiomas and that chromogenic in situ hybridization is an efficient, economic, and reliable method for routinely assessing NF2 gene deletion in formalin-fixed, paraffin-embedded tissues.
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Affiliation(s)
- Maria D Begnami
- Laboratory of Pathology, Surgical Pathology Section, National Cancer Institute, NIH, Bethesda, Maryland, USA
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16
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Murnyák B, Szepesi R, Hortobágyi T. [Molecular genetics of familial tumour syndromes of the central nervous system]. Orv Hetil 2015; 156:171-7. [PMID: 25618858 DOI: 10.1556/oh.2015.30092] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Although most of the central nervous system tumours are sporadic, rarely they are associated with familial tumour syndromes. These disorders usually present with an autosomal dominant inheritance and neoplasia develops at younger age than in sporadic cases. Most of these tumours are bilateral, multiplex or multifocal. The causative mutations occur in genes involved in cell cycle regulation, cell growth, differentiation and DNA repair. Studying these hereditary cancer predisposition syndromes associated with nervous system tumours can facilitate the deeper understanding of the molecular background of sporadic tumours and the development of novel therapeutic agents. This review is an update on hereditary tumour syndromes with nervous system involvement with emphasis on molecular genetic characteristics and their clinical implications.
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Affiliation(s)
- Balázs Murnyák
- Debreceni Egyetem, Általános Orvostudományi Kar Patológiai Intézet, Neuropatológiai Tanszék Debrecen Nagyerdei krt. 98. 4032
| | - Rita Szepesi
- Debreceni Egyetem, Általános Orvostudományi Kar Orvosi Rehabilitáció és Fizikális Medicina Tanszék Debrecen Debreceni Egyetem, Általános Orvostudományi Kar Neurológiai Tanszék Debrecen
| | - Tibor Hortobágyi
- Debreceni Egyetem, Általános Orvostudományi Kar Patológiai Intézet, Neuropatológiai Tanszék Debrecen Nagyerdei krt. 98. 4032
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Neurofibromatosis type 2 vestibular schwannoma treatment: a review of the literature, trends, and outcomes. Otol Neurotol 2015; 35:889-94. [PMID: 24675066 DOI: 10.1097/mao.0000000000000272] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVE Review the useful hearing preservation and tumor control outcomes of microsurgery (MS), stereotactic radiation (SR), conservative management (CM), and chemotherapy (ChT) for Neurofibromatosis type 2 vestibular schwannomas. DATA SOURCES Ovid MEDLINE was used to conduct a thorough search of English-language publications dating from 1948 to February 2013. STUDY SELECTION Patients must have had useful hearing at diagnosis and treated with one of the 4 treatments as their primary therapy. All sporadic vestibular schwannoma cases were excluded. DATA EXTRACTION A total of 19 articles were reviewed. Hearing preservation was defined as unchanged or improved useful hearing. Tumor control was defined as no change in size or tumor regression for SR, CM, and ChT-treated cases, and as no recurrence for MS treated cases. CONCLUSION Microsurgery seems to have the worse overall results, while SR has very good tumor control with poor useful hearing preservation. If a patient qualifies for CM, he is likely to show the most satisfactory results with the least treatment available. A close follow-up on ChT clinical trials and possible side-effects is warranted as preliminary short-term results are quite favorable. Additional long-term studies are required for a better understanding of this disease.
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18
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He S, Pham MH, Pease M, Zada G, Giannotta SL, Wang K, Mack WJ. A review of epigenetic and gene expression alterations associated with intracranial meningiomas. Neurosurg Focus 2014; 35:E5. [PMID: 24289130 DOI: 10.3171/2013.10.focus13360] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECT A more comprehensive understanding of the epigenetic abnormalities associated with meningioma tumorigenesis, growth, and invasion may provide useful targets for molecular classification and development of targeted therapies for meningiomas. METHODS The authors performed a review of the current literature to identify the epigenetic modifications associated with the formation and/or progression of meningiomas. RESULTS Several epigenomic alterations, mainly pertaining to DNA methylation, have been associated with meningiomas. Hypermethylation of TIMP3 inactivates its tumor suppression activity while CDKN2 (p14[ARF]) and TP73 gene hypermethylation and HIST1H1c upregulation interact with the p53 regulation of cell cycle control. Other factors such as HOX, IGF, WNK2, and TGF-β epigenetic modifications allow either upregulation or downregulation of critical pathways for meningioma development, progression, and recurrence. CONCLUSIONS Genome-wide methylation profiling demonstrated that global hypomethylation correlates with tumor grades and severity. Identification of additional epigenetic changes, such as histone modification and higher-order chromosomal structure, may allow for a more thorough understanding of tumorigenesis and enable future individualized treatment strategies for meningiomas.
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Preusser M, Berghoff AS, Hottinger AF. High-grade meningiomas: new avenues for drug treatment? Curr Opin Neurol 2014; 26:708-15. [PMID: 24184974 DOI: 10.1097/wco.0000000000000035] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
PURPOSE OF REVIEW For standard first-line treatment of high-grade meningiomas, surgical resection and radiotherapy are regarded as standard of care. In the recurrent setting after exhaustion of all local treatment options, no effective therapies are known and several drugs have failed to show efficacy, but novel compounds may offer hope for better disease control. RECENT FINDINGS Upregulation of proangiogenic molecules and dysregulation of some signaling pathways such as the platelet-derived growth factor and mammalian target of rapamycin are recurrently found in high-grade meningiomas. Furthermore, in-vitro studies and single patient experience indicate that trabectedin may be an effective therapy in this tumor type. Unfortunately, so far there is a lack of conclusive clinical trials to draw definite conclusions of efficacy of these approaches. SUMMARY There remains a significant unmet need for defining the role of medical therapy in recurrent high-grade meningioma, and more basic research and multicentric well designed trials are needed in this rare and devastating tumor type. Potentially promising novel therapeutics include antiangiogenic drugs, molecular inhibitors of signaling cascades, immunotherapeutics or trabectedin. However, more basic research is required to identify more promising drug targets. VIDEO ABSTRACT AVAILABLE See the Video Supplementary Digital Content 1 (http://links.lww.com/CONR/A22).
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Affiliation(s)
- Matthias Preusser
- aDepartment of Medicine I & Comprehensive Cancer Center - CNS Unit, Medical University of Vienna bDepartment of Clinical Neurosciences, CHUV, Lausanne University Medical Center and University of Lausanne, Switzerland
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20
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Abstract
This article will review the neuropathology of meningiomas. From the neurosurgeon's point of view, accurate neuropathological diagnosis will play an increasingly important role in clinical practice. Predicting an individual patient's prognosis will become ever more important with the advent of various new radiotherapeutic/radiosurgical modalities. Defining the optimal treatment for nonbenign meningiomas requires a robust and reproducible diagnosis. This review will therefore not only describe classical radiological and histopathological diagnosis, but will also focus on the emerging field of molecular neuropathology. Implementing these advances in our daily clinical routine holds the promise of improving diagnostic accuracy.
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Affiliation(s)
- Christian Hartmann
- Institut für Neuropathologie der Charité, Augustenburger Platz 1, 13353 Berlin, Germany.
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21
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Wada K, Maruno M, Suzuki T, Kagawa N, Hashiba T, Fujimoto Y, Hashimoto N, Izumoto S, Yoshimine T. Chromosomal and genetic abnormalities in benign and malignant meningiomas using DNA microarray. Neurol Res 2013; 27:747-54. [PMID: 16197812 DOI: 10.1179/016164105x35648] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
BACKGROUND Meningioma is the commonest brain tumor and many genetic abnormalities, such as the loss of chromosome 22q and the mutation of NF2, have been reported. METHODS These classical abnormalities were detected using Southern blot, PCR, fluorescence in situ hybridization and comparative genomic hybridization, but these methods examine only very limited regions or limited mapping resolution of the tumor genome. In this study, we used DNA microarray assay, which detects numerous genetic abnormalities simultaneously and analyses a global assessment of molecular events in meningioma cells. We studied 31 meningiomas by GenoSensor Array 300 in order to detect the chromosomal aberrations and genetic abnormalities in the whole genome. RESULTS This study demonstrated not only classical chromosomal aberration, such as loss of chromosome 22q in 19 meningiomas (61.3%), but also new genetic characteristics of meningiomas, such as amplification of MSH2 in 16 meningiomas (51.6%), deletion of GSCL in 13 meningiomas (41.9%) and deletion of HIRA in seven meningiomas (22.6%). CONCLUSIONS These results suggest that DNA microarray assay is useful in research for the genetic characters of meningiomas and understanding tumorigenesis.
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Affiliation(s)
- Kouichi Wada
- Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan
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22
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Hawasli AH, Rubin JB, Tran DD, Adkins DR, Waheed S, Hullar TE, Gutmann DH, Evans J, Leonard JR, Zipfel GJ, Chicoine MR. Antiangiogenic agents for nonmalignant brain tumors. J Neurol Surg B Skull Base 2013; 74:136-41. [PMID: 24436903 DOI: 10.1055/s-0033-1338262] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2012] [Accepted: 12/13/2012] [Indexed: 01/14/2023] Open
Abstract
Objective To assess the treatment response and side effects for the use of antiangiogenic agents such as vascular endothelial growth factor (VEGF) inhibitors for patients with vestibular schwannomas and meningiomas. Design and Methods Retrospective review of eight male and two female patients (ages 14 to 70, mean 36 years), treated with bevacizumab (9) or pazopanib (1). Six patients had neurofibromatosis type 2 (NF2) with bilateral vestibular schwannomas and meningiomas, and the four others had aggressive recurrent meningiomas. Results During treatment (range 4 to 21 months, mean 9.1) with antiangiogenic agents, two patients with an atypical meningioma and radiation necrosis had dramatic partial response, the six NF2 patients had stable or slightly improved disease, and two meningioma patients had disease progression. Hearing was stable in three of the NF2 patients and was improved in three NF2 patients (one of whom received a cochlear implant). Minor toxicities included epistaxis, nausea, diarrhea, weight loss, and abdominal pain. No grade 3 or 4 toxicities were observed. Conclusion Antiangiogenic agents appear to be safe for the treatment of patients with nonmalignant brain tumors, and in select cases may be efficacious.
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Affiliation(s)
- Ammar H Hawasli
- Department of Neurosurgery, Washington University School of Medicine, Saint Louis, Missouri, USA
| | - Joshua B Rubin
- Department of Pediatrics, Washington University School of Medicine, Saint Louis, Missouri, USA ; Department of Anatomy and Neurobiology, Washington University School of Medicine, Saint Louis, Missouri, USA
| | - David D Tran
- Division of Oncology, Department of Medicine, Washington University School of Medicine, Saint Louis, Missouri, USA
| | - Douglas R Adkins
- Division of Oncology, Department of Medicine, Washington University School of Medicine, Saint Louis, Missouri, USA
| | - Shahid Waheed
- J. B. & Greeta B. Arthur Cancer Center, Mexico, Missouri, USA
| | - Timothy E Hullar
- Department of Otolaryngology, Washington University School of Medicine, Saint Louis, Missouri, USA ; Department of Anatomy and Neurobiology, Washington University School of Medicine, Saint Louis, Missouri, USA
| | - David H Gutmann
- Department of Neurology, Washington University School of Medicine, Saint Louis, Missouri, USA
| | - John Evans
- Department of Neurosurgery, Washington University School of Medicine, Saint Louis, Missouri, USA
| | - Jeffrey R Leonard
- Department of Neurosurgery, Washington University School of Medicine, Saint Louis, Missouri, USA
| | - Gregory J Zipfel
- Department of Neurosurgery, Washington University School of Medicine, Saint Louis, Missouri, USA
| | - Michael R Chicoine
- Department of Neurosurgery, Washington University School of Medicine, Saint Louis, Missouri, USA
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Abstract
Surgical pathology of the peripheral nervous system includes traumatic injury, entrapment syndromes, and tumors. The recent significant advances in the understanding of the pathophysiology and cellular biology of peripheral nerve degeneration and regeneration has yet to be translated into improved surgical techniques and better outcome after peripheral nerve injury. Decision making in peripheral nerve surgery continues to be a complex challenge, where the mechanism of injury, repeated clinical evaluation, neuroradiological and neurophysiological examination, and detailed knowledge of the peripheral nervous system response to injury are prerequisite to obtain the best possible outcome. Surgery continues to be the primary treatment modality for peripheral nerve tumors and advances in adjuvant oncological treatment has improved outcome after malignant peripheral nerve tumors. The present chapter provides background knowledge of surgical peripheral nerve disease and some general and practical guidance toward its clinical management.
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Affiliation(s)
- Kåre Fugleholm
- Department of Neurosurgery, Rigshospitalet, Copenhagen, Denmark.
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24
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Hearing preservation after LINAC radiosurgery and LINAC radiotherapy for vestibular schwannoma. J Clin Neurosci 2012; 19:1065-70. [DOI: 10.1016/j.jocn.2012.01.015] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2012] [Accepted: 01/19/2012] [Indexed: 11/24/2022]
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Abstract
Neurogenic tumors are an uncommon yet important category of soft tissue tumors in children and adolescents because of their frequent association with various genetic syndromes. The heterogeneous cellular composition of the peripheral nerve and the wide metaplastic capacity of the neural crest and its derivatives generate a variety of neoplasms with neurogenic differentiation. This article reviews the clinicopathologic features and differential diagnosis of neurogenic tumors in the first two decades of life, and highlights use of selected ancillary methods for diagnosis.
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Affiliation(s)
- Justin M M Cates
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA.
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Mittal S, Jain D, Roy S, Mehta VS. Correlation of p63 Protein Expression With Histological Grade of Meningiomas. Int J Surg Pathol 2012; 20:349-54. [DOI: 10.1177/1066896911434549] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Prediction of tumor behavior in meningiomas based on morphological features alone remains difficult. Several immunohistochemical biomarkers have been proposed to assist conventional methods. However, no single immunohistochemical marker can unequivocally discriminate between benign and aggressive meningiomas. There is only 1 study available in the literature that correlates p63 expression with overall histological grade of the meningioma. The present study is undertaken to assess the correlation between p63 expression and histological grade of meningiomas. For this purpose, the authors studied and analyzed the immunohistochemical expression of p63 in 85 cases of meningioma, including WHO grade I (63), grade II (11), and grade III (11) cases. Correlation between histological grade and nuclear immunoreactivity to p63 antibody was performed. Furthermore, expression of p63 protein was correlated with short clinical follow-up and Ki-67 proliferation index. Among 85 patients analyzed, there were 61 women (71.7 %) and 24 men (28.2%) between 7 and 75 years old. Expression of p63 protein was found in 34.9% of grade I cases, but in grade II and III, 63.6% of cases each were immunoreactive. Correlation between histological grade and p63 immunoreactivity was significant ( P = .02). p63-positive grade I meningiomas did not show elevated Ki-67 index. The present study contradicts earlier reports because there are a considerable number of grade I meningiomas that express p63. Although p63 expression is significantly associated with higher histological grade of meningiomas, it may not be considered as a sole biomarker to assess aggressive behavior of the tumor.
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Germline SMARCB1 mutation predisposes to multiple meningiomas and schwannomas with preferential location of cranial meningiomas at the falx cerebri. Neurogenetics 2011; 13:1-7. [DOI: 10.1007/s10048-011-0300-y] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2011] [Accepted: 09/19/2011] [Indexed: 01/30/2023]
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Fong B, Barkhoudarian G, Pezeshkian P, Parsa AT, Gopen Q, Yang I. The molecular biology and novel treatments of vestibular schwannomas. J Neurosurg 2011; 115:906-14. [PMID: 21800959 DOI: 10.3171/2011.6.jns11131] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Vestibular schwannomas are histopathologically benign tumors arising from the Schwann cell sheath surrounding the vestibular branch of cranial nerve VIII and are related to the NF2 gene and its product merlin. Merlin acts as a tumor suppressor and as a mediator of contact inhibition. Thus, deficiencies in both NF2 genes lead to vestibular schwannoma development. Recently, there have been major advances in our knowledge of the molecular biology of vestibular schwannomas as well as the development of novel therapies for its treatment. In this article the authors comprehensively review the recent advances in the molecular biology and characterization of vestibular schwannomas as well as the development of modern treatments for vestibular schwannoma. For instance, merlin is involved with a number of receptors including the CD44 receptor, EGFR, and signaling pathways, such as the Ras/raf pathway and the canonical Wnt pathway. Recently, merlin was also shown to interact in the nucleus with E3 ubiquitin ligase CRL4(DCAF1). A greater understanding of the molecular mechanisms behind vestibular schwannoma tumorigenesis has begun to yield novel therapies. Some authors have shown that Avastin induces regression of progressive schwannomas by over 40% and improves hearing. An inhibitor of VEGF synthesis, PTC299, is currently in Phase II trials as a potential agent to treat vestibular schwannoma. Furthermore, in vitro studies have shown that trastuzumab (an ERBB2 inhibitor) reduces vestibular schwannoma cell proliferation. With further research it may be possible to significantly reduce morbidity and mortality rates by decreasing tumor burden, tumor volume, hearing loss, and cranial nerve deficits seen in vestibular schwannomas.
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Affiliation(s)
- Brendan Fong
- Department of Neurological Surgery, University of California, Los Angeles, CA 90095-1761, USA
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Singla N, Umredkar A, Mohindra S, Pathak A. Ruptured posterior cerebral artery aneurysm in association with neurofibromatosis type 2--a case report. Br J Neurosurg 2011; 25:322-3. [PMID: 21344971 DOI: 10.3109/02688697.2010.546897] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Intracranial aneurysms have been described in patients with Neurofibromatosis (NF)- 1, but not with NF-2 apart from one instance of a middle meningeal artery aneurysm (Louis DN, Ramesh V, Gusella JF. Neuropathology and molecular genetics of neurofibromatosis 2 and related tumors. We report a case of NF-2 and ruptured posterior cerebral artery aneurysm.
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31
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FEDI M, KALNINS RM, SHUEY N, FITT GJ, NEWTON M, MITCHELL LA. Cystic meningioangiomatosis in neurofibromatosis type 2: an MRI–pathological study. Br J Radiol 2009; 82:e129-32. [DOI: 10.1259/bjr/56536580] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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32
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Dickinson PJ, Surace EI, Cambell M, Higgins RJ, Leutenegger CM, Bollen AW, Lecouteur RA, Gutmann DH. Expression of the Tumor Suppressor Genes NF2, 4.1B, and TSLC1 in Canine Meningiomas. Vet Pathol 2009; 46:884-92. [PMID: 19429976 DOI: 10.1354/vp.08-vp-0251-d-fl] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Meningiomas are common primary brain tumors in dogs; however, little is known about the molecular genetic mechanisms involved in their tumorigenesis. Several tumor suppressor genes have been implicated in meningioma pathogenesis in humans, including the neurofibromatosis 2 ( NF2), protein 4.1B ( 4.1 B), and tumor suppressor in lung cancer-1 ( TSLC1) genes. We investigated the expression of these tumor suppressor genes in a series of spontaneous canine meningiomas using quantitative real-time reverse transcription polymerase chain reaction (RT-PCR) ( NF2; n = 25) and western blotting (NF2/merlin, 4.1B, TSLC1; n = 30). Decreased expression of 4.1B and TSLC1 expression on western blotting was seen in 6/30 (20%) and in 15/30 (50%) tumors, respectively, with 18/30 (60%) of meningiomas having decreased or absent expression of one or both proteins. NF2 gene expression assessed by western blotting and RT-PCR varied considerably between individual tumors. Complete loss of NF2 protein on western blotting was not seen, unlike 4.1B and TSLC1. Incidence of TSLC1 abnormalities was similar to that seen in human meningiomas, while perturbation of NF2 and 4.1B appeared to be less common than reported for human tumors. No association was observed between tumor grade, subtype, or location and tumor suppressor gene expression based on western blot or RT-PCR. These results suggest that loss of these tumor suppressor genes is a frequent occurrence in canine meningiomas and may be an early event in tumorigenesis in some cases. In addition, it is likely that other, as yet unidentified, genes play an important role in canine meningioma formation and growth.
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Affiliation(s)
- P. J. Dickinson
- Departments of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California Davis, Davis, CA
| | - E. I. Surace
- Department of Neurology, Washington University School of Medicine, St. Louis, MO
| | - M. Cambell
- Departments of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California Davis, Davis, CA
| | - R. J. Higgins
- Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California Davis, Davis, CA
| | - C. M. Leutenegger
- Medicine and Epidemiology, School of Veterinary Medicine, University of California Davis, Davis, CA
| | - A. W. Bollen
- Department of Pathology, School of Medicine, University of California San Francisco, San Francisco, CA
| | - R. A. Lecouteur
- Departments of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California Davis, Davis, CA
| | - D. H. Gutmann
- Department of Neurology, Washington University School of Medicine, St. Louis, MO
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Abstract
Surgery is the mainstay for many patients with meningiomas, and it remains the standard. In large single-institution series, gross-total resection has been reported to achieve 5-, 10-, and 15-year recurrence-free survival rates of approximately 90, 80, and 70%, respectively. There are a growing number of series of patients with prolonged follow-up in which authors have evaluated fractionated external-beam radiation therapy (EBRT) either as an adjuvant to surgery for subtotally resected, recurrent, or higher-grade meningiomas, or as an alternative to surgery. The primary focus of this review is EBRT, but to lend perspective, a comparative analysis of surgery and radiosurgery is also provided.
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Affiliation(s)
- Leland Rogers
- GammaWest Radiation Therapy, Salt Lake City, Utah 84102, USA.
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34
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Begnami MD, Palau M, Rushing EJ, Santi M, Quezado M. Evaluation of NF2 gene deletion in sporadic schwannomas, meningiomas, and ependymomas by chromogenic in situ hybridization. Hum Pathol 2007; 38:1345-50. [PMID: 17509660 PMCID: PMC2094208 DOI: 10.1016/j.humpath.2007.01.027] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2006] [Revised: 01/26/2007] [Accepted: 01/29/2007] [Indexed: 10/23/2022]
Abstract
Fluorescence in situ hybridization, loss of heterozygosity testing, and comparative genomic hybridization have been used to detect NF2 gene alterations in both sporadic and neurofibromatosis type 2 (NF2)-associated central nervous system tumors. In this study, we performed chromogenic in situ hybridization (CISH) and immunohistochemistry to evaluate for NF2 gene deletion in a group of sporadic meningiomas, schwannomas, and ependymomas. Twenty-two sporadic tumors, including 9 ependymomas, 10 meningiomas, and 3 schwannomas, were studied. CISH and immunohistochemistry were performed using the NF2 gene deletion probe and NF2 polyclonal antibody. Deletion of the NF2 gene was identified in 11 (50%) tumors, including 60% (6/10) of meningiomas, 33% (3/9) of ependymomas, and 67% (2/3) of schwannomas. The remaining 11 (50%) cases were diploid. Overall, immunoexpression of NF2 protein was observed in 50% (11/22) tumors, and concordance between CISH and immunohistochemistry was observed in 73% of cases. Our results support previous observations that schwannomas and meningiomas, and to a lesser degree, ependymomas, express a high incidence of NF2 gene deletion, which supports the hypothesis that NF2 gene plays an important role in their tumorigenesis. In addition, we have validated CISH as an efficient, economic, and reliable method for routinely assessing NF2 gene deletion in these tumors.
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Affiliation(s)
- Maria D Begnami
- Laboratory of Pathology, Surgical Pathology Section, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA.
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35
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Riemenschneider MJ, Perry A, Reifenberger G. Histological classification and molecular genetics of meningiomas. Lancet Neurol 2006; 5:1045-54. [PMID: 17110285 DOI: 10.1016/s1474-4422(06)70625-1] [Citation(s) in RCA: 343] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Meningiomas account for up to 30% of all primary intracranial tumours. They are histologically classified according to the World Health Organization (WHO) classification of tumours of the nervous system. Most meningiomas are benign lesions of WHO grade I, whereas some meningioma variants correspond with WHO grades II and III and are associated with a higher risk of recurrence and shorter survival times. Mutations in the NF2 gene and loss of chromosome 22q are the most common genetic alterations associated with the initiation of meningiomas. With increase in tumour grade, additional progression-associated molecular aberrations can be found; however, most of the relevant genes are yet to be identified. High-throughput techniques of global genome and transcriptome analyses and new meningioma models provide increasing insight into meningioma biology and will help to identify common pathogenic pathways that may be targeted by new therapeutic approaches.
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36
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Abstract
Schwannomatosis or neurilemmomatosis has been used to describe patients with multiple nonvestibular schwannomas with no other stigmata of neurofibromatosis type-2 (NF-2). In our case, schwannomatosis, multiple schwannomas were present in a 21-yr-old woman with no stigmata or family history of NF-1 or NF-2. She had no evidence of vestibular schwannoma or other intracranial tumors. Multiple peripheral tumors were found in the carotid space of the neck, and soft tissue of posterior shoulder, lower back, ankle and middle mediastinum. All of those tumors were completely limited to the right side of the body. All surgically removed tumor specimens in this patient proved to be schwannomas.
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Affiliation(s)
- Dong Hun Kim
- Department of Radiology, Chosun University Hospital, Gwangju, Korea
| | - Jung Hwa Hwang
- Department of Radiology, Soonchunhyang University Hospital, Seoul, Korea
| | - Sung-Tae Park
- Department of Radiology, Soonchunhyang University Hospital, Seoul, Korea
| | - Ji Hoon Shin
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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37
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Tamiolakis D, Papadopoulos N, Venizelos I, Lambropoulou M, Nikolaidou S, Bolioti S, Kiziridou A, Manavis J, Alexiadis G, Simopoulos C. Loss of chromosome 1 in myxopapillary ependymoma suggests a region out of chromosome 22 as critical for tumour biology: a FISH analysis of four cases on touch imprint smears. Cytopathology 2006; 17:199-204. [PMID: 16879268 DOI: 10.1111/j.1365-2303.2006.00287.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Ependymomas are glial tumours. They constitute approximately 5-10% of intracranial tumours and are tumours which can recur. Predictive factors of outcome in ependymomas are not well established. Karyotypic studies are relatively scarce and loss of chromosome 22 has been described to correlate with recurrence. We are unaware of any reports involving chromosome 1 aberrations in the malignant progression of ependymomas. METHODS Cytogenetic analysis of four myxopapillary ependymomas was performed using double target fluorescent in situ hybridization (FISH), focusing on chromosomes 1 and 22. RESULTS One patient's tumour had recurred. FISH was performed on 500 nuclei/tumours. All four cases showed a loss of chromosome 22q while only one showed an additional loss of chromosome 1p, and this was the one that recurred. CONCLUSIONS We support the presence of a tumour suppressor gene on 1p associated with relapse in myxopapillary ependymomas and suggest that status of chromosome 1p by FISH may indicate a high-risk group of patients harbouring this tumour. More studies of this type are needed towards this direction as our results refer to a minimal number of individuals analysed.
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Affiliation(s)
- D Tamiolakis
- Department of Cytology, Regional Hospital of Chania, Thrace, Greece
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38
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Omeis I, Hillard VH, Braun A, Benzil DL, Murali R, Harter DH. Meningioangiomatosis associated with neurofibromatosis: report of 2 cases in a single family and review of the literature. ACTA ACUST UNITED AC 2006; 65:595-603. [PMID: 16720184 DOI: 10.1016/j.surneu.2005.09.034] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2005] [Accepted: 09/05/2005] [Indexed: 10/24/2022]
Abstract
BACKGROUND Meningioangiomatosis (MA) is a rare benign disorder. It may occur sporadically or in association with neurofibromatosis (NF). The sporadic type typically presents with seizures, whereas that associated with NF is often asymptomatic. Of the 100 cases reported, only 14 are associated with NF. We now report 2 additional cases of MA associated with neurofibromatosis 2 (NF2) in a single family, with one occurring in the cerebellum. The etiology, pathology, and imaging features of MA are presented. CASE DESCRIPTION A 38-year-old woman (patient 1) presented with a 4-month history of ataxia. She had been diagnosed previously with NF2. Magnetic resonance imaging (MRI) scans of the brain revealed bilateral acoustic neuromas and multiple calcified intracranial lesions. Her 13-year-old daughter (patient 2) presented with complex partial seizures. MRI scans of the brain revealed bilateral acoustic neuromas and a right parietal mass. Patient 1 underwent a suboccipital craniotomy to resect the right-sided acoustic neuroma. A small portion of normal-appearing cerebellar cortex was resected to avoid undue retraction. Histopathologic examination showed the presence of a lesion consistent with MA. Patient 2 underwent a right temporal-parietal craniotomy to remove the enhancing epileptogenic right posterior temporoparietal lesion. Histopathologic analysis showed a lesion consistent with meningioma and MA. CONCLUSIONS MA has been reported infrequently in association with NF2. We now report 2 cases of MA associated with NF2 in one family, and we add the cerebellum to possible locations of occurrence. MA should be considered in the differential diagnosis of cortical lesions, particularly in patients with NF2.
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Affiliation(s)
- Ibrahim Omeis
- Department of Neurosurgery, New York Medical College, Valhalla, NY 10595, USA.
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39
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Hartmann C, Sieberns J, Gehlhaar C, Simon M, Paulus W, von Deimling A. NF2 mutations in secretory and other rare variants of meningiomas. Brain Pathol 2006; 16:15-9. [PMID: 16612978 PMCID: PMC8095906 DOI: 10.1111/j.1750-3639.2006.tb00557.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
The WHO classification defines different histological variants of meningiomas. Mutations of the tumor suppressor gene NF2 on 22q have been described in 30% to 60 % of sporadic meningiomas. However, the vast majority of the meningiomas that have been subject to NF2 analysis belong to the most frequent variants like transitional, fibroblastic and meningothelial meningiomas. Within these subtypes, transitional and fibroblastic meningiomas harbor significantly more NF2 mutations than meningothelial meningiomas, indicating molecular subsets of these tumors. To determine whether rare meningioma variants carry NF2 mutations we analyzed 80 tumors. NF2 mutations were detected in 5 (36%) of 14 psammomatous, 1 (11%) of 9 angiomatous, 2 (22%) of 9 clear cell, 1 (33%) of 3 chordoid and 1 (100%) of 1 papillary meningioma. In the single papillary meningioma, 2 different NF2 mutations were observed. No NF2 mutations were found in 33 secretory, 7 microcystic, 2 lymphoplasmacyte-rich, one rhabdoid and one metaplastic meningioma. In the control group of 25 fibroblastic meningiomas, 11 cases were identified to carry an NF2 mutation. These results support the concept of different molecular subgroups of meningiomas which overlap with histological variants.
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Affiliation(s)
- Christian Hartmann
- Department of Neuropathology, Charité, Universitätsmedizin Berlin, Germany.
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40
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Giulioni M, Acciarri N, Zucchelli M, Marucci G, Badaloni F, Calbucci F. Meningioangiomatosis involving the wall of the middle cerebral artery. J Neurooncol 2006; 78:105-6. [PMID: 16554969 DOI: 10.1007/s11060-005-9066-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2005] [Accepted: 10/25/2005] [Indexed: 11/30/2022]
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41
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Grönholm M, Muranen T, Toby GG, Utermark T, Hanemann CO, Golemis EA, Carpén O. A functional association between merlin and HEI10, a cell cycle regulator. Oncogene 2006; 25:4389-98. [PMID: 16532029 DOI: 10.1038/sj.onc.1209475] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Merlin and ezrin are homologous proteins with opposite effects on neoplastic growth. Merlin is a tumor suppressor inactivated in the neurofibromatosis 2 disease, whereas upregulated ezrin expression is associated with increased malignancy. Merlin's tumor suppressor mechanism is not known, although participation in cell cycle regulation has been suggested. To characterize merlin's biological activities, we screened for molecules that would interact with merlin but not ezrin. We identified the cyclin B-binding protein and cell cycle regulator HEI10 as a novel merlin-binding partner. The interaction is mediated by the alpha-helical domain in merlin and the coiled-coil domain in HEI10 and requires conformational opening of merlin. The two proteins show partial subcellular colocalization, which depends on cell cycle stage and cell adhesion. Comparison of Schwann cells and schwannoma cultures demonstrated that the distribution of HEI10 depends on merlin expression. In transfected cells, a constitutively open merlin construct affected HEI10 protein integrity. These results link merlin to the cell cycle control machinery and may help to understand its tumor suppressor function.
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Affiliation(s)
- M Grönholm
- Neuroscience Program, Biomedicum Helsinki, Department of Pathology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.
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42
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Hameed M, Chen F, Mahmet K, Das K, Kim S. Schwannoma with a reciprocal t(9;22)(q22;q13). ACTA ACUST UNITED AC 2006; 164:92-3. [PMID: 16364772 DOI: 10.1016/j.cancergencyto.2005.06.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2005] [Revised: 06/23/2005] [Accepted: 06/24/2005] [Indexed: 11/20/2022]
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43
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Murray AJ, Hughes TAT, Neal JW, Howard E, Evans DGR, Harper PS. A case of multiple cutaneous schwannomas; schwannomatosis or neurofibromatosis type 2? J Neurol Neurosurg Psychiatry 2006; 77:269-71. [PMID: 16421138 PMCID: PMC2077573 DOI: 10.1136/jnnp.2005.067017] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
A 54 year old man presented with numerous cutaneous schwannomas, cranial nerve lesions, and spinal cord lesions, but no evidence of vestibular nerve involvement. There was no family history of neurocutaneous lesions. To help discriminate between the various possible diagnoses in this patient, molecular analysis of two cutaneous schwannomas was undertaken. An identical point mutation in the NF2 gene in the two anatomically distinct tumours was found, confirming this as a case of NF2 mosaicism.
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Affiliation(s)
- A J Murray
- Institute of Medical Genetics, University Hospital of Wales, Heath Park, Cardiff CF14 4XW, UK.
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44
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Ryu CH, Kim SW, Lee KH, Lee JY, Kim H, Lee WK, Choi BH, Lim Y, Kim YH, Lee KH, Hwang TK, Jun TY, Rha HK. The merlin tumor suppressor interacts with Ral guanine nucleotide dissociation stimulator and inhibits its activity. Oncogene 2005; 24:5355-64. [PMID: 16007223 DOI: 10.1038/sj.onc.1208633] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Neurofibromatosis type 2 (NF2) is the most commonly mutated gene in benign tumors of the human nervous system such as schwannomas and meningiomas. The NF2 gene encodes a protein called schwannomin or merlin, which is involved in regulating cell growth and proliferation through protein-protein interactions with various cellular proteins. In order to better understand the mechanism by which merlin exerts its function, yeast two-hybrid screening was performed and Ral guanine nucleotide dissociation stimulator (RalGDS), a downstream molecule of Ras, was identified as a merlin-binding protein. The direct interaction between merlin and RalGDS was confirmed both in vitro and in the NIH3T3 cells. The domain analyses revealed that the broad C-terminal region of merlin (aa 141-595) is necessary for the interaction with the C-terminal Ras-binding domain (RBD) of RalGDS. Functional studies showed that merlin inhibits the RalGDS-induced RalA activation, the colony formation and the cell migration in mammalian cells. These results suggest that merlin can function as a tumor suppressor by inhibiting the RalGDS-mediated oncogenic signals.
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Affiliation(s)
- Chung Hun Ryu
- Catholic Neuroscience Center, The Catholic University of Korea, Seoul 137-701, Korea
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45
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Grönholm M, Teesalu T, Tyynelä J, Piltti K, Böhling T, Wartiovaara K, Vaheri A, Carpén O. Characterization of the NF2 protein merlin and the ERM protein ezrin in human, rat, and mouse central nervous system. Mol Cell Neurosci 2005; 28:683-93. [PMID: 15797715 DOI: 10.1016/j.mcn.2004.11.014] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2004] [Revised: 11/12/2004] [Accepted: 11/19/2004] [Indexed: 11/28/2022] Open
Abstract
The neurofibromatosis 2 (NF2) protein, merlin, is structurally related to the ERM (ezrin-radixin-moesin) protein family of membrane-cytoskeleton linkers and is mutated in nervous system tumors. Apart from tumor suppressor activity, merlin's functions are poorly understood. We compared the localization and expression of merlin and ezrin in developing and adult brain and in brain-derived progenitor cells. Both proteins were widely but differentially expressed in human, rat, and mouse brain. In brain tissue and neuronal progenitor cell cultures merlin was predominantly found in neurons while ezrin was expressed in astrocytes. Merlin expression was seen from E11 in mouse embryos, whereas ezrin was present earlier. Both proteins were expressed in embryonic mouse neurospheres, where ezrin was specifically localized in filopodia of adherent neuronal progenitor cells. Subcellular analysis demonstrated ezrin in fine filopodial structures in astrocytes, while merlin was detected in neuronal synaptic junctions. The widespread expression of merlin in brain and its association with protein kinase A suggest a role for merlin in brain biology.
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Affiliation(s)
- Mikaela Grönholm
- Neuroscience Program, Biomedicum Helsinki, University of Helsinki and Helsinki University Central Hospital, PB 63, Haartmaninkatu 8, 00014 Helsinki, Finland.
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46
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Wada K, Maruno M, Suzuki T, Kagawa N, Hashiba T, Fujimoto Y, Hashimoto N, Izumoto S, Yoshimine T. Chromosomal and genetic aberrations differ with meningioma subtype. Brain Tumor Pathol 2004; 21:127-33. [PMID: 15696974 DOI: 10.1007/bf02482188] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Meningioma is one of the most common brain tumors, and a variety of genetic abnormalities have been detected by the Southern blotting, polymerase chain reaction (PCR), fluorescence in situ hybridization (FISH), and comparative genomic hybridization (CGH) methods. However, these methods detect only a very limited portion of the tumor genome or have a limited mapping resolution. In this study, we used DNA microarray assay, which detects numerous genetic abnormalities and analyzes a global assessment of molecular events in tumor cells. We analyzed genomic DNA from 26 patients with benign meningiomas by GenoSensor Array 300 in order to characterize gene amplifications, gene deletions, and chromosomal information in the whole genome. Loss of chromosome 22q was found most frequently. This chromosomal aberration was detected in 14 meningiomas (53.8%), particularly in transitional and fibrous meningiomas. In meningothelial meningiomas, amplification of INS and TCL1A was detected more frequently than in other meningioma subtypes. DNA microarray assay revealed new genetic differences among the meningioma subtypes, thus indicating that this novel technique is useful for understanding tumor genesis and for the diagnosis of meningioma subtype.
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Affiliation(s)
- Kouichi Wada
- Department of Neurosurgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
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47
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Abstract
Over the past 5 to 10 years, important advances were made in the understanding of meningioma biology. Progress in molecular genetics probably represents the most important accomplishment in the comprehensive knowledge of meningioma pathogenesis. Several genes could be identified as targets for mutation or inactivation. Additional chromosomal regions were found to be commonly deleted or amplified, suggesting the presence of further tumor suppressor genes or proto-oncogenes, respectively, in these regions. Histopathologically, the most important innovation is represented by the revised WHO classification in the year 2000. Meningioma grading criteria in the new classification scheme are more precise and objective, and should thus improve consistency in predicting tumor recurrence and aggressive behavior. This review focuses mainly on the advances in molecular biology that were achieved in recent years. It summarizes the most important aspects of meningioma classification as the basis to place biological observations into a correlative context, and, further, includes mechanisms of angiogenesis and edema formation as well as the role of hormone receptors in meningiomas.
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Affiliation(s)
- Katrin Lamszus
- Department of Neurosurgery, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
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48
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Grönholm M, Vossebein L, Carlson CR, Kuja-Panula J, Teesalu T, Alfthan K, Vaheri A, Rauvala H, Herberg FW, Taskén K, Carpén O. Merlin links to the cAMP neuronal signaling pathway by anchoring the RIbeta subunit of protein kinase A. J Biol Chem 2003; 278:41167-72. [PMID: 12896975 DOI: 10.1074/jbc.m306149200] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The cAMP-protein kinase A (PKA) pathway, important in neuronal signaling, is regulated by molecules that bind and target PKA regulatory subunits. Of four regulatory subunits, RIbeta is most abundantly expressed in brain. The RIbeta knockout mouse has defects in hippocampal synaptic plasticity, suggesting a role for RIbeta in learning and memory-related functions. Molecules that interact with or regulate RIbeta are still unknown. We identified the neurofibromatosis 2 tumor suppressor protein merlin (schwannomin), a molecule related to the ezrin-radixin-moesin family of membrane-cytoskeleton linker proteins, as a binding partner for RIbeta. Merlin and RIbeta demonstrated a similar expression pattern in central nervous system neurons and an overlapping subcellular localization in cultured hippocampal neurons and transfected cells. The proteins were coprecipitated from brain lysates by cAMP-agarose and coimmunoprecipited from cellular lysates with specific antibodies. In vitro binding studies verified that the interaction is direct. The interaction appeared to be under conformational regulation and was mediated via the alpha-helical region of merlin. Sequence comparison between merlin and known PKA anchoring proteins identified a conserved alpha-helical PKA anchoring protein motif in merlin. These results identify merlin as the first neuronal binding partner for PKA-RIbeta and suggest a novel function for merlin in connecting neuronal cytoskeleton to PKA signaling.
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Affiliation(s)
- Mikaela Grönholm
- Biomedicum Helsinki, Department of Pathology, Neuroscience Center, Institute of Biotechnology, University of Helsinki and Helsinki University Central Hospital, 00014 Helsinki, Finland.
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49
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Pylkkänen L, Sarlomo-Rikala M, Wessman M, Hämäläinen E, Sainio M, Husgafvel-Pursiainen K, Carpén O. Chromosome 22q alterations and expression of the NF2 gene product, merlin, in gastrointestinal stromal tumors. Hum Pathol 2003; 34:872-9. [PMID: 14562282 DOI: 10.1016/s0046-8177(03)00349-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the digestive tract. A characteristic genetic alteration in GISTs is constitutive activation of the c-kit proto-oncogene, but alterations in chromosomes 14 and 22 may also play a role in the molecular pathogenesis. In this study, 42 GISTs were analyzed for loss of heterozygosity (LOH) on the long arm of chromosome 22 (22q). Overall, 69% of the tumors studied showed LOH with at least 1 of the 22q markers. Allele losses were compared with tumor mitotic activity, the most commonly used prognostic marker for this tumor. Interestingly, allele deletion at 22q was significantly more frequent in tumors with high mitotic activity (>/= l2 mitoses/10 high-power fields [HPF]) than in tumors with low mitotic activity (< 2 mitoses/HPF)-88% versus 56% (P < 0.01). A total of 26% (11 of 42) of all tumors demonstrated loss of all 22q sites analyzed, consistent with the loss of 1 copy of the entire long arm. Such tumors carried a 4.6-fold (95% confidence interval, 0.5 to 49.8) risk for recurrence compared with tumors with no LOH. LOH was frequently detected at the neurofibromatosis 2 (NF2) tumor-suppressor gene locus at 22q12. Sequencing of the NF2 gene from 5 GISTs did not reveal mutations, however. Furthermore, 16 of 19 tumors (84%) analyzed by immunohistochemistry were positive for the NF2 gene product, merlin. The findings suggest that allelic losses at 22q are associated with high mitotic activity and recurring disease, and that alterations in the NF2 gene are unlikely to participate in the pathogenesis of GIST.
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Affiliation(s)
- Lea Pylkkänen
- Department of Industrial Hygiene, Finnish Institute of Occuapational Health, Helsinki, Finland
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Koga T, Iwasaki H, Ishiguro M, Matsuzaki A, Kikuchi M. Losses in chromosomes 17, 19, and 22q in neurofibromatosis type 1 and sporadic neurofibromas: a comparative genomic hybridization analysis. CANCER GENETICS AND CYTOGENETICS 2002; 136:113-20. [PMID: 12237234 DOI: 10.1016/s0165-4608(02)00527-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Neurofibromatosis type 1 (von Recklinghausen's NF1) is an autosomal dominant disease associated with an increased risk of benign and malignant neoplasia including malignant peripheral nerve sheath tumors (MPNSTs). In this study, we employed comparative genomic hybridization (CGH) to determine changes in the relative chromosome copy number in 24 patients with neurofibromas, including 12 NF1-associated and 12 sporadic cases. Differences in the frequency and distribution of chromosomal imbalances were observed in both NF1-asociated and sporadic neurofibromas. Chromosomal imbalances were more common in NF1-associated tumors than in sporadic neurofibromas. In both groups, the number of losses was higher than the number of gains, suggesting a predominant role of tumor suppressor gene in tumorigenesis. A number of new chromosomal imbalances were noted including chromosomes 17, 19, and chromosome arm 22q, which may be related to oncogenes or tumor suppressor genes in neurofibromas. In NF1-associated neurofibromas, the most frequent losses were found in chromosome 17 (the minimal common regions were 17p11.2-->p13 in nine cases and 17q24-->q25 in six cases) and 19p (19p13.2 in nine cases). In addition, both NF1-associated and sporadic neurofibromas often exhibited losses at chromosome arms 19q and 22q (in NF1 tumors, the minimal common regions were 19q13.2-->qter in seven cases).
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Affiliation(s)
- Takamasa Koga
- Department of Pathology, School of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan
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