|
1
|
Semyachkina-Glushkovskaya O, Sokolovski S, Fedosov I, Shirokov A, Navolokin N, Bucharskaya A, Blokhina I, Terskov A, Dubrovski A, Telnova V, Tzven A, Tzoy M, Evsukova A, Zhlatogosrkaya D, Adushkina V, Dmitrenko A, Manzhaeva M, Krupnova V, Noghero A, Bragin D, Bragina O, Borisova E, Kurths J, Rafailov E. Transcranial Photosensitizer-Free Laser Treatment of Glioblastoma in Rat Brain. Int J Mol Sci 2023; 24:13696. [PMID: 37762000 PMCID: PMC10530910 DOI: 10.3390/ijms241813696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 08/29/2023] [Accepted: 09/02/2023] [Indexed: 09/29/2023] Open
Abstract
Over sixty years, laser technologies have undergone a technological revolution and become one of the main tools in biomedicine, particularly in neuroscience, neurodegenerative diseases and brain tumors. Glioblastoma is the most lethal form of brain cancer, with very limited treatment options and a poor prognosis. In this study on rats, we demonstrate that glioblastoma (GBM) growth can be suppressed by photosensitizer-free laser treatment (PS-free-LT) using a quantum-dot-based 1267 nm laser diode. This wavelength, highly absorbed by oxygen, is capable of turning triplet oxygen to singlet form. Applying 1267 nm laser irradiation for a 4 week course with a total dose of 12.7 kJ/cm2 firmly suppresses GBM growth and increases survival rate from 34% to 64%, presumably via LT-activated apoptosis, inhibition of the proliferation of tumor cells, a reduction in intracranial pressure and stimulation of the lymphatic drainage and clearing functions. PS-free-LT is a promising breakthrough technology in non- or minimally invasive therapy for superficial GBMs in infants as well as in adult patients with high photosensitivity or an allergic reaction to PSs.
Collapse
Affiliation(s)
- Oxana Semyachkina-Glushkovskaya
- Physics Department, Humboldt University, Newtonstrasse 15, 12489 Berlin, Germany;
- Department of Biology, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (A.S.); (N.N.); (I.B.); (A.T.); (V.T.); (A.T.); (A.E.); (D.Z.); (V.A.); (A.D.); (M.M.); (V.K.)
| | - Sergey Sokolovski
- Optoelectronics and Biomedical Photonics Group, AIPT, Aston University, Birmingham B4 7ET, UK;
| | - Ivan Fedosov
- Physics Department, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (I.F.); (A.D.); (M.T.)
| | - Alexander Shirokov
- Department of Biology, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (A.S.); (N.N.); (I.B.); (A.T.); (V.T.); (A.T.); (A.E.); (D.Z.); (V.A.); (A.D.); (M.M.); (V.K.)
- Institute of Biochemistry and Physiology of Plants and Microorganisms, Russian Academy of Sciences, Prospekt Entuziastov 13, 410049 Saratov, Russia
| | - Nikita Navolokin
- Department of Biology, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (A.S.); (N.N.); (I.B.); (A.T.); (V.T.); (A.T.); (A.E.); (D.Z.); (V.A.); (A.D.); (M.M.); (V.K.)
- Department of Pathological Anatomy, Saratov Medical State University, Bolshaya Kazachaya Str. 112, 410012 Saratov, Russia;
| | - Alla Bucharskaya
- Department of Pathological Anatomy, Saratov Medical State University, Bolshaya Kazachaya Str. 112, 410012 Saratov, Russia;
| | - Inna Blokhina
- Department of Biology, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (A.S.); (N.N.); (I.B.); (A.T.); (V.T.); (A.T.); (A.E.); (D.Z.); (V.A.); (A.D.); (M.M.); (V.K.)
| | - Andrey Terskov
- Department of Biology, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (A.S.); (N.N.); (I.B.); (A.T.); (V.T.); (A.T.); (A.E.); (D.Z.); (V.A.); (A.D.); (M.M.); (V.K.)
| | - Alexander Dubrovski
- Physics Department, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (I.F.); (A.D.); (M.T.)
| | - Valeria Telnova
- Department of Biology, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (A.S.); (N.N.); (I.B.); (A.T.); (V.T.); (A.T.); (A.E.); (D.Z.); (V.A.); (A.D.); (M.M.); (V.K.)
| | - Anna Tzven
- Department of Biology, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (A.S.); (N.N.); (I.B.); (A.T.); (V.T.); (A.T.); (A.E.); (D.Z.); (V.A.); (A.D.); (M.M.); (V.K.)
| | - Maria Tzoy
- Physics Department, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (I.F.); (A.D.); (M.T.)
| | - Arina Evsukova
- Department of Biology, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (A.S.); (N.N.); (I.B.); (A.T.); (V.T.); (A.T.); (A.E.); (D.Z.); (V.A.); (A.D.); (M.M.); (V.K.)
| | - Daria Zhlatogosrkaya
- Department of Biology, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (A.S.); (N.N.); (I.B.); (A.T.); (V.T.); (A.T.); (A.E.); (D.Z.); (V.A.); (A.D.); (M.M.); (V.K.)
| | - Viktoria Adushkina
- Department of Biology, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (A.S.); (N.N.); (I.B.); (A.T.); (V.T.); (A.T.); (A.E.); (D.Z.); (V.A.); (A.D.); (M.M.); (V.K.)
| | - Alexander Dmitrenko
- Department of Biology, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (A.S.); (N.N.); (I.B.); (A.T.); (V.T.); (A.T.); (A.E.); (D.Z.); (V.A.); (A.D.); (M.M.); (V.K.)
| | - Maria Manzhaeva
- Department of Biology, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (A.S.); (N.N.); (I.B.); (A.T.); (V.T.); (A.T.); (A.E.); (D.Z.); (V.A.); (A.D.); (M.M.); (V.K.)
| | - Valeria Krupnova
- Department of Biology, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (A.S.); (N.N.); (I.B.); (A.T.); (V.T.); (A.T.); (A.E.); (D.Z.); (V.A.); (A.D.); (M.M.); (V.K.)
| | - Alessio Noghero
- Lovelace Biomedical Research Institute, Albuquerque, NM 87108, USA; (A.N.); (D.B.); (O.B.)
| | - Denis Bragin
- Lovelace Biomedical Research Institute, Albuquerque, NM 87108, USA; (A.N.); (D.B.); (O.B.)
- Department of Neurology, School of Medicine, University of New Mexico, Albuquerque, NM 87131, USA
| | - Olga Bragina
- Lovelace Biomedical Research Institute, Albuquerque, NM 87108, USA; (A.N.); (D.B.); (O.B.)
- Department of Neurology, School of Medicine, University of New Mexico, Albuquerque, NM 87131, USA
| | - Ekaterina Borisova
- Institute of Electronics, Bulgarian Academy of Sciences, Tsarigradsko Chaussee Blvd. 72, 1784 Sofia, Bulgaria;
| | - Jürgen Kurths
- Physics Department, Humboldt University, Newtonstrasse 15, 12489 Berlin, Germany;
- Department of Biology, Saratov State University, Astrakhanskaya Str. 83, 410012 Saratov, Russia; (A.S.); (N.N.); (I.B.); (A.T.); (V.T.); (A.T.); (A.E.); (D.Z.); (V.A.); (A.D.); (M.M.); (V.K.)
- Potsdam Institute for Climate Impact Research, Telegrafenberg A31, 14473 Potsdam, Germany
- Centre for Analysis of Complex Systems, Sechenov First Moscow State Medical University Moscow, 119991 Moscow, Russia
| | - Edik Rafailov
- Optoelectronics and Biomedical Photonics Group, AIPT, Aston University, Birmingham B4 7ET, UK;
| |
Collapse
|
|
2
|
Storz C, Sankowski R, Roelz R, Prinz M, Urbach H, Erny D, Taschner CA. Freiburg Neuropathology Case Conference : Recurrent Speech Arrest, Neologistic Jargon Aphasia, and Impaired Memory Function in a 39-year-old Patient. Clin Neuroradiol 2023; 33:869-876. [PMID: 37462746 PMCID: PMC10450002 DOI: 10.1007/s00062-023-01335-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2023] [Indexed: 08/26/2023]
Affiliation(s)
- C Storz
- Department of Neuroradiology, Medical Centre-University of Freiburg, Breisacherstraße 64, 79106, Freiburg, Germany
- Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - R Sankowski
- Department of Neuropathology, Medical Centre-University of Freiburg, Freiburg, Germany
- Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - R Roelz
- Department of Neurosurgery, Medical Centre-University of Freiburg, Freiburg, Germany
- Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - M Prinz
- Department of Neuropathology, Medical Centre-University of Freiburg, Freiburg, Germany
- Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - H Urbach
- Department of Neuroradiology, Medical Centre-University of Freiburg, Breisacherstraße 64, 79106, Freiburg, Germany
- Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - D Erny
- Department of Neuropathology, Medical Centre-University of Freiburg, Freiburg, Germany
- Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - C A Taschner
- Department of Neuroradiology, Medical Centre-University of Freiburg, Breisacherstraße 64, 79106, Freiburg, Germany.
- Faculty of Medicine, University of Freiburg, Freiburg, Germany.
| |
Collapse
|
|
3
|
Dias DJL, Dias ASDS, Camargo MV, Lederman HM. MRI Findings of Desmoplastic Infantile Ganglioglioma: A Case Report and Analysis. Cureus 2023; 15:e43770. [PMID: 37727160 PMCID: PMC10506886 DOI: 10.7759/cureus.43770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2023] [Indexed: 09/21/2023] Open
Abstract
Desmoplastic infantile gangliogliomas (DIG) are rare intracranial tumors that predominantly affect children. They are characterized by a mixture of glial and neuronal components interspersed with abundant fibrous stroma and are typically located on the surface of the cerebral hemispheres. In this case report, we present a seven-year-old male child with a late presentation of DIG, which is typically diagnosed between zero and 60 months of age. We discuss the MRI findings, clinical symptoms, and differential diagnosis of DIG in patients with this central nervous system tumor.
Collapse
Affiliation(s)
- Diego Jordão L Dias
- Neuroradiology, Hospital de Base - Faculdade de Medicina de São José do Rio Preto (FAMERP), São José do Rio Preto, BRA
| | - Amanda Selvátici Dos S Dias
- Neurology, Hospital de Base - Faculdade de Medicina de São José do Rio Preto (FAMERP), São José do Rio Preto, BRA
| | - Marcos V Camargo
- Pediatric Radiology, Institute of Pediatric Oncology - GRAACC - Universidade Federal de São Paulo (UNIFESP), São Paulo, BRA
| | - Henrique M Lederman
- Pediatric Radiology, Institute of Pediatric Oncology - GRAACC - Universidade Federal de São Paulo (UNIFESP), São Paulo, BRA
| |
Collapse
|
|
4
|
Currie S, Fatania K, Frood R, Whitehead R, Start J, Lee MT, McDonald B, Rankeillor K, Roberts P, Chakrabarty A, Mathew RK, Murray L, Short S, Scarsbrook A. Imaging Spectrum of the Developing Glioblastoma: A Cross-Sectional Observation Study. Curr Oncol 2023; 30:6682-6698. [PMID: 37504350 PMCID: PMC10378288 DOI: 10.3390/curroncol30070490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 07/06/2023] [Accepted: 07/10/2023] [Indexed: 07/29/2023] Open
Abstract
Glioblastoma (GBM) has the typical radiological appearance (TRA) of a centrally necrotic, peripherally enhancing tumor with surrounding edema. The objective of this study was to determine whether the developing GBM displays a spectrum of imaging changes detectable on routine clinical imaging prior to TRA GBM. Patients with pre-operative imaging diagnosed with GBM (1 January 2014-31 March 2022) were identified from a neuroscience center. The imaging was reviewed by an experienced neuroradiologist. Imaging patterns preceding TRA GBM were analyzed. A total of 76 out of 555 (14%) patients had imaging preceding TRA GBM, 57 had solitary lesions, and 19 had multiple lesions (total = 84 lesions). Here, 83% of the lesions had cortical or cortical/subcortical locations. The earliest imaging features for 84 lesions were T2 hyperintensity/CT low density (n = 18), CT hyperdensity (n = 51), and T2 iso-intensity (n = 15). Lesions initially showing T2 hyperintensity/CT low density later showed T2 iso-intensity. When CT and MRI were available, all CT hyperdense lesions showed T2 iso-intensity, reduced diffusivity, and the following enhancement patterns: nodular 35%, solid 29%, none 26%, and patchy peripheral 10%. The mean time to develop TRA GBM from T2 hyperintensity was 140 days and from CT hyperdensity was 69 days. This research suggests that the developing GBM shows a spectrum of imaging features, progressing through T2 hyperintensity to CT hyperdensity, T2 iso-intensity, reduced diffusivity, and variable enhancement to TRA GBM. Red flags for non-TRA GBM lesions are cortical/subcortical CT hyperdense/T2 iso-intense/low ADC. Future research correlating this imaging spectrum with pathophysiology may provide insight into GBM growth patterns.
Collapse
Affiliation(s)
- Stuart Currie
- Department of Neuroradiology, Leeds Teaching Hospitals NHS Trust, Leeds General Infirmary, Floor B, Clarendon Wing, Great George Street, Leeds LS1 3EX, UK
- Leeds Institute of Medical Research, University of Leeds, Leeds LS2 9TJ, UK; (L.M.); (S.S.); (A.S.)
| | - Kavi Fatania
- Radiology Academy, Leeds Teaching Hospitals NHS Trust, Leeds General Infirmary, Floor B, Clarendon Wing, Great George Street, Leeds LS1 3EX, UK; (K.F.); (R.F.); (R.W.); (J.S.); (M.-T.L.)
| | - Russell Frood
- Radiology Academy, Leeds Teaching Hospitals NHS Trust, Leeds General Infirmary, Floor B, Clarendon Wing, Great George Street, Leeds LS1 3EX, UK; (K.F.); (R.F.); (R.W.); (J.S.); (M.-T.L.)
| | - Ruth Whitehead
- Radiology Academy, Leeds Teaching Hospitals NHS Trust, Leeds General Infirmary, Floor B, Clarendon Wing, Great George Street, Leeds LS1 3EX, UK; (K.F.); (R.F.); (R.W.); (J.S.); (M.-T.L.)
| | - Joanna Start
- Radiology Academy, Leeds Teaching Hospitals NHS Trust, Leeds General Infirmary, Floor B, Clarendon Wing, Great George Street, Leeds LS1 3EX, UK; (K.F.); (R.F.); (R.W.); (J.S.); (M.-T.L.)
| | - Ming-Te Lee
- Radiology Academy, Leeds Teaching Hospitals NHS Trust, Leeds General Infirmary, Floor B, Clarendon Wing, Great George Street, Leeds LS1 3EX, UK; (K.F.); (R.F.); (R.W.); (J.S.); (M.-T.L.)
| | - Benjamin McDonald
- Department of Histopathology, Leeds Teaching Hospitals NHS Trust, St James’s University Hospital, Leeds LS9 7TF, UK; (B.M.); (K.R.); (P.R.); (A.C.)
| | - Kate Rankeillor
- Department of Histopathology, Leeds Teaching Hospitals NHS Trust, St James’s University Hospital, Leeds LS9 7TF, UK; (B.M.); (K.R.); (P.R.); (A.C.)
| | - Paul Roberts
- Department of Histopathology, Leeds Teaching Hospitals NHS Trust, St James’s University Hospital, Leeds LS9 7TF, UK; (B.M.); (K.R.); (P.R.); (A.C.)
| | - Aruna Chakrabarty
- Department of Histopathology, Leeds Teaching Hospitals NHS Trust, St James’s University Hospital, Leeds LS9 7TF, UK; (B.M.); (K.R.); (P.R.); (A.C.)
| | - Ryan K. Mathew
- Department of Neurosurgery, Leeds Teaching Hospitals NHS Trust, Leeds General Infirmary, Floor G, Jubilee Wing, Great George Street, Leeds LS1 3EX, UK
- School of Medicine, University of Leeds, Leeds LS2 9JT, UK
| | - Louise Murray
- Leeds Institute of Medical Research, University of Leeds, Leeds LS2 9TJ, UK; (L.M.); (S.S.); (A.S.)
- Department of Clinical Oncology, Leeds Teaching Hospitals NHS Trust, St James’s University Hospital, Leeds LS9 7TF, UK
| | - Susan Short
- Leeds Institute of Medical Research, University of Leeds, Leeds LS2 9TJ, UK; (L.M.); (S.S.); (A.S.)
- Department of Clinical Oncology, Leeds Teaching Hospitals NHS Trust, St James’s University Hospital, Leeds LS9 7TF, UK
| | - Andrew Scarsbrook
- Leeds Institute of Medical Research, University of Leeds, Leeds LS2 9TJ, UK; (L.M.); (S.S.); (A.S.)
- Department of Radiology, Nuclear Medicine, Leeds Teaching Hospitals NHS Trust, Bexley Wing, St James’s University Hospital, Leeds LS9 7TF, UK
| |
Collapse
|
|
5
|
Photodynamic Opening of the Blood-Brain Barrier and the Meningeal Lymphatic System: The New Niche in Immunotherapy for Brain Tumors. Pharmaceutics 2022; 14:pharmaceutics14122612. [PMID: 36559105 PMCID: PMC9784636 DOI: 10.3390/pharmaceutics14122612] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 11/13/2022] [Accepted: 11/24/2022] [Indexed: 11/29/2022] Open
Abstract
Photodynamic therapy (PDT) is a promising add-on therapy to the current standard of care for patients with glioblastoma (GBM). The traditional explanation of the anti-cancer PDT effects involves the PDT-induced generation of a singlet oxygen in the GBM cells, which causes tumor cell death and microvasculature collapse. Recently, new vascular mechanisms of PDT associated with opening of the blood-brain barrier (OBBB) and the activation of functions of the meningeal lymphatic vessels have been discovered. In this review, we highlight the emerging trends and future promises of immunotherapy for brain tumors and discuss PDT-OBBB as a new niche and an important informative platform for the development of innovative pharmacological strategies for the modulation of brain tumor immunity and the improvement of immunotherapy for GBM.
Collapse
|
|
6
|
Corrêa JAP, Diniz LT, Stavale JN, Kitamura FC, Tibana LAT, Duarte ML, Freitas LF. A rare case of intraventricular gangliocytoma. ARQUIVOS DE NEURO-PSIQUIATRIA 2022; 80:101-102. [DOI: 10.1590/0004-282x-anp-2021-0261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 08/08/2021] [Indexed: 11/21/2022]
|
|
7
|
Qin G, Ma K, Yi L, Tan B, Chen Q, Chen S, Mao Y, Li Y. Negative or positive imaging: ganglioglioma in a boy with epilepsy. Br J Neurosurg 2021:1-3. [PMID: 34823414 DOI: 10.1080/02688697.2021.2005776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 09/13/2021] [Accepted: 11/09/2021] [Indexed: 10/19/2022]
Abstract
Ganglioglioma is a rare primary tumour of the central nervous system, which characteristically contain both neuronal and glial neoplastic components mainly in children and adolescents. The most common clinical presentation is refractory epilepsy. The imaging findings of ganglioglioma are obvious and varied. However, ganglioglioma with normal neuroimaging is rare. We report a 12-year-old boy presented with intractable focal epilepsy with normal CT and almost negative MRI. The epileptogenic focus was found to be located in the left posterior superior temporal gyrus by comprehensive evaluation including PET-CT imaging and stereo electroencephalography monitoring. The epileptogenic focus was resected, and the histological examination of the surgical specimen confirmed ganglioglioma. He was seizure-free at last follow-up 14 months after surgery.
Collapse
Affiliation(s)
- Guangbiao Qin
- Neurosurgery Department, Capital Institute of Pediatrics, Beijing, China
| | - Kangping Ma
- Neurosurgery Department, Capital Institute of Pediatrics, Beijing, China
| | - Linhua Yi
- Neurosurgery Department, Capital Institute of Pediatrics, Beijing, China
| | - Bojing Tan
- Neurosurgery Department, Capital Institute of Pediatrics, Beijing, China
| | - Qian Chen
- Neurology Department, Capital Institute of Pediatrics, Beijing, China
| | - Shuhua Chen
- Neurology Department, Capital Institute of Pediatrics, Beijing, China
| | - Yingying Mao
- Neurology Department, Capital Institute of Pediatrics, Beijing, China
| | - Yunlin Li
- Neurosurgery Department, Capital Institute of Pediatrics, Beijing, China
| |
Collapse
|
|
8
|
Early stage glioblastoma: retrospective multicentric analysis of clinical and radiological features. Radiol Med 2021; 126:1468-1476. [PMID: 34338949 DOI: 10.1007/s11547-021-01401-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 07/12/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES The aim of this study was to report our experience with early stage glioblastoma (e-GB) and to investigate the possible clinical and imaging features that may be helpful to the radiologist to correctly diagnose this entity. METHODS We performed a retrospective research of patients diagnosed with glioblastoma at two hospitals during a 10-year period. We reviewed all pre-operative MR and included only patients with early stage GB lesions, characterized by hyperintense on T2-weighted signal, with or without contrast-enhancement at post-contrast T1-weighted images, without "classic" imaging appearance of GB (necrosis, haemorrhage, oedema). All preoperative MR were evaluated by an experienced neuroradiologist and information on patients' demographics, clinical presentation, follow-up, and histopathology results study were collected. When available, preoperative CT examination was also evaluated. RESULTS We found 14 e-GBs in 13 patients (9 males, 4 females, median age 63 years) among 660 patients diagnosed with GB between 2010 and 2020. In 10 lesions, serial imaging revealed the transformation of e-GB in classic glioblastoma in a median time of 3 months. Clinical presentation included stroke-like symptoms, vertigo, seizures and confusion. Preoperative plain CT was performed in 8/13 cases and in 7 e-GBs presented as a hyperdense lesion. Ten out of 14 lesions transformed in classic GB before surgical intervention or biopsy. All lesions revealed typical immunohistochemical pattern of primary glioblastoma. CONCLUSIONS E-GB is a rare entity that can often lead to misdiagnosis. However, the radiologist should be aware of its imaging appearance to suggest the diagnosis and to request close imaging follow-up, hopefully improving the prognosis of this very aggressive disease.
Collapse
|
|
9
|
Ahn SS, Cha S. Pre- and Post-Treatment Imaging of Primary Central Nervous System Tumors in the Molecular and Genetic Era. Korean J Radiol 2021; 22:1858-1874. [PMID: 34402244 PMCID: PMC8546137 DOI: 10.3348/kjr.2020.1450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 04/08/2021] [Accepted: 04/09/2021] [Indexed: 11/15/2022] Open
Abstract
Recent advances in the molecular and genetic characterization of central nervous system (CNS) tumors have ushered in a new era of tumor classification, diagnosis, and prognostic assessment. In this emerging and rapidly evolving molecular genetic era, imaging plays a critical role in the preoperative diagnosis and surgical planning, molecular marker prediction, targeted treatment planning, and post-therapy assessment of CNS tumors. This review provides an overview of the current imaging methods relevant to the molecular genetic classification of CNS tumors. Specifically, we focused on 1) the correlates between imaging features and specific molecular genetic markers and 2) the post-therapy imaging used for therapeutic assessment.
Collapse
Affiliation(s)
- Sung Soo Ahn
- Department of Radiology, Severance Hospital, Research Institute of Radiological Science and Center for Clinical Image Data Science, Yonsei University College of Medicine, Seoul, Korea.,Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Soonmee Cha
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA.
| |
Collapse
|
|
10
|
Pérez-Serrano C, Bartolomé Á, Bargalló N, Sebastià C, Nadal A, Gómez O, Oleaga L. Perinatal post-mortem magnetic resonance imaging (MRI) of the central nervous system (CNS): a pictorial review. Insights Imaging 2021; 12:104. [PMID: 34292413 PMCID: PMC8298710 DOI: 10.1186/s13244-021-01051-0] [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: 02/04/2021] [Accepted: 06/30/2021] [Indexed: 11/28/2022] Open
Abstract
Central nervous system (CNS) abnormalities cause approximately 32–37.7% of terminations of pregnancy (TOP). Autopsy is currently the gold standard for assessing dead foetuses and stillborn. However, it has limitations and is sometimes subject to parental rejection. Recent studies have described post-mortem foetal magnetic resonance imaging (MRI) as an alternative and even complementary to autopsy for CNS assessment. Radiologists now play a key role in the evaluation of perinatal deaths. Assessment of foetal CNS abnormalities is difficult, and interpretation of foetal studies requires familiarisation with normal and abnormal findings in post-mortem MRI studies as well as the strengths and limitations of the imaging studies. The purpose of this pictorial review is to report our experience in the post-mortem MRI evaluation of the CNS system, including a description of the protocol used, normal CNS findings related to post-mortem status, abnormal CNS findings in our sample, and the correlation of these findings with histopathological results.
Collapse
Affiliation(s)
- Carlos Pérez-Serrano
- Radiology Department, CDIC, Hospital Clínic de Barcelona, C/Villarroel no. 170, 08036, Barcelona, Spain.
| | - Álvaro Bartolomé
- Radiology Department, CDIC, Hospital Clínic de Barcelona, C/Villarroel no. 170, 08036, Barcelona, Spain
| | - Núria Bargalló
- Radiology Department, CDIC, Hospital Clínic de Barcelona, C/Villarroel no. 170, 08036, Barcelona, Spain
| | - Carmen Sebastià
- Radiology Department, CDIC, Hospital Clínic de Barcelona, C/Villarroel no. 170, 08036, Barcelona, Spain
| | - Alfons Nadal
- Pathology Department, CDB, Hospital Clínic de Barcelona, C/Villarroel no. 170, 08036, Barcelona, Spain
| | - Olga Gómez
- Gynecology Department, ICGON, Hospital Clínic de Barcelona, C/Villarroel no. 170, 08036, Barcelona, Spain
| | - Laura Oleaga
- Radiology Department, CDIC, Hospital Clínic de Barcelona, C/Villarroel no. 170, 08036, Barcelona, Spain.,University of Barcelona, Barcelona, Spain
| |
Collapse
|
|
11
|
Abstract
Primary pediatric brain tumors comprise a broad group of neoplasm subtypes that can be categorized based on their histological and molecular features according to the 2016 World Health Organization (WHO) classification of central nervous system (CNS) tumors. The majority of the pediatric brain tumors demonstrate a singular preference for this age group and have a unique molecular profile. The separation of certain tumor entities, including different types of embryonal tumors, low-grade gliomas, and high-grade gliomas, may have a significant impact by guiding appropriate treatment for these children and potentially changing their outcomes. Currently, the focus of the imaging diagnostic studies is to follow the molecular updates, searching for potential imaging patterns that translate this information in molecular profile results, therefore helping the final diagnosis. Due to the high impact of accurate diagnosis in this context, the scientific community has presented extensive research on imaging pediatric tumors in recent years. This article summarizes the key characteristics of the imaging features of the most common primary childhood brain tumors, categorizing them according to the recent WHO classification update, which is based on each of their molecular profiles. The purpose of this review article is to familiarize radiologists with their key imaging features and thereby improve diagnostic accuracy.
Collapse
|
|
12
|
Bag AK, Chiang J, Patay Z. Radiohistogenomics of pediatric low-grade neuroepithelial tumors. Neuroradiology 2021; 63:1185-1213. [PMID: 33779771 PMCID: PMC8295117 DOI: 10.1007/s00234-021-02691-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 03/10/2021] [Indexed: 12/14/2022]
Abstract
PURPOSE In addition to histology, genetic alteration is now required to classify many central nervous system (CNS) tumors according to the most recent World Health Organization CNS tumor classification scheme. Although that is still not the case for classifying pediatric low-grade neuroepithelial tumors (PLGNTs), genetic and molecular features are increasingly being used for making treatment decisions. This approach has become a standard clinical practice in many specialized pediatric cancer centers and will likely be more widely practiced in the near future. This paradigm shift in the management of PLGNTs necessitates better understanding of how genetic alterations influence histology and imaging characteristics of individual PLGNT phenotypes. METHODS The complex association of genetic alterations with histology, clinical, and imaging of each phenotype of the extremely heterogeneous PLGNT family has been addressed in a holistic approach in this up-to-date review article. A new imaging stratification scheme has been proposed based on tumor morphology, location, histology, and genetics. Imaging characteristics of each PLGNT entity are also depicted in light of histology and genetics. CONCLUSION This article reviews the association of specific genetic alteration with location, histology, imaging, and prognosis of a specific tumor of the PLGNT family and how that information can be used for better imaging of these tumors.
Collapse
Affiliation(s)
- Asim K Bag
- Department of Diagnostic Imaging, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Mail Stop 220, Memphis, TN, 38105, USA.
| | - Jason Chiang
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Zoltan Patay
- Department of Diagnostic Imaging, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Mail Stop 220, Memphis, TN, 38105, USA
| |
Collapse
|
|
13
|
Diagnosis and Therapeutic Management of Ventricular Gangliogliomas: An Illustrated Review. World Neurosurg 2021; 149:e651-e663. [PMID: 33548530 DOI: 10.1016/j.wneu.2021.01.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 01/22/2021] [Accepted: 01/23/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Gangliogliomas (GGs) are extremely rare benign neoplasms frequently located within the temporal lobe that usually present with seizures. GGs growing predominantly within the ventricular system (VGGs) are even more infrequent, so definite conclusions concerning their diagnosis and therapeutic management are lacking. METHODS A retrospective review of case reports of VGGs was performed from the introduction of modern imaging techniques, including 4 new illustrative cases treated in our department. RESULTS Thirty-four cases were collected. Ages ranged from 10 to 71 years (mean, 26.62 years), and 55.9% were male. Most patients developed symptoms related to high intracranial pressure. The lateral ventricles were predominantly involved (58.8%). Obstructive hydrocephalus was observed in 54.5% of patients. Cystic degeneration and calcification were frequently observed. Surgical treatment was carried out in all cases. Morbidity and mortality were 17.6% and 2.9%, respectively. Gross total tumor resection was achieved in 64.5% of patients. Four patients experienced tumor dissemination along the neural axis. More than 90% of patients maintained a good functional status at last follow-up. CONCLUSIONS Despite their low incidence, a diagnosis of VGGs should be considered in young male adults who progressively develop intracranial hypertension, caused by a ventricular mass showing signs of cystic degeneration and calcification. Maximal and safe surgical resection represents the gold standard for the treatment of symptomatic VGGs, although total removal is frequently precluded by difficulties in defining appropriate tumor boundaries. Adjuvant radiotherapy should be considered if an incomplete resection was carried out, especially in World Health Organization grade III neoplasms.
Collapse
|
|
14
|
Tuan TA, Duc NM. Giant Cerebellar Ganglioglioma Mimicking a Pilocytic Astrocytoma. J Clin Imaging Sci 2021; 11:3. [PMID: 33500838 PMCID: PMC7827300 DOI: 10.25259/jcis_212_2020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 12/08/2020] [Indexed: 11/04/2022] Open
Abstract
A benign brain tumor, called a ganglioglioma (GG), can sometimes be found in the cerebrum. We describe an unusual pediatric case of GG in the cerebellum in this article. An 11-year-old male patient had a headache and epilepsy disorder. The head magnetic resonance imaging results revealed a giant cyst with an enhancing mural nodule in the right cerebellar hemisphere that flattened the fourth ventricle. Pilocytic astrocytoma was the provisional diagnosis based on clinical and imaging details. After radical mass eradication, a GG was demonstrated through histopathological analysis. Even though GG is an uncommon tumor, it should be included in the differential diagnosis for a cerebellar mass with both cystic and solid components in children.
Collapse
Affiliation(s)
- Tran Anh Tuan
- Departments of Radiology, Bach Mai Hospital, Ha Noi, Vietnam.,Hanoi Medical University, Ha Noi, Vietnam
| | - Nguyen Minh Duc
- Hanoi Medical University, Ha Noi, Vietnam.,Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam.,Children's Hospital 02, Ho Chi Minh City, Vietnam
| |
Collapse
|
|
15
|
Mathkour M, Banerjee S, Werner C, Hanna J, Abou-Al-Shaar H, Dindial R, Scullen T, Boehm L, Tubbs RS, Ware ML. Cerebellar pleomorphic xanthoastrocytoma in the setting of neurofibromatosis type-I: Does it portend a different prognosis? A case report and systematic review. Clin Neurol Neurosurg 2020; 200:106346. [PMID: 33160715 DOI: 10.1016/j.clineuro.2020.106346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 10/19/2020] [Accepted: 10/27/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Pleomorphic xanthoastrocytoma (PXA) is a rare brain tumor occurring supra- and infra-tentorially in both young adults and children. PXA is a benign tumor with a favorable prognosis. It is not traditionally considered as a neurofibromatosis type 1 (NF-1)-associated lesion, and its prognosis remains largely unknown, on the contrary to non-NF-1 PXA tumors. OBJECTIVE Herein, we present a rare case of cerebellar PXA in a patient with NF-1 and performed systematic review of NF-1-associated PXA. METHOD We present a case of NF-1-associated PXA arising in the cerebellar region. We also reviewed the literature in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines to identify published cases of cerebellar vs. non-cerebellar NF-1-associated PXA and NF1 vs. non-NF1 PXAs, highlighting their management paradigm, prognosis, and outcomes. RESULT Our systematic review yielded only four previously reported cases of NF-1-associated PXAs in the cerebellar region. Our review suggests that infratentorial PXAs have a higher recurrence and lower survival rates than non-cerebellar NF-1-associated PXAs and non-NF1 PXAs in general. CONCLUSION Early and precise diagnosis is important for these lesions with the aid of imaging features, histology, immunohistochemistry, and genetic markers. Surgical resection with goal of GTR remains the mainstay management strategy for PXA, with adjuvant therapy usually reserved for anaplastic or malignant lesions. The identification of BRAF-V600E mutation and role of BRAF inhibitors hold promise as a diagnostic tool and treatment modality, respectively, for PXAs, and their relationship to NF-1 is worth further exploration.
Collapse
Affiliation(s)
- Mansour Mathkour
- Ochsner Health System, Department of Neurosurgery, Ochsner Neuroscience Institute, Ochsner Clinic Foundation, New Orleans, LA, USA; Neurosurgery Division, Surgery Department, Jazan University, Jazan, Saudi Arabia.
| | - Somdeb Banerjee
- Tulane Medical Center, Department of Neurosurgery, New Orleans, LA, USA
| | - Cassidy Werner
- Tulane Medical Center, Department of Neurosurgery, New Orleans, LA, USA
| | - Joshua Hanna
- Ochsner Health System, Department of Neurosurgery, Ochsner Neuroscience Institute, Ochsner Clinic Foundation, New Orleans, LA, USA; Tulane Medical Center, Department of Neurosurgery, New Orleans, LA, USA
| | - Hussam Abou-Al-Shaar
- University of Pittsburgh Medical Center, Neurosurgery Department, Pittsburgh, PA, USA
| | - Rishawn Dindial
- Ochsner Health System, Department of Neurosurgery, Ochsner Neuroscience Institute, Ochsner Clinic Foundation, New Orleans, LA, USA
| | - Tyler Scullen
- Ochsner Health System, Department of Neurosurgery, Ochsner Neuroscience Institute, Ochsner Clinic Foundation, New Orleans, LA, USA; Tulane Medical Center, Department of Neurosurgery, New Orleans, LA, USA
| | - Lauren Boehm
- Tulane Medical Center, Department of Neurosurgery, New Orleans, LA, USA
| | - R Shane Tubbs
- Tulane Medical Center, Department of Neurosurgery, New Orleans, LA, USA
| | - Marcus L Ware
- Ochsner Health System, Department of Neurosurgery, Ochsner Neuroscience Institute, Ochsner Clinic Foundation, New Orleans, LA, USA
| |
Collapse
|
|
16
|
Pleomorphic Xanthoastrocytoma of the Pineal Region in a Pediatric Patient With Neurofibromatosis Type 1. Ochsner J 2020; 20:226-231. [PMID: 32612482 PMCID: PMC7310189 DOI: 10.31486/toj.18.0156] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background: Pleomorphic xanthoastrocytoma (PXA) is a rare and often focal glioma that most commonly affects children and young adults. Lesions are preferentially supratentorial and superficial, although infratentorial masses have been described, along with occasional involvement of the leptomeninges. The World Health Organization (WHO) categorizes these tumors as grade II, with surgical resection carrying a favorable prognosis. However, these tumors may undergo malignant degeneration and must be identified for appropriate treatment and prognosis. PXA has been associated with neurofibromatosis type 1 (NF1), although it is not the classic phenotype of NF1. We present a novel report of PXA, atypically located in the pineal region of a patient with a history of NF1. Case Report: A 17-year-old male with a history of NF1 presented with 1 month of bifrontal headaches. Magnetic resonance imaging was significant for a heterogeneous tectal mass, suspicious for a glioma extending to the fourth ventricle and causing displacement of the cerebral aqueduct without obstructive hydrocephalus. Following an infratentorial-supracerebellar approach for tumor resection, histopathology confirmed a low-grade variable neoplasm consistent with PXA. Postoperative imaging confirmed gross total resection with no evidence of recurrence at 9 months postoperatively. Conclusion: To our knowledge, this case is the fifth report of pineal PXA and the first associated with NF1. Because PXA presents similarly to other NF1-related intracranial tumors, careful diagnosis via immunohistochemistry is imperative. Gross tumor resection is usually curative; however, PXA has the propensity to undergo malignant degeneration and may require adjuvant treatment.
Collapse
|
|
17
|
Abstract
Significant advances in the field of neonatal imaging has resulted in the generation of large complex data sets of relevant information for routine daily clinical practice, and basic and translational research. The evaluation of this data is a complex task for the neonatal imager who must distinguish normal and incidental findings from clinically significant abnormalities which are often adjunctive data points applicable to clinical evaluation and treatment. This review provides an overview of the imaging manifestations of disease processes commonly encountered in the neonatal brain. Since MRI is currently the highest yield technique for the diagnosis and characterization of the normal and abnormal brain, it is therefore the focus of the majority of this review. When applicable, discussion of some of the pertinent known pathophysiology and neuropathological aspects of disease processes are reviewed.
Collapse
|
|
18
|
Mansour S, Luther E, Eichberg DG, Shah A, Echeverry N, Humayun Gultekin S, Ivan M, Komotar R. Multifocal Intracranial Ganglioglioma in a Sexagenarian: Case Report and Review of the Current Literature. World Neurosurg 2019; 138:498-503. [PMID: 31877395 DOI: 10.1016/j.wneu.2019.12.084] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 12/12/2019] [Accepted: 12/13/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND Gangliogliomas are rare, well-differentiated, low-grade neoplasms that most often occur unifocally in children and most commonly affect the temporal lobe. Gangliogliomas that occur in patients age >40 years tend to have worse prognoses. These tumors generally stain positively for neural and glial cell markers, as well as CD34. Here we report an unprecedented case of multifocal intracranial ganglioglioma in an adult age >40 who had a favorable course, and review the current literature on multifocal intracranial gangliogliomas. CASE DESCRIPTION A 60-year-old female presented to her ophthalmologist with blurry vision in the right eye and an unremarkable neurologic exam. She was referred for brain imaging, which showed multiple lesions in both cerebral hemispheres. Biopsy of the right occipital lesion was elected, as it enhanced the most on magnetic resonance imaging. CONCLUSIONS Multifocal intracranial gangliogliomas are exceedingly rare tumors, especially in adults. These tumors present unique management barriers because as they are multifocal at the time of diagnosis, making resection more technically challenging. In our review, the average age at diagnosis was 19.2 years, and 80% of the cases had at least 1 lesion in the temporal lobe. Two studies opted for resection of intracranial tumors, whereas the remaining studies performed biopsy with conservative management and serial imaging. Biopsy was performed in all cases. We present the first case of an intracranial multifocal ganglioglioma in a patient age >40 years with lesions in the occipital lobe, corpus callosum, and frontal lobe at presentation.
Collapse
Affiliation(s)
- Samuel Mansour
- Florida Atlantic University Charles E. Schmidt College of Medicine, Boca Raton, USA.
| | - Evan Luther
- Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, USA
| | - Daniel G Eichberg
- Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, USA
| | - Ashish Shah
- Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, USA
| | - Nikolas Echeverry
- Florida Atlantic University Charles E. Schmidt College of Medicine, Boca Raton, USA
| | - Sakir Humayun Gultekin
- Department of Pathology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Michael Ivan
- Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, USA
| | - Ricardo Komotar
- Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, USA
| |
Collapse
|
|
19
|
She DJ, Lu YP, Xiong J, Cao DR, Geng DY, Yin B. Comparison of conventional, diffusion, and perfusion MRI between infratentorial ganglioglioma and pilocytic astrocytoma. Acta Radiol 2019; 60:1687-1694. [PMID: 31032625 DOI: 10.1177/0284185119845088] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- De-jun She
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, PR China
| | - Yi-ping Lu
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, PR China
| | - Ji Xiong
- Institute of Functional and Molecular Medical Imaging, Fudan University, Shanghai, PR China
| | - Dai-rong Cao
- Department of Pathology, Huashan Hospital, Fudan University, Shanghai, PR China
| | - Dao-ying Geng
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, PR China
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, PR China
| | - Bo Yin
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, PR China
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, PR China
| |
Collapse
|
|
20
|
Freiburg Neuropathology Case Conference : Hypersalivatory Seizures in a 6-year-old Child. Clin Neuroradiol 2019; 29:581-586. [PMID: 31388687 DOI: 10.1007/s00062-019-00820-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
|
|
21
|
Khandpur U, Huntoon K, Smith-Cohn M, Shaw A, Elder JB. Bilateral Recurrent Dysplastic Cerebellar Gangliocytoma (Lhermitte-Duclos Disease) in Cowden Syndrome: A Case Report and Literature Review. World Neurosurg 2019; 127:319-325. [DOI: 10.1016/j.wneu.2019.03.131] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 03/12/2019] [Accepted: 03/13/2019] [Indexed: 10/27/2022]
|
|
22
|
Chatrath A, Mastorakos P, Mehta GU, Wildeman M, Moosa S, Jane JA. Ganglioglioma Arising from the Septum Pellucidum: Case Report and Review of the Literature. Pediatr Neurosurg 2019; 54:36-45. [PMID: 30620941 DOI: 10.1159/000495043] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 10/27/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND Gangliogliomas are low-grade neoplasms that typically affect patients under the age of 30 and present with epilepsy and symptoms of mass effect. Here, we report a case of an intraventricular ganglioglioma involving the septum pellucidum in a pediatric patient with history of optic glioma. Only one other pediatric intraventricular ganglioglioma arising from the septum pellucidum has been reported previously. CASE REPORT The patient initially presented at 9 months of age with a pilocytic astrocytoma centered on the optic chiasm, treated with chemotherapy and radiation at 3 years of age. Routine follow-up imaging at 13 years of age revealed the development of a mass in the septum pellucidum, which was subtotally resected endoscopically because of its proximity to the fornices. Pathology confirmed a ganglioglioma positive for the BRAF V600E mutation. The tumor residual progressed and was treated with stereotactic radiosurgery. The patient was asymptomatic at her 6-month follow-up visit and the size of the nodule remained stable. LITERATURE REVIEW Our review of the 25 previously reported intraventricular gangliogliomas found that their pre-surgical diagnoses were often incorrect, reflecting the difficulty of making the diagnosis with signs, symptoms, and imaging alone. Patients can be reassured that the prognosis is generally favorable following uncomplicated neurosurgical resection.
Collapse
Affiliation(s)
- Ajay Chatrath
- Department of Neurological Surgery, University of Virginia Health Science Center, University of Virginia, Charlottesville, Virginia, USA
| | - Panagiotis Mastorakos
- Department of Neurological Surgery, University of Virginia Health Science Center, University of Virginia, Charlottesville, Virginia, USA.,Department of Neurological Surgery, NIH/NINDS, Bethesda, Maryland, USA
| | - Gautam U Mehta
- Department of Neurological Surgery, University of Virginia Health Science Center, University of Virginia, Charlottesville, Virginia, USA.,Department of Neurological Surgery, NIH/NINDS, Bethesda, Maryland, USA.,Department of Neurosurgery, University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA
| | - Miriam Wildeman
- Department of Pathology, University of Virginia Health Science Center, University of Virginia, Charlottesville, Virginia, USA
| | - Shayan Moosa
- Department of Neurological Surgery, University of Virginia Health Science Center, University of Virginia, Charlottesville, Virginia, USA
| | - John A Jane
- Department of Neurological Surgery, University of Virginia Health Science Center, University of Virginia, Charlottesville, Virginia, USA,
| |
Collapse
|
|
23
|
Freiburg Neuropathology Case Conference. Clin Neuroradiol 2018; 28:461-466. [DOI: 10.1007/s00062-018-0712-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
|
24
|
Mata-Mbemba D, Donnellan J, Krishnan P, Shroff M, Muthusami P. Imaging Features of Common Pediatric Intracranial Tumours: A Primer for the Radiology Trainee. Can Assoc Radiol J 2018; 69:105-117. [DOI: 10.1016/j.carj.2017.10.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 10/24/2017] [Accepted: 10/26/2017] [Indexed: 11/30/2022] Open
Affiliation(s)
- Daddy Mata-Mbemba
- Division of Neuroradiology, Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - John Donnellan
- Division of Image Guided Therapy, Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Pradeep Krishnan
- Division of Neuroradiology, Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Manohar Shroff
- Division of Neuroradiology, Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Prakash Muthusami
- Division of Neuroradiology, Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada
| |
Collapse
|
|
25
|
Shrot S, Hwang M, Stafstrom CE, Huisman TAGM, Soares BP. Dysplasia and overgrowth: magnetic resonance imaging of pediatric brain abnormalities secondary to alterations in the mechanistic target of rapamycin pathway. Neuroradiology 2017; 60:137-150. [PMID: 29279945 DOI: 10.1007/s00234-017-1961-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 12/07/2017] [Indexed: 12/22/2022]
Abstract
The current classification of malformations of cortical development is based on the type of disrupted embryological process (cell proliferation, migration, or cortical organization/post-migrational development) and the resulting morphological anomalous pattern of findings. An ideal classification would include knowledge of biological pathways. It has recently been demonstrated that alterations affecting the mechanistic target of rapamycin (mTOR) signaling pathway result in diverse abnormalities such as dysplastic megalencephaly, hemimegalencephaly, ganglioglioma, dysplastic cerebellar gangliocytoma, focal cortical dysplasia type IIb, and brain lesions associated with tuberous sclerosis. We review the neuroimaging findings in brain abnormalities related to alterations in the mTOR pathway, following the emerging trend from morphology towards genetics in the classification of malformations of cortical development. This approach improves the understanding of anomalous brain development and allows precise diagnosis and potentially targeted therapies that may regulate mTOR pathway function.
Collapse
Affiliation(s)
- Shai Shrot
- Division of Pediatric Radiology and Pediatric Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 1800 Orleans Street, Zayed 4174, Baltimore, MD, 21287, USA
- Department of Diagnostic Imaging, Sheba Medical Center, 52621, Ramat-Gan, Israel
| | - Misun Hwang
- Division of Pediatric Radiology and Pediatric Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 1800 Orleans Street, Zayed 4174, Baltimore, MD, 21287, USA
| | - Carl E Stafstrom
- Division of Pediatric Neurology, Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Thierry A G M Huisman
- Division of Pediatric Radiology and Pediatric Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 1800 Orleans Street, Zayed 4174, Baltimore, MD, 21287, USA
| | - Bruno P Soares
- Division of Pediatric Radiology and Pediatric Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 1800 Orleans Street, Zayed 4174, Baltimore, MD, 21287, USA.
| |
Collapse
|
|
26
|
Brain Granuloma: Rare Complication of a Retained Catheter. World Neurosurg 2017; 110:210-216. [PMID: 29175575 DOI: 10.1016/j.wneu.2017.11.066] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 11/09/2017] [Accepted: 11/11/2017] [Indexed: 11/21/2022]
Abstract
BACKGROUND Ventriculoperitoneal (VP) shunt is the most frequent treatment for hydrocephalus. VP shunt malfunction is a very common problem in neurosurgical practice, often requiring shunt revision procedures. In some cases, complete removal of a VP shunt may present difficulties, leading the surgeon to leave the ventricular catheter in situ. This decision is often made to avoid possible adverse events, primarily risk of life-threatening hemorrhage. However, a nonfunctioning catheter left in the ventricular system may lead to further complications. CASE DESCRIPTION We report the case of an adult man who presented with a tumor-like cystic lesion, with mural and nodular postcontrast enhancement, caused by a huge granuloma formed around the tip of a retained ventricular catheter. CONCLUSIONS This occurrence is extremely rare, and this is the first reported case in the literature. Preoperative differential diagnosis was challenging and included infection, metastasis, dysembryogenetic lesions, and rare reversible porencephalic cysts. According to several physiopathogenetic theories recently reported in the literature, the granuloma may develop as the result of persistent chronic inflammatory reactions between the ventricular catheter left in situ and the brain parenchyma. Application of neuroendoscopic techniques is improving management of VP shunt revisions, allowing safe removal of catheters stuck or lost in the ventricular system. Neuroendoscopy may represent an additional option to avoid possible complications related to retained ventricular catheters.
Collapse
|
|
27
|
|
|
28
|
Abstract
Brain tumors can develop in the prenatal and neonatal time periods. Neuroimaging studies are crucial for the early detection of prenatal and neonatal brain tumors. Imaging allows for characterization of morphology, as well as the detection of hydrocephalus, local invasion, and distant spread. The imaging features of the more common neonatal brain tumors, including teratomas, choroid plexus tumors, ATRTs, and neoplasm mimics are described.
Collapse
|
|
29
|
Gaba P, Puffer RC, Hoover JM, Wharen RE, Parney IF. Perioperative Outcomes in Intracranial Pleomorphic Xanthoastrocytoma. Neurosurgery 2017; 12:339. [DOI: 10.1227/neu.0000000000001250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
|
|
30
|
|
|
31
|
Papanagiotou P, Politi M. [Tumors of the posterior cranial fossa]. Radiologe 2016; 56:967-975. [PMID: 27757491 DOI: 10.1007/s00117-016-0177-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Various types of brain tumor can occur in the region of the posterior fossa. Brain metastases in adults are the most common malignancies at this localization. Ependymomas, medulloblastomas and pilocytic astrocytomas occur mostly in children and only rarely in adults. Other tumors that occur in the posterior fossa are meningiomas, schwannomas, hemangioblastomas, brain stem gliomas and epidermoid tumors. Due to the fact that the various tumors of the posterior fossa have different treatment approaches and prognoses, an accurate and specific diagnosis is mandatory. This review discusses the imaging aspects by computed tomography (CT) and magnetic resonance imaging (MRI) of the most frequent tumors of the posterior fossa.
Collapse
Affiliation(s)
- P Papanagiotou
- Klinik für Diagnostische und Interventionelle Neuroradiologie, Klinikum Bremen-Mitte/Bremen-Ost, Bremen, Deutschland.
| | - M Politi
- Klinik für Diagnostische und Interventionelle Neuroradiologie, Klinikum Bremen-Mitte/Bremen-Ost, Bremen, Deutschland
| |
Collapse
|
|
32
|
Raybaud C. Cerebral hemispheric low-grade glial tumors in children: preoperative anatomic assessment with MRI and DTI. Childs Nerv Syst 2016; 32:1799-811. [PMID: 27659823 DOI: 10.1007/s00381-016-3188-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Accepted: 07/07/2016] [Indexed: 12/01/2022]
Abstract
PURPOSE The aims of this study are to analyze how the nature and the behavior of low-grade glial tumors (LGGT) in children may correlate with the anatomy of the cerebral hemispheres and to evaluate the consequent impact of diffusion tensor imaging (DTI) techniques in the presurgical assessment. METHODS This is a combined review of a series of 155 cases of LGGT and of the recent literature on the subject. RESULTS The cases retrieved from our data bank were divided in central hemispheric tumors (basal ganglia and thalami) (36 cases), glioneuronal cortical-based tumors (49 cases), and glial tumors of the cerebral mantle (70 cases). A close correlation was found in the thalamus between the primary location of the tumor (juxta-ventricular, inferior, lateral, bilateral) and its extension (ventricular lumen, midbrain and mesial temporal, globus pallidus, respectively) which may relate to the connectivity. Among the glioneuronal tumors, most gangliogliomas were located in the temporal lobe and especially in the mesial temporal structures. In addition, the morphologic feature of the ganglioglioma was different there from the neocortical areas. As a complementary approach, DTI data may assist in evaluating the structure and the extension of the LGGT, in addition to planning the surgical strategy. CONCLUSIONS In the cerebral hemispheres like in the rest of the central nervous system, there is some degree of correlation between the anatomy and the nature, appearance, and behavior of the LGGT in children.
Collapse
Affiliation(s)
- Charles Raybaud
- Division of Neuroradiology, Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, M5G1X8, Canada.
| |
Collapse
|
|
33
|
Intraventricular Gangliogliomas: A Review. World Neurosurg 2016; 87:39-44. [DOI: 10.1016/j.wneu.2015.11.044] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Revised: 11/11/2015] [Accepted: 11/14/2015] [Indexed: 11/19/2022]
|
|
34
|
Abstract
OBJECTIVE The purpose of this article is to describe an MRI protocol optimized for epilepsy evaluation, common causes of epilepsy visualized on MR images of patients evaluated for medically intractable partial epilepsy, and the basic concepts of advanced imaging techniques in the evaluation of epilepsy. CONCLUSION Epilepsy is one of the most common neurologic disorders in the United States. The long-term seizure-free success of epilepsy surgery is related to the ability to define and completely resect the epileptogenic zone. Detection of structural lesions at preoperative imaging requires not only a dedicated epilepsy protocol but also meticulous examination of the images by the interpreting radiologist with particular attention to subtle abnormalities that might otherwise go unreported.
Collapse
|
|
35
|
Song JY, Kim JH, Cho YH, Kim CJ, Lee EJ. Treatment and outcomes for gangliogliomas: a single-center review of 16 patients. Brain Tumor Res Treat 2014; 2:49-55. [PMID: 25408925 PMCID: PMC4231627 DOI: 10.14791/btrt.2014.2.2.49] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Revised: 07/04/2014] [Accepted: 07/14/2014] [Indexed: 11/29/2022] Open
Abstract
Background Ganglioglioma is a rare and slowly growing benign tumor. We investigated the outcomes of patients who underwent different combination treatments. Methods Between 1998 and 2012, 16 patients, including 11 men and 5 women, with a median age of 12.5 years (range, 2.5-65 years) were treated for intracranial gangliogliomas at our institution. The median follow-up period was 5.7 years (range, 48 days-15.6 years). Fifteen cases were included in the outcome assessment because one patient was lost to follow-up. Complete resection was achieved in 8 (53%) patients. Six (40%) patients underwent incomplete resection with or without adjuvant radiotherapy, and one patient with a brainstem tumor underwent only stereotactic biopsy. Results Gangliogliomas predominantly affected young (87.5%), male patients and most frequently presented with seizures (64%). Of eight patients who underwent complete resection, seven did not show recurrence, whereas only three of six with incomplete resection showed no recurrence. Four patients with recurrence received salvage treatments (two repeat surgeries and two radiosurgeries). A tumor control rate of 93% (14/15) was achieved at the last follow-up. No recurrence or malignant changes were observed after a median follow-up of 12 and 4.5 years in four patients who received gamma knife (GK) radiosurgery as adjuvant and salvage treatment. Conclusion Complete resection produced the best outcomes and incomplete resection followed by adjuvant or salvage treatments showed favorable outcomes. In patients who are not eligible for complete resection because of tumor location or potential neurologic deficits following surgery, GK radiosurgery should be considered for the treatment of residual or recurrent tumors.
Collapse
Affiliation(s)
- Jye Young Song
- Department of Neurosurgery, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea
| | - Jeong Hoon Kim
- Department of Neurosurgery, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea
| | - Young Hyun Cho
- Department of Neurosurgery, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea
| | - Chang Jin Kim
- Department of Neurosurgery, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea
| | - Eun Jung Lee
- Department of Neurosurgery, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea
| |
Collapse
|
|
36
|
|
|
37
|
Saad AF, Layton KF, Finn SS, Opatowsky MJ. Ganglioglioma and migraine headache. Proc (Bayl Univ Med Cent) 2014; 27:215-6. [PMID: 24982564 DOI: 10.1080/08998280.2014.11929113] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Mixed neuronal/glial neoplasms represent a minority of intracranial neoplasms, typically associated with a more favorable prognosis than the more common higher-grade glial neoplasms. We describe a young man with headache, confusion, and slurred speech who was found to have a ganglioglioma.
Collapse
Affiliation(s)
- Amin F Saad
- Departments of Diagnostic Radiology (Saad, Layton, Opatowsky) and Neurosurgery (Finn), Baylor University Medical Center at Dallas
| | - Kennith F Layton
- Departments of Diagnostic Radiology (Saad, Layton, Opatowsky) and Neurosurgery (Finn), Baylor University Medical Center at Dallas
| | - S Sam Finn
- Departments of Diagnostic Radiology (Saad, Layton, Opatowsky) and Neurosurgery (Finn), Baylor University Medical Center at Dallas
| | - Michael J Opatowsky
- Departments of Diagnostic Radiology (Saad, Layton, Opatowsky) and Neurosurgery (Finn), Baylor University Medical Center at Dallas
| |
Collapse
|
|
38
|
Hostnik ET, Kube SA, Jortner B, Hager D, Garman RH. Pleomorphic xanthoastrocytoma within the medulla oblongata of a young dog. Vet Pathol 2014; 52:176-80. [PMID: 24686391 DOI: 10.1177/0300985814522818] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A 13-week-old male intact Poodle mix dog developed an acute onset of vestibular ataxia, tetraparesis, and vomiting. The patient presented ambulatory, tetraparetic, and ataxic with a head tilt to the left and a disconjugate nystagmus (rotary nystagmus with fast phase to the right in right eye and vertical nystagmus in left eye). There were absent postural reactions in the left pelvic and left thoracic limbs and decreased right-sided postural reactions. Magnetic resonance imaging demonstrated an intra-axial mass within the left midcaudal medulla oblongata. On gross dissection, there was a left-sided neoplasm in the medulla oblongata with surrounding hemorrhage. The histologic findings indicated that the mass was a pleomorphic xanthoastrocytoma. This tumor, an uncommon variant of an astrocytoma most often seen in children and young adult humans, has yet to be described in dogs.
Collapse
Affiliation(s)
- E T Hostnik
- Diagnostic Imaging, Ohio State University Veterinary Medical Center, Columbus, Ohio, USA
| | - S A Kube
- VCA South Shore Animal Hospital, South Weymouth, Massachusetts, USA
| | - B Jortner
- Laboratory for Neurotoxicity Studies, Virginia Tech, Blacksburg, Virginia, USA
| | - D Hager
- Eagle Eye Radiology, Cardiff, California, USA
| | - R H Garman
- Consultants in Veterinary Pathology, Inc, Murrysville, Pennsylvania, USA
| |
Collapse
|
|
39
|
Martínez R, Carmona FJ, Vizoso M, Rohde V, Kirsch M, Schackert G, Ropero S, Paulus W, Barrantes A, Gomez A, Esteller M. DNA methylation alterations in grade II- and anaplastic pleomorphic xanthoastrocytoma. BMC Cancer 2014; 14:213. [PMID: 24650279 PMCID: PMC4000050 DOI: 10.1186/1471-2407-14-213] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Accepted: 03/13/2014] [Indexed: 12/31/2022] Open
Abstract
Background Pleomorphic xanthoastrocytoma (PXA) is a rare WHO grade II tumor accounting for less than 1% of all astrocytomas. Malignant transformation into PXA with anaplastic features, is unusual and correlates with poorer outcome of the patients. Methods Using a DNA methylation custom array, we have quantified the DNA methylation level on the promoter sequence of 807 cancer-related genes of WHO grade II (n = 11) and III PXA (n = 2) and compared to normal brain tissue (n = 10) and glioblastoma (n = 87) samples. DNA methylation levels were further confirmed on independent samples by pyrosequencing of the promoter sequences. Results Increasing DNA promoter hypermethylation events were observed in anaplastic PXA as compared with grade II samples. We further validated differential hypermethylation of CD81, HCK, HOXA5, ASCL2 and TES on anaplastic PXA and grade II tumors. Moreover, these epigenetic alterations overlap those described in glioblastoma patients, suggesting common mechanisms of tumorigenesis. Conclusions Even taking into consideration the small size of our patient populations, our data strongly suggest that epigenome-wide profiling of PXA is a valuable tool to identify methylated genes, which may play a role in the malignant progression of PXA. These methylation alterations may provide useful biomarkers for decision-making in those patients with low-grade PXA displaying a high risk of malignant transformation.
Collapse
Affiliation(s)
- Ramón Martínez
- Department of Neurosurgery, University of Goettingen, Robert Koch, Str, 40, 37075 Goettingen, Germany.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
|
40
|
Paudel K, Borofsky S, Jones RV, Levy LM. Dysembryoplastic neuroepithelial tumor with atypical presentation: MRI and diffusion tensor characteristics. J Radiol Case Rep 2013; 7:7-14. [PMID: 24421925 DOI: 10.3941/jrcr.v7i11.1559] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
We report the neuroimaging findings of a 26-year-old female patient with a biopsy-proven dysembryoplastic neuroepithelial tumor (DNET). DNETs are an uncommon, usually benign, glial-neural cortical neoplasm of children and young adults who typically present with intractable seizures. DNETs may occur in any region of the supratentorial cortex, but have a predilection for the temporal lobes. Accurate neuroimaging diagnosis is essential since patients with DNET benefit from complete resection. However, accurate differentiation from other cortical lesions may be challenging. Typical conventional Magnetic Resonance Imaging (MRI) features can help in the differentiation from other similar cortical tumors. Diffusion tensor imaging can also provide important additional diagnostic information regarding the degree of involvement of adjacent parenchyma and white matter tracts. In this case, tractography and fractional anisotropy maps demonstrated that fiber tracts surrounding the lesion were displaced, but fiber integrity was maintained, which is more suggestive of a DNET rather than a more aggressive neoplasm. Accurate identification of DNETs is essential for the purpose of rendering a timely diagnosis and start appropriate treatment.
Collapse
Affiliation(s)
- Kalyan Paudel
- Department of Radiology, the George Washington University Hospital, Washington, DC, USA
| | - Samuel Borofsky
- Department of Radiology, the George Washington University Hospital, Washington, DC, USA
| | - Robert V Jones
- Department of Pathology, the George Washington University Hospital, Washington, DC, USA
| | - Lucien M Levy
- Department of Radiology, the George Washington University Hospital, Washington, DC, USA
| |
Collapse
|
|
41
|
Conventional and advanced MRI features of pediatric intracranial tumors: supratentorial tumors. AJR Am J Roentgenol 2013; 200:W483-503. [PMID: 23617516 DOI: 10.2214/ajr.12.9724] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE. Our objective is to review the imaging characteristics and applications of conventional and advanced neuroimaging techniques of supratentorial intracranial masses in the pediatric population. Specifically, we review astrocytomas, oligodendrogliomas, primary neuroectodermal tumors, dysembryoplastic neuroepithelial tumors, gangliogliomas, arachnoid cysts, and choroid plexus and pineal region masses. CONCLUSION. Advanced imaging methods, such as MR spectroscopy, perfusion MRI, functional MRI, diffusion-tensor imaging, and tractography, help develop a more accurate differential diagnosis and aid in planning tumor treatment.
Collapse
|
|
42
|
Gonçalves VT, Reis F, Queiroz LDS, França Jr M. Pleomorphic xanthoastrocytoma: magnetic resonance imaging findings in a series of cases with histopathological confirmation. ARQUIVOS DE NEURO-PSIQUIATRIA 2012; 71:35-9. [DOI: 10.1590/s0004-282x2012005000016] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Accepted: 08/02/2012] [Indexed: 11/22/2022]
Abstract
Pleomorphic xanthoastrocytoma (PXA) is a rare glioma. This paper aimed to analyze magnetic resonance imaging (MRI) characteristics in a series of patients diagnosed with PXA. We analyzed MRI findings in 9 patients with histopathologic diagnosis of PXA in our department over the last 12 years. The mean age of patients was 27.3 years. Cortical location was observed in all cases. The lesion imaging was solid-cystic in six cases. In eight cases, the solid component presented hypo or isointense on T1 and iso or hyperintense on T2. Contrast enhancement in the solid component was observed in eight cases. The observed imaging pattern of PXA was superficial location with leptomeningeal involvement, solid-cystic pattern and contrast enhancement in the solid component. We should consider that the association between PXA and other cortical tumors may occur, particularly, with gangliogliomas, which tend to be the main differential diagnosis in MRI.
Collapse
|
|
43
|
Raz E, Kapilamoorthy TR, Gupta AK, Fiorelli M. Case 186: Dysembrioplastic neuroepithelial tumor. Radiology 2012; 265:317-20. [PMID: 22993223 DOI: 10.1148/radiol.12100118] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Eytan Raz
- Department of Neurology and Psychiatry, Sapienza University of Rome, Viale dell' Università, 30, 00185 Rome, Italy.
| | | | | | | |
Collapse
|
|
44
|
Raz E, Zagzag D, Saba L, Mannelli L, Di Paolo PL, D'Ambrosio F, Knopp E. Cyst with a mural nodule tumor of the brain. Cancer Imaging 2012; 12:237-44. [PMID: 22935908 PMCID: PMC3458787 DOI: 10.1102/1470-7330.2012.0028] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The purpose of this article is to illustrate the imaging findings of lesions that present as cyst with a mural nodule tumor (CMNT). CMNT is a subtype pattern of intra-axial enhancement in central nervous system tumors, typical of a variety of brain neoplasms, including, as the most common, hemangioblastoma, pilocytic astrocytoma, ganglioglioma and pleomorphic xanthoastrocytoma and as less common tanycytic ependymoma, intraparenchymal schwannoma, desmoplastic infantile ganglioglioma and cystic metastasis. A retrospective design was chosen given the rarity of CMNT. Relevant cases were obtained retrospectively to review the different lesions that can present with the appearance of CMNT.
Collapse
Affiliation(s)
- Eytan Raz
- Department of Radiology, New York University School of Medicine, 660 First Avenue, New York, NY 10016, USA.
| | | | | | | | | | | | | |
Collapse
|
|
45
|
Abstract
With a major role in revealing epileptogenic lesions, magnetic resonance imaging (MRI) has also been very helpful in surgical planning and postoperative follow-up of drug-resistant focal epilepsies. In this article, in addition to discussing the most common epileptogenic lesions, advanced quantitative and functional MRI techniques in detecting abnormalities and revealing hemodynamic and microstructural changes are emphasized.
Collapse
|
|
46
|
Cerebral pleomorphic xanthoastrocytoma associated with NF1: an updated review with a rare atypical case from Africa. Neurosurg Rev 2011; 35:313-9; discussion 319. [DOI: 10.1007/s10143-011-0362-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2011] [Revised: 05/25/2011] [Accepted: 07/31/2011] [Indexed: 02/05/2023]
|
|
47
|
Paldino MJ, Faerber EN, Poussaint TY. Imaging tumors of the pediatric central nervous system. Radiol Clin North Am 2011; 49:589-616, v. [PMID: 21807164 DOI: 10.1016/j.rcl.2011.05.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Primary tumors of the central nervous system (CNS) are the second most common neoplasms in children and the leading cause of death in this patient population. The primary objective of this article is to describe the most common pediatric brain tumors and to offer an overview of their respective imaging features, primarily on magnetic resonance imaging. Precise anatomic characterization is essential for developing an appropriate differential diagnosis. Once equipped with this critical information, physicians should be better able to make firm diagnoses, leading to improved disease management and patient outcomes in the setting of CNS tumors of childhood.
Collapse
Affiliation(s)
- Michael J Paldino
- Division of Neuroradiology, Department of Radiology, Children's Hospital Boston, 300 Longwood Avenue, Boston, MA 02115, USA.
| | | | | |
Collapse
|
|
48
|
Horiguchi S, Mitsuya K, Watanabe R, Yagishita S, Nakasu Y. Pleomorphic xanthoastrocytoma and moyamoya disease in a patient with neurofibromatosis type 1 - case report - . Neurol Med Chir (Tokyo) 2011; 51:310-4. [PMID: 21515957 DOI: 10.2176/nmc.51.310] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A 32-year-old man with familial neurofibromatosis type 1 presented with a rare case of coexisting pleomorphic xanthoastrocytoma (PXA) and moyamoya disease manifesting as progressive right hemiparesis. Magnetic resonance (MR) imaging with gadolinium showed an enhanced mass lesion in the left basal ganglia extending to the left parietal lobe. Preoperative angiography showed severe stenosis of the bilateral internal carotid arteries, and moyamoya vessels. The patient underwent open biopsy. Histological examination showed the characteristic findings of PXA. After radiation therapy and chemotherapy, MR imaging showed decreased size and enhancement of the tumor, but his clinical condition worsened with generalized convulsions and consciousness disturbance. He died 1 year and 6 months after the first presentation. Autopsy findings demonstrated necrosis in the main mass and tumor cell dissemination without anaplastic change. The rare combination of PXA and moyamoya disease in the basal ganglia limited treatment options. Injured moyamoya vessels and ischemic condition might have caused tumor progression and dissemination. Radiation therapy, in combination with moyamoya disease, induced decreased cerebral blood flow (CBF) in the left frontal lobe. Tumor dissemination, CBF decrease, and hydrocephalus led to the clinical deterioration of this patient.
Collapse
|
|
49
|
Safavi-Abbasi S, Di Rocco F, Chantra K, Feigl GC, El-Shawarby A, Samii A, Samii M. Posterior cranial fossa gangliogliomas. Skull Base 2011; 17:253-64. [PMID: 18174926 DOI: 10.1055/s-2007-984486] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Ganglioglioma (GG) is an uncommon primary lesion of the central nervous system that is typically located supratentorially. There are only a few reports of GG arising from the cerebellum. To the best of our knowledge this is the first case of a cerebellar GG with supratentorial extension and a longstanding history before its recognition. In fact, this 29-year-old male presented with an 11-year history of intermittent headaches. A cranial computerized tomography (CT) performed at the onset of his complaints failed to reveal the tumor. After a particularly longstanding cephalalgic episode, the patient underwent a new CT scan that was also negative. However, magnetic resonance (MR) imaging of the brain revealed a space-occupying lesion in the right cerebellar hemisphere with extension to the level of the superior colliculi and pineal recess. The tumor was partially removed through a midline suboccipital craniotomy and supracerebellar approach. Pathological examination of the tumor showed composition of atypical ganglion cells and astrocytes, indicating the diagnosis of cerebellar GG. At last follow-up, 24 months after surgery, the patient reported a marked improvement of his clinical condition with significant reduction of intensity and frequency of the headache. The present report illustrates how cerebellar GG may remain undetectable by CT and may therefore present with a longstanding history and nonspecific signs and symptoms. MR investigation can lead to the proper diagnosis. Even after partial removal the prognosis remains good and remission of the symptoms may be achieved. In this article, we review the literature and summarize the current understanding of infratentorial GGs.
Collapse
Affiliation(s)
- Sam Safavi-Abbasi
- Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
| | | | | | | | | | | | | |
Collapse
|
|
50
|
Gonçalves VT, Fabiano R, Queiroz LDS, Zanardi VDA. Periventricular pleomorphic xanthoastrocytoma (PXA): an uncommon tumor at an atypical site. ARQUIVOS DE NEURO-PSIQUIATRIA 2011; 69:570. [PMID: 21755146 DOI: 10.1590/s0004-282x2011000400034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
|