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Keizer ME, Kunst HPM, Temel Y. Skull Base Tumors: The Equilibrium between Curation and Preservation. Cancers (Basel) 2023; 15:2829. [PMID: 37345166 DOI: 10.3390/cancers15102829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 05/12/2023] [Indexed: 06/23/2023] Open
Abstract
Tumors located at the skull base constitute a particular challenge for medical teams [...].
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Affiliation(s)
- Max E Keizer
- Department of Neurosurgery, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands
- Academic Alliance for Skull Base Pathology, Maastricht and Radboud University Medical Centers, 6229 HX Maastricht, The Netherlands
| | - Henricus P M Kunst
- Academic Alliance for Skull Base Pathology, Maastricht and Radboud University Medical Centers, 6229 HX Maastricht, The Netherlands
- Department of Otorhinolaryngology and Head & Neck Surgery, Radboudumc, 6525 GA Nijmegen, The Netherlands
- Department of Otorhinolaryngology, Maastricht University Medical Center, 6525 GA Maastricht, The Netherlands
| | - Yasin Temel
- Department of Neurosurgery, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands
- Academic Alliance for Skull Base Pathology, Maastricht and Radboud University Medical Centers, 6229 HX Maastricht, The Netherlands
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Tumor Biology and Microenvironment of Vestibular Schwannoma-Relation to Tumor Growth and Hearing Loss. Biomedicines 2022; 11:biomedicines11010032. [PMID: 36672540 PMCID: PMC9856152 DOI: 10.3390/biomedicines11010032] [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] [Received: 10/30/2022] [Revised: 12/16/2022] [Accepted: 12/19/2022] [Indexed: 12/25/2022] Open
Abstract
Vestibular schwannoma is the most common benign neoplasm of the cerebellopontine angle. It arises from Schwann cells of the vestibular nerve. The first symptoms of vestibular schwannoma include hearing loss, tinnitus, and vestibular symptoms. In the event of further growth, cerebellar and brainstem symptoms, along with palsy of the adjacent cranial nerves, may be present. Although hearing impairment is present in 95% of patients diagnosed with vestibular schwannoma, most tumors do not progress in size or have low growth rates. However, the clinical picture has unpredictable dynamics, and there are currently no reliable predictors of the tumor's behavior. The etiology of the hearing loss in patients with vestibular schwannoma is unclear. Given the presence of hearing loss in patients with non-growing tumors, a purely mechanistic approach is insufficient. A possible explanation for this may be that the function of the auditory system may be affected by the paracrine activity of the tumor. Moreover, initiation of the development and growth progression of vestibular schwannomas is not yet clearly understood. Biallelic loss of the NF2 gene does not explain the occurrence in all patients; therefore, detection of gene expression abnormalities in cases of progressive growth is required. As in other areas of cancer research, the tumor microenvironment is coming to the forefront, also in vestibular schwannomas. In the paradigm of the tumor microenvironment, the stroma of the tumor actively influences the tumor's behavior. However, research in the area of vestibular schwannomas is at an early stage. Thus, knowledge of the molecular mechanisms of tumorigenesis and interactions between cells present within the tumor is crucial for the diagnosis, prediction of tumor behavior, and targeted therapeutic interventions. In this review, we provide an overview of the current knowledge in the field of molecular biology and tumor microenvironment of vestibular schwannomas, as well as their relationship to tumor growth and hearing loss.
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Leisz S, Klause CH, Vital Dos Santos T, Haenel P, Scheer M, Simmermacher S, Mawrin C, Strauss C, Scheller C, Rampp S. Vestibular Schwannoma Volume and Tumor Growth Correlates with Macrophage Marker Expression. Cancers (Basel) 2022; 14:cancers14184429. [PMID: 36139588 PMCID: PMC9496830 DOI: 10.3390/cancers14184429] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/06/2022] [Accepted: 09/08/2022] [Indexed: 11/17/2022] Open
Abstract
Simple Summary The variable growth behavior of vestibular schwannomas (VS) makes therapy decisions very difficult. These benign tumors, which originate from the eighth cranial nerve, partly show a very slow growth rate over many years. Nevertheless, VS can lead to severe symptoms such as hearing loss and dizziness within a short time due to their increase in size. Despite numerous preliminary studies, no apparent influencing factor on size progression could be found so far. In our study, we consider the influence of growth factors and macrophage markers on the volume and growth rate of VS. While growth factors show no effect on tumor growth, higher expression of macrophage markers indicates an infiltration of macrophages. They may thus enhance the growth of VS and therefore represent a potential therapeutic target. Abstract Vestibular schwannoma is the most common benign tumor of the cerebellopontine angle and originates from Schwann cells surrounding the vestibulocochlear nerve. Since the size of the VS varies widely, affected patients suffer from symptoms of varying severity. It is often difficult to determine the optimal time for therapy, due to the unpredictability of the growth rate. Despite many investigations on influencing factors, no mechanism responsible for the increase in the growth rate of certain VS has been identified so far. Therefore, the present study investigates the influence of the seven markers: Ki-67, cyclooxygenase 2 (COX2), vascular endothelial growth factor (VEGF), macrophage colony-stimulating factor (M-CSF), granulocyte-macrophage colony-stimulating factor (GM-CSF), CD163, and CD68 on tumor progression and tumor size in a cohort of 173 VS. The markers were determined by quantitative PCR and correlated with tumor volume and VS growth rate. The analysis showed a significantly negative correlation of the Ki-67, COX2, and VEGF on tumor volume. Moreover, with a higher volume of VS, the expression of the macrophage markers CD68, CD163, and GM-CSF increased significantly. Our results suggest that the increase in VS size is not primarily due to Schwann cell growth but to an infiltration of macrophages. This may have an impact on non-invasive therapy to preserve the hearing function of affected patients.
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Affiliation(s)
- Sandra Leisz
- Department of Neurosurgery, Medical Faculty, Martin Luther University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany
- Correspondence: ; Tel.: +49-(0)-345-557-7014
| | - Clara Helene Klause
- Department of Neurosurgery, Medical Faculty, Martin Luther University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany
| | - Tania Vital Dos Santos
- Department of Neurosurgery, Medical Faculty, Martin Luther University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany
| | - Pia Haenel
- Department of Neurosurgery, Medical Faculty, Martin Luther University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany
| | - Maximilian Scheer
- Department of Neurosurgery, Medical Faculty, Martin Luther University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany
| | - Sebastian Simmermacher
- Department of Neurosurgery, Medical Faculty, Martin Luther University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany
| | - Christian Mawrin
- Department of Neuropathology, Otto von Guericke University Magdeburg, Leipziger Str. 44, 39120 Magdeburg, Germany
| | - Christian Strauss
- Department of Neurosurgery, Medical Faculty, Martin Luther University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany
| | - Christian Scheller
- Department of Neurosurgery, Medical Faculty, Martin Luther University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany
| | - Stefan Rampp
- Department of Neurosurgery, Medical Faculty, Martin Luther University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany
- Department of Neurosurgery, University Hospital Erlangen, Schwabachanlage 6, 91054 Erlangen, Germany
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Behling F, Bersali I, Santacroce A, Hempel J, Kandilaris K, Schittenhelm J, Tatagiba M. Transition of a vestibular schwannoma to a malignant peripheral nerve sheath tumor with loss of H3K27 trimethylation after radiosurgery-a case report and review of the literature. Neurosurg Rev 2021; 45:915-922. [PMID: 34392463 PMCID: PMC8827336 DOI: 10.1007/s10143-021-01620-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 07/17/2021] [Accepted: 07/30/2021] [Indexed: 01/19/2023]
Affiliation(s)
- Felix Behling
- Department of Neurosurgery, Eberhard-Karls University of Tübingen, Hoppe-Seyler Street 3, 72076, Tübingen, Germany. .,Comprehensive Cancer Center Tübingen, Eberhard-Karls University, Tübingen, Germany.
| | - Imane Bersali
- Department of Neurosurgery, Eberhard-Karls University of Tübingen, Hoppe-Seyler Street 3, 72076, Tübingen, Germany
| | - Antonio Santacroce
- Department of Neurosurgery, St. Barbara-Klinik Hamm-Heessen, Hamm, Germany
| | - Johann Hempel
- Comprehensive Cancer Center Tübingen, Eberhard-Karls University, Tübingen, Germany.,Department of Diagnostic and Interventional Neuroradiology, Eberhard-Karls University, Tübingen, Germany
| | - Kosmas Kandilaris
- Comprehensive Cancer Center Tübingen, Eberhard-Karls University, Tübingen, Germany.,Department of Neuropathology, Eberhard-Karls University, Tübingen, Germany
| | - Jens Schittenhelm
- Comprehensive Cancer Center Tübingen, Eberhard-Karls University, Tübingen, Germany.,Department of Neuropathology, Eberhard-Karls University, Tübingen, Germany
| | - Marcos Tatagiba
- Department of Neurosurgery, Eberhard-Karls University of Tübingen, Hoppe-Seyler Street 3, 72076, Tübingen, Germany.,Comprehensive Cancer Center Tübingen, Eberhard-Karls University, Tübingen, Germany
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