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Cooper-Khan RS, Frankovich AN, Thompson CA, Thomovsky SA, Lewis MJ. Clinical Findings and Outcome in 30 Dogs with Presumptive or Confirmed Nerve Sheath Tumors. Vet Sci 2024; 11:192. [PMID: 38787164 PMCID: PMC11125868 DOI: 10.3390/vetsci11050192] [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: 02/09/2024] [Revised: 03/28/2024] [Accepted: 04/26/2024] [Indexed: 05/25/2024] Open
Abstract
Nerve sheath tumors (NSTs) are well-recognized primary nervous system tumors, but there is relatively limited information in dogs including comparison of NSTs in different anatomical locations. This retrospective study describes the clinical features and outcomes in a group of dogs with NSTs affecting the cranial nerves or spinal nerves. Thirty dogs were included, 25 with a presumptive diagnosis and five confirmed by histopathologic analysis. Seven dogs also had cytology of tumor samples, which were supportive of the NST diagnosis in four. Eight dogs had cranial nerve-associated NSTs, with six involving the trigeminal nerve. Twenty-two dogs had spinal nerve-associated NSTs including 13 invading the spinal canal and nine peripheral to the spinal canal, with the majority affecting nerves or nerve roots of the brachial plexus. The prognosis was poor, with dogs being euthanized eventually because of disease progression. Among dogs alive 1 week after diagnosis, the median survival time was 4 months but ranged from 2 weeks to >2 years. While there was a broad overlap between NST locations, survival was generally longer for dogs without spinal canal or intracranial involvement. The results expand available information on NSTs in dogs but should be interpreted with caution given the small number of dogs with a definitive diagnosis. Further investigation is warranted to determine how tumor location, invasiveness, and treatments pursued impact outcome.
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Affiliation(s)
- Rachel S. Cooper-Khan
- Department of Veterinary Clinical Sciences, Purdue University College of Veterinary Medicine, 625 Harrison Street, West Lafayette, IN 47907, USA; (R.S.C.-K.); (S.A.T.)
| | - Alexandra N. Frankovich
- Department of Comparative Pathobiology, Purdue University College of Veterinary Medicine, 625 Harrison Street, West Lafayette, IN 47907, USA; (A.N.F.); (C.A.T.)
| | - Craig A. Thompson
- Department of Comparative Pathobiology, Purdue University College of Veterinary Medicine, 625 Harrison Street, West Lafayette, IN 47907, USA; (A.N.F.); (C.A.T.)
| | - Stephanie A. Thomovsky
- Department of Veterinary Clinical Sciences, Purdue University College of Veterinary Medicine, 625 Harrison Street, West Lafayette, IN 47907, USA; (R.S.C.-K.); (S.A.T.)
| | - Melissa J. Lewis
- Department of Veterinary Clinical Sciences, Purdue University College of Veterinary Medicine, 625 Harrison Street, West Lafayette, IN 47907, USA; (R.S.C.-K.); (S.A.T.)
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, NC 27606, USA
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Yeole U, Rao KVLN, Beniwal M, Sivakoti S, Santosh V, Somanna S. Cranial and Spinal Malignant Peripheral Nerve Sheath Tumor: A Pathological Enigma. J Neurosci Rural Pract 2021; 12:770-779. [PMID: 34737514 PMCID: PMC8558969 DOI: 10.1055/s-0041-1735325] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Objective
Malignant peripheral nerve sheath tumor (MPNST) arises from nerve sheaths, mostly seen in peripheral nerves but rare in craniospinal nerves. The information available in the literature to build up treatment strategy and improve clinical outcomes is scarce. We are reviewing cases from our institute, with emphasis on radiological features for early differentiation from its benign variants.
Methods
We analyzed pathologically diagnosed cases retrospectively from January 2007 to December 2018 at our institute. Clinicoradiological details and treatment parameters were collected from medical records for evaluation. Each case was contacted telephonically for final clinical follow-up at the time of writing the manuscript.
Results
A total of seven cases of MPNST were diagnosed in the last 10 years. It included four intracranial and three spinal cases. The mean age for the cohort was 34.3 years, with five females. We could achieve gross total resection (GTR) and subtotal resection in four (57.1%) and two (28.6%) cases, respectively. We could achieve an overall survival of 57.1% in the average follow-up of 28.2 months (range: 8–84 months).
Conclusion
MPNST is a rare tumor with a bad prognosis. Radical surgical resection is the mainstay of the treatment, but it is not always possible to achieve it because of the inaccessible location and large size of lesions. Preoperative diagnosis is challenging; however, few radiological findings may give a clue toward it. As a disease entity overall, it has a poor outcome with a high rate of fatality.
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Affiliation(s)
- Ujwal Yeole
- Neurosurgery Services, Department of Surgical Oncology, Tata Memorial Centre and Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - K V L Narsinga Rao
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Manish Beniwal
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Sumitra Sivakoti
- Department of Pathology and Lab Medicine, All India Institute of Medical Sciences, Nalgonda, Telangana, India
| | - Vani Santosh
- Department of Neuropathology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Sampath Somanna
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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3
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Chandra SR, Das S, Wolf A. Parotid Neurogenic Tumors: MPNST Sarcoma to Schwannoma-Review of Literature and Guidelines in Management. J Maxillofac Oral Surg 2021; 20:356-363. [PMID: 34408362 DOI: 10.1007/s12663-021-01523-2] [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: 05/13/2020] [Accepted: 02/03/2021] [Indexed: 10/21/2022] Open
Abstract
Objective To delineate a distinct clinical, pathological, cytoimmunohistochemical distinguishing features of extracranial parotid neurogenic tumors. Pleomorphic adenoma, the most common parotid neoplasm by itself can mimic a neurogenic tumor, i.e., schwannoma. We have reported such rare entity in earlier publications. This is a systematic review with a case discussion of the third only documented malignant peripheral nerve sheath tumor (MPNST) arising in the parotid in a noncontiguous fashion. We review the management, diagnostic immunohistochemistry of this low-grade sarcoma, which has not been documented thus far. Purpose Significant diagnostic and management pitfalls may occur even with fine-needle aspiration or biopsy, as they will not be ideal in diagnosis of parotid neurogenic neoplasms preoperatively. Ultrasound as well as magnetic resonance imaging may not offer a specific facial nerve course in association to the neoplastic lesion. Majority of the neurogenic tumors can be misdiagnosed and hence, improperly managed leading to facial nerve injury and tumor morbidity. Due to the lack of ideal diagnostic modality and morbidity of facial nerve injury, a thorough review of differential diagnosis inclusive of neurogenic tumors of the parotid is to be considered in indications of surgical approaches. We retrospectively review successful resection with preservation of facial nerve function in our parotid neurogenic tumors. Conclusion The objective of this paper is to review the guidelines and treatment planning of parotid neurogenic tumors.
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Affiliation(s)
- Srinivasa Rama Chandra
- Division of OMF-Head and Neck Surgery, Department of Surgery, 98415 Nebraska Medical Centre, University of Nebraska Medical Centre, Omaha, NE 68198-4125 USA
| | - Shibani Das
- Department of Plastic and Maxillofacial Surgery, Ashwini Hospital, Cuttack, Odisha India
| | - Alejandro Wolf
- Division of OMF-Head and Neck Surgery, Department of Surgery, 98415 Nebraska Medical Centre, University of Nebraska Medical Centre, Omaha, NE 68198-4125 USA
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Galzio RJ, Del Maestro M, Pagkou D, Caulo M, Asioli S, Righi A, Fabbri VP, Luzzi S. First documented case of intracranial falcine malignant peripheral nerve sheath tumor: illustrative case. JOURNAL OF NEUROSURGERY. CASE LESSONS 2021; 2:CASE21255. [PMID: 36131576 PMCID: PMC9589474 DOI: 10.3171/case21255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 06/24/2021] [Indexed: 06/15/2023]
Abstract
BACKGROUND The authors reported the first documented case of intracranial extraaxial nonneurofibromatosis type 1-related nontriton malignant peripheral nerve sheath tumor (MPNST) originating from the falx cerebri. OBSERVATIONS A 34-year-old man with headache, short-term memory deficit, postural instability, and blurred vision presented with a large heterogenous contrast-enhanced intraventricular cystic lesion originating from the free margin of the falx cerebri. The patient received surgery using the right posterior interhemispheric approach. Gross total resection was performed, and the inferior border of the falx cerebri was resected. The postoperative course was uneventful. Histological examination revealed hypercellular foci of neoplastic spindle cells with hyperchromatic and wavy nuclei. Hence, a diagnosis of MPNST was made based on concomitant immunochemistry findings, including mouse double minute 2 homolog focal positivity and geographic loss of H3K27me3. The patient received adjuvant radiotherapy, and recurrence was not observed. LESSONS Intracranial MPNSTs are extremely rare tumors, typically originating from the cranial nerves in the posterior cranial fossa. An even rarer variant of these tumors, referred to as malignant intracerebral nerve sheath tumors, may directly arise from the brain parenchyma. The authors reported the first case of an intracranial MPNST originating from the dura mater of the falx cerebri, acting as an extraaxial lesion with prevalent expansion in the right ventricle.
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Affiliation(s)
| | | | - Diamantoula Pagkou
- Neurosurgery Unit, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Massimo Caulo
- Department of Neurosurgery, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
| | - Sofia Asioli
- Department of Neuroscience and Clinical Sciences, University of Chieti, Italy
| | - Alberto Righi
- Department of Biomedical and Neuromotor Sciences (DIBINEM)-Surgical Pathology Section, University of Bologna, Italy
| | | | - Sabino Luzzi
- Department of Pathology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy; and
- Neurosurgery Unit, Department of Surgical Sciences, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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Ding J, Wang L, Zhao H, Wang F, Sun T. Malignant Peripheral Nerve Sheath Tumor of the Cerebellar Hemisphere: An Unusual Location and Multiple Intracranial Parenchyma Metastases. Cureus 2021; 13:e14373. [PMID: 33976994 PMCID: PMC8106482 DOI: 10.7759/cureus.14373] [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] [Indexed: 11/09/2022] Open
Abstract
Malignant peripheral nerve sheath tumors (MPNSTs) are rare soft tissue malignancies that can occur in any part of the body. The most common sites are the proximal limbs and trunk. Intracranial MPNSTs are rare; most originate from the auditory, trigeminal, and other cranial nerves, and occurrence within the brain parenchyma is rarer. Here, we describe a malignant peripheral schwannoma in the cerebellar hemisphere of the brain parenchyma. To our knowledge, this is the first case of brain parenchymal metastasis of an MPNST. We observed no effects on the tumor after the application of multiple chemotherapy drugs; thereafter, we explored the literature surrounding the condition.
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Affiliation(s)
- Jiangwei Ding
- Department of Neurosurgery, General Hospital of Ningxia Medical University, Ningxia Medical University, Yinchuan, CHN
| | - Lei Wang
- Department of Neurosurgery, Ningxia Key Laboratory of Cerebrocranial Disease, Ningxia Medical University, General Hospital of Ningxia Medical University, Yinchuan, CHN
| | - Haibiao Zhao
- Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, CHN
| | - Feng Wang
- Department of Neurosurgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, CHN
| | - Tao Sun
- Department of Neurosurgery, Ningxia Key Laboratory of Cerebrocranial Disease, General Hospital of Ningxia Medical University, Yinchuan, CHN
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Not So Benign Bell's Palsy: Malignant Peripheral Nerve Sheath Tumor of the Facial Nerve Involving the Temporal Bone. J Gen Intern Med 2021; 36:1102-1105. [PMID: 33469775 PMCID: PMC8041929 DOI: 10.1007/s11606-020-06463-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 12/13/2020] [Indexed: 10/22/2022]
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Incidence and prognosis of distant metastasis in malignant peripheral nerve sheath tumors. Acta Neurochir (Wien) 2021; 163:521-529. [PMID: 33219865 DOI: 10.1007/s00701-020-04647-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 11/09/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Malignant peripheral nerve sheath tumors (MPNSTs) are a type of soft tissue sarcomas (STS) with recurrence and metastatic potential. We aimed to investigate the risk factors for developing distant metastases (DM) and to identify the prognostic factors in patients with DM. METHODS Based on the Surveillance, Epidemiology, and End Result (SEER) database, MPNST patients diagnosed between 2010 and 2016 were extracted in our study. The logistic regression model was performed for predicting DM development while the Cox proportional hazard regression model was conducted for revealing the prognostic factors. RESULTS Eventually, 764 patients diagnosed with MPNSTs were included with 109 cases presenting with metastases at initial diagnosis. Larger tumor size and lymph node metastases were independent risk factors for developing DM. The median overall survival (OS) for patients with metastases was 8.0 (95% CI: 6.1-9.9) months. Multiple metastatic sites and no surgical treatment were prognostic factors for worse survival. Tumors located in non-head and neck region were related with better survival. CONCLUSIONS The incidence of DM was 14.3% with a dismal median OS of 8.0 months for metastatic MPNSTs. More evaluation should be applied for patients with large tumor size and lymph metastases. Tumors located in head and neck region and the presence of multiple metastases predicted worse survival outcome. Surgical treatment can significantly improve the survival of MPNST patients with distant metastasis.
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Patankar AP, Sheth JH. Intracranial Malignant Nerve Sheath Tumor in the Middle Cranial Fossa: A Rare Case Report with Review of Literature. Asian J Neurosurg 2019; 14:922-926. [PMID: 31497130 PMCID: PMC6703013 DOI: 10.4103/ajns.ajns_59_19] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Intracranial malignant nerve sheath tumors rarely arise in the central nervous system. They usually arise from the cranial nerves, though rare cases of intraparenchymal lesions have also been reported. We report a case of malignant nerve sheath tumor located in the right middle cranial fossa. Preoperatively, the lesion resembled a meningioma arising from the petrous temporal bone. The lesion was completely excised. Postoperatively, the patient developed righted-sided complete facial nerve palsy. Histopathology and immunohistochemistry revealed the lesion to be a malignant nerve sheath tumor. The development of postoperative facial nerve palsy was puzzling but could be explained if we consider the possibility of the lesion arising from the facial nerve near the geniculate ganglion. Intracranial malignant nerve sheath tumor centered over the geniculate ganglion and projecting into the middle cranial fossa is uncommon, and to the best of our knowledge, only one such case has been previously reported. We review the relevant literature, discuss the management and add to the previously reported cases of this rare condition.
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Martin E, Muskens IS, Coert JH, Smith TR, Broekman MLD. Treatment and survival differences across tumor sites in malignant peripheral nerve sheath tumors: a SEER database analysis and review of the literature. Neurooncol Pract 2018; 6:134-143. [PMID: 31386019 DOI: 10.1093/nop/npy025] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background Currently, literature is scarce on differences across all possible tumor sites in malignant peripheral nerve sheath tumors (MPNSTs). To determine differences in treatment and survival across tumor sites and assess possible predictors for survival, we used the Surveillance, Epidemiology, and End Results (SEER) database. Methods MPNST cases were obtained from the SEER database. Tumor sites were recoded into: intracranial, spinal, head and neck (H&N), limbs, core (thorax/abdomen/pelvis), and unknown site of origin. Patient and tumor characteristics, treatment modalities, and survival were extracted. Overall survival (OS) was assessed using univariable and multivariable Cox regression hazard models. Kaplan-Meier survival curves were constructed per tumor site for OS and disease-specific survival (DSS). Results A total of 3267 MPNST patients were registered from 1973 to 2013; 167 intracranial (5.1%), 119 spinal (3.6%), 449 H&N (13.7%), 1022 limb (31.3%), 1307 core (40.0%), and 203 unknown (6.2%). The largest tumors were found in core sites (80.0 mm, interquartile range [IQR]: 60.0-115.0 mm) and the smallest were intracranial (37.4 mm, IQR: 17.3-43.5 mm). Intracranial tumors were least frequently resected (58.1%), whereas spinal tumors were most often resected (83.0%). Radiation was administered in 35.5% to 41.8%. Independent factors associated with decreased survival were: older age, male sex, black race, no surgery, partial resection, large tumor size, high tumor grade, H&N site, and core site (all P < .05). Intracranial and pediatric tumors show superior survival (both P < .05). Intracranial tumors show superior OS and DSS curves, whereas core tumors have the worst (P < .001). Conclusion Superior survival is seen in intracranial and pediatric MPNSTs. Core and H&N tumors have a worse prognosis.
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Affiliation(s)
- Enrico Martin
- Computational Neuroscience Outcomes Center, Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.,Department of Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, The Netherlands.,Department of Plastic and Reconstructive Surgery, University Medical Center Utrecht, The Netherlands
| | - Ivo S Muskens
- Computational Neuroscience Outcomes Center, Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - J H Coert
- Department of Plastic and Reconstructive Surgery, University Medical Center Utrecht, The Netherlands
| | - Timothy R Smith
- Computational Neuroscience Outcomes Center, Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Marike L D Broekman
- Computational Neuroscience Outcomes Center, Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.,Department of Neurosurgery, Leiden University Medical Center, The Netherlands.,Department of Neurosurgery, Haaglanden Medical Center, The Hague, The Netherlands
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Shimanskiy VN, Shevchenko KV, Ryzhova MV, Tanyashin SV, Odamanov DA, Poshataev VK. [A malignant peripheral nerve sheath tumor developed from the auditory nerve: a case report and a literature review]. ZHURNAL VOPROSY NEĬROKHIRURGII IMENI N. N. BURDENKO 2017; 81:95-100. [PMID: 28914875 DOI: 10.17116/neiro201781495-100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We present a rare clinical case of a patient with a malignant peripheral nerve sheath tumor developed from the auditory nerve as well as a literature review, including 30 reported cases of this disease.
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Affiliation(s)
| | | | - M V Ryzhova
- Burdenko Neurosurgical Institute, Moscow, Russia
| | | | - D A Odamanov
- Burdenko Neurosurgical Institute, Moscow, Russia
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Liu X, Li W, Yuan H, Gu W, Chen D. Surgical treatment of rare giant malignant tumors of the scalp: A report of 3 cases with different tumor types. Oncol Lett 2016; 12:3411-3416. [PMID: 27900013 DOI: 10.3892/ol.2016.5113] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 06/16/2016] [Indexed: 01/17/2023] Open
Abstract
The scalp is the most frequent site of occurrence of malignant tumors. As an area that is generally neglected by the patient and not closely monitored during physical examinations, scalp tumors can go unnoticed until they become malignant. The present study reports 3 cases of rare giant malignant tumors of the scalp, namely a peripheral nerve sheath tumor, a fibrous tumor and a malignant proliferating trichilemmal tumor, that were treated at The First Bethune Hospital of Jilin University (Changchun, China). Vascularized free anterolateral thigh flap surgery was performed in 2 of the 3 cases. A local flap repair was applied to the third case. The implanted skin grafts remained viable post-operatively and wound repair was uneventful. No signs of malignancy were detected on the edge of the pathological section upon closer pathological examination. In the follow-up period, no recurrence was detected in any of the cases.
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Affiliation(s)
- Xiaoliang Liu
- Department of Neurological and Cancer Surgery, The First Bethune Hospital, Jilin University, Changchun, Jilin 130021, P.R. China
| | - Wenzhong Li
- Department of Neurological and Cancer Surgery, The First Bethune Hospital, Jilin University, Changchun, Jilin 130021, P.R. China
| | - Hepei Yuan
- Department of Pathology, The First Bethune Hospital, Jilin University, Changchun, Jilin 130021, P.R. China
| | - Weihong Gu
- Department of Surgery, The Second Bethune Hospital, Jilin University, Changchun, Jilin 130041, P.R. China
| | - Dawei Chen
- Department of Neurological and Cancer Surgery, The First Bethune Hospital, Jilin University, Changchun, Jilin 130021, P.R. China
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12
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Malignant peripheral nerve sheath tumors of the head and neck: a case series and literature review. Case Rep Otolaryngol 2014; 2014:368920. [PMID: 25548703 PMCID: PMC4273476 DOI: 10.1155/2014/368920] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 11/03/2014] [Accepted: 11/17/2014] [Indexed: 01/30/2023] Open
Abstract
Background. Malignant peripheral nerve sheath tumors (MPNSTs) of the head and neck are rare aggressive neoplasms with a poor prognosis. This study describes the management and outcomes of 3 of our patients with MPNSTs of the head and neck. Methods. We identified 3 patients presenting with MPNST of the head and neck and treated at the University of North Carolina. We compared our results to the literature from 1963 to 2014. Results. Mean follow-up was 31 months. Average age at diagnosis was 44.7 years of age. All patients received wide-local excision and adjuvant radiotherapy. No patients recurred during the series. Recurrence-free survival time for the patients was 45, 37, and 3 months, respectively. Conclusions. Our data series confirms that a combined-modality approach with complete surgical resection and adjuvant radiotherapy leads to improved outcomes in MPNSTs of the head and neck. Nonetheless, due to historically poor outcomes, continued research into newer therapies needs to be explored.
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13
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Grisold W, Grisold A. Cancer around the brain. Neurooncol Pract 2014; 1:13-21. [PMID: 26034610 DOI: 10.1093/nop/npt002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Accepted: 12/11/2013] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Neuro-oncologists are familiar with primary brain tumors, intracerebral metastases meningeal carcinomatosis and extracerebral intracranial tumors as meningeoma. For these conditions, and also some other rare tumor entities several treatment options exist. Cancer can also involve structures around the brain as the dura, the base of the skull, the cavities of the skull and tissue around the bony skull, the skin, the tissue of the neck. and either compress, invade or spread in the central or peripheral nervous system. METHODS A systematic literature research was conducted determining symptoms and signs, tumor sites of nerve invasion, tumor types, diagnostic techniques, mechanisms of nerve invasion, and important differential diagnosis. Additional cases from own experience were added for illustration. RESULTS The mechanisms of tumor invasion of cranial nerves is heterogenous and not only involves several types of invasion, but also spread along the cranial nerves in antero- and retrograde fashion and even spread into different nerve territories via anastomosis. In addition the concept of angiosomas may have an influence on the spread of metastases. CONCLUSION In addition to the well described tumor spread in meningeal carcinomatosis and base of the skull metastases, dural spread, lesions of the bony skull, the cavities of the skull and skin of the face and tissue of the neck region need to be considered, and have an impact on therapeutic decisions.
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Affiliation(s)
- Wolfgang Grisold
- Department Neurology , KFJ Hospital Vienna , Vienna, Austria (W.G.); Department of Neurology , University Hospital of Vienna , Vienna, Austria (A.G.)
| | - Anna Grisold
- Department Neurology , KFJ Hospital Vienna , Vienna, Austria (W.G.); Department of Neurology , University Hospital of Vienna , Vienna, Austria (A.G.)
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