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Caporalini C, Scagnet M, Giunti L, Cetica V, Mei D, Conti V, Moscardi S, Macconi L, Giordano F, D'Incerti L, Genitori L, Guerrini R, Buccoliero A. Myxoid glioneuronal tumor: Histopathologic, neuroradiologic, and molecular features in a single center series. Neoplasia 2023; 37:100885. [PMID: 36764090 PMCID: PMC9929589 DOI: 10.1016/j.neo.2023.100885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 01/17/2023] [Accepted: 02/01/2023] [Indexed: 02/10/2023]
Abstract
BACKGROUND Myxoid glioneuronal tumor (MGT) is a benign glioneuronal neoplasm recently introduced in the World Health Organization (WHO) classification of the central nervous system (CNS) tumors. MGTs are typically located in the septum pellucidum, foramen of Monro or periventricular white matter of the lateral ventricle. They were previously diagnosed as dysembryoplastic neuroepithelial tumors (DNT), showing histological features almost indistinguishable from classical cortical DNT. Despite that, MGTs have been associated with a specific dinucleotide substitution at codon 385 in the platelet-derived growth factor receptor alpha (PDGFRA) gene, replacing a lysine residue with either leucine or isoleucine (p. LysK385Leu/Iso). This genetic variation has never been described in any other CNS tumor. MATERIALS AND METHODS Thirty-one consecutive tumors, previously diagnosed as DNTs at the Meyer Children's Hospital IRCCS between January 2010 and June 2021 were collected for a comprehensive study of their clinical, imaging, pathological features, and molecular profile. RESULTS In six out of the thirty-one tumors we had previously diagnosed as DNTs, we identified the recurrent dinucleotide mutation in the PDGFRA. All six tumors were typically located within the periventricular white matter of the lateral ventricle and in the septum pellucidum. We then renamed these lesions as MGT, according to the latest WHO CNS classification. In all patients we observed an indolent clinical course, without recurrence. CONCLUSION MGT represent a rare but distinct group of neoplasm with a typical molecular profiling, a characteristic localization, and a relative indolent clinical course.
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Affiliation(s)
- C. Caporalini
- Pathology Unit, Meyer Children's Hospital IRCCS, Viale Pieraccini 24, Florence 50100, Italy,Corresponding author.
| | - M. Scagnet
- Neurosurgery Unit, Meyer Children's Hospital IRCCS, Florence, Italy
| | - L. Giunti
- Neuro-Oncology Unit, Department of Pediatric Oncology, Meyer Children's Hospital IRCCS, Florence, Italy
| | - V. Cetica
- Neuroscience Department, Meyer Children's Hospital IRCCS, Florence, Italy
| | - D. Mei
- Neuroscience Department, Meyer Children's Hospital IRCCS, Florence, Italy
| | - V. Conti
- Neuroscience Department, Meyer Children's Hospital IRCCS, Florence, Italy
| | - S. Moscardi
- Pathology Unit, Meyer Children's Hospital IRCCS, Viale Pieraccini 24, Florence 50100, Italy
| | - L. Macconi
- Radiology Unit, Meyer Children's Hospital IRCCS, Florence, Italy
| | - F. Giordano
- Neurosurgery Unit, Meyer Children's Hospital IRCCS, Florence, Italy
| | - L. D'Incerti
- Radiology Unit, Meyer Children's Hospital IRCCS, Florence, Italy
| | - L. Genitori
- Neurosurgery Unit, Meyer Children's Hospital IRCCS, Florence, Italy
| | - R. Guerrini
- Neuroscience Department, Meyer Children's Hospital IRCCS, Florence, Italy
| | - A.M. Buccoliero
- Pathology Unit, Meyer Children's Hospital IRCCS, Viale Pieraccini 24, Florence 50100, Italy
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2
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Giunti L, Rinaldi B, Serio V, Buccoliero A, Fiorentini E, Casati G, Iorio A, Marturano A, Genitori L, Sardi I. P06.07 Germline mutation of SMARCE1 gene in a family with spinal meningiomas. Neuro Oncol 2021. [DOI: 10.1093/neuonc/noab180.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
BACKGROUND
Meningioma is the most common benign primary intracranial tumor, arising from arachnoid cells of the meninges, but in 20% of cases displays aggressive behavior. Meningiomas are mainly sporadic and the familial forms are very rare. Meningioma account for a small subset (1–4%) of all pediatric brain tumors and may be associated with hereditary tumor predisposition syndrome caused by germline mutations of NF2, SMARCB1, SUFU, and SMARCE1 genes.
MATERIAL AND METHODS
We present a case of a 16-year-old girl with spinal clear cell meningiomas (CCMs) WHO II with a second spinal lesion identified during the follow-up. Considering the multiple lesions, we performed Whole Exome Sequencing (WES) on DNA from peripheral blood to search for an underlying CCMs tumor predisposition syndrome (#607174).
RESULTS
We identified a heterozygous frameshift variant c.439delA (p.Ser147fs) in SMARCE1, chromatin remodelling factor that acts as a tumor suppressor gene. Meningioma analysis by Sanger sequencing showed a loss of heterozygosity (LOH) of the wild-type allele. We identified the c.439delA in the constitutional DNA of the father and the sister but not in the mother. At the moment, the father is asymptomatic and the 14 years old sister showed two spinal lesions (meningiomas likely) at the first MRI.
CONCLUSION
We report a family study of hereditary tumor predisposition syndrome to CCMs with SMARCE1 mutation in which are present two asymptomatic carriers with different ages and gender. The asymptomatic carriers will undergo neurological examination and MRI of the brain and spine, according to a screening protocol. The incomplete penetrance phenomenon is known in SMARCE1-related families with CCMs and it is probably due to the interaction of SMARCE1 with yet unidentified genes.
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Affiliation(s)
- L Giunti
- Neuro-oncology Unit, Meyer Children’s Hospital, Florence, Italy
| | - B Rinaldi
- Medical Genetic Unit, Meyer Children’s Hospital, Florence, Italy
| | - V Serio
- Medical Genetic Unit, Meyer Children’s Hospital, Florence, Italy
| | - A Buccoliero
- Neuro-oncology Unit, Meyer Children’s Hospital, Florence, Italy
| | - E Fiorentini
- Medical Genetic Unit, Meyer Children’s Hospital, Florence, Italy
| | - G Casati
- Neuro-oncology Unit, Meyer Children’s Hospital, Florence, Italy
| | - A Iorio
- Neuro-oncology Unit, Meyer Children’s Hospital, Florence, Italy
| | - A Marturano
- Neuro-oncology Unit, Meyer Children’s Hospital, Florence, Italy
| | - L Genitori
- Neurosurgery Unit, Meyer Children’s Hospital, Florence, Italy
| | - I Sardi
- Neuro-oncology Unit, Meyer Children’s Hospital, Florence, Italy
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3
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Giordano F, Moscheo C, Lenge M, Mari F, Grandoni M, Buccoliero A, Sardi I, Genitori L, Guidi M. P14.46 SUBEPENDYMAL GIANT CELLS ASTROCYTOMA (SEGA) IN TUBEROUS SCLEROSIS COMPLEX (TSC): A SERIES OF 31 PATIENTS. Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz126.281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Subependymal Giant Cells Astrocytomas (SEGAs) are characteristic of Tuberous Sclerosis Complex (TSC). They are usually benign tumors but may rapidly grow and cause hydrocephalus and raised intracranial pressure. Surgery is mandatory for large and symptomatic SEGAs
METHODS
31 patients harboring SEGAs in TSC were admitted for surgery. The main indications for surgery were tumor size and location, tumoral growth and cystization/hemorrhage, and hydrocephalus. In presence of symptomatic hydrocephalus firts surgery aimed to reduce intracranial pressure
RESULTS
Forty-four surgeries were performed in 31 patients achieving Gross Total and Subtotal Removal in 36 and 8 patients respectively. Recurrences occurred in 11 patients; nine of them were reoperated while two were administered therapy with m-TOR pathway inhibitors. Surgical morbidity and mortality accounted for 22.7% and 2.3% respectively; hydrocephalus was the main complication. After an average follow-up of 5 years, 90% of patients had no evidence of the disease and most (93,3%) had a good clinical status after surgery; 12 out of 30 patients (40%) had a VP-shunt for hydrocephalus
Conclusions
GTR is feasible and represents the treatment of choice of SEGAs in TSC. Therapy with m-TOR pathway inhibitors is to be considered in selected patients and especially in recurrences of SEGAs
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Affiliation(s)
- F Giordano
- Meyer Pediatric Hospital, Firenze, Italy
| | - C Moscheo
- Meyer Pediatric Hospital, Firenze, Italy
| | - M Lenge
- Meyer Pediatric Hospital, Firenze, Italy
| | - F Mari
- Meyer Pediatric Hospital, Firenze, Italy
| | - M Grandoni
- Meyer Pediatric Hospital, Firenze, Italy
| | | | - I Sardi
- Meyer Pediatric Hospital, Firenze, Italy
| | - L Genitori
- Meyer Pediatric Hospital, Firenze, Italy
| | - M Guidi
- Meyer Pediatric Hospital, Firenze, Italy
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4
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Sardi I, Censullo M, Rousseau M, Guidi M, Giordano F, Fonte C, Farina S, Carra F, Genitori L. P08.03 Separation and divorce after the diagnosis of child’s brain tumor. Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz126.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
BACKGROUND
The diagnosis of a child’s brain tumor is a terrible situation for every member of the family. Numerous are the case of separations and divorces in Italy after a diagnosis of a child’s cancer. In particular, it happens with parents of children affected with brain tumor, being the most frequent solid tumor and the first cause of a tumor child’s death. The crisis related to the discovery of a tumor consists of four phases: shock, reaction, processing and re-orientation. It can happen that the diagnosis, experienced as a traumatic experience, can unite the family members as well as separate them. If there is already a process of family disintegration, a trauma can be a cause for breakup. The aim of our study was to investigate the possible correlation between brain tumor diagnosis in children and parental separations/divorces.
MATERIAL AND METHODS
We considered 427 patients afferent from 2012 to 2018 to the Neuro-Oncology Unit of the Meyer Children’s Hospital. Brain tumors are the 55–60% of all the tumors of our hospital, with an extra-regionality greater than 65%. The data analysis was conducted through information obtained directly from the families during follow-up visits or by telephone interviews.
RESULTS
Consistent with literature data in our series, the most frequent brain tumors were low-grade gliomas medulloblastomas, high-grade gliomas, ependymomas, midline diffuse gliomas, craniopharyngiomas, germ cell tumors and other rare pediatric tumors. The population was divided in 16 females and 18 males from different Italian regions: 65% from Central Italy, 23% from the South and Islands, 12% from the North. Data analysis showed 34 cases of separation and/or divorce, equal to 7% of our whole population, during treatment and more frequently at the end of treatment or after death. The median age of the 34 patients at the diagnosis of brain tumor was 9.5 years (range 1–19 years), with a higher percentage of cases of separations (41%) for parents of patients aged 10 years-14 years; 7 were the cases of separation and/or divorce when the diagnosis of brain tumor was made around 12–48 months after the child birth.
CONCLUSION
The diagnosis of a child’s brain tumor can generate stress in the family leading to different reactions, such as conflicts between parents or a real family crisis. The results of our study suggest a possible correlation between the diagnosis of a child’s brain tumor and the cases of separation and/or divorce. High risk medulloblastomas and high-grade gliomas that are likely to have a shorter path due to the unfavorable prognosis of the disease, appear to be the pathologies more often related to situations of family disputes. However, further investigations are necessary to verify the trend emerged from our study respect to the normal population.
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Affiliation(s)
- I Sardi
- Neuro-Oncology Unit, Florence, Italy
| | | | | | - M Guidi
- Neuro-Oncology Unit, Florence, Italy
| | | | - C Fonte
- Neuro-Oncology Unit, Florence, Italy
| | - S Farina
- Neuro-Oncology Unit, Florence, Italy
| | - F Carra
- Neuro-Oncology Unit, Florence, Italy
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5
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Giunti L, Cetica V, De Gregorio V, Mei D, Barba C, Buccoliero A, Genitori L, Guerrini R, Giglio S, Sardi I, Guidi M, Censullo M. P04.08 The role of SCN1A in glioblastomas and mixed neuronal glial tumors of pediatric age. Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz126.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
BACKGROUND
Low and high grade gliomas, are the most common pediatric central nervous system (CNS) tumors and they show an extremely broad range of clinical behavior. Pediatric glioma is distinct from its adult counterpart with different genetic/epigenetic profile and biological features. Recently, several studies have shown the involvement of voltage-gated Na+ channels (VGSC) in different types of cancer, including gliomas. VGSC are multimeric transmembrane complexes, responsible for membrane depolarization in excitable cells playing an important role also in cell proliferation, migration, apoptosis and differentiation. VGSC are therapeutic targets in cardiovascular and neurological disorders and, in cancers, they could be a novel target for the development of promising anticancer therapy
MATERIAL AND METHODS
Firstly, we explored the genetic background of 9 pediatric glioblastomas (1–9 pGBMs), through whole-exome sequencing (WES) using HiSeq1000 platform (Illumina) with paired-end approach. On the basis of our results, we extended our study in another group of 16 epileptogenic mixed neuronal-glial tumors of pediatric age, (WHO grade I and II), through an amplicon approach (TSCA) using MiniSeq System platform (Illumina)
RESULTS
We identified variants in SCN1A gene in 3/9 pGBMs: case 3 had c.5782C>G in tumor and blood; case 5 showed c.2278G>T and two mosaic variants (c.5933C>T, 22% and c.4942C>T, 14%); case 6 showed c.667G>T variant only in tumor, and not in other non tumoral tissues (blood, urine and buccal swab). No variants in SCN1A were identified in a group of 16 pediatric mixed gliomas
CONCLUSION
In this study, we explore the genetic background of two groups of pediatric neuroepithelial brain tumors, through Next generation sequencing approach. We identified only in pGBMs variants in SCN1A gene that encoded for VGSCs and is involved in a spectrum of early-onset epileptic encephalopathies. None of our mutated patients showed history of epilepsy. Now, it is not clear the significance of these variants in pGBMs but interestingly, these variants are present in pGBM and not in mixed gliomas. Further studies on a big cohort of patients are needed to establish if they could play a role in pGBMs aggressiveness, migration and progression. Moreover, VGSCs could be a pharmacological target in pGBMs treatment
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Affiliation(s)
- L Giunti
- Medical Genetics Unit, Meyer Children Hospital, Firenze, Italy
| | - V Cetica
- Child Neurology Unit, Meyer Children’s University Hospital, Firenze, Italy
| | - V De Gregorio
- Neuro-Oncology Unit, Meyer Children’s University Hospital, Firenze, Italy
| | - D Mei
- Child Neurology Unit, Meyer Children’s University Hospital, Firenze, Italy
| | - C Barba
- Child Neurology Unit, Meyer Children’s University Hospital, Firenze, Italy
| | - A Buccoliero
- Pathology Unit Meyer Children’s University Hospital, Firenze, Italy
| | - L Genitori
- Neurosurgery Unit, Meyer Children’s University Hospital, Firenze, Italy
| | - R Guerrini
- Child Neurology Unit, Meyer Children’s University Hospital, Firenze, Italy
| | - S Giglio
- Medical Genetics Unit, Meyer Children Hospital, Firenze, Italy
| | - I Sardi
- Neuro-Oncology Unit, Meyer Children’s University Hospital, Firenze, Italy
| | - M Guidi
- Medical Genetics Unit, Meyer Children Hospital, Firenze, Italy
| | - M Censullo
- Medical Genetics Unit, Meyer Children Hospital, Firenze, Italy
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6
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Guidi M, Lucchesi M, Buccoliero A, Scoccianti S, Farina S, Fonte C, Caporalini C, Moscheo C, Genitori L, Sardi I. P01.044 Impact of the addition of vinorelbine to temozolomide in the first-line treatment of pediatric high grade gliomas. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- M Guidi
- Neuro-Oncology Unit - Meyer Children’s Hospital, Florence, Italy
| | - M Lucchesi
- Neuro-Oncology Unit - Meyer Children’s Hospital, Florence, Italy
| | - A Buccoliero
- Pathology Unit - Meyer Children’s Hospital, Florence, Italy
| | - S Scoccianti
- Radiotherapy Unit - Careggi Hospital, Florence, Italy
| | - S Farina
- Neuro-Oncology Unit - Meyer Children’s Hospital, Florence, Italy
| | - C Fonte
- Neuro-Oncology Unit - Meyer Children’s Hospital, Florence, Italy
| | - C Caporalini
- Pathology Unit - Meyer Children’s Hospital, Florence, Italy
| | - C Moscheo
- Neuro-Oncology Unit - Meyer Children’s Hospital, Florence, Italy
| | - L Genitori
- Neurosurgery Unit - Meyer Children’s Hospital, Florence, Italy
| | - I Sardi
- Neuro-Oncology Unit - Meyer Children’s Hospital, Florence, Italy
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7
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Guidi M, Giunti L, Buccoliero A, Farina S, Fonte C, Caporalini C, Moscheo C, Censullo M, Genitori L, Sardi I. P05.46 Metachronous malignancies and brain tumor in children with germline TP53 mutation. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- M Guidi
- Neuro-Oncology Unit - Meyer Children’s Hospital, Florence, Italy
| | - L Giunti
- Neuro-Oncology Unit - Meyer Children’s Hospital, Florence, Italy
| | - A Buccoliero
- Pathology Unit - Meyer Children’s Hospital, Florence, Italy
| | - S Farina
- Neuro-Oncology Unit - Meyer Children’s Hospital, Florence, Italy
| | - C Fonte
- Neuro-Oncology Unit - Meyer Children’s Hospital, Florence, Italy
| | - C Caporalini
- Pathology Unit - Meyer Children’s Hospital, Florence, Italy
| | - C Moscheo
- Neuro-Oncology Unit - Meyer Children’s Hospital, Florence, Italy
| | - M Censullo
- Neuro-Oncology Unit - Meyer Children’s Hospital, Florence, Italy
| | - L Genitori
- Neurosurgery Unit - Meyer Children’s Hospital, Florence, Italy
| | - I Sardi
- Neuro-Oncology Unit - Meyer Children’s Hospital, Florence, Italy
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8
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Da Ros M, Iorio A, Fantappiè O, De Gregorio V, Bonaccorsi L, Laffi G, Genitori L, Sardi I. P08.10 Efficacy of Temozolomide and Aldoxorubicin combination in U87-luc glioblastoma xenograft mice model. Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox036.200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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9
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Bacci GM, Ghin M, Lucchesi M, Guidi M, Ferraro M, Farina S, Favre C, Genitori L, Caputo R, Sardi I. P10.05 Periodic assessment with optical coherence tomography in children treated with multimodal therapies for brain tumors. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now188.229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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10
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Lucchesi M, Scoccianti S, Guidi M, Facchini L, Farina S, Fonte C, Favre C, Genitori L, Sardi I. P10.03 The prognostic role of primary treatment in pediatric High-Grade Gliomas: the experience at Meyer Children’s Hospital. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now188.227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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11
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Lucchesi M, Scoccianti S, Guidi M, Facchini L, Farina S, Fonte C, Favre C, Genitori L, Sardi I. P10.04 K27M mutation in Histone H3.3 defines a different disease in pediatric and young adult High Grade Gliomas with unique clinical features: the florentine experience with literature review. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now188.228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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12
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Lucchesi M, Scoccianti S, Guidi M, Facchini L, Farina S, Fonte C, Favre C, Genitori L, Sardi I. P10.02 Retrospective analysis on chemotherapy for pediatric High-Grade Gliomas: the experience at Meyer Children’s Hospital. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now188.226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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13
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van Scheppingen J, Iyer AM, Prabowo AS, Mühlebner A, Anink JJ, Scholl T, Feucht M, Jansen FE, Spliet WG, Krsek P, Zamecnik J, Buccoliero AM, Giordano F, Genitori L, Kotulska K, Jozwiak S, Jaworski J, Liszewska E, van Vliet EA, Aronica E. Expression of microRNAs miR21, miR146a, and miR155 in tuberous sclerosis complex cortical tubers and their regulation in human astrocytes and SEGA-derived cell cultures. Glia 2016; 64:1066-82. [PMID: 27014996 DOI: 10.1002/glia.22983] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 02/29/2016] [Accepted: 03/02/2016] [Indexed: 12/23/2022]
Abstract
Tuberous sclerosis complex (TSC) is a genetic disease presenting with multiple neurological symptoms including epilepsy, mental retardation, and autism. Abnormal activation of various inflammatory pathways has been observed in astrocytes in brain lesions associated with TSC. Increasing evidence supports the involvement of microRNAs in the regulation of astrocyte-mediated inflammatory response. To study the role of inflammation-related microRNAs in TSC, we employed real-time PCR and in situ hybridization to characterize the expression of miR21, miR146a, and miR155 in TSC lesions (cortical tubers and subependymal giant cell astrocytomas, SEGAs). We observed an increased expression of miR21, miR146a, and miR155 in TSC tubers compared with control and perituberal brain tissue. Expression was localized in dysmorphic neurons, giant cells, and reactive astrocytes and positively correlated with IL-1β expression. In addition, cultured human astrocytes and SEGA-derived cell cultures were used to study the regulation of the expression of these miRNAs in response to the proinflammatory cytokine IL-1β and to evaluate the effects of overexpression or knockdown of miR21, miR146a, and miR155 on inflammatory signaling. IL-1β stimulation of cultured glial cells strongly induced intracellular miR21, miR146a, and miR155 expression, as well as miR146a extracellular release. IL-1β signaling was differentially modulated by overexpression of miR155 or miR146a, which resulted in pro- or anti-inflammatory effects, respectively. This study provides supportive evidence that inflammation-related microRNAs play a role in TSC. In particular, miR146a and miR155 appear to be key players in the regulation of astrocyte-mediated inflammatory response, with miR146a as most interesting anti-inflammatory therapeutic candidate.
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Affiliation(s)
- J van Scheppingen
- Department of (Neuro)Pathology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - A M Iyer
- Department of (Neuro)Pathology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - A S Prabowo
- Department of (Neuro)Pathology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - A Mühlebner
- Department of (Neuro)Pathology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.,Department of Pediatrics, Medical University of Vienna, Vienna, Austria
| | - J J Anink
- Department of (Neuro)Pathology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - T Scholl
- Department of Pediatrics, Medical University of Vienna, Vienna, Austria
| | - M Feucht
- Department of Pediatrics, Medical University of Vienna, Vienna, Austria
| | - F E Jansen
- Department of Pediatric Neurology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - W G Spliet
- Department of Pathology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - P Krsek
- Department of Pediatric Neurology, 2nd Faculty of Medicine and Motol University Hospital, Prague, Czech Republic
| | - J Zamecnik
- Department of Pathology and Molecular Medicine, 2nd Faculty of Medicine and Motol University Hospital, Prague, Czech Republic
| | - A M Buccoliero
- Pathology Unit, Anna Meyer Children's Hospital, Florence, Italy
| | - F Giordano
- Department of Neurosurgery, Anna Meyer Children's Hospital, Florence, Italy
| | - L Genitori
- Department of Neurosurgery, Anna Meyer Children's Hospital, Florence, Italy
| | - K Kotulska
- Department of Neurology and Epileptology, Children's Memorial Health Institute, Warsaw, Poland
| | - S Jozwiak
- Department of Child Neurology, Medical University of Warsaw, Warsaw, Poland
| | - J Jaworski
- Laboratory of Molecular and Cellular Neurobiology, International Institute of Molecular and Cell Biology, Warsaw, Poland
| | - E Liszewska
- Laboratory of Molecular and Cellular Neurobiology, International Institute of Molecular and Cell Biology, Warsaw, Poland
| | - E A van Vliet
- Department of (Neuro)Pathology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - E Aronica
- Department of (Neuro)Pathology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.,Swammerdam Institute for Life Sciences, Center for Neuroscience, University of Amsterdam, Amsterdam, the Netherlands.,Stichting Epilepsie Instellingen Nederland (SEIN), the Netherlands
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14
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Lucchesi M, Buccoliero A, Moriondo M, Stival A, Facchini L, Becciani S, Guidi M, Farina S, De Martino M, Genitori L, Sardi I. 1410 Absence of human cytomegalovirus infection in childhood brain tumors. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30581-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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15
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Sardi I, Cardellicchio S, Iorio AL, da Ros M, la Marca G, Giunti L, Massimino M, Genitori L. P03.09 * PHARMACOLOGICAL MODULATION OF BLOOD-BRAIN BARRIER: FUTURE STRATEGY FOR TREATMENT OF BRAIN TUMORS. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou174.132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Cardellicchio S, Farina S, Bresci C, Settimelli V, Chiaro S, Massimino M, Genitori L, Sardi I. P05.07 * A LOWER-DOSE CISPLATIN-ETOPOSIDE REGIMEN FOR CHILDREN WITH HYPOTHALAMIC/CHIASMATIC TUMOR AND DIENCEPHALIC CACHEXIA. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou174.165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Hoffman LM, Donson AM, Nakachi I, Griesinger AM, Birks DK, Amani V, Hemenway MS, Liu AK, Wang M, Hankinson TC, Handler MH, Foreman NK, Zakrzewska M, Zakrzewski K, Fendler W, Stefanczyk L, Liberski PP, Massimino M, Gandola L, Ferroli P, Valentini L, Biassoni V, Garre ML, Sardi I, Genitori L, Giussani C, Massimi L, Bertin D, Mussano A, Viscardi E, Modena P, Mastronuzzi A, Barra S, Scarzello G, Cinalli G, Peretta P, Giangaspero F, Massimino M, Boschetti L, Biassoni V, Garre ML, Schiavello E, Sardi I, Genitori L, Bertin D, Modena P, Calareso G, Barra S, Scarzello G, Cinalli G, Peretta P, Mastronuzzi A, Giussani C, Giangaspero F, Antonelli M, Pecori E, Gandola L, Massimino M, Biassoni V, Di Meco F, Garre ML, Schiavello E, Sardi I, Genitori L, Bertin D, Viscardi E, Modena P, Barra S, Scarzello G, Cinalli G, Peretta P, Migliorati R, Taborelli A, Giangaspero F, Antonelli M, Pecori E, Gandola L, Witt H, Sill M, Wani K, Mack SC, Capper D, Pajtler K, Lambert S, Tzaridis T, Milde T, Northcott PA, Kulozik AE, Witt O, Collins VP, Ellison DW, Taylor MD, Kool M, Jones DTW, Korshunov A, Ken A, Pfister SM, Makino K, Nakamura H, Kuroda JI, Kuratsu JI, Toledano H, Margolin Y, Ohali A, Michowiz S, Witt H, Johann P, Tzaridis T, Tabori U, Walker E, Hawkins C, Taylor M, Yaniv I, Avigad S, Hoffman L, Plimpton SR, Foreman NK, Stence NV, Hankinson TC, Handler MH, Hemenway MS, Vibhakar R, Liu AK, Lourdusamy A, Rahman R, Ward J, Rogers H, Grundy R, Punchihewa C, Lee R, Lin T, Orisme W, Dalton J, Aronica E, Smith A, Gajjar A, Onar A, Pounds S, Tatevossian R, Merchant T, Ellison D, Parker M, Mohankumar K, Punchihewa C, Weinlich R, Dalton J, Tatevossian R, Phoenix T, Thiruvenkatam R, White E, Gupta K, Gajjar A, Merchant T, Boop F, Smith A, Ding L, Mardis E, Wilson R, Downing J, Ellison D, Gilbertson R, Ward J, Lourdusamy A, Speed D, Gould T, Grundy R, Rahman R, Mack SC, Witt H, Pfister SM, Korshunov A, Taylor MD, Consortium TIE, Hoffman LM, Griesinger A, Donson A, Birks D, Amani V, Foreman NK, Ohe N, Yano H, Nakayama N, Iwama T, Wright K, Hassall T, Bowers DC, Crawford J, Bendel A, Fisher PG, Merchant T, Ellison D, Klimo P, Boop F, Armstrong G, Qaddoumi I, Robinson G, Wetmore C, Broniscer A, Gajjar A, Rogers H, Chapman R, Mayne C, Duane H, Kilday JP, Coyle B, Grundy R, Graul-Conroy A, Hartsell W, Bragg T, Goldman S, Rebsamen S, Puccetti D, Salamat S, Patel NJ, Gomi A, Oguma H, Hayase T, Kawahara Y, Yagi M, Morimoto A, Wilbur C, Dunham C, Hawkins C, Tabori U, Mabbott D, Carret AS, Lafay-Cousin L, McNeely PD, Eisenstat D, Wilson B, Johnston D, Hukin J, Mynarek M, Kortmann RD, Kaatsch P, Pietsch T, Timmermann B, Fleischhack G, Benesch M, Friedrich C, von Bueren AO, Gerber NU, Muller K, Tippelt S, Warmuth-Metz M, Rutkowski S, von Hoff K, Murugesan MK, White E, Poppleton H, Thiruvenkatam R, Gupta K, Currle S, Kranenburg T, Eden C, Wright K, Ellison D, Gilbertson R, Boulos N, Dapper J, Patel Y, Wright K, Mohankumar K, Freeman B, Gajjar A, Shelat A, Stewart C, Guy R, Gilbertson R, Adamski J, Taylor M, Tabori U, Huang A, Bartels U, Ramaswamy V, Krishnatry R, Laperriere N, Hawkins C, Bouffet E, Araki A, Chocholous M, Gojo J, Dorfer C, Czech T, Dieckmann K, Slavc I, Haberler C, Pietsch T, Mynarek M, Doerner E, Muehlen AZ, Warmuth-Metz M, Kortmann R, von Buehren A, Friedrich C, von Hoff K, Rutkowski S, von Hoff K, Kortmann RD, Gerber NU, Mynarek M, Muller K, Friedrich C, von Bueren AO, Benesch M, Warmuth-Metz M, Ottensmeier H, Resch A, Kwiecien R, Faldum A, Kuehl J, Pietsch T, Rutkowski S, Sabnis D, Storer L, Simmonds L, Blackburn S, Lowe J, Grundy R, Kerr I, Coyle B, Pietsch T, Wohlers I, Goschzik T, Dreschmann V, Denkhaus D, Doerner E, Rahmann S, Klein-Hitpass L, Iglesias MJL, Riet FG, Dhermain FD, Canale S, Dufour C, Rose CS, Puget S, Grill J, Bolle S, Parkes J, Davidson A, Figaji A, Pillay K, Kilborn T, Padayachy L, Hendricks M, Van Eyssen A, Piccinin E, Lorenzetto E, Brenca M, Massimino M, Modena P, Taylor M, Ramaswamy V, Bouffet E, Aldape K, Cho YJ, Weiss W, Phillips J, Jabado N, Mora J, Fan X, Jung S, Lee JY, Zitterbart K, French P, Kros JM, Hauser P, Faria C, Korshunov A, Pfister S, Mack SC. EPENDYMOMA. Neuro Oncol 2014; 16:i17-i25. [PMCID: PMC4046284 DOI: 10.1093/neuonc/nou068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/07/2023] Open
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Spacca B, Giordano F, Mussa F, Genitori L. Congenital Median Perisellar Transsphenoidal Encephaloceles in Children: Surgical Treatment with an Extracranial Transoral Transnasal Approach. Skull Base Surg 2012. [DOI: 10.1055/s-0032-1314071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Bosis S, Semino M, Picciolli I, Pinzani R, Genitori L, Principi N, Esposito S. Meningitis complicated by subdural empyema and deafness caused by pneumoccoccal serotype 7F in a 17-month-old child: a case report. J Prev Med Hyg 2012; 53:98-100. [PMID: 23240168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Despite the availability of effective antibacterial agents and vaccines, pneumococcal meningitis and sepsis are still associated with high mortality rates and a high risk of neurological sequelae. We describe the case of a 17-month-old boy vaccinated with heptavalent pneumococcal conjugate vaccine (PCV7) who developed bacterial meningitis complicated by subdural empyema and deafness caused by Streptococcus pneumoniae serotype 7F. The 7F strain is not contained in PCV7 (the only vaccine on the market at the time of the onset of meningitis) but is included in the new pediatric 13-valent PCV, which may therefore prevent cases such as this in the future.
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Affiliation(s)
- S Bosis
- Pediatric Clinic 1, University of Milan, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Kim JH, Song HB, Kim DH, Park KD, Kim JH, Kim JH, Lee BJ, Kim DH, Kim JH, Khatua S, Kalkan E, Brown R, Pearlman M, Vats T, Abela L, Fiaschetti G, Shalaby T, Grunder E, Ma M, Grahlert J, Baumgartner M, Siler U, Nonoguchi N, Ohgaki H, Grotzer M, Adachi JI, Suzuki T, Fukuoka K, Yanagisawa T, Mishima K, Koga T, Matsutani M, Nishikawa R, Sardi I, Giunti L, Bresci C, Cardellicchio S, Da Ros M, Buccoliero AM, Farina S, Arico M, Genitori L, Massimino M, Filippi L, Erdreich-Epstein A, Zhou H, Ren X, Schur M, Davidson TB, Ji L, Sposto R, Asgharzadeh S, Tong Y, White E, Murugesan M, Nimmervoll B, Wang M, Marino D, Ellison D, Finkelstein D, Pounds S, Malkin D, Gilbertson R, Eden C, Ju B, Murugesan M, Phoenix T, Poppleton H, Lessman C, Taylor M, Gilbertson R, Sardi I, la Marca G, Cardellicchio S, Da Ros M, Malvagia S, Giunti L, Fratoni V, Farina S, Arico M, Genitori L, Massimino M, Giovannini MG, Giangaspero F, Badiali M, Gleize V, Paris S, Moi L, Elhouadani S, Arcella A, Morace R, Antonelli M, Buttarelli F, Mokhtari K, Sanson M, Smith S, Ward J, Wilson M, Rahman C, Rose F, Peet A, Macarthur D, Grundy R, Rahman R, Venkatraman S, Birks D, Balakrishnan I, Alimova I, Harris P, Patel P, Foreman N, Vibhakar R, Wu H, Zhou Q, Wang D, Wang G, Dang D, Pencreach E, Nguyen A, Guerin E, Lasthaus C, Guenot D, Entz-Werle N, Unland R, Schlosser S, Farwick N, Plagemann T, Richter G, Juergens H, Fruehwald M, Chien CL, Lee YH, Lin CI, Hsieh JY, Lin SC, Wong TT, Ho DMT, Wang HW, Lagah S, Tan IL, Malcolm S, Grundy R, Rahman R, Majani Y, Smith S, Grundy R, Rahman R, van Vuurden DG, Aronica E, Wedekind LE, Hulleman E, Biesmans D, Bugiani M, Vandertop WP, Kaspers GJL, Wurdinger T, Noske DP, Van der Stoop PM, van Vuurden DG, Shukla S, Wedekind LE, Kuipers GK, Hulleman E, Noske DP, Wurdinger T, Vandertop WP, Slotman BJ, Kaspers GJL, Cloos J, Sun T, Warrington N, Luo J, Ganzhorn S, Tabori U, Druley T, Gutmann D, Rubin J, Castelo-Branco P, Choufani S, Mack S, Galagher D, Zhang C, Lipman T, Zhukova N, Martin D, Merino D, Wasserman J, Samuel C, Alon N, Hitzler J, Wang JCY, Malkin D, Keller G, Dirks PB, Pfister S, Taylor MD, Weksberg R, Tabori U, Leblond P, Meignan S, Dewitte A, Le Tinier F, Wattez N, Lartigau E, Lansiaux A, Hanson R, Gordon I, Zhao S, Camphausen K, Warren K, Warrington NM, Sun T, Gutmann DH, Rubin JB, Nguyen A, Lasthaus C, Jaillet M, Pencreach E, Guerin E, Guenot D, Entz-Werle N, Kovacs Z, Martin-Fiori E, Shalaby T, Grotzer M, Bernasconi M, Werner B, Dyberg C, Baryawno N, Milosevic J, Wickstrom M, Northcott PA, Taylor MD, Kool M, Kogner P, Johnsen JI, Wilson M, Reynolds G, Davies N, Arvanitis T, Peet A, Zoghbi A, Meisterernst M, Fruehwald MC, Kerl K, Orr B, Haffner M, Nelson W, Yegnasubramanian S, Eberhart C, Fotovati A, Abu-Ali S, Wang PS, Deleyrolle L, Lee C, Triscott J, Chen J, Franciosi S, Nakamura Y, Sugita Y, Uchiumi T, Kuwano M, Leavitt B, Singh S, Jury A, Jones C, Wakimoto H, Reynolds B, Pallen C, Dunn S, Fletcher S, Levine J, Li M, Kagawa N, Hirayama R, Chiba Y, Kijima N, Arita H, Kinoshita M, Hashimoto N, Izumoto S, Maruno M, Yoshimine T. BIOLOGY. Neuro Oncol 2012; 14:i7-i15. [PMCID: PMC3483341 DOI: 10.1093/neuonc/nos095] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/24/2023] Open
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Zaghloul M, Elbeltagy M, Mousa A, Eldebawy E, Amin A, Pavelka Z, Vranova V, Valaskova I, Tomasikova L, Oltova A, Ventruba J, Mackerle Z, Kren L, Skotakova J, Zitterbart K, Sterba J, Milde T, Kleber S, Korshunov A, Witt H, Hielscher T, Koch P, Koch HG, Jugold M, Deubzer HE, Oehme I, Lodrini M, Grone HJ, Benner A, Brustle O, Gilbertson RJ, von Deimling A, Kulozik AE, Pfister SM, Ana MV, Witt O, Milde T, Hielscher T, Witt H, Kool M, Mack SC, Deubzer HE, Oehme I, Lodrini M, Benner A, Taylor MD, von Deimling A, Kulozik AE, Pfister SM, Witt O, Korshunov A, Fouyssac F, Schmitt E, Mansuy L, Marchal JC, Coffinet L, Bernier V, Chastagner P, Sperl D, Zacharoulis S, Massimino M, Schiavello E, Pizer B, Piette C, Kitanovski L, von Hoff K, Quehenberger F, Rutkowski S, Benesch M, Tzaridis TD, Witt H, Milde T, Bender S, Pfaff E, Barbus S, Bageritz J, Jones DTW, Kulozik A, Lichter P, Korshunov A, Witt O, Pfister SM, Song SH, Kang CW, Kim SH, Bandopadhayay P, Ullrich N, Goumnerova L, Scott RM, Silvera VM, Ligon KL, Marcus KJ, Robison N, Manley PE, Chi S, Kieran MW, Schiavello E, Biassoni V, Pierani P, Cesaro S, Maura M, Witt H, Mack S, Jager N, Jones DTW, Bender S, Stutz A, Milde T, Northcott PA, Fults DW, Gupta N, Karajannis M, Kulozik AE, von Deimling A, Witt O, Rutka JT, Lichter P, Korbel J, Korshunov A, Taylor MD, Pfister SM, de Rezende ACP, Chen MJ, da Silva NS, Cappellano A, Cavalheiro S, Weltman E, Currle S, Thiruvenkatam R, Murugesan M, Kranenburg T, Phoenix T, Gupta K, Gilbertson R, Rogers H, Kilday JP, Mayne C, Ward J, Adamowicz-Brice M, Schwalbe E, Clifford S, Coyle B, Grundy R, Rogers H, Mayne C, Kilday JP, Coyle B, Grundy R, Kilday JP, Mitra B, Domerg C, Ward J, Andreiuolo F, Osteso-Ibanez T, Mauguen A, Varlet P, Le Deley MC, Lowe J, Ellison DW, Gilbertson RJ, Coyle B, Grill J, Grundy RG, Fleischhack G, Pajtler K, Zimmermann M, Rutkowski S, Warmuth-Metz M, Kortmann RD, Pietsch T, Faldum A, Bode U, Gandola L, Pecori E, Scarzello G, Barra S, Mascarin M, Scoccianti S, Mussano A, Garre ML, Jacopo S, Pierani P, Viscardi E, Balter R, Bertin D, Giangaspero F, Massimino M, Pearlman M, Khatua S, Van Meter T, Koul D, Yung A, Paulino A, Su J, Dauser R, Whitehead W, Teh B, Chintagumpala M, Perek D, Drogosiewicz M, Filipek I, Polnik MP, Baginska BD, Wachowiak J, Kazmierczak B, Sobol G, Musiol K, Kowalczyk J, Slusarz HW, Peregud-Pogorzelski J, Grajkowska W, Roszkowski M, Teo WY, Chintagumpala M, Okcu F, Dauser R, Mahajan A, Adesina A, Whitehead W, Jea A, Bollo R, Paulino AC, Velez-Char N, Doerner E, Muehlen AZ, Vladimirova V, Warmuth-Metz M, Kortmann R, von Hoff K, Friedrich C, Rutkowski S, von Bueren AO, Pietsch T, Barszczyk M, Buczkowicz P, Morrison A, Tabori U, Hawkins C, Krajewski K, von Hoff K, Kammler G, Friedrich C, von Bueren A, Kortmann RD, Krauss J, Warmuth-Metz M, Rutkowski S, Ferreira C, Dieffenbach G, Barbosa C, Cuny P, Grill J, Piccinin E, Massimino M, Giangaspero F, Brenca M, Lorenzetto E, Sardi I, Genitori L, Pollo B, Bertin D, Maestro R, Modena P, MacDonald S, Ebb D, Lavally B, Yeap B, Marcus K, Tarbell N, Yock T, Schittone S, Donson A, Birks D, Amani V, Griesinger A, Handler M, Madey M, Merchant T, Foreman N, Hukin J, Ailon T, Dunham C, Carret AS, Tabori U, McNeely PD, Zelcer S, Wilson B, Lafay-Cousin L, Johnston D, Eisenstat D, Silva M, Jabado N, Yip S, Goddard K, Fryer C, Hendson G, Hawkins C, Dunn S, Singhal A, Lassen-Ramshad Y, Vestergaard A, Seiersen K, Schultz HP, Hoeyer M, Petersen JB, Moreno L, Popov S, Jury A, Al Sarraj S, Jones C, Zacharoulis S, Bowers D, Gargan L, Horton CJ, Rakheja D, Margraf L, Yeung J, Hamilton R, Okada H, Jakacki R, Pollack I, Fleming A, Jabado N, Saint-Martin C, Freeman C, Albrecht S, Montes JL. EPENDYMOMA. Neuro Oncol 2012; 14:i33-i42. [PMCID: PMC3483345 DOI: 10.1093/neuonc/nos099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023] Open
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Barba C, Montanaro D, Giordano F, Frija F, Genitori L, Guerrini R. P2.17 Non invasive functional mapping in children with symptomatic perirolandic seizures: the contribution of functional MRI during passive motor tasks. Clin Neurophysiol 2011. [DOI: 10.1016/s1388-2457(11)60216-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Abstract
We describe the case a 2-day-old female with congenital glioblastoma. Total resection was followed by adjuvant and high dose chemotherapy, as indicated by the current Italian infant protocol. The child is alive and well 18 months after diagnosis. A review of 67 selected congenital brain tumors showed the mortality rate was 82%. Even though the majority of patients had glioblastoma, only 5/67 had received adjuvant therapy. To ensure optimal outcomes, we recommend total or subtotal surgical resection, followed by adjuvant and high dose chemotherapy. Given the lack specific protocols for congenital brain tumors an international consensus seems to be needed, starting with congenital glioblastoma.
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Affiliation(s)
- G M Milano
- Unit of Pediatric Oncology and Haematology, Ospedale S. Maria della Misericordia, A.O. di Perugia, Italy.
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Buccoliero AM, Castiglione F, Rossi Degl'Innocenti D, Paglierani M, Maio V, Gheri CF, Garbini F, Moncini D, Taddei A, Sardi I, Sanzo M, Giordano F, Mussa F, Genitori L, Taddei GL. O6-Methylguanine-DNA-methyltransferase in recurring anaplastic ependymomas: PCR and immunohistochemistry. J Chemother 2008; 20:263-8. [PMID: 18467255 DOI: 10.1179/joc.2008.20.2.263] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Ependymomas are the third most common brain tumor in children. The post surgical management is controversial. There are no convincing data on an effective role for chemotherapy. O(6)-Methylguanine-DNA-Methyltransferase (MGMT) is a DNA repair protein considered to be a chemosensitivity predictor. Hypermethylation of the MGMT gene promoter is an important cause of MGMT inactivation. We evaluated the MGMT gene promoter methylation and the immunohistochemical MGMT protein expression in 12 recurrent anaplastic ependymomas affecting children. Our purpose was to investigate the molecular rationale of the administration of alkylating agents to children affected by recurrent anaplastic ependymomas. All ependymomas lacked MGMT promoter hypermethylation and 9 (75%) showed high MGMT protein expression (>50% tumoral cells). Differences between different recurrences in the same patient were not observed. These results may indicate MGMT as a factor of chemoresistance to alkylating drugs in anaplastic ependymomas and support the uncertainties regarding the actual benefit of chemotherapy for patients with anaplastic ependymomas.
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Affiliation(s)
- A M Buccoliero
- Department of Human Pathology and Oncology, University of Florence, Florence, Italy.
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Giordano F, Donati P, Mussa F, Sanzo M, Sardo L, Di Pietro G, Genitori L. Les kystes arachnoïdiens temporo-sylviens chez l’enfant : microchirurgie ou neuro-endoscopie ? Une série de 42 cas. Neurochirurgie 2006. [DOI: 10.1016/s0028-3770(06)71302-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Longatti P, Godano U, Gangemi M, Delitala A, Morace E, Genitori L, Alafaci C, Benvenuti L, Brunori A, Cereda C, Cipri S, Fiorindi A, Giordano F, Mascari C, Oppido PA, Perin A, Tripodi M. Cooperative study by the Italian neuroendoscopy group on the treatment of 61 colloid cysts. Childs Nerv Syst 2006; 22:1263-7. [PMID: 16648939 DOI: 10.1007/s00381-006-0105-8] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2005] [Revised: 11/13/2005] [Indexed: 11/30/2022]
Abstract
OBJECTS Microsurgical resection, stereotactic aspiration and VP shunt have for years been the choice options for the treatment of colloid cysts of the third ventricle. Recently, endoscopic approaches have aroused increasing interest and gained acceptance. Although safer, this minimally invasive approach is considered less efficacious than microsurgery. Relatively long-term results are now available and some conclusions might be inferred on the usefulness of this procedure. MATERIALS AND METHODS Between 1994 and 2005, 61 patients harbouring a colloid cyst of the third ventricle were treated with neuroendoscopic technique in 11 Italian neurosurgical centres. Cyst diameters ranged from 6 to 32 mm. A flexible endoscope was used in 34 cases, a rigid one in 21, both instruments in six. The technique consisted in cyst fenestrations, colloid aspiration, coagulation of the internal cyst wall and, occasionally, capsule excision. Mean postoperative hospital stay was 6.7 days. Early postoperative neuroimaging revealed a cyst residue in 36 cases (mean diameter 4.3 mm). There were two complications (3.2%). Follow-up varied between 1 and 132 months (mean 32 months, more than 5 years in 17 patients). There were seven asymptomatic recurrences, three of them evolving from a previous residue. CONCLUSION The endoscopic approach to the treatment of colloid cysts is safe, effective and well accepted by patients. Although asymptomatic, recurrences (11.4%) cast a persisting shadow on the long-term results, and, therefore, the controversy with the traditional microsurgical treatment remains open.
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Affiliation(s)
- P Longatti
- Ospedale di Treviso, Università di Padova, 31100 Treviso [corrected] Italy
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Sandri A, Sardi N, Genitori L, Giordano F, Peretta P, Basso ME, Bertin D, Mastrodicasa L, Todisco L, Mussa F, Forni M, Ricardi U, Cordero di Montezemolo L, Madon E. Diffuse and focal brain stem tumors in childhood: prognostic factors and surgical outcome. Experience in a single institution. Childs Nerv Syst 2006; 22:1127-35. [PMID: 16568342 DOI: 10.1007/s00381-006-0083-x] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2005] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Brainstem tumors (BSTs) are usually gliomas and are divided into diffuse BSTs (DBSTs) and focal BSTs (FBSTs). The aim of this study is to investigate the different outcomes of these two entities. METHODS Thirty-one patients with BSTs were admitted to our institution from 1995 to 2003. Patients with DBSTs were treated with locoregional radiotherapy (1.8 Gy/day for 54 Gy) and weekly vincristine for radiosensitization (1.5 mg/sm for six total doses). Patients with FBSTs underwent surgical resection. Chemotherapy and/or radiotherapy were considered in progression. RESULTS AND CONCLUSIONS Fourteen patients were diagnosed as having DBSTs. The responses to treatment were ten cases of partial response, three of stable disease, and one of progressive disease. General and/or neurological symptoms improved in more than 80% of patients. The median time from diagnosis to progression and to death were, nonetheless, 8 (range of 3-13) and 13 (range of 4-25) months, respectively, with a 2-year overall survival rate of 12.3% [standard error (SE) 11.2]. Seventeen patients were diagnosed as having FBSTs. Gross total removal was achieved in 4/17 cases, subtotal removal in 7/17, and partial removal in 6/17. There was one surgery-related death. Eight out of 17 patients had adjuvant chemo- and/or radiotherapy after progression: 6/8 are without neurological symptoms and 2/8 have died due to tumor progression. The 4-year overall and disease-free survival rates are 87.4 (SE 8.4) and 58.8% (SE 11.9), respectively, the extent of resection being the most important prognostic factor (p=0.012). DBSTs continue to carry a dismal prognosis, thus demanding new treatment modalities; FBSTs can be treated surgically and patients benefit from a better prognosis.
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Affiliation(s)
- A Sandri
- Pediatric Oncology Department, University of Turin, Torino, Piazza Polonia 94, 10124 Turin, Italy.
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Spinelli G, Genitori L, Raffaini M, Giannini D. O.136 Complications concerning the Le Fort III facial osteo-distraction. J Craniomaxillofac Surg 2006. [DOI: 10.1016/s1010-5182(06)60165-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Einaudi S, Matarazzo P, Peretta P, Grossetti R, Giordano F, Altare F, Bondone C, Andreo M, Ivani G, Genitori L, de Sanctis C. Hypothalamo-hypophysial dysfunction after traumatic brain injury in children and adolescents: a preliminary retrospective and prospective study. J Pediatr Endocrinol Metab 2006; 19:691-703. [PMID: 16789636 DOI: 10.1515/jpem.2006.19.5.691] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
With two study protocols, one retrospective and the other prospective, we evaluated hypothalamo-hypophysial dysfunction (HHD) in paediatric patients treated for traumatic brain injury (TBI) in the neurosurgical or intensive care department at our hospital. The retrospective group comprised 22 patients who had experienced TBI 0.7-7.25 years before the study. The prospective group included 30 patients assessed at TBI (T0), 26 of 30 after 6 months (T6), and 20 of 26 after 12 months (T12). Auxological and hormonal basal parameters of hypothalamo-hypophysial function were evaluated at recall in the retrospective group, and at T0, T6 and T12 in the prospective group. Basal data and standard dynamic tests in selected patients revealed one with precocious puberty, one with total anterior hypopituitarism, one with central hypogonadism, and one with growth hormone (GH) deficiency in the retrospective group; three patients with cerebral salt-wasting syndrome, one with diabetes insipidus and seven with low T3 syndrome at T0 (all transient), one with hypocorticism at T6 confirmed at T12, and one with GH deficiency at T12 in the prospective group. The results of our study show that post-TBI HHD in our paediatric cohort is not uncommon. Of the 48 patients who underwent a complete evaluation (22 retrospective study patients and 26 prospective study patients evaluated at T6) five (10.4%) developed HHD 6 months or more after TBI. HHD was newly diagnosed in one previously normal patient from the prospective group at 12 months after TBI. GH deficiency was the most frequent disorder in our paediatric cohort.
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Affiliation(s)
- S Einaudi
- Department of Paediatric Endocrinology, Regina Margherita Children's Hospital, Piazza Polonia 94, 10126 Turin, Italy.
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Genitori L, Giordano F, Mussa F, Sanzo M, Sardo L, Spacca B, Di Pietro G, Shamsaldin M, Donati P. Astrocytomes giganto-cellulaires subépendymaires (SEGA) dans la maladie de Bourneville (ST). Une série chirurgicale de 16 cas. Neurochirurgie 2005. [DOI: 10.1016/s0028-3770(05)83564-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Matarazzo P, Genitori L, Lala R, Andreo M, Grossetti R, de Sanctis C. Endocrine function and water metabolism in children and adolescents with surgically treated intra/parasellar tumors. J Pediatr Endocrinol Metab 2004; 17:1487-95. [PMID: 15570985 DOI: 10.1515/jpem.2004.17.11.1487] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Hydroelectrolytic disorders often complicate surgery of intra/parasellar tumors in children and adolescents. Eighteen patients undergoing microneurosurgical procedures for intra-supra-sellar craniopharyngioma (10 patients), hypothalamic germinomas (3 patients), hypothalamic-chiasmatic astrocytomas (3 patients), pituitary adenomas (2 patients) were studied. The hydroelectrolytic balance was assessed from 8 hours before surgery to 1 week after with a specific protocol in which water metabolism alterations were treated with standard procedure. Diabetes insipidus (DI) was observed in 10/18 patients before surgery and in 15/18 patients after surgery; during surgery it was effectively treated with synthetic desmopressin (DDAVP) and hydroelectrolytic solutions. Hyponatremia, isolated or associated (with diuresis contraction or polyuria), seen during surgery and in the following 24 hours, was treated with variation of the infusion rate. We show that close monitoring and treatment of hydroelectrolytic disorders in patients submitted to neurosurgery for intra/ parasellar tumors may significantly reduce their morbidity and mortality rate.
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Affiliation(s)
- P Matarazzo
- Department of Pediatric Endocrinology, Regina Margherita Children 's Hospital, Turin, Italy.
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Ricardi U, Corrias A, Einaudi S, Genitori L, Sandri A, di Montezemolo LC, Besenzon L, Madon E, Urgesi A. Thyroid dysfunction as a late effect in childhood medulloblastoma: a comparison of hyperfractionated versus conventionally fractionated craniospinal radiotherapy. Int J Radiat Oncol Biol Phys 2001; 50:1287-94. [PMID: 11483340 DOI: 10.1016/s0360-3016(01)01519-x] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Primary hypothyroidism is a common sequela of craniospinal radiotherapy in the treatment of childhood medulloblastoma. Due to the strong radiobiologic rationale, hyperfractionation can reduce the delayed effects of radiation injury. METHODS AND MATERIALS The authors compared the incidence of thyroid dysfunction after conventionally fractionated radiotherapy (Group A, n = 20 patients) vs. hyperfractionated radiotherapy (Group B, n = 12 patients) in a group of pediatric patients with posterior fossa primitive neuroectodermal tumor (PNET). RESULTS The mean age at the time of tumor diagnosis was 7.4 years in Group A and 8.4 years in Group B. Thyroid function was evaluated yearly, with ultrasonographic examination every 2 years. The patients were followed after diagnosis for a mean of 10.8 years for Group A and 6.0 years for Group B. Approximately 80% of the Group A (16/20) and 33.3% of the Group B (4/12) patients developed primary hypothyroidism within a similar period after irradiation (4.2 vs. 3.5 years, respectively). Analysis by cumulative incidence function demonstrated a significant difference in the risk of developing thyroid dysfunction between these two groups of patients (p < 0.05). Ultrasonography showed reduced thyroid volume in 7 Group A patients and structural changes in 21 patients (17 Group A, 4 Group B cases); a thyroid benign nodule was detected in 2 Group A patients. CONCLUSIONS The current study findings suggest that the use of hyperfractionated craniospinal radiotherapy in the treatment of childhood medulloblastoma is associated with a lower risk of these patients' developing late thyroid dysfunction.
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Affiliation(s)
- U Ricardi
- Department of Radiation Oncology, Regina Margherita Children's Hospital, Turin, Italy.
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Corrias A, Einaudi S, Ricardi U, Sandri A, Besenzon L, Altare F, Artesani L, Genitori L, Andreo M, De Sanctis C. Thyroid diseases in patients treated during pre-puberty for medulloblastoma with different radiotherapic protocols. J Endocrinol Invest 2001; 24:387-92. [PMID: 11434661 DOI: 10.1007/bf03351038] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
We evaluated thyroid disease in 32 patients treated, during pre-puberty, for medulloblastoma, followed for at least 4 years and without relapse during observation. After surgery the patients underwent chemotherapy (CT) and radiotherapy (RT). The protocols were as follows: 20 patients (group A) SNC 76 and SNC 85 protocols which included conventional fractionated RT (36-40 Gy to the craniospinal axis and a 14-18 Gy boost to the posterior fossa, administered as 1.5-1.8 Gy per fraction per day) and a junction between the cranial and the spinal fields at C2-C3 level; 12 patients (group B) SNC 91 protocol which included hyperfractionated RT (36 Gy to the craniospinal axis and a 30 Gy boost to the posterior fossa; this was administred as 1 Gy per fraction twice per day) and a junction at levels C5-C6 or C6-C7 level. The mean age at diagnosis was 7.4+/-3.2 years for group A and 8.4+/-2.6 years for group B. Thyroid function was evaluated yearly and ultrasonographic characteristics every 2 years. The patients were followed for a mean of 10.8+/-3.8 for group A and 6+/-1.4 years for group B. Primary hypothyroidism was diagnosed in 16 group A patients and 4 group B patients, and central hypothyroidism was diagnosed in 2 group A patients (difference in risk of developing hypothyroidism evaluated with a Wilcoxon-test: p=0.048). Ultrasonography showed reduced thyroid volume in 7 group A cases, and structural changes in 21 patients (17 group A, 4 group B); 9 L-thyroxine-treated patients were confirmed hypothyroid after having stopped therapy. A thyroid nodule was detected in two cases (one from each group). In conclusion, our data indicate that thyroid injury may be diminished by the use of hyperfractionation and low-junction radiotherapy in the treatment of medulloblastoma.
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Affiliation(s)
- A Corrias
- Division of Pediatric Endocrinology, Regina Margherita Hospital, Turin, Italy.
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Genitori L, Peretta P, Nurisso C, Macinante L, Mussa F. Chiari type I anomalies in children and adolescents: minimally invasive management in a series of 53 cases. Childs Nerv Syst 2000; 16:707-18. [PMID: 11151721 DOI: 10.1007/s003810000338] [Citation(s) in RCA: 107] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The authors studied the role of the sole posterior fossa bony decompression in the management of symptomatic children affected by Chiari type I anomalies. The series in the pediatric literature of this subject were reviewed and compared with that presented in this article. From May 1994 to December 1998, 53 patients (3 months to 26 years) were observed. They were divided into: asymptomatic patients (27), who received no surgical treatment and were only subject to clinical observation; symptomatic patients (brain stem compression 16, syringomyelia 10, including 7 with holocord). All the symptomatic patients were treated with the same surgical approach: bony decompression of posterior fossa with removal of the posterior arch of C-1 and the outer layer of the dura without dural opening. In all 16 (100%) of the 16 patients with brain stem compression the symptoms resolved or improved; in patients with syringomyelia the symptoms were resolved or improved in 94.4% of cases. Two children required further surgery after 13 and 24 months, respectively. This series seems to demonstrate that even a simple extradural surgical approach, with a lower rate of postoperative complications and short stay in hospital, is sufficient to arrest the disease and to improve the symptomatology in a high percentage of cases (97.2%), which is comparable to that achieved with other, more aggressive, procedures.
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Affiliation(s)
- L Genitori
- Division of Pediatric Neurosurgery, Children's Hospital (O.I.R.M.), Piazza Polonia 94, 10126 Turin, Italy.
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Abstract
A boy is described with early puberty and Chiari 1 malformation. It is not known whether there was an etiological relationship between these two conditions, or whether they were coincidental. This report emphasizes the utility of MRI when early puberty is diagnosed, particularly in males.
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Affiliation(s)
- S Interlici
- Centre of Auxology, Az. Osp. O.I.R.M./S. Anna-Regina Margherita, University of Turin, Italy
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36
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Franceschini P, Licata D, Di Cara G, Guala A, Franceschini D, Genitori L. Macrocephaly-Cutis marmorata telangiectatica congenita without cutis marmorata? Am J Med Genet 2000; 90:265-9. [PMID: 10710221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
We report on two patients with clinical manifestations consistent with a diagnosis of macrocephaly-cutis marmorata telangiectatica congenita (M-CMTC). Both showed macrocephaly with high forehead, overgrowth, capillary hemangiomata involving philtrum, nose, and lips, and redundant skin. In addition, the first had cutis marmorata and joint laxity. The second had postaxial polydactyly of hands and feet, cutaneous syndactyly of third and fourth right fingers and of second and third right toes without evident cutis marmorata. A magnetic resonance imaging scan showed cerebral alterations in both patients. The first had bilateral cortical dysplasia with frontal bilateral myelinization defect of corona radiata. The second had mild intertonsillar widening, cavum septi pellucidi, small porencephalic areas in the anterolateral region of cellae, and subsequently developed a nonobstructive hydrocephalus. Reviewing all reported cases we propose a new criterion for M-CMTC diagnosis.
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Affiliation(s)
- P Franceschini
- Dipartimento di Scienze Pediatriche e dell'Adolescenza, Università di Torino, Turin, Italy
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Franceschini P, Licata D, Guala A, Di Cara G, Signorile F, Franceschini D, Genitori L, Restagno G. Long first metacarpal in monozygotic twins with probable Baller-Gerold syndrome. Am J Med Genet 1998; 80:303-8. [PMID: 9856554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
We report on a pair of monozygotic twins with probable Baller-Gerold syndrome (BGS). Twin A had severe coronal craniosynostosis. Twin B had right radioulnar and ipsilateral first metacarpal hypoplasia. Both had bilateral fifth finger clinodactyly. Assuming that the twins were truly monozygotic, a single genetic disorder (i.e., BGS) could explain the variable expression. Together the twins have the typical anomalies of BGS. The diagnosis was supported by the metacarpophalangeal profile (MPP) which confirmed hypoplasia of the first right metacarpal in Twin A and bilateral fifth finger brachymesophalangy in both twins. Furthermore, the MPP showed an unexpected abnormal lengthening of the first metacarpal (unilateral in Twin A and bilateral in Twin B), a previously undetected radial ray defect in BGS. These findings suggest the possibility that the MPP may assist recognition of mild cases of BGS such as those with apparently isolated craniosynostosis or isolated upper limbs defects.
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Affiliation(s)
- P Franceschini
- Dipartimento di Scienze Pediatriche e dell'Adolescenza, Università di Torino, Turin, Italy
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39
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Ricard U, Besenzon L, Cordero di Montezemolo L, Cenni M, Sandri S, Genitori L, Urgesi A. Low dose hyperfractionated craniospinal radiation therapy for childhood cerebellar medulloblastoma: Early results of a phase I–II study. Eur J Cancer 1997. [DOI: 10.1016/s0959-8049(97)85623-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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40
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Abstract
Clinical examination of patients affected by plagiocephaly or trigonocephaly reveals evident malformation of the orbits, and the ocular repercussions are pronounced when children are operated on at an advanced age. Since it is generally accepted that binocular vision is fully developed by approximately 6 months of age, a late correction of plagiocephalic or trigonocephalic skull deformities may be an obstacle to the development of normal visual function. For the present report we investigated astigmatism and strabismus in 53 children, 39 of whom were operated on for plagiocephaly and 14 for trigonocephaly. Traction on the ocular globe induced by the bony deformation caused by the craniosynostosis may explain astigmatism and strabismus.
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Affiliation(s)
- D Denis
- Department of Ophthalmology, Hôpital de la Timone Adulte, Marseille, France
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41
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Lena G, van Calenberg F, Genitori L, Choux M. Supratentorial interhemispheric cysts associated with callosal agenesis: surgical treatment and outcome in 16 children. Childs Nerv Syst 1995; 11:568-73. [PMID: 8556722 DOI: 10.1007/bf00300994] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Cerebrospinal-fluid-filled interhemispheric cysts associated with callosal agenesis are relatively rare lesions, and have been subject to a varied and confusing terminology. From a pragmatic surgical point of view, we believe that the dorsal III ventricular cyst [35] and the giant interhemispheric cyst [23], although of different embryological origin, can be classified as one group. The most important condition that must be distinguished from interhemispheric cysts is the alobar form of holoprosencephaly. We describe the clinical symptomatology in 16 children who were surgically treated with a cysto-peritoneal shunt. The outcome, both neurologically and developmentally, was good in the large majority of cases, and compared favorably to similar cases in the older literature. It therefore seems reasonable, at the present state of knowledge and until further studies clarify the origin and natural history of these cysts, to treat them as early as possible in order to prevent gross developmental deficits.
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Affiliation(s)
- G Lena
- Department of Pediatric Neurosurgery, Hôpital des Enfants, La Timone, Marseille, France
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42
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Abstract
BACKGROUND Trigonocephaly, caused by premature closure of the metopic suture, is a rare form of craniosynostosis. The aim of this study was to assess the visual outcome in children operated on for trigonocephaly. METHODS We present eight cases of children with trigonocephaly surgically corrected by the same craniofacial technique. CT with 3D reconstruction was performed in all cases. Genitori defined three types of trigonocephaly according to the severity of the deformity of the skull base only types II and III were included in this study directed at evaluation of the ocular disorder. A complete eye examination was performed on all children by the same observer, with a follow-up of 2-6 years. RESULTS 3D-CT reconstruction of the skull base showed that the frontozygomatic region was affected by the deformation. Ocular examination showed considerable astigmatism in most children with late operation. A low degree of strabismus was observed in most children. CONCLUSION This study demonstrated that reconstructive surgery should be performed by the age of 6 months, given the immaturity of the visual system up to that time. Close cooperation between neurosurgeons, pediatricians and ophthalmologists is of paramount importance in order to prevent this bone deformation exerting an adverse effect on visual development. The ophthalmologist must possess a basic understanding of the various craniosynostoses.
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Affiliation(s)
- D Denis
- Department of Ophthalmology, Hôpital de la Timone, Marseille, France
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43
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Vagner-Capodano AM, Zattara-Cannoni H, Gambarelli D, Gentet JC, Genitori L, Lena G, Graziani N, Raybaud C, Choux M, Grisoli F. Detection of i(17q) chromosome by fluorescent in situ hybridization (FISH) with interphase nuclei in medulloblastoma. Cancer Genet Cytogenet 1994; 78:1-6. [PMID: 7987794 DOI: 10.1016/0165-4608(94)90037-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Medulloblastomas are the most frequent primitive neurectodermal tumors in children. An isochromosome for the long arm of 17, i(17q), is found in 30% of medulloblastomas. For some authors, this abnormality is observed in cases with a shorter survival time. In our cytogenetic studies of 30 medulloblastomas, we observed i(17q) in only three cases, a monosomy 17 in two cases, a monosomy 22 in four cases, nonspecific numerical or structural abnormalities in five cases, and normal karyotypes in 12 cases. We compared the results of karyotypic analysis after culture and FISH with a chromosome 17 alpha satellite DNA probe on interphase nuclei in five cases of medulloblastoma. In one case, i(17q) was only observed in four cells in karyotypic analysis, in three cases a normal karyotype was found, and in one case karyotypic analysis was impossible. In all of these cases, i(17q) was observed in a great number of nuclei by FISH on interphase nuclei. Our study shows that the FISH on interphase nuclei permitted us to observe i(17q) in the cases where it was not or could not be completely detected by karyotypic analysis. The association of these two techniques is required to detect i(17q), an abnormality whose prognosis value in medulloblastomas is now recognized.
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Abstract
Plagiocephaly, which is caused by premature closure of one of the coronal sutures, leads to fronto-orbital asymmetry. The aim of this work was to study the repercussions of orbital deformation on the visual system. Twenty-one patients presenting with plagiocephaly at birth and operated on by the same craniofacial technique (bilateral approach with translation and advancement of the entire involved orbits) were included in the study. All of the patients were examined by clinical anthropometry with three-dimensional reconstruction and underwent complete eye examination by the same observer. Follow-up after craniofacial surgery ranged from 15 months to 4 years. In the last few years, three-dimensional reconstruction has shown that the anatomic region affected by the deformation is the frontozygomatic region and has thus made it possible to advance to another theory on the origins of ocular problems. The severe effect of orbital anomalies on the development of the visual system (binocular vision, strabismus with amblyopia, refractive errors) has been emphasized in the literature. The present study shows that the scheduling of reconstructive surgery is fundamental and must not exceed 6 months, given the immaturity of the visual system up until this time. This means that the ophthalmologist must be able to recognize the various craniostenoses in order to schedule reconstructive surgery as soon as possible. Cooperation between the neurosurgeon and the ophthalmologist is of paramount importance if the pathogenic effects of this bone deformation are to be stopped and proper visual development preserved.
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Affiliation(s)
- D Denis
- Département d'Ophtalmologie, Centre Hospitalo-universitaire de la Timone, Marseille, France
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45
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Abstract
Between 1975 and 1992, 426 children with craniofacial malformations were treated in the Department of Pediatric Neurosurgery at the Hôpital des Enfants de la Timone in Marseille. Plagiocephaly was present in 71 (16.6%). The authors present a reproducible analysis of the skull base in plagiocephaly based on these 71 patients. A control group of Mediterranean children (n = 20) was used for comparison. Clinical anthropometric patterns were analyzed in all cases. Comparison with the control group showed a difference only in the nasion-lambda distance. Data obtained from clinical anthropometry were compared for the involved and the uninvolved sides. A three-dimensional reconstruction was possible in 20 cases. The statistical correlation between the basal angles (nasion-pterional, nasion-petrosal, nasion-clino-basion, and zygomatic angles) of the involved and uninvolved sides allows a new nosographic identification of this complex malformation.
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Affiliation(s)
- L Genitori
- Département de Neurochirurgie Pédiatrique, Hospitalo-Universitaire de la Timone, Marseille, France
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46
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Affiliation(s)
- M Choux
- Department of Pediatric Neurosurgery, Hopital des Enfants, La Timone, Marseille, France
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47
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Abstract
Shunt infection remains the foremost problem of shunt implantation after mechanical malfunctions. Diversionary cerebrospinal fluid shunt implantation has a high complication rate, with 5% to 15% of such shunts becoming infected. Of these infections, 70% are diagnosed within 1 month after surgery and more than 90% within 6 months. Shunt infection in the vast majority of cases is therefore a complication of shunt surgery. The authors review their experience with shunt implantation during two time periods. From January, 1978, to December, 1982, 302 children with hydrocephalus underwent 606 operations. Among these children, 47 (15.56%) developed a proven shunt infection, with an incidence of infection per procedure of 7.75%. As a result of this study, a new protocol for shunt procedures involving modifications in the immediate pre-, intra-, and postoperative management of children undergoing shunt implantation was initiated. With this new protocol, 600 children underwent a total of 1197 procedures between January, 1983, and December, 1990. The incidence of shunt infection decreased dramatically, with two infections (0.33%) in 600 patients and a per-procedure rate of 0.17%. The overall annual risk of a shunt infection in the pediatric neurosurgical unit is currently 1.04%.
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Affiliation(s)
- M Choux
- Department of Pediatric Neurosurgery, Hôpital des Enfants, La Timone, Marseille, France
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48
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Vagner-Capodano AM, Gentet JC, Gambarelli D, Pellissier JF, Gouzien M, Lena G, Genitori L, Choux M, Raybaud C. Cytogenetic studies in 45 pediatric brain tumors. Pediatr Hematol Oncol 1992; 9:223-35. [PMID: 1525001 DOI: 10.3109/08880019209016590] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Brain tumors are the most frequent childhood tumors. There have been few cytogenetic studies published on these tumors in children compared to the numerous studies on adult brain tumors. We examined chromosomes from 45 primary pediatric brain neoplasms including 14 medulloblastomas, 12 astrocytomas, 4 glioblastomas, 7 ependymomas, 5 craniopharyngiomas, 2 meningiomas, and 1 ganglioglioma. Chromosomal abnormalities were found in 10 medulloblastomas out of the 14 analyzed. The most frequently observed abnormalities were the total or partial loss of one chromosome 17: monosomy 17, i(17q), and a monosomy 22 in 4 cases of desmoplastic medulloblastoma. In glioblastoma, we observed the gain of chromosome 7, chromosome 3, a monosomy 10, and hyperdiploidy. The loss of chromosome X was observed in 2 cases of ependymoma as was a monosomy 22. Our observations show that from the cytogenetic point of view childhood brain tumors differ from adult brain tumors.
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49
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Genitori L, Lang D, Philip N, Cavalheiro S, Lena G, Choux M. Cranioectodermal dysplasia with sagittal craniosynostosis (Sensenbrenner's syndrome): case report and review of the literature. Br J Neurosurg 1992; 6:601-6. [PMID: 1472328 DOI: 10.3109/02688699209002380] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
We report the clinical features and neurosurgical management of a 9-month-old girl with cranioectodermal dysplasia and scaphocephaly. The technique of surgical correction is discussed together with details of the pre-operative investigations. The importance of early referral to an experienced geneticist is emphasized.
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Affiliation(s)
- L Genitori
- Department of Pediatric Neurosurgery, Hôpital des Enfants de La Timone, Marseille, France
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50
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Figarella-Branger D, Gambarelli D, Dollo C, Devictor B, Perez-Castillo AM, Genitori L, Lena G, Choux M, Pellissier JF. Infratentorial ependymomas of childhood. Correlation between histological features, immunohistological phenotype, silver nucleolar organizer region staining values and post-operative survival in 16 cases. Acta Neuropathol 1991; 82:208-16. [PMID: 1718129 DOI: 10.1007/bf00294447] [Citation(s) in RCA: 48] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
We have examined pathological criteria in 16 cases of infratentorial ependymomas of childhood using a conventional histological approach, with immunohistochemistry and silver nucleolar organizer region staining (AgNORs). We have found that some of these criteria are of prognostic value. The following histological features were evaluated in each case: cellular density, cellular or nuclear pleiomorphism, mitosis, focal necrosis, endothelial proliferation and complete loss of differentiation. The expression of the following antigens was also studied: epithelial membrane antigen (EMA), human natural killer (HNK1), glial fibrillary acidic protein (GFAP) and vimentin. Only three histological criteria have been retained as indicative of bad prognosis, i.e., high mitotic index, a large amount of necrosis and complete loss of differentiation. These criteria distinguish ependymomas from anaplastic ependymomas. GFAP was expressed in all tumors while other antigens were more variable. In addition tumors expressing large amounts of GFAP were statistically associated with a better prognosis. Increased vimentin expression associated with a decrease of GFAP immunoreactivity correlated with anaplasia and short survival. EMA was not directly correlated with postoperative survival but may be considered as a further prognostic factor. Finally AgNORs values were not statistically correlated with postoperative survival.
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Affiliation(s)
- D Figarella-Branger
- Laboratoire d'Anatomie Pathologique et de Neuropathologie, CHU Timone, Marseille, France
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