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Thirty patients with low-grade (WHO Grade II) astrocytomas involving the insula, who had undergone stereotactic biopsy followed by radiotherapy, were followed up to evaluate the outcome with regard to control of seizures, memory and language function, Karnofsky Performance scale and regression in tumor volume. Patients were followed up for a mean of 27.8 months, during which time they showed improvement in all the factors that were studied. A statistically significant change was, however, seen only in the reduction in tumor size, probably due to the small sample size and the short duration of follow-up. Stereotactic biopsy followed by radiation therapy provides a good short-term outcome in patients with low-grade insular astrocytomas.
Dendritic cell vaccination has been applied to the treatment of a variety of cancers, including malignant astrocytoma. We have treated 13 patients with malignant astrocytoma using dendritic cell vaccination and have shown that this treatment is safe and is likely to be effective in combination with standard adjuvant therapy. Future studies should prospectively incorporate dendritic cell vaccination together with chemotherapy. Ideally, dendritic cell vaccination should be tested in a prospective fashion, in a coordinated trial involving multiple centres.
A cerebellar tumor was incidentally discovered on a CT scan of a 14-year-old boy, which was taken after a minor head trauma. The tumor had a large and thick-wall lining cyst, and was not enhanced with a contrast medium. Therefore, it was considered a ganglioglioma rather than a pilocytic astrocytoma. During surgery, the cerebellar cortex surrounding the tumor was found to be swollen. The tumor and the swollen cortex were removed en block. Histological examinations proved it to be a pilocytic astrocytoma associated with an extension to the surrounding leptomeninges. Radiological diagnosis, therapeutic strategy and prognosis of pilocytic astrocytomas with such an extension or dissemination into the subarachnoid space are discussed.
BACKGROUND: p53 is a tumor suppressor gene implicated in the genesis of a variety of malignancies including brain tumors. Overexpression of the p53 protein is often used as a surrogate indicator of alterations in the p53 gene. AIMS: In this study, data is presented on p53 protein expression in adult cases (>15 years of age) of astrocytic (n=152) and oligodendroglial (n=28) tumors of all grades. Of the astrocytic tumors, 86% were supratentorial in location while remaining 14% were located infratentorially - 8 in the the cerebellum and 13 in the brainstem. All the oligodendrogliomas were supratentorial. MATERIALS AND METHODS: p53 protein expression was evaluated on formalin-fixed paraffin-embedded sections using streptavidin biotin immunoperoxidase technique after high temperature antigen retrieval. RESULTS: Overall 52% of supratentorial...
Optic pathway/hypothalamic astrocytomas (OPHA) in young children often show accelerated growth and require rather intensive induction chemotherapy. Fifteen children (median age: 3 years) with a large OPHA were treated. All of them presented with progressive disease, and the tumor size was larger than 34 mm. Pilocytic astrocytoma was confirmed histologically in 10 patients. Eleven patients had visual disturbance, six had diencephalic syndrome and four had hydrocephalus. The children received six to eight cycles of cisplatin (20 mg/m(2): days 1-5) and vincristine (1.4 mg/m(2): days 1, 8, 15), every 4 weeks. Objective response was obtained in 11 patients (73%); one complete response, eight partial responses and two minor responses. Although the remaining four cases were evaluated as stable disease, all tumors decreased in volume. All chil...
abstractCentral nervous system (CNS) tumors in children have a relatively high frequency. They are the second most common form of cancer in childhood only exceeded by acute lymphoblastic leukemia (ALL). However, prognosis is more severe and at present more children die because of CNS tumor than of ALL. The incidence of CNS tumors is estimated 3.5 per 100,000 in children below 15 years of age.1 Boys appear to be at greater risk than girls (1.1:1) and this ratio is even higher in primitive neuro-ectodermal tumor (PNET), plexus papilloma, and germinoma (2:1).1 The most frequently occurring histological tumor type is astrocytoma (40-50%) followed by medulloblastoma (15-20%), ependymoma (8-13%), and craniopharyngiomas (7-10%) as shown in Table 1.2 Astrocytomas are classified according to increasing malignancy grade as pilocytic, fibrillary,...
The co-occurrence of two or more brain tumors with different histological features is rare. The authors report three rare cases of intracranial tumors associated with pituitary adenomas. Two of the pituitary tumors were functioning adenomas: a prolactinoma and a thyrotropin secreting adenoma. Two of the associated intracranial neoplasms were gliomas and one was a meningioma. Radiological and clinical examination for syndromal association was negative in all cases. We briefly discuss the presentation and treatment options of these cases and review the 19 previous publications in the literature of pituitary tumors occurring in association with other neoplasms and explore the possible links underlying these co-occurring neoplasms. Our three cases represent 0.86% of all pituitary tumors operated at our institute over a 9-year period.
In recent years, there has been a marked improvement in our understanding of molecular genetics of gliomas. These advancements offer hope for development of tailored therapies targeting a tumor′s unique molecular profile, and may also translate into improved classification and identification of newer prognostic markers. This review focuses on the neuropathological features of different types of glial neoplasms according to the World Health Organization classification, and the recent advances in their molecular biology with emphasis on the genetic mechanisms underlying tumor progression, diagnostic and prognostic markers and potential therapeutic targets.
Simultaneous presence of congenital irreducible atlantoaxial dislocation (AAD) and cervical intramedullary astrocytoma has not been previously described and may cause disabling myelopathy. This 55-year-old lady presented with suboccipital pain, spastic quadriparesis, Lhermitte′s phenomenon and sphincteric disturbances. Lateral radiographs and magnetic resonance imaging showed irreducible AAD, occipitalized atlas, C2-3 fusion, and,an intramedullary tumor from C2-5 level iso-to-hypointense, non-enhancing, except in a small segment in the dorsal C2 level. A suboccipital craniectomy with C2-5 laminectomy revealed a greyish-white tenacious tumor. The tumor was decompressed using a C2-5 midline myelotomy and duroplasty. An occipitocervical lateral mass fixation was performed. Histopathology revealed a low-grade astrocytoma. At three-month fo...
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