ABSTRACT
Tumor heterogeneity is the concept that different tumor cells provide distinct biomorphological lesions, gene expressions, proliferation, microenvironment and graduated capacity of metastatic lesions. Brain tumor heterogeneity has been recently discussed about the interesting interaction of chronic inflammation, microenvironment, epigenetics and glioma steam cells. Brain tumors remain a challenge with regards to medication and disease, due to the lack of treatment options and unsatisfactory results. These results might be the result of the brain tumor heterogeneity and its multiple resistance mechanisms to chemo and radiotherapy.
Subject(s)
Neoplastic Stem Cells/cytology , Brain Neoplasms/genetics , Genetic Heterogeneity , Gene Expression Profiling , Glioma/genetics , Receptor Protein-Tyrosine Kinases/genetics , Drug Resistance, Neoplasm/genetics , Stem Cell Niche/genetics , Tumor Microenvironment , Clonal Evolution/genetics , Cellular Microenvironment/genetics , RNA-SeqABSTRACT
Background Sarcoidosis is a granulomatous disease predominant in women and black men that has inflammatory origin of unknown etiology; neurosarcoidosis is a rare and critical presentation of the disease. Case description A 26-year-old black female presented frontal headache for 1 year, as well as behavioral and mood changes for 15 days. Skull tomography and nuclear magnetic imaging of the skull revealed damaged meninges, a right frontal bone lesion, and an intraparenchymal contrast-enhancing lesion. Screening with computed tomography (CT) scans was performed, and it showed signs of bronchiectasis in the lower third of the right lung, but it was asymptomatic. The biopsy showed signs of reactional lesion with the presence of non-caseating granulomas. After the treatment with corticosteroids, the patient presented progressive improvement. Conclusions Neurosarcoidosis is a rare and critical pathology of sarcoidosis that presents a lytic bone lesion and clinical psychiatric symptoms; neurosarcoidosis is also rare in the literature.
Introdução A sarcoidose é uma doença granulomatosa de origem inflamatória de etiologia desconhecida, predominante em mulheres e negros, sendo a neurosarcoidose uma apresentação da doença rara relacionada a gravidade. Relato de Caso Paciente com 26 anos, negra, apresenta quadro cefaleia frontal ha 1 ano e há 15 dias apresentando sinais de alterações de comportamento e humor. Tomografia de crânio e Ressonância nucelar magnética de crânio que evidenciaram lesão óssea frontal direita, comprometimento meninges e lesão intraparenquimatosa captante de contraste. Realizado screening com tomografias que evidenciaram sinais de bronquiectasia em terço inferior pulmão direito, assintomática. Biopsia indicando sinais de lesão reacional com presenças de granulomas não caseosos, Após a manutenção da corticoterapia, a paciente apresentou melhora progressiva. Conclusões A neurosarcoidose é uma patologia grave e rara da sarcoidose, nesse caso apresenta uma lesão óssea lítica e sintomas psiquiátricos, apresentação rara na literatura.