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Purpose To investigate the clinicopathologic characteristics, diagnosis, differential diagnosis and prognosis of malignant solitary fibrous tumor/hemangiopericytoma ( SFT/HPC). Methods Sixteen cases of intracranial malignant SFT/HPC were retrospectively studied. The clinical data, imaging features, histopathological and immunohistochemical characteris-tics were analyzed. Results The 8 male and 8 female patients were between 31 and 71 years of age ( mean 51). The median age was 51 years (range, 31-71 years). 16 malignant SFT/HPC cases were originated from intracalvarium. The imaging features showed intracranial neoplasms with relatively clear surrounding boundaries. Microscopically spindle shaped cells were hypercel-lular, and exhibited≥5 mitoses per 10 HPF. Cytological atypia was mild. The clinicopathologic characteristics included pattern-less growth pattern, storiform or fascicular growth pattern, solita-ry fibrous tumor-like regions and hemangiopericytoma-like re-gions. Tnere were 2 cases with abundant papillary structure and 2 with sarcomatous structure, 2 with focal necrosis, 2 with inva-ded cerebral tissues, and 10 with invaded meninges. Immuno-histochemically, 93. 75% ( 15/16 ) cases were positive for STAT6, with 15/16 showing diffuse staining. 87. 5% (14/16) cases were positive for CD34, with 37. 5% (6/16) showing dif-fuse staining. 81. 25% (13/16) cases were positive for BCL-2. 68. 75% (11/16) cases were positive for CD99. The Ki-67 in-dex ranged from 5% to 40% . Sixteen patients were followed up for 1-64 months, and 7 patients ( 43. 75% ) had recurrences. Conclusion Malignant SFT/HPC shares malignant behaviours. STAT6 is a specific marker for the diagnosis of this tumor. The prognosis of malignant SFT/HPC is related to the extent of tumor excision and long-term follow-up.
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Objective To investigate the treatment outcomes of 41 patients with suprasellar and pineal germinoma who are treated in our department in recent 18 years,and to explore related therapeutic strategies.Methods A total of 41 patients with concurrent suprasellar and pineal germinoma who were treated in our department from January 1996 to August 2013 were enrolled.There were 35 male patients and 6 female patients,and the median age was 16 years (range 5-39 years).Five patients had pathologically confirmed germinoma and 36 patients had clinically diagnosed germinoma.Conventional radiotherapy was performed for 33 patients, and intensity-modulated radiotherapy was performed for 8 patients.Combined-modality chemoradiotherapy was performed for the 5 patients with pathologically diagnosed germinoma.The 6 MV X-ray was applied for radiotherapy;6 patients received whole ventricular irradiation and a boost in tumor region, 16 received whole-brain radiotherapy and a boost in tumor region,and 19 received craniospinal irradiation and a boost in tumor region.The median radiation dose for tumor region was 45.0 Gy (37.8-50.0 Gy),and the median dose for prophylactic irradiation was 25.0 Gy (17.8-35.0 Gy).The survival was caculated using Kaplan-Meier method.Results The number of patients followed were 26 at 5-years.The 5-year overall survival rate and relapse-free survival rate were 95% and 85%,respectively.Relapse and metastasis were noted in 8 patients,and 3 of them died.There were 4 patients with spinal cord metastasis,1 patient with ventricular dissemination,and 3 patients with periventricular relapse.Among the 22 patients who did not undergo spinal irradiation,4(18.2%) experienced spinal cord metastasis,and all the other 19 patients who underwent spinal irradiation did not experience spinal cord metastasis.The 8 patients undergoing intensity-modulated radiotherapy and the 5 patients undergoing combined-modality chemoradiotherapy did not experience treatment failure during follow-up.Conclusions Radiotherapy for intracranial germinoma has a good therapeutic effect,and the patients with suprasellar and pineal germinoma who do not undergo spinal cord irradiation have a high failure rate.It is suggested to perform spinal cord irradiation for patients with suprasellar and pineal lesions.
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OBJECTIVE To evaluate the clinical feature and surgical treatment of large nasopharyngeal angiofibromas with intracranial orcavernous sinus extension.METHODS A total of 16 male patients were collected with a age ranged from 11 to 35 years(mean,17.21 years).All patients underwent resection of nasopharyngeal angiofibromas with intracranial or cavernous sinus extension.The procedure included lateral rhinotomy,craniofacial combined approach,median labiomandibulotomy combined with a trans-palatal,transmaxillary approach and middle face degloving approach.RESULTS Sixteen cases received 28 procedures.Seven patients had no recurrence but 9 patients had recurrence at least once.Twenty eight procedures include 11 times lateral rhinotomy,6 times craniofacial combined approach,2 times frontotemporal approach,4 times transpalatal approach,2 transmaxillary approach,1 median labiomandibulotomy combined with a trans-palatal and 2 times middle face degloving approaches.CONCLUSION Radical operative resection is the main treatment method for nasopharyngeal angiofibroma with intracranial or cavernous sinus extension.The first operation recurrence rate is 8/15(53.0%) and sphenoid tumor residual may often be ignored in the operation and it is the main site of tumor recurrence.Craniofacial,median labiomandibulotomy combined with a trans-palatal and middle face degloving approaches were the best choices for large nasopharyngeal angio fi broma with intracranial or cavernous sinus extension.
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The epidemiologic features of 652 histologically confirmed intracranial tumors were reviewed. 600 were primary tumors and 52 were metastatic. 17.4% of all tumors were gliomas and 23.2% were meningiomas. 73% of adult tumors were supratentorial, most commonly meningiomas, while 10% of pediatric tumors (age14) were infratentorial, predominantly medulloblastomas. There was an equal distribution of the tumors in the first decades of life. The medulloblastomas and astrocytoma I-II, peaked in early childhood whereas meningiomas, neurilemmomas and metastatic tumors increased in frequency with advancing age. The overall risk for intracranial tumors was the same for both sexes. However, women had greater susceptibility for meningiomas, pituitary adenomas and merilemmomas. The features of intracranial tumors in Filipinos mirrored those seen in Blacks and other Asians, and differed from most Western profiles. It is possible that racial difference play a role in the development of intracranial tumors.
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Humans , Male , Female , Middle Aged , Adult , AdolescentABSTRACT
Cyber -knife a new stereotaxic radiosurgery instrument, which structure and technical characteristics are introduced. By application of real-time image aiming and synchronous dynamic tracking techniques, abandoning vicious location frame to solve the questions of traditional directional radiosurgery technique only use pate tumour. Cyber-knife is an innovative stereotaxic radiosurgery instrument, extends the indications of stereotaxic radiosurgery from intracranial neoplasms to extracranial tumors and has a widest development prospect in medical treatment.