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Mastology (Online) ; 32: 1-6, 2022.
Article in English | LILACS-Express | LILACS | ID: biblio-1363057


Introduction: The presence of brain metastases secondary to primary breast cancer implies a worse prognosis for those affected. Therefore, the aim of this study was to determine the median survival after the diagnosis of brain metastasis in patients with breast carcinoma in a center in northeastern Brazil. Methods: The medical records of 345 patients diagnosed with breast cancer, treated between 1998 and July 2018, were analyzed. Those with brain metastasis along with their treatment performed and survival were identified. Results: Nine (2.6%) patients had brain metastasis; the mean age was 56.8 years. The mean survival time determined by the Kaplan-Meier method was 23.8 months (95%CI 6.9­40.8). Seven patients (78%) died from the disease and two were lost to follow-up (22%); invasive carcinoma of no special type was the most frequent (78%). Molecular classification by immunohistochemistry was possible in seven patients: five luminal B subtype cases, one luminal A case and one triple-negative case; luminal B subtype was associated with longer survival: 23.3 months (95%CI 3.0­43.6). As for the initial clinical staging, according to the TNM Classification of Malignant Tumors, there was one IA case, one IIA case, three IIB cases and two IIIB cases. Three patients underwent modified radical mastectomy, and six underwent conservative treatment (quadrantectomy); there was no statistical difference in survival between the different forms of treatment (p=0.771). Conclusion: The median survival after diagnosis of brain metastasis from breast cancer was 23.80 months.

Arq. bras. neurocir ; 40(4): 368-373, 26/11/2021.
Article in English | LILACS-Express | LILACS | ID: biblio-1362105


Glioblastoma multiforme (GBM) is the most frequent and most aggressive primary brain tumor in adults,mainly located in the cerebral hemispheres. In the literature, few cases of primary GBM have been reported to have radiographic and intraoperative features of extra-axial lesions, leading to a diagnostic dilemma. Despite the advances in imaging modalities, the diagnosis of GBM can be challenging, and it is mainly based on the histopathologic confirmation of the excised tumor. We describe the case of a 76- year-old previously healthy female patient who presented to our hospital due to speech disturbances and cognitive impairment. The diagnosis of the tumor type on magnetic resonance imaging (MRI) was difficult, as the findings were suggestive of a malignant meningioma due to the heterogeneous enhancement of a dural-based mass with a dural tail sign. Moreover, the intraoperative findings revealed an extra-axial mass attached to the dura. A histological examination confirmed the diagnosis of glioblastoma with arachnoid infiltration. The patient underwent adjuvant radiotherapy and concomitant temozolomide treatment, she had clinical improvement postoperatively, and was stable during the six months of follow-up. Glioblastoma should be considered in the differential diagnosis of primary extra-axial mass with atypical and malignant features, especially in elderly patients.

MedUNAB ; 24(3): 359-364, 202112.
Article in Spanish | LILACS | ID: biblio-1353578


Introducción. El xantoastrocitoma pleomórfico es una lesión glial de bajo grado de malignidad (grado II), puede presentar transformación maligna progresando a xantoastrocitoma pleomórfico anaplásico o glioblastoma multiforme, clasificados en grado III y IV, respectivamente, de acuerdo con la OMS. El glioblastoma epitelioide es un subtipo morfológico poco común del glioblastoma, de comportamiento agresivo, asociado a recurrencia temprana y compromiso leptomeníngeo. Presentación del caso. Se describe un reporte de caso de paciente femenina de 13 años con hallazgos de xantoastrocitoma pleomórfico anaplásico asociado a glioblastoma epitelioide, neoplasia poco frecuente que suele presentarse en la población pediátrica y en los adultos jóvenes. Discusión. El diagnóstico de glioblastoma epitelioide constituye un desafío, solo se han reportado unas pocas series pequeñas en la población adulta y pediátrica. Conclusión. Los hallazgos imagenológicos en las dos entidades son similares y comparten características histopatológicas e incluso algunos hallazgos moleculares superpuestos, lo cual dificulta su diferenciación, por lo que continúa siendo de gran controversia si se presentan conjuntamente o si el xantoastrocitoma pleomórfico anaplásico es un precursor del glioblastoma epitelioide.

Introduction. Pleomorphic xanthoastrocytoma is a glial lesion with low grade of malignancy (grade II), it can present malignant transformation progressing to anaplastic pleomorphic xanthoastrocytoma or glioblastoma multiforme, classified as grade III and IV, respectively, according to the WHO. Epithelioid glioblastoma is a rare morphological subtype of glioblastoma, with aggressive behavior, associated with early recurrence and leptomeningeal compromise. Case Presentation. Case report of a 13-year-old female patient with findings of anaplastic pleomorphic xanthoastrocytoma associated with epithelioid glioblastoma, a rare neoplasm that usually occurs in the pediatric population and in young adults. Discussion. The diagnosis of epithelioid glioblastoma is challenging, only a few small series have been reported in the adult and pediatric population. Conclusion. The imaging findings in the two entities are similar and share histopathological characteristics and even some overlapping molecular findings, which makes their differentiation difficult. For this reason, there is still a great controversy whether these entities are present continuously or whether the anaplastic pleomorphic xanthoastrocytoma is a precursor of epithelioid glioblastoma.

Introdução. O xantoastrocitoma pleomórfico é uma lesão glial de baixo grau de malignidade (grau II), pode apresentar transformação maligna progredindo para xantoastrocitoma pleomórfico anaplásico ou glioblastoma multiforme, classificados como grau III e IV, respectivamente, de acordo com a OMS. O glioblastoma epitelióide é um subtipo morfológico raro de glioblastoma, com comportamento agressivo, associado a recorrência precoce e envolvimento leptomeníngeo. Apresentação do caso. É descrito um relatório de caso de uma paciente feminina de 13 anos com achados de xantoastrocitoma pleomórfico anaplásico associado ao glioblastoma epitelióide, uma neoplasia rara que geralmente ocorre na população pediátrica e em adultos jovens. Discussão. O diagnóstico do glioblastoma epitélioide é desafiador, apenas algumas pequenas séries foram reportadas na população adulta e pediátrica. Conclusão. As descobertas imagiológicas nas duas entidades são semelhantes e compartilham características histopatológicas e, até mesmo, algumas descobertas moleculares sobrepostas, o que dificulta sua diferenciação, portanto permanece controverso se ocorrem juntas ou se o xantoastrocitoma pleomórfico anaplásico é um precursor do glioblastoma epitélioide.

Brain Neoplasms , Astrocytoma , Glioblastoma , Diagnosis, Differential , Glioma
Arq. neuropsiquiatr ; 79(6): 504-510, June 2021. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1285370


ABSTRACT Background: Central nervous system (CNS) tumors are a heterogeneous group with high morbidity and mortality. Objectives: To describe the epidemiology of primary CNS tumors diagnosed in the state of Sergipe from 2010 to 2018. Methods: We evaluated histopathological and immunohistochemical reports on primary CNS tumors diagnosed in Sergipe, Brazil, between 2010 and 2018 and collected data regarding age, sex, location, World Health Organization (WHO) classification and histology. Results: Altogether, 861 primary CNS tumors were found. Tumors in brain locations occurred most frequently (50.8%; n=437). The neoplasms observed were most prevalent in the age range 45‒54 years (20.4%; n=176). Grade I tumors occurred most frequently, corresponding to 38.8% of the cases (n=38) in the age group of 0‒14 years, and 44.6% (n=340) in the population ≥15 years old. Between 0 and 14 years of age, other astrocytic tumors were the most prevalent (29.6%; n=29). In the age group between 15 and 34, gliomas were the most frequent (32.7%; n=54). Meningiomas predominated in the age group of 35 years and above, comprising 47.5% of cases (n=206) in the 35‒74 age group; and 61.2% (n=30) among patients over 75 years old. Conclusion: The epidemiology of primary CNS tumors in Sergipe between 2010 and 2018 is consistent with data in other current studies on the subject. Studies on the epidemiological evolution of these entities in Sergipe are needed.

RESUMO Introdução: Os tumores do sistema nervoso central (SNC) são um grupo heterogêneo de entidades que apresenta significativa morbimortalidade. Objetivos: O presente estudo visa à descrição epidemiológica dos tumores primários do SNC com diagnóstico histopatológico no estado de Sergipe, Brasil, entre 2010 e 2018. Métodos: Foram avaliados laudos histopatológicos e imuno-histoquímicos de tumores primários do SNC, diagnosticados entre 2010 e 2018, no estado de Sergipe. Os dados coletados foram descritos de acordo com as variáveis de idade, sexo, localização, classificação da Organização Mundial da Saúde (OMS) e tipo histológico. Resultados: Foram encontrados 861 tumores primários do SNC. A localização cerebral foi a mais frequente (50,8%; n=437). As neoplasias observadas prevaleceram na faixa etária de 45 a 54 anos (20,4%; n=176). Os tumores grau I foram os mais frequentes, correspondendo a 38,8% dos casos (n=38) na faixa etária de 0‒14 anos e 44,6% (n=340) na população a partir de 15 anos de idade. Na faixa etária entre 0‒14 anos, o grupo histológico dos outros tumores astrocíticos foi o mais prevalente (29,6%; n=29). Na população entre 15‒34 anos, os gliomas foram os mais frequentes (32,7%; n=54). Os meningiomas predominaram nas faixas etárias a partir de 35 anos, com 47,5% dos casos (n=206) entre 35‒74 anos; e 61,2% (n=30) nos pacientes acima de 75 anos de idade. Conclusão: A descrição epidemiológica dos tumores primários do SNC em Sergipe, entre 2010 e 2018, é condizente com outros trabalhos atuais sobre o tema. Estudos voltados à evolução epidemiológica dessas entidades em Sergipe são necessários.

Arch. argent. pediatr ; 119(2): e171-e175, abril 2021. ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-1152122


Los tumores del sistema nervioso central representan la segunda enfermedad oncológica más habitual en niños y adolescentes. Entre los tumores intracraneales, los de células germinales son infrecuentes. Los síntomas que desencadenan son cefalea, náuseas, vómitos, déficits hormonales, alteraciones visuales, pérdida de peso, pobre crecimiento y pubertad precoz. Menos frecuentemente, producen trastornos del movimiento o psiquiátricos. Algunos de estos tumores pueden ser asintomáticos un largo período, lo que desencadena un diagnóstico tardío.Se presenta a una paciente femenina de 14 años con pérdida de peso y falla del crecimiento, con diagnóstico erróneo de trastorno de la conducta alimentaria. Tras estudios pertinentes, se arribó al diagnóstico de germinoma del sistema nervioso central. Al ser esta patología infrecuente y de presentación variable, requiere alto sentido de alerta por parte de la familia involucrada y del equipo de salud para evitar retrasos en el diagnóstico y el tratamiento

Central nervous system tumors are the second most frequent oncological disease among children and teenagers. Among the intracranial tumors, the germ cells ones are infrequent. The symptoms they cause are headaches, nausea and vomiting, hormonal deficits, visual disturbances, weight loss, poor growth and early puberty. Less frequently, they produce movement or psychiatric disorders. Some of these tumors can be asymptomatic for a long period leading to a late diagnosis.The case of a 14-year-old female patient is presented. She showed weight loss and growth failure, with wrong diagnosis of eating disorder. After proper study methods, we arrived to central nervous system germinoma diagnosis. Because this pathology is rare and has a variable form of presentation, it requires that the family involved and the health team to be alert, to avoid delays in diagnosis and treatment.

Humans , Female , Adolescent , Germinoma/diagnostic imaging , Brain Neoplasms , Weight Loss , Germinoma/therapy , Failure to Thrive , Hypopituitarism
Acta neurol. colomb ; 37(1): 20-23, ene.-mar. 2021. tab, graf
Article in Spanish | LILACS | ID: biblio-1248565


RESUMEN La presentación inicial de los tumores cerebrales depende en gran medida de su localización y las estructuras que se encuentren adyacentes, y en algunos casos pueden tener un curso asintomático. Sin embargo, una de las causas poco frecuentes pero bien conocidas de hemorragias intracraneales espontáneas, es la presentación inicial de tumores cerebrales primarios y secundarios. En este artículo se presenta el caso de un paciente de 72 años que ingresó al servicio de urgencias con alteración del estado de conciencia y hemiparesia braquiocrural izquierda. Al examen físico presentó cifras tensionales elevadas, por lo que se realizó una tomografía de cráneo que puso en evidencia una lesión ocupante de espacio con efecto de masa y características que sugirió una hemorragia intratumoral, la cual requirió drenaje y resección del tumor extraaxial. Posteriormente, el resultado de la patología reveló un meningioma atípico grado II.

SUMMARY The initial presentation of brain tumors will depend especially on their location, adjacent structures or in some cases may have an asymptomatic course. However, one of the rare but well-known causes of spontaneous intracraneal hemorrhages is the initial presentation of primary and secondary brain tumors. This article presents the case of a 72-year-old patient who has entered to the emergency department with altered consciousness state and left brachio-crural hemiparesis, the patient in the vital signs has presented high-tension rates. The cranial CT has shown a space occupying lesion with mass effect and characteristics suggesting intratumoral hemorrhage that required drainage and resection of the extra-axial tumor. The result of the pathology revealed an atypical meningioma grade II.

Cancer Research and Clinic ; (6): 731-736, 2021.
Article in Chinese | WPRIM | ID: wpr-912958


Objective:To investigate the clinical significance of changes in heparin binding protein(HBP), procalcitonin (PCT) and prealbumin (PA) levels in the early diagnosis of intracranial infection in patients with brain tumors after surgery.Methods:The clinical data of 160 patients with brain tumors who underwent surgical treatment in the Second Affiliated Hospital of Xuzhou Medical University from January 2015 to December 2020 were retrospectively analyzed. And 80 cases of intracranial infection after surgery were classified as the infection group. According to the severity of infection, patients were divided into 33 cases in the mild infection group, 36 cases in the moderate infection group, and 11 cases in the severe infection group; 80 cases without postoperative intracranial infection were classified as the non-infection group. All enrolled members were tested for HBP, PCT, PA at time points of 0 h before surgery, 12 h after surgery, 3 d after surgery, and 6 d after surgery. Receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficacy of intracranial infection in patients with brain tumors after surgery.Results:The levels of HBP and PCT in the infected group were higher than those in the non-infected group before and after surgery at all time points (all P < 0.05). The level of PA in the infected group was lower than that in the non-infected group (all P < 0.05). The levels of HBP and PCT in both groups at various time points after surgery were higher than those before surgery (all P < 0.05), which showed a decreasing trend over time. The level of PA of both groups at all time points after surgery was lower than that before surgery (all P < 0.05), which showed a trend of first decreasing and increasing and then decreasing over time. The preoperative HBP level in the severe infection group [35.45 ng/ml (23.61 ng/ml, 59.44 ng/ml)] was higher than that in the mild infection group [12.51 ng/ml (5.11 ng/ml, 19.92 ng/ml)] and the moderate infection group [22.22 ng/ml (16.49 ng/ml, 27.55 ng/ml)], and differences were statistically significant ( Z = 41.167, 19.105, both P < 0.05). The preoperative PCT level in the severe infection group [1.50 μg/L (1.27 μg/L, 2.44 μg/L)] was higher than that in the mild infection group [0.53 μg/L (0.25 μg/L, 0.85 μg/L)] and the moderate infection group [0.90 μg/L (0.47 μg/L, 1.42 μg/L)], and differences were statistically significant ( Z = 36.167, 14.875; both P < 0.05). The preoperative PA level in the severe infection group [159.22 mg/L (141.61 mg/L, 191.79 mg/L)] was lower than that in the mild infection group [215.91 mg/L (195.21 mg/L, 239.90 mg/L)] and the moderate infection group [194.48 mg/L (178.40 mg/L, 207.60 mg/L)] ( Z = 35.955, 19.567, both P < 0.05). The levels of HBP and PCT before operation were positively correlated with the degree of infection ( r = 0.637, 0.485, both P < 0.01). The preoperative level of PA was negatively correlated with the degree of infection ( r = -0.576, P < 0.01). The preoperative single index detection showed that the maximum the area of the curve (AUC) of postoperative intracranial infection in patients with brain tumors predicted by PA was 0.808 (95% CI 0.741-0.874). The highest specificity of intracranial infection in patients with brain tumors predicted by HBP was 96.3%. The AUC of postoperative intracranial infection in patients with brain tumors predicted by the combination of the three tests was 0.892 (95% CI 0.839-0.944), which was greater than that predicted by other single indicators, and the sensitivity was the highest (86.3%). The AUC of postoperative intracranial infection in patients with brain tumors diagnosed by PCT at 12 h after surgery was maximum [0.804 (95% CI 0.734-0.874)] when predicted by other single indicators. The highest specificity of postoperative intracranial infection in patients with brain tumors diagnosed by HBP was 98.6%. The AUC of postoperative intracranial infection in patients with brain tumors diagnosed by the combination of the three tests was 0.895 (95% CI 0.840-0.950), which was greater than that diagnosed by other single indicators, and the highest sensitivity was 85.0%. Conclusion:The levels of HBP, PCT and PA can provide a reference for the early diagnosis of postoperative intracranial aseptic inflammation in patients with brain tumors. The combined diagnosis of HBP, PCT and PA can better diagnose the postoperative intracranial infection in patients with brain tumors.

Cancer Research and Clinic ; (6): 557-560, 2021.
Article in Chinese | WPRIM | ID: wpr-912923


Glioma is one of the most common primary intracranial tumors, accounting for 80% of malignant brain tumors. The conventional treatment of glioma is surgical resection followed by temozolomide chemotherapy, but the drug resistance will gradually appear that results in a poor prognosis of the patient. Berberine is an alkaloid extracted from Coptis Rhizoma, which has a wide range of pharmacological activities. It exerts its pharmacological effects on glioma such as inhibiting tumor growth through controlling different molecular and cellular pathways. In this article, the application of berberine in the treatment of glioma and the research progress of specific molecular mechanism are reviewed.

Article in Chinese | WPRIM | ID: wpr-909253


Gliomas are a group of refractory heterogeneous diseases. Gliomas even at the same pathological type and grade exhibit different outcomes after treatment. Therefore, glioma patients have obvious survival difference. The development of intraoperative auxiliary means has greatly contributed to surgical resection of glioma and remarkably increased therapeutic effects. The development of sensitizer realizes the combination of radiotherapy and chemotherapy and can improve the anti-tumor effects of oral temozolomide. Molecular markers and signal pathways involved in glioma, such as isocitrate dehydrogenase-1 mutation, epidermal growth factor amplification, high expression of vascular endothelial growth factor, Notch signal pathway, miRNA, etc. are involved in the occurrence and development of glioma and have an obvious impact on the proliferation, metastasis and invasion of glioma. They are potential molecular targets for the clinical treatment of glioma. Many different immunotherapy schemes are actively carried out in patients with glioma, but the unique tumor immune microenvironment of the central nervous system needs to be considered. This paper reviews the treatment progress of glioma in recent years.

Autops. Case Rep ; 11: e2021258, 2021. graf
Article in English | LILACS | ID: biblio-1249031


Congenital medulloblastoma is a rare brain tumor that appears in less than 1% of pediatric patients. Congenital medulloblastoma has a poor prognosis and should be suspected in patients with clinical manifestations of hyporeactivity, slow suction reflexes, and the presence of hydrocephalus. Herein we present the case of a 12-day-old female newborn who developed non-communicative hydrocephalus, hyporeactivity, and hyporeflexia. Magnetic resonance imaging of her brain showed a heterogeneous and cystic mass on the posterior cranial fossa. A suboccipital craniotomy was performed. The histopathologic analysis reported a congenital medulloblastoma. She remained in hospital until her death at 112 days old. This is one of the first case reports with clinical-radiological and pathological documentation. Awareness of this diagnosis can allow prenatal intervention, rendering a better prognosis. This case report exemplifies the importance of good prenatal follow-up.

Humans , Female , Pregnancy , Infant, Newborn , Cerebellar Neoplasms/congenital , Medulloblastoma/congenital , Prenatal Diagnosis , Fatal Outcome
Rev. bras. oftalmol ; 79(4): 276-277, July-Aug. 2020. graf
Article in English | LILACS | ID: biblio-1137971


Abstract Cerebellar astrocytoma (low-grade glioma) is the most frequent tumor of the Central Nervous System in pediatric age, corresponding to 10-20% of brain tumors, having its maximum incidence at 5 years. Brain tumors are the second cause of death at this age, behind leukemias. Its most frequent clinic is headache with vomiting which can worsen in the morning and awaken the patient at night. The most frequent ophthalmological clinic is papilledema and involvement of the cranial nerve VI. In our case we present an atypical presentation (cranial IV), in which a quick derivation favored a better prognosis.

Resumo O astrocitoma cerebelar (glioma de baixo grau) é o tumor mais frequente do Sistema Nervoso Central em idade pediátrica, correspondendo a 10-20% dos tumores cerebrais, tendo sua incidência máxima em 5 anos. Os tumores cerebrais são a segunda causa de morte nesta idade, atrás das leucemias. Sua clínica mais frequente é a cefaleia com vômitos que podem piorar pela manhã e despertar o paciente à noite. A clínica oftalmológica mais frequente é o papiledema e o envolvimento do nervo craniano VI. Em nosso caso apresentamos uma apresentação atípica (IV craniana), em que uma derivação rápida favoreceu um melhor prognóstico.

Humans , Child, Preschool , Astrocytoma/diagnostic imaging , Brain Neoplasms/diagnostic imaging , Papilledema/physiopathology , Glioma/diagnostic imaging , Headache/physiopathology , Tomography, X-Ray Computed/methods
CES med ; 34(2): 103-113, mayo-ago. 2020. tab, graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1285736


Resumen Objetivo: Caracterizar los pacientes diagnosticados con tumores del sistema nervioso central en el Instituto Neurológico de Colombia durante el periodo 2010-2015. Métodos: Estudio descriptivo retrospectivo. Para los tumores primarios se usó la clasificación de la Organización Mundial de la Salud y para los metastásicos se usó la Clasificación Internacional de Enfermedades en Oncología. Resultados: Se identificaron 288 pacientes, 194 de ellos con tumores primarios y 94 tumores metastásicos. No se lograron clasificar los tumores primarios en el 23,7 % de los casos y para los metastásicos no se obtuvo la clasificación morfológica (histológica) en el 35,1 % de los casos. Los hombres presentaron con mayor frecuencia tumores de comportamiento maligno tipo glioblastoma NEO (no especificado de otra manera) (14,9 %) y en las mujeres predominaron los tumores de comportamiento benigno tipo meningioma (23,2 %). En mayores de 65 años, tanto el glioblastoma NEO como el meningioma fueron más frecuentes en mujeres con 17,4 % y 28,3 %, respectivamente. Entre los pacientes con tumores metastásicos, de acuerdo con la clasificación topográfica, los tumores primarios más frecuentes se localizaron en pulmón (39,4 %) y mama (17 %). No se identificó el sitio primario de metástasis en el 11,7 % de los casos. La histología más comúnmente identificada fue el adenocarcinoma (14,9 %), seguido del carcinoma (8,5 %). Conclusiones: Para una vigilancia efectiva de la enfermedad es necesario realizar un monitoreo epidemiológico y clínico de tumores primarios y metastásicos, mediante el uso de registros institucionales de cáncer, incluyendo datos topográficos, histológicos y moleculares, según disponibilidad.

Abstract Objective: The aim of this study was to characterize patients with a diagno- sis of a central nervous system (CNS) tumors at the Instituto Neurologico de Colombia during the period between 2010 to 2015. Methods: A retrospective descriptive study was conducted. The Classification of the World Health Organization was used for CNS primary tumors whereas the International Classification of Diseases for oncology (ICD-O) was used for CNS metastatic tumors. Results: 288 patients were identified, 194 of them with primary tumors of CNS and 94 with metastatic tu- mors from systemic cancer. It was not possible to classify primary tumors in 23.7% of the cases and regarding the metastatic tumors it was not possible to obtain the classification in 35.1 % of the cases. Men presented more frequently tumors of ma- lignant behavior such as glioblastoma NOS (not otherwise specified) (14.9 %) while in women benign behavior tumors such as meningioma predominated (23.2 %). For population older than 65 years old, both glioblastoma NOS and meningioma were more frequent in women with 17.4 % and 28.3 %, respectively. In patients with CNS metastatic tumors, according to the topographic classification, the most frequent primary tumors were lung (39.4 %), followed by breast (17 %). Its origin was not iden- tified in 11.7 % of the cases. The most identified histology was adenocarcinoma (14.9 %), followed by carcinoma (8.5 %). Conclusion: For disease surveillance, it is necessary to complete epidemiological and clinical monitoring of primary and metastatic tumors of the CNS by using institutional cancer registries including topographic, histological and molecular data according to availability.

Rev. neuropsiquiatr ; 83(3): 203-207, jul-sep 2020. graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1150079


Resumen El sarcoma fibromixoide de bajo grado (LGFMS) es un tumor de tejidos blandos de origen mesenquimal. Los sarcomas son un grupo heterogéneo, que representa el 1% de todas las neoplasias. Los sarcomas primarios del sistema nervioso central (SNC) son raros y representan solo el 0,7% del total de sarcomas, con una incidencia estimada de 3 por cada 10 millones de personas por año. En este artículo, se describe el caso de una mujer de 59 años que presentó un sarcoma fibromixoide intracraneal de bajo grado, localizado en la región parietal derecha. Se discute el curso clínico, estudios de imágenes, características histopatológicas y tratamiento de este diagnóstico infrecuente y, por lo mismo, muy poco reportado. El diagnóstico definitivo se obtiene, ciertamente, mediante estudios histo-patológicos.

Summary Low-grade fibromyxoid sarcoma (LGFMS) is a soft tissue tumor of mesenchymal origin. Sarcomas are a heterogeneous group, representing 1% of all neoplasm diagnoses. Primary sarcomas of the central nervous system (CNS) are rare, and represent only 0.7% of all sarcomas, with an estimated incidence of 3 per 10 million people per year. The case of a 59-year-old woman who developed a low-grade intracranial fibromyxoid sarcoma in the right parietal region, is described. The clinical course, imaging studies, histopathological features, and treatment approach of this unusual diagnosis, are discussed. Low-grade intracranial fibromyxoid sarcoma is a rare and probably under- reported condition. The definitive diagnosis is usually made through histo-pathological studies.

Arq. bras. neurocir ; 39(1): 12-15, 15/03/2020.
Article in English | LILACS-Express | LILACS | ID: biblio-1362407


Chordoid meningiomas (CMs) are a rare subgroup of tumors, accounting for 0.5% of all meningiomas. Chordoid meningioma tumors correspond to World Health Organization (WHO) Grade II lesions and behave aggressively, with an increased likelihood of recurrence. There are few genetic studies about CMs, but we understand that there is deletion at many chromosomal loci. Histologically, CMs are characterized by strands and cords of meningothelial cells arranged in a mucinous stroma. Morphologically, it can mimic other chondroid and myxoid tumors within the brain and its vicinity, thus posing a diagnostic challenge. Chordoid meningiomas have an aggressive clinical course and a propensity to recur compared with classical meningiomas. The goal of the treatment is surgery, with total resection of the tumor; however, due to its high degree of recurrence, radiotherapy is often necessary as an adjuvant treatment.

Arq. neuropsiquiatr ; 78(2): 112-120, Feb. 2020. tab, graf
Article in English | LILACS | ID: biblio-1088992


Abstract Background: Central nervous system (CNS) gliosarcoma (GSM) is a rare primary neoplasm characterized by the presence of glial and sarcomatous components. Objective: In this report, we describe the clinical and neuroimaging aspects of three cases of GSM and correlate these aspects with pathological findings. We also provide a brief review of relevant literature. Methods: Three patients were evaluated with magnetic resonance imaging (MRI), and biopsies confirmed the diagnosis of primary GSM, without previous radiotherapy. Results: The analysis of conventional sequences (T1, T1 after contrast injection, T2, Fluid attenuation inversion recovery, SWI and DWI/ADC map) and advanced (proton 1H MR spectroscopy and perfusion) revealed an irregular, necrotic aspect of the lesion, peritumoral edema/infiltration and isointensity of the solid component on a T2-weighted image. These features were associated with irregular and peripheral contrast enhancement, lipid and lactate peaks, increased choline and creatine levels in proton spectroscopy, increased relative cerebral blood volume (rCBV) in perfusion, multifocality and drop metastasis in one of the cases. Conclusion: These findings are discussed in relation to the general characteristics of GSM reported in the literature.

Resumo Introdução: O gliossarcoma (GSM) do sistema nervoso central (SNC) é uma neoplasia primária rara, caracterizada pela presença de componentes gliais e sarcomatosos. Objetivo: Nosso objetivo é descrever os aspectos clínicos e de neuroimagem de três casos com este diagnóstico e correlacioná-los com os achados patológicos. Também foi realizada uma breve revisão da literatura relevante. Métodos: Três pacientes foram avaliados por ressonância magnética (RM), e biópsias confirmaram o diagnóstico de GSM primário, sem radioterapia prévia. Resultados: Foram analisadas as sequências convencionais (T1, T1 após injeção de contraste, T2, FLAIR-fluid attenuation inversion recovery, SWI, DWI/mapa ADC) e as sequências avançadas (espectroscopia de prótons 1H e perfusão), observando-se aspecto necrótico e irregular da lesão, edema/infiltração peritumoral, isointensidade do componente sólido em T2, associada a realce irregular e periférico pelo meio de contraste, pico de lípides e de lactato e aumento dos níveis de colina e creatina na espectroscopia de prótons, aumento do volume sanguíneo cerebral relativo (rCBV) na perfusão, multifocalidade e "drop" mestástase em um dos casos. Conclusão: O presente estudo descreve características do GSM, discutindo as informações na literatura científica, ilustrando algumas particularidades desses tumores.

Humans , Brain Neoplasms/diagnostic imaging , Gliosarcoma/diagnostic imaging , Magnetic Resonance Imaging , Magnetic Resonance Spectroscopy
Autops. Case Rep ; 10(4): e2020205, 2020. graf
Article in English | LILACS | ID: biblio-1131853


Atypical teratoid/rhabdoid tumor (AT/RT) is a rare central nervous system (CNS) tumor diagnosed primarily in infants and usually portends a poor prognosis. Despite being the most common embryonal tumor in children less than 1 year old, diagnosis is difficult to make based on clinical findings or imaging alone. A complete diagnosis of AT/RT requires identification of loss of integrase interactor 1 (INI1) protein or the SWI/SNF-related, matrix-associated, actin-dependent regulator of chromatin, subfamily b, member 1 (SMARCB1) gene, in its most common presentation. Moreover, their presentation with other primary rhabdoid tumors in the body raises significant suspicion for rhabdoid tumor predisposition syndrome (RTPS). We report a case of a one-month-old infant admitted for worsening emesis and failure to thrive, who was later found to have brain and bladder masses on radiologic imaging. Autopsy with subsequent immunoprofile and molecular testing were crucial in establishing the absence of INI1 nuclear expression and possible homozygous deletion of SMARCB1 in the urinary bladder tumor tissue. Sequencing of the peripheral blood demonstrated probable single copy loss at the SMARCB1 locus. The constellation of findings in tumor and peripheral blood sequencing suggested the possibility of germline single copy SMARCB1 loss, followed by somatic loss of the remaining SMARCB1 allele due to copy neutral loss-of-heterozygosity. Such a sequence of genetic events has been described in malignant rhabdoid tumors (MRT). Dedicated germline testing of this patient's family members could yield answers as to whether rhabdoid tumor predisposition syndrome will continue to have implications for the patient's family.

Humans , Female , Infant , Brain Neoplasms/pathology , Rhabdoid Tumor/pathology , Autopsy , Urinary Bladder Neoplasms/pathology , Fatal Outcome
Article in Chinese | WPRIM | ID: wpr-861972


Objective: To explore the application effect of 1.0T open MR and real-time technique-guided biopsy of brain lesions. Methods: Data of 112 patients with brain lesions who underwent 1.0T open MR real-time technique-guided puncture biopsy were analyzed retrospectively. The pathological results after surgical operation or follow-up results were taken as the final diagnostic criteria. The diagnostic accuracy, sensitivity, specificity, positive predictive value (PTV), negative predictive value (NPV) of puncture biopsy in diagnosis of cerebral lesions were calculated. Results: Among 112 lesions in 112 patients, the maximum diameter of lesions was 0.91-4.53 cm, with an average of (2.32±0.81)cm, which was ≤1.5 cm in 29 cases and >1.5 cm in 83 cases. All biopsy specimens were technically successfully obtained. And 108 procedures yielded definitive diagnoses. In 4 cases, small amount of intracranial hemorrhage was observed during the puncture, and no other serious complication was found, and the complication rate was 3.57% (4/112). The diagnostic accuracy, sensitivity, specificity, PTV and NPV were 96.43% (108/112), 96.34% (79/82), 96.67% (29/30), 98.75% (79/80) and 90.63% (29/32), respectively. No significant difference was detected between lesions >1.5 cm and those ≤1.5 cm (all P>0.05). Conclusion: 1.0T open MR real-time technique-guided biopsy of brain lesions is safe and feasible.

Cancer Research and Clinic ; (6): 69-72, 2020.
Article in Chinese | WPRIM | ID: wpr-799306


Pituitary adenoma is a common neuroendocrine tumor, and its complex pathogenesis makes its treatment a clinical problem. Recently, studies have shown that long non-coding RNA (LncRNA), as a class of endogenous RNA with a length of more than 200 nucleotides and basically no protein-coding function, plays an important regulatory role in various forms in multiple tumors including pituitary adenoma, and is closely related to the proliferation, invasion and metastasis of pituitary adenoma. Based on the latest research status at home and abroad, this paper summarizes the research progress of LncRNA in pituitary adenoma, hoping to provide new ideas for the diagnosis, treatment and prognosis of pituitary adenoma.

Cancer Research and Clinic ; (6): 32-35, 2020.
Article in Chinese | WPRIM | ID: wpr-799300


Objective@#To analyze the expressions of coordinated stimulating molecular programmed death 1(PD-1) and programmed death ligand 1 (PD-L1) in human glioma and their clinical significances.@*Methods@#A total of 70 postoperative paraffin specimens of brain glioma and 35 normal brain tissues in Heji Hospital Affiliated to Changzhi Medical College from January 2013 to December 2017 were collected. The expressions of PD-1 and PD-L1 in 70 glioma tissues and 35 normal brain tissues were detected by immunohistochemical SP method. The relationship between the expressions of PD-1 and PD-L1 and their correlation with the clinicopathological features were analyzed.@*Results@#The positive expression rates of PD-1 and PD-L1 in glioma tissues were 69% (48/70) and 62% (43/70), respectively, which were higher than those in normal brain tissues [29% (10/35), 31% (11/35)], the differences were statistically significant (χ2 values were 15.099 and 8.407, both P < 0.05). The positive expression rates of PD-1 and PD-L 1 in high-grade glioma were 81% (30/37) and 73% (27/37), respectively, which were higher than those in low-grade glioma [55% (18/33) and 49% (16/33)], the differences were statistically significant (χ 2 values were 5.699 and 4.415, both P < 0.05). There was no significant difference in the positive expression rates of PD-1 and PD-L1 among patients with different sex, age and maximum tumor diameter (all P > 0.05). There was a positive correlation between the expressions of PD-1 and PD-L1 proteins in glioma tissues (r= 0.372, P= 0.002).@*Conclusions@#The PD-1 and PD-L1 may become new biological indicators for evaluating the occurrence and development of glioma.