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1.
Rev. medica electron ; 41(5): 1129-1141, sept.-oct. 2019. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1094117

ABSTRACT

RESUMEN Introducción: el astrocitoma anaplásico y el glioblastoma multiforme son las formas más agresivas de glioma maligno. Existen avances en radioterapia, quimioterapia y tratamientos de resección quirúrgica agresiva. Esto último incluye métodos como los de tomografía de coherencia óptica, cirugía guiada por fluorescencia, craneotomía de vigilia, terapia térmica intersticial con láser para la ablación por glioblastoma multiforme, microscopía intraoperatoria confocal y espectrometría de masas intraoperatoria, pero a pesar de todo ello el pronóstico resulta sombrío. Objetivo: determinar el comportamiento de los gliomas de alto grado en el Servicio de Neurocirugía de la provincia Matanzas. Materiales y métodos: estudio observacional, descriptivo, transversal, con los pacientes diagnosticados de gliomas de alto grado, en el Servicio Neurocirugía, de la provincia Matanzas, en el período de 1ero de enero del 2017 a 1ero de enero del 2019, para un total de 40 casos. Resultados: la edad media de las lesiones fue de 52 años, la cefalea fue el síntoma predominante, con el 72,2 %. La sintomatología se presentó con una evolución de menos de un mes. Conclusiones: en el 62 % predominaron los gliomas frontales y la variedad histológica glioblastoma multiforme. La excéresis subtotal se aplicó en la mayor cantidad de cirugías, la calidad de vida al egreso fue superior que al ingreso (AU).


ABSTRACT Introduction. Anaplastic astrocytoma (AA) and Glioblastoma multiforme (GBM) are the most aggressive forms of malignant glioma. Despite advances in radiotherapy, chemotherapy and aggressive surgical resection treatments, such as optical coherence tomography, fluorescence-guided surgery, waking craniotomy, laser interstitial thermal therapy for GBM ablation, intraoperative confocal microscopy and intraoperative mass spectrometry, the prognosis remains bleak. Objective: to determine the behavior of high grade gliomas in the Neurosurgery Service of the province of Matanzas. Materials and methods: cross-sectional, descriptive, observational study with patients diagnosed with high-grade gliomas in the Neurosurgery Service of the province of Matanzas, in the period from January 1, 2017 to January 1, 2019, for a total of 40 cases. Results: the average age of the lesionated patients was 52 years; headache was the predominant symptom, with 72.2 %; the evolution at the presentation of symptoms was less than a month. Conclusions: frontal gliomas predominated in 62 % of the cases, and predominated also glioblastoma multiforme histological variety. Subtotal excision was used in most surgeries. Life quality at discharging was higher than at the moment of admission (AU).


Subject(s)
Humans , Glioma/epidemiology , Epidemiology, Descriptive , Cross-Sectional Studies , Observational Study , Glioma/surgery , Glioma/diagnosis , Neurosurgery
2.
São Paulo; s.n; s.n; 2019. 85 p. tab, graf.
Thesis in English | LILACS | ID: biblio-1007407

ABSTRACT

Gliomas are the most common form of primary intracranial malignancy, among which astrocytomas are the most frequent. Ectodermal-cortex protein 1 (ENC 1), also known as Nuclear Restricted Protein/Brain (NRP/B), was first characterized as a protein which interacts with the cytoskeleton by binding to actin through Kelch-like domains, being related to neural fate specification during development of the nervous system. The first chapter of this thesis confirms ENC1 as a tumor suppression properties by a genomic edition approach, analyses ENC1 expression in a set of patient glioma samples and describes the correlation these data with patients survival and progression-free survival, concluding that ENC1 expression may constitute a biomarker for glioma aggressiveness. The second chapter refers to the identification and in vitro characterization of the LHTNELQ peptide, which was selected by the Phage Display method using human glioblastoma cells. This new peptide is able to be internalized by these cells and features as a new tool for the development of glioma therapeutics. The third chapter report an alternative method to generate growth curves of adherent cell cultures, which is based on the CFSE fluorescence decay over time. It is an alternative method to determine growth curves of cultured cells, with smaller variation among technical replicates than that of counting-based methods


Gliomas são a forma mais comum de malignidades primárias intracranianas, dentre os quais os astrocitomas são os mais frequentes. A proteína Ectodermal-neural cortex 1 (ENC1), também conhecida como Nuclear Restricted Protein/Brain (NRP/B), foi primeiramente caracterizada como uma proteína que interage com o citoesqueleto por meio de ligação à actina através de domínios Kelch-like, sendo relacionada com diferenciação neuronal durante o desenvolvimento do sistema nervoso. O primeiro capítulo desta tese descreve confirmação da capacidade supressora tumoral de ENC1 por abordagem de edição genômica, analisa a expressão de ENC1 em um conjunto de amostras de pacientes com gliomas e correlaciona esses dados com tempo de sobrevida geral e sobrevida livre de progressão tumoral nos pacientes, concluindo que a expressão de ENC1 pode ser utilizada como um biomarcador da agressividade do glioma. O segundo capítulo apresenta a identificação e caracterização in vitro do peptídeo LHTNELQ, que foi selecionado pela metodologia de Phage display utilizandose de células de glioblastoma humano. Este novo peptídeo é capaz de internalizar-se nestas células e figura como uma nova ferramenta para o desenvolvimento de estratégias terapêuticas para glioblastomas. No terceiro capítulo propõe-se um método alternativo para gerar curvas de crescimento celular de cultura aderente, o qual é baseado no decaimento da fluorescência do reagente CFSE ao longo do tempo. Tratase de um método alternativo para a determinação de curvas de crescimento de culturas aderentes, com menor variação entre as réplicas técnicas do que os métodos baseados em contagem das células


Subject(s)
Cell Growth Processes , Fluorescence , Glioma/diagnosis , Actin Cytoskeleton/classification , Glioblastoma , Kelch-Like ECH-Associated Protein 1/adverse effects
3.
Medicina (B.Aires) ; 78(5): 305-310, oct. 2018. ilus, tab
Article in Spanish | LILACS | ID: biblio-976118

ABSTRACT

Los tumores del tronco cerebral son infrecuentes en la población adulta. Las controversias surgen cuando se considera la necesidad de confirmar el diagnóstico histopatológico en esta área elocuente del cerebro, balanceando los beneficios de obtener un diagnóstico certero y las desventajas de los procedimientos invasivos. Existen escasas publicaciones acerca de su tratamiento quirúrgico en adultos, todas series pequeñas analizadas retrospectivamente. Presentamos nuestra experiencia con el propósito de contribuir al proceso de toma de decisiones. Diez de 13 pacientes fueron intervenidos. Las lesiones se clasificaron en focales (n:7), infiltrativa difusa (n:1), tectal (1) y exofítica (1). El estado neurológico según la escala Karnofsky Performance Status fue ≥ 70 en 6 casos y < 70 en 7. Las muestras fueron obtenidas mediante abordaje microquirúrgico directo o por biopsia estereotáctica. Los hallazgos histopatológicos fueron confirmados en todos los casos: astrocitoma pilocítico (n:1), glioma de bajo grado (n:1), glioblastoma (n:1), hemangioblastoma celular (n:1), subependimoma (n:1), disgerminoma (n:1), y lesiones pseudotumorales (n:4, 3 cavernomas, 1 pseudotumor inflamatorio). La amplia variedad de hallazgos patológicos en esta localización en adultos exige una precisa definición histopatológica, que no solo determina la terapéutica adecuada sino que también previene las consecuencias potencialmente catastróficoas de los tratamientos empíricos.


Brainstem tumors are uncommon beyond childhood. Controversies arise regarding the need of histological diagnosis in this eloquent area of the brain, weighting the benefits of a reliable diagnosis against the disadvantages of invasive procedures. There are scant publications about the surgical management of brainstem tumors in adults, all of them involving small retrospective cohorts. We are reporting our experience with the aim of contributing to the decision making process. Out of a series of 13 patients, 10 were approached surgically. According to Guillamo´s classification the lesions were: focal (n:7), diffuse infiltrative (n:1), tectal (n:1), and exophytic (n:1). According to the Karnofsky Performance Status scale, the neurological status was ≥ 70 in 6 cases and < 70 in 7. Histopathology was confirmed in all 10 treated cases and the samples were obtained by a direct microsurgical approach or by stereotactic biopsy. Histopathological findings were: pilocytic astrocytoma (n:1), low grade glioma (n:1), glioblastoma (n:1), cellular haemangioblastoma (n:1), subependimoma (n:1), pseudotumoral lesions (n:4; 3 cavernomas, 1 inflammatory pseudotumor), and disgerminoma (n:1). As a broad variety of pathologies could be found in this brain localization, an accurate histopathological definition can not only determine the adequate therapy, but also avoid the disastrous consequences of empiric treatments.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Brain Stem Neoplasms/surgery , Brain Stem Neoplasms/pathology , Biopsy , Magnetic Resonance Imaging , Cerebral Angiography/methods , Retrospective Studies , Karnofsky Performance Status , Hemangioblastoma/diagnosis , Hemangioma, Cavernous, Central Nervous System/surgery , Hemangioma, Cavernous, Central Nervous System/diagnosis , Brain Stem Neoplasms/diagnosis , Glioma/diagnosis , Granuloma, Plasma Cell/diagnosis
4.
Arq. bras. med. vet. zootec. (Online) ; 70(5): 1383-1387, set.-out. 2018. ilus
Article in English | ID: biblio-946855

ABSTRACT

The aim of this report was to describe the magnetic resonance imaging (MRI) and pathological features of a canine mixed glioma. A 12-year-old boxer male dog was presented for necropsy along with data from an MRI evaluation conducted ante-mortem. The images were examined and showed a poorly demarcated prosencephalic lesion, hyperintense on T2W images, hypointense on T1W images and heterogeneously hyperintense on T2W FLAIR images. There was mild nonuniform contrast enhancement, apparent midline shift, moderate perilesional edema and marked distortion of the adjacent lateral ventricle. The brain was evaluated macroscopically, microscopically and immunohistochemically. Grossly, there was a poorly demarcated soft mass, with areas of hemorrhage, within the left parietal and temporal lobes. Histologically, there was a densely cellular mass composed of two geographically distinct populations of neoplastic cells. The first population was composed of small and round cells organized in a honeycomb pattern. The second population constituted of intermingled streams and bundles of neoplastic cells that were strongly immunolabeled for glial fibrillary acidic protein (GFAP). The diagnosis of a mixed glioma was based on MRI findings, and mainly on histological and immunohistochemical findings.(AU)


O objetivo deste relato foi descrever as características patológicas e das imagens de ressonância magnética de um glioma misto canino. Um cão de 12 anos de idade da raça Boxer foi submetido à necropsia. As imagens obtidas ante mortem por ressonância magnética foram analisadas, e nelas se observou uma lesão prosencefálica com contornos pouco definidos, sinal hiperintenso nas imagens ponderadas em T2, hipointenso nas imagens ponderadas em T1, e heterogeneamente hiperintenso em T2-FLAIR. Havia discreto realce desuniforme ao contraste, evidente desvio da linha média, edema perilesional moderado e marcada distorção do ventrículo lateral adjacente. O encéfalo foi avaliado macroscopicamente, microscopicamente e imuno-histoquimicamente. Macroscopicamente, havia uma massa pobremente demarcada, com áreas de hemorragia, nos lobos parietal e temporal esquerdos. Histologicamente, havia uma massa densamente celular, composta por duas populações de células neoplásicas distintas separadas geograficamente. A primeira população era composta por células pequenas e redondas, organizadas com aspecto de favo de mel. A segunda população era constituída por feixes entrelaçados de células neoplásicas fortemente imunomarcadas para a proteína fibrilar ácida glial (GFAP). O diagnóstico de glioma misto foi obtido com base nos achados imaginológicos e, principalmente, em suas características histológicas e imuno-histoquímicas.(AU)


Subject(s)
Animals , Dogs , Dogs/abnormalities , Glioma/diagnosis , Magnetic Resonance Spectroscopy , Autopsy/veterinary
5.
Bogotá; IETS; mayo 2016. tab, graf.
Monography in Spanish | LILACS, BRISA | ID: biblio-846465

ABSTRACT

Problema de investigación: Evaluar la RICE de la radioterapia (medida la efectividad en AVAC), el PS y el PS+BEV para el tratamiento de pacientes mayores de edad con diagnóstico reciente de GBM confirmado \r\nhistológicamente y con resección macroscópica completa. Tipo de evaluación económica: Análisis de costo\r\n-efectividad. Población objetivo: Pacientes mayores de 18 años con diagnóstico reciente de GBM confirmado histológicamente y con resección macroscópica completa. Intervención y comparadores: Comparación 1: PS comparado con radioterapia, Comparación 2: PS+BEV comparado con PS. Horizonte temporal: Se consideró un horizonte temporal de dos años, con ciclos de 1 mes de duración. Tasa de descuento: La tasa de descuento del caso base fue del 5 % y se llevaron a cabo análisis para tasas de 0 %, 3,5 %, 7 % y 12 %. Estructura del modelo: Se diseñó un modelo de Markov con tres estados de salud (estable, progresión y muerte). Fuentes de datos de efectividad y seguridad: Los datos de efectividad y seguridad fueron obtenidos de cuatro estudios clínicos multicéntricos; la información acerca de la valoración de los desenlaces fue obtenida de una ETES. Desenlaces y valoración: Las ponderaciones para la calidad de vida percibida por los pacientes en cada estado de salud fueron obtenidas de una ETES publicada previamente, y fueron utilizadas para calcular los AVAC. Costos incluidos: Fueron incluidos los costos que generan un gasto directo al SGSSS en Colombia. No se incluyeron costos de cuidadores, costos de pérdidas de productividad ni \r\ncostos de transporte. Fuentes de datos de costos: La valoración de los costos se hizo mediante el uso de \r\nSISMED y de la Circular 03 de 2015 de precios máximos en el caso de los medicamentos, y del manual tarifario ISS 2001 para el caso de los procedimientos. Resultados del caso base: La RICE del PS comparado con la radioterapia es de $ 55.410.625, lo que resulta en que no sería una alternativa costo-efectiva para el país. La RICE del PS+ BEVvs. PS ($ 1.795.371.090) comparado con tres veces el PIB per cápita hace que \r\nesta no se considere una estrategia costo-efectiva para el contexto colombiano. Análisis de sensibilidad:\r\nCuando el costo de la dosis de TMZ concomitante con radioterapia es igual a $ 136.868,6 o menos, el PS se \r\nvuelve una tecnología en salud costo-efectiva para Colombia comparado con la RT. Y solo resulta costo-efectivo a su precio actual si el umbral de disponibilidad a pagar fuera mayor a $ 50.000.000. Bajo ningún escenario de disponibilidad a pagar entre 1 y 3 PIB per cápita, el PS+BEV tendría probabilidad de ser costo-efectivo en Colombia al ser comparado con el PS. Conclusiones y discusión: Aunque las diferencias en términos de AVAC no son amplias entre las diferentes tecnologías, el uso de TMZ (es decir, el PS) es el que mejores resultados reporta frente a la radioterapia sola y frente a la inclusión del BEV al PS (aunque el uso del BEV en esta indica ción es off-label en Colombia).(AU)


Subject(s)
Humans , Adult , Bevacizumab/administration & dosage , Glioblastoma/therapy , Glioma/diagnosis , Glioma/radiotherapy , Radiotherapy, Adjuvant/methods , Biomedical Technology/economics , Colombia , Cost-Benefit Analysis/economics , Health Evaluation/economics
6.
Bogotá; IETS; mayo 2016. tab.
Monography in Spanish | LILACS, BRISA | ID: biblio-846816

ABSTRACT

Tecnologías evaluadas: Nueva: temozolomida. Población: Pacientes mayores de 16 años con diagnóstico reciente de glioblástoma multiforme en Colombia. Perspectiva: La perspectiva del presente AIP corresponde al tercero pagador, que en este caso es el Sistema General de Seguridad Social en Salud (SGSSS) en Colombia. Horizonte temporal: El horizonte temporal de este AIP en el caso base corresponde a un año. Adicionalmente se reportan las estimaciones del impacto presupuestal para los años 2 y 3, bajo el supuesto de la inclusión en el POS en el año 1. Costos incluidos: Costos de las tecnologías analizadas. Fuente de costos: Los precios de cada tecnología considerada fueron consultados en el manual tarifario ISS 2001 y ajustados con un +25%, +30% y +48%. Escenarios: Para este AIP no fueron diseñados escenarios de adopción debido a que la tecnología evaluada ya se utiliza en la práctica clínica colombiana, para toda la población objetivo del análisis. Resultados: El caso base involucraría una inversión total de $29.494.699.472\r\npara el año 1, $4.225.358.276,32 para el año 2 y $ 4.974.085.010,60 para el año 3. En el caso base se asuma la inclusión de la temozolomida en el POS.(AU)


Subject(s)
Humans , Adult , Alkylating Agents/therapeutic use , Glioma/diagnosis , Glioma/therapy , Biomedical Technology , Colombia , Health Evaluation/economics
7.
JPMI-Journal of Postgraduate Medical Institute. 2016; 30 (1): 15-22
in English | IMEMR | ID: emr-178990

ABSTRACT

Gliomas are devastating cancers of the nervous system with poor prognosis. Their aggressiveness produces a mortality rate rarely seen with other malignant tumours and the lack of effective treatment has left very few options. On-colytic viruses, with their long history of experimentation, have been deemed to be a key player in the future treatment of gliomas. This review will focus on the two main contenders, adenovirus and herpes simplex virus, for glioma treatment and discuss how far the field has come since its conception. The concept of each vector and the rationales behind their use will be contrasted before discussing the future of the field. Data was located by accessing the MEDLINE database using the PubMed search system. Data was selected on the basis of the insight its information provided as well as on the dependability of the experimental method used


Subject(s)
Mortality , Oncolytic Virotherapy , Adenoviridae , Simplexvirus , Glioma/diagnosis
8.
Article in English | WPRIM | ID: wpr-110203

ABSTRACT

Chordoid glioma is a rare low grade tumor typically located in the third ventricle. Although a chordoid glioma can arise from ventricle with tumor cells having features of ependymal differentiation, intraventricular dissemination has not been reported. Here we report a case of a patient with third ventricular chordoid glioma and intraventricular dissemination in the lateral and fourth ventricles. We described the perfusion MR imaging features of our case different from a previous report.


Subject(s)
Adult , Cerebral Ventricle Neoplasms/diagnosis , Fourth Ventricle/pathology , Glioma/diagnosis , Humans , Lateral Ventricles/pathology , Magnetic Resonance Imaging/methods , Male , Third Ventricle/pathology
9.
Rev. otorrinolaringol. cir. cabeza cuello ; 75(3): 257-260, dic. 2015. ilus
Article in Spanish | LILACS | ID: lil-771698

ABSTRACT

Los gliomas nasales son restos de tejido neuroglial que se presentan como una masa craneofacial. Es poco frecuente y no tiene características malignas, pero local-mente es bastante agresivo. Se encuentra dentro del diagnóstico diferencial de masas congénitas de la línea media. Se presenta el caso de un recién nacido que presenta un pólipo nasal derecho y distrés respiratorio. La RNM revela una masa intranasal sin conexión intracraneal. Vía endoscópica se realiza exéresis de la masa sin complicaciones. Biopsia confirma diagnóstico de glioma.


Nasal gliomas are glial tissue residues presented as a craniofacial mass. It is rare and has no malignant features, but locally it is quite aggressive. It is included in the differential diagnosis of congenital midline masses. The case of a newborn is reported which presents a right nasal polyp and respiratory distress. The MRI reveals an intracranial mass with no intranasal connection. Endoscopic resection of the mass is done with no complications. Biopsy confirms glioma diagnosis.


Subject(s)
Humans , Male , Infant , Glioma/diagnosis , Glioma/surgery , Nose Neoplasms/diagnosis , Nose Neoplasms/surgery , Biopsy , Magnetic Resonance Imaging
11.
Salvador; s.n; 2015. 70 p. ilus, tab.
Thesis in Portuguese | LILACS | ID: biblio-1000978

ABSTRACT

Introdução e objetivos: O glioblastoma multiforme é um glioma de alto grau que apresenta um prognóstico ruim. O diagnóstico definitivo é estabelecido pela avaliação histológica, porém este pode apresentar conflitos na classificação, com isso surge à necessidade de ferramentas que auxiliem o patologista em sua análise. Atualmente, maior ênfase tem sido dada a alterações na glicosilação, pois estão associadas a neoplasias, e a descoberta da capacidade de lectinas em reconhecer tais alterações fez destas, ferramentas aplicáveis para o diagnóstico biomédico. Dessa forma, o objetivo deste trabalho é analisar a marcação das lectinas CpL, WGA e Con A em células da linhagem C6...


Introduction and objectives: Glioblastoma multiforme is a high-grade glioma that has a poor prognosis. The definitive diagnosis is established by histological assessment. However, this can present conflicts in grading gliomas, which justifies new tools to assist the pathologist in his analysis. Currently, it is known that there are changes in glycosylation pattern of molecules associated with cancer, and the discovery of the ability of lectins to recognize these changes made these tools applicable for biomedical diagnosis. Thus, the aim of this study is to analyze the labelling of C6...


Subject(s)
Humans , Glioma/complications , Glioma/diagnosis , Glioma/immunology , Glioma/pathology , Glioma/blood , Lectins , Lectins/analysis , Lectins/physiology , Lectins/immunology
12.
Rev. chil. obstet. ginecol ; 79(6): 517-523, 2014. ilus
Article in Spanish | LILACS | ID: lil-734799

ABSTRACT

Presentamos el caso clínico de una paciente de 18 años sin antecedentes a destacar. Cursando las 30 semanas de embarazo se constata una tumoración abdominal que requirió tratamiento quirúrgico y se diagnosticó un teratoma inmaduro grado 3, asociado a gliomatosis peritoneal. Se realizó una cesárea al término y se instauró el tratamiento con quimioterapia presentando una recidiva a los siete meses que requirió tratamiento quirúrgico conservador y nuevo plan de quimioterapia estando actualmente libre de enfermedad y en seguimiento. Lo infrecuente de esta patología y asociada a embarazo, motivó su comunicación.


We report the case of a healthy 18-year old patient with adnexal mass diagnosed by her 30th week of pregnancy. It required surgical treatment and a grade 3 immature teratoma associated with peritoneal gliomatosis was diagnosed. A cesarean section was performed at term and subsequently chemotherapy was established. The patient presented a recurrence seven months later, which required fertility-sparing surgery and a new chemotherapy plan. The patient is currently disease-free and under surveillance. The infrequency of this disease and associated with pregnancy, led to their communication.


Subject(s)
Humans , Adult , Female , Pregnancy , Glioma/surgery , Ovarian Neoplasms/surgery , Peritoneal Neoplasms/surgery , Teratoma/surgery , Glioma/diagnosis , Neoplasms, Multiple Primary , Ovarian Neoplasms/diagnosis , Peritoneal Neoplasms/diagnosis , Pregnancy Complications, Neoplastic , Teratoma/diagnosis
13.
In. Salamano Tessore, Ronald L; Scaramelli Giordan, Alejandro; Oehninger Gatti, Carlos L. Diagnóstico y tratamiento en neurología. Montevideo, Dedos, oct.2012. p.367-377.
Monography in Spanish | LILACS | ID: lil-759859
14.
Arq. bras. neurocir ; 31(2)jun. 2012.
Article in Portuguese | LILACS | ID: lil-666952

ABSTRACT

Os gliomas representam 30%-40% de todas as neoplasias intracranianas e aproximadamente 50% são glioblastomas. São classificados em graus pela OMS, de acordo com sua patologia. Apresentam altas taxas de mortalidade. Existem marcadores tumorais que podem auxiliar na detecção precoce e avaliar prognóstico. Realizada revisão sobre o tema marcadores tumorais por meio do site PubMed. MGMT é uma proteína que restaura o DNA, impedindo a sua alquilação. A metilação do MGMT por meio de fenômeno epigenético impede sua transcrição inibindo sua ação, tornando o tumor suscetível a fármacos. IDH e codeleção cromossômica 1p19q são marcadores tumorais e estão associados a melhor prognóstico. As neoplasias intracranianas apresentam altas taxas de mortalidade e sua detecção precoce por meio de marcadores e o conhecimento de alterações que conferem bom prognóstico podem auxiliar no tratamento dessa doença. A análise molecular auxilia na detecção e no tratamento de tumores.


Gliomas represent 30%-40% of all intracranial tumors and approximately 50% are glioblastomas. They are classified by the WHO in degrees, according to their pathology. Have high mortality rates. There are tumor markers may help in early detection and assess prognosis. Was performed a review about the topic tumor markers through PubMed. MGMT is a protein that restores the DNA, preventing its alkylation. Methylation of MGMT through epigenetic phenomenon prevents their transcription and inhibits its action, making the tumor susceptible to drugs. IDH and chromosomal deletion 1p19q are tumor markers and are associated with better prognosis. The intracranial tumors have high rates of mortality and early detection through biomarkers and knowledge of changes that confer a good prognosis can help in treating this disease. Molecular analysis allows the detection and treatment of tumors.


Subject(s)
Humans , Middle Aged , Glioma/diagnosis , Glioma/therapy , Biomarkers, Tumor/chemistry , Biomarkers, Tumor/therapeutic use , Isocitrate Dehydrogenase
15.
J. pediatr. (Rio J.) ; 87(5): 425-432, set.-out. 2011. ilus, tab
Article in Portuguese | LILACS | ID: lil-604434

ABSTRACT

OBJETIVOS: Realizar análise de sobrevida e avaliar, através de análise multivariada, a influência de diversas variáveis na sobrevida, definindo fatores prognósticos de pacientes pediátricos com tumores do sistema nervoso central (SNC) tratados em um único centro. MÉTODOS: Analisamos, retrospectivamente, a sobrevida de 103 crianças portadoras de tumores cerebrais primários, diagnosticadas consecutivamente no período entre janeiro de 2000 e dezembro de 2006. Análise multivariada de fatores influenciando a sobrevida global por regressão de Cox foi usada para definir possíveis fatores prognósticos. RESULTADOS: A mediana e a média de idade foram de 7,2 e 7,6 anos. Houve predominância do sexo masculino (relação 1,22:1). A maioria dos pacientes tinha meduloblastoma ou tumores neuroectodérmicos primitivos (PNET, 38 por cento) ou astrocitomas de baixo grau (18 por cento). As topografias mais comuns foram cerebelar (49 por cento) e tronco cerebral (21 por cento). A sobrevida, 5 anos após o diagnóstico, foi de 84 por cento para astrocitomas de baixo grau e 51 por cento para meduloblastomas e PNET. Fatores prognósticos para a sobrevida global foram histopatológico (astrocitomas de alto grau e ependimomas, razão de risco entre 3,7 e 3,9), cirurgia (razão de risco 0,5 para tumores completamente ressecados) e radioterapia (razão de risco 0,5 para pacientes que receberam radioterapia). CONCLUSÕES: A sobrevida global de pacientes pediátricos com tumores cerebrais neste estudo é comparável àquela dos registros populacionais dos Estados Unidos e Europa. Os fatores de prognóstico definidos para sobrevida global também se assemelham àqueles previamente publicados.


OBJECTIVES: To estimate survival and evaluate prognostic factors of pediatric patients with central nervous system (CNS) tumors treated in a single center. METHODS: Retrospective analysis of survival of 103 children with primary brain tumors diagnosed consecutively from January 2000 to December 2006. Cox regression was used for multivariate analysis of factors that affect overall survival to define possible prognostic factors. RESULTS: Median and mean ages were 7.2 and 7.6 years. There was a male predominance (1.22:1). Most patients had medulloblastomas or primitive neuroectodermal tumors (PNET, 38 percent), or low-grade astrocytomas (18 percent). The anatomic site of most tumors was the cerebellum (49 percent) and the brain stem (21 percent). Five-year survival after diagnosis was 84 percent for low-grade astrocytomas and 51 percent for medulloblastomas and PNET. Prognostic factors for overall survival were histopathological type (high-grade astrocytomas and ependymomas; hazard ratio = 3.7 to 3.9), surgery (hazard ratio of 0.5 for completely resected tumors) and radiotherapy (hazard ratio of 0.5 for patients who underwent radiotherapy). CONCLUSIONS: Overall survival of pediatric patients with brain tumors in this study was similar to that found in populations of the United States and Europe. The prognostic factors defined for overall survival are also similar to those published in previous studies.


Subject(s)
Child , Female , Humans , Male , Brain Neoplasms/diagnosis , Glioma/diagnosis , Brain Neoplasms/mortality , Brain Neoplasms/therapy , Brazil/epidemiology , Epidemiologic Methods , Glioma/mortality , Glioma/therapy , Medulloblastoma/diagnosis , Medulloblastoma/mortality , Medulloblastoma/therapy , Neuroectodermal Tumors, Primitive/diagnosis , Neuroectodermal Tumors, Primitive/mortality , Neuroectodermal Tumors, Primitive/therapy , Prognosis , Treatment Outcome
18.
Pan Arab Journal of Neurosurgery. 2010; 14 (1): 19-23
in English | IMEMR | ID: emr-98300

ABSTRACT

Though schwannomas constitute 8% of all intracranial tumours[5], less than 20 cases of intracerebral schwannomas have been reported so far in world literature.[7] All the rest of schwannomas arise from the cranial nerves. Its malignant counterpart, malignant intracerebral nerve sheath tumour [MJNST] is even rarer. Only six cases of MINST have been reported to date [1] We report a MINST managed by the authors and review the relevant literature. Forty-year-old male patient presented with features of raised intracranial pressure. Cranial magnetic resonance imaging [MRI] revealed a well-defined enhancing parenchymal tumour of right insular region. It was unique in having a hyperintense peripheral rim on T2-weighted images akin to the cerebrospinal fluid cleft. At surgery, the tumour was firm and discrete and it could be shelled out from the surrounding parenchyma. Histopathology revealed a lobular tumour, uniform distribution of vascular spaces lined by plump endothelial cells with rhabdomyoblastic differentiation and cellular component with mitotic figures. Most of tumour cells were positive for vimentin with variable and patchy positively of S-100. Malignant intracerebral nerve sheath tumour is an extremely rare tumor [1] Schwannomas are not known to undergo malignant degeneration and hence, it is preferable to label it MINST [10] However, it can mimick a malignant glioma on radiology, its discrete nature both on the MRI and at surgery remains unique. Lobular nature and rhabdomyoblastic differentiation has been described for the first time. Complete excision followed by irradiation and chemotherapy seems to be most appropriate treatment but the prognosis is still poor [6]


Subject(s)
Humans , Male , Adult , Neurilemma/pathology , Glioma/diagnosis , Magnetic Resonance Imaging , Nerve Sheath Neoplasms/pathology , Glioma/pathology
19.
Jordan Medical Journal. 2010; 44 (4): 466-475
in English | IMEMR | ID: emr-110191

ABSTRACT

The aims of this study are to identify the Immunohistochemical [IHC] expression of Glial Fibrillary Acidic Protein [GFAP] in different types of neuroepithelial tumors in Mosul city and to correlate the results with grade of tumor, with the results of other studies and to assess the diagnostic role of GFAP in the diagnonsis of neuroepithelial tumors and their differentiation from neuroglial tumors. This study included 56 cases of neuroepithelial tumors. 22 cases were collected during the period extending from October 2007 to May 2008. [The rest of the cases were retrieved from a filing system extending back to 2004]. In addition to two miscellaneous tumors, [one meningioma and the other secondary adenocarcinoma]. All cases were obtained from Al- Jamhuri Teaching Hospital in the western side of Mosul City, Northern Iraq and some private laboratories. Typing and grading of the tumors were done according to World Health Organization [WHO] classification system. IHC procedure was done for GFAP using polyclonal antibodies and chromogen visualizing system. A semi-quantitative histochemical score was used to record the results of GFAP staining according to the system established by Catherine L. Nutt et al. Thirty seven cases were diagnosed as astrocytoma, while 8 cases out of ependymoma, 4 cases of oligodendroglioma, and three cases medulloblastoma were shown. In addition, this study revealed that one case for each of: oligoastrocytoma, Medulloepithelioma, atypical rhabdoid tumor and astroblastoma. Glial Fibrillary Acidic Protein [GFAP] was expressed in 85.7% of neuroepithelial tumors. Higher GFAP positivity was found in glioma than other types of neuroepithelial tumors [P value <0.05]. On the other hand, GFAP was expressed in [36%] of astrocytoma. In oligodendroglioma, 3 cases out of 4 were positive while all cases of ependymoma were positive. In addition, oligoastrocytoma was positive while the remaining cases of neuroepithelial tumors were negative. In general, each type of glioma had special staining pattern of GFAP. GFAP status was found to be inversely related with the grade of glioma [P value <0.05]. GFAP is expressed more frequently in glioma than in other neuroepithelial tumors and this result is similar to many other studies done outside Iraq and it is correlated inversely with the grade of tumor. So, it is a valid supplementary diagnostic procedure for neuroepithelial tumors and a reliable marker to differentiate between glial from non-glial tumors on one hand and between different types of glial tumors on the other hand


Subject(s)
Humans , Neoplasms, Neuroepithelial/diagnosis , Immunohistochemistry , Diagnosis, Differential , Glioma/diagnosis
20.
Article in English | WPRIM | ID: wpr-53667

ABSTRACT

A 13-year-old girl with a right intraorbital optic nerve glioma (ONG) was referred to our glaucoma clinic because of uncontrolled intraocular pressure (IOP) in her right eye. The IOP reached as high as 80 mmHg. Several months earlier, she had undergone stereotactic image-guided robotic radiosurgery using the CyberKnife for her ONG; the mass had become smaller after treatment. Her visual acuity was no light perception. Slit lamp examination revealed rubeosis iridis, a swollen pale optic disc, and vitreous hemorrhage. After medical treatment, the IOP decreased to 34 mmHg, and no pain was reported. Although the mass effect of an ONG can cause neovascular glaucoma (NVG), this case shows that stereotactic radiosurgery may also cause NVG, even after reducing the mass of the tumor. Patients who undergo radiosurgery targeting the periocular area should be followed carefully for complications.


Subject(s)
Adolescent , Diagnosis, Differential , Female , Fluorescein Angiography , Follow-Up Studies , Fundus Oculi , Glaucoma, Neovascular/diagnosis , Glioma/diagnosis , Gonioscopy , Humans , Intraocular Pressure , Magnetic Resonance Imaging , Optic Nerve Neoplasms/diagnosis , Radiosurgery/adverse effects
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