ABSTRACT
High grade gliomas usually show a transient response to standard therapy by radiation. A local evolution leads to patient death in most of the cases. Necropsic series suggest that metastatic evolution is rather frequent in lungs, lymph nodes, bones or bone marrow. Are these metastatic deposits present initially? The authors retrospectively reviewed the bone marrow smears performed in 20 patients and the bone scans in 10 patients with high grade gliomas at time of diagnosis. None of these investigations showed metastatic deposits. It is thus suggested that metastatic deposits are probably a late event in the natural history of high grade gliomas. However, if local treatment could reach local control, metastases would probably become a major problem. Thus definitive cure of high grade glioma may require multidisciplinary approach.
Subject(s)
Astrocytoma/secondary , Bone Marrow Neoplasms/secondary , Bone Neoplasms/secondary , Brain Neoplasms/pathology , Ependymoma/secondary , Glioblastoma/secondary , Astrocytoma/diagnosis , Astrocytoma/diagnostic imaging , Astrocytoma/pathology , Biomarkers, Tumor/analysis , Bone Marrow/chemistry , Bone Marrow Examination , Bone Neoplasms/diagnostic imaging , Brain Neoplasms/diagnosis , Disease Progression , Ependymoma/diagnosis , Ependymoma/diagnostic imaging , Ependymoma/pathology , Glial Fibrillary Acidic Protein/analysis , Glioblastoma/diagnosis , Glioblastoma/diagnostic imaging , Glioblastoma/pathology , Humans , Neoplasm Metastasis , Neoplasm Proteins/analysis , Prospective Studies , Radionuclide Imaging , Retrospective StudiesABSTRACT
OBJECT: Somatostatin receptors have been found on a variety of tumours like neuroendocrine breast or brain tumours. Their detection opens new diagnostic and therapeutic paths. The aim of this work was to investigate their expression in medulloblastomas. METHODS: Using both techniques, reverse transcriptase-polymerase chain reaction and immunohistochemistry, we analysed mRNA of different subtypes of somatostatin receptors in 15 medulloblastomas and the localisation of the subtype SSTR2 receptor at the cellular level in 13 medulloblastomas. All five subtypes mRNA were variably expressed in each medulloblastoma. The signal obtained after Southern blotting for SSTR2 receptor amplification was the highest as compared to the signal obtained for the other receptor subtypes. Immunostaining for SSTR2A receptor was present in every tumour specimen and was specifically located to the cellular membrane of neoplastic cells. No staining was identified at the level of peritumoral veins. CONCLUSION: The evidence of predominant expression of SSTR2 receptors in medulloblastomas opens interesting prospects for their diagnosis and therapy.
