MedWorm: Ependymoma

Aurora A is differentially expressed in gliomas, is associated with patient survival in glioblastoma and is a potential chemotherapeutic target in gliomas.

Cell Cycle — Mon, 30 Jan 2012 08:36:21 +0100

Authors: Lehman NL, O'Donnell JP, Whiteley LJ, Stapp RT, Lehman TD, Roszka KM, Schultz LR, Williams CJ, Mikkelsen T, Brown SL, Ecsedy JA, Poisson LM Abstract Aurora A is critical for mitosis and is overexpressed in several neoplasms. Its overexpression transforms cultured cells, and both its overexpression and knockdown cause genomic instability. In transgenic mice, Aurora A haploinsufficiency, not overexpression, leads to increased malignant tumor formation. Aurora A thus appears to have both tumor-promoting and tumor-suppressor functions. Here, we report that Aurora A protein, measured by quantitative protein gel blotting, is differentially expressed in major glioma types in lineage-specific patterns. Aurora A protein levels in WHO grade II oligodendrogliomas (n = 16) and grade I...

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Bevacizumab and irinotecan in children with recurrent or refractory brain tumors: Toxicity and efficacy trends

Pediatric Blood and Cancer — Fri, 27 Jan 2012 05:00:00 +0100

ConclusionBevacizumab‐related acute toxicity appears to be low in children, even in combination with irinotecan. Further prospective trials are required to confirm the hypothetical efficacy of bevacizumab and to assess the risk of long‐term toxicity especially in the youngest children. Pediatr Blood Cancer © 2012 Wiley Periodicals, Inc. (Source: Pediatric Blood and Cancer)

Space-time clustering of childhood central nervous system tumours in Yorkshire, UK

BMC Cancer — Fri, 13 Jan 2012 05:00:00 +0100

Conclusions: There was some evidence for a transient environmental component to the aetiology of PNETs. However, a possible role for chance cannot be excluded. (Source: BMC Cancer)

Ependymoma with cartilaginous metaplasia might have more aggressive behavior: a case report and literature review

Brain Tumor Pathology — Fri, 06 Jan 2012 16:49:44 +0100

We report a case of ependymoma with cartilaginous and osseous metaplasia in a 5-year-old boy. Microscopically, the tumor was composed of neoplastic ependymal tissue and mature cartilage and bone. Immunohistochemically, glial fibrillary acidic protein and epithelial membrane antigen were positive for ependymoma cells but negative for cartilage and bone. Recurrence occurred after 15-month follow-up. The patient deteriorated rapidly and died after 1 month. Reviewing 8 reported cases and our latest case, we found that 3 cases of ependymoma with cartilaginous metaplasia were treated with radiotherapy. Six cases had recurrence from 6 months to 8 years and 2 cases died on the day of operation. These findings suggest that ependymoma with cartilaginous metaplasia might have mor...

Clinicopathologic Features of Intracranial Central Neurocytomas in 2 Dogs

Journal of Veterinary Internal Medicine — Sun, 01 Jan 2012 05:00:00 +0100

Conclusions and Clinical ImportanceCentral neurocytoma should be a differential diagnosis for dogs with intraventricular brain masses. Morphologic differentiation of central neurocytoma from other intraventricular neoplasms, such as ependymoma or oligdendroglioma, can be difficult, and definitive diagnosis often requires immunohistochemical or ultrastructural confirmation of the neural origin of the neoplasm. (Source: Journal of Veterinary Internal Medicine)

Papillary tumor of the pineal region.

Baylor University Medical Center Proceedings — Sun, 01 Jan 2012 05:00:00 +0100

Authors: Vandergriff C, Opatowsky M, O'Rourke B, Layton K Abstract Presented is a patient with papillary tumor of the pineal region (PTPR), an uncommon and recently recognized neoplasm. As its name implies, PTPR does not arise from the pineal gland itself. The cell of origin is thought to be the specialized ependymocytes of the subcommissural organ. Primary tumors of the pineal region include pineal parenchymal neoplasms, germ cell neoplasms, and tumors arising from adjacent structures, including meningiomas, astrocytomas, and ependymomas. Like other masses in this location, PTPR often leads to obstructive hydrocephalus. Due to the relative paucity of reported cases of PTPR, its natural history is unknown. PMID: 22275792 [PubMed - in process] (Source: Baylor University Medical ...

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Clear cell ependymoma with trisomy 19 developing bone metastases

Child's Nervous System — Fri, 30 Dec 2011 07:09:25 +0100

Content Type Journal ArticleCategory Case ReportPages 1-4DOI 10.1007/s00381-011-1656-xAuthors M. Payet, Neuro Oncologie Pédiatrique et Adulte, Institut d’Hémato-Oncologie Pédiatrique, 1 place Joseph Renaut, 69008 Lyon, FranceC. Conter, Neuro Oncologie Pédiatrique et Adulte, Institut d’Hémato-Oncologie Pédiatrique, 1 place Joseph Renaut, 69008 Lyon, FranceF. Labrousse, Department of Pathology, CHU Limoges, Limoges, FranceA. Maues De Paula, Department of Pathology and Neuropathology, Timone Hospital, Marseille, FranceA. Marabelle, Neuro Oncologie Pédiatrique et Adulte, Institut d’Hémato-Oncologie Pédiatrique, 1 place Joseph Renaut, 69008 Lyon, FranceD. Figarella Branger, Department of Pathology and Neuropathology, Timone Hospital, Marseille, FranceR. Bouvier, Department of...

EGFR as a predictor of relapse in myxopapillary ependymoma

Pediatric Blood and Cancer — Tue, 20 Dec 2011 05:00:00 +0100

AbstractMyxopapillary ependymoma (MPE) is a rare subtype of ependymoma in children. Though classified as a Grade I tumor, their unpredictable behavior and propensity for local and disseminated recurrence poses a therapeutic challenge. Till date no predictive molecular markers exist for such recurrence, especially with dissemination. We demonstrated that Epidermal Growth Factor Receptor (EGFR) expression was seen in relapsed MPE both at diagnosis and at recurrence and none in the nonrecurring tumors. This finding suggests EGFR could be a predictive biomarker for recurrence in MPE. Pediatr Blood Cancer © 2011 Wiley Periodicals, Inc. (Source: Pediatric Blood and Cancer)

Growth Hormone Secretion After Conformal Radiation Therapy in Pediatric Patients With Localized Brain Tumors [Pediatric Oncology]

Journal of Clinical Oncology — Fri, 16 Dec 2011 05:00:00 +0100

Conclusion GH secretion after CRT can be predicted on the basis of dose and time after irradiation in pediatric patients with localized brain tumors. These findings provide an objective radiation dose constraint for the hypothalamus. (Source: Journal of Clinical Oncology)

Consensus recommendations for current treatments and accelerating clinical trials for patients with neurofibromatosis type 2

American Journal of Medical Genetics Part A — Fri, 02 Dec 2011 05:00:00 +0100

AbstractNeurofibromatosis type 2 (NF2) is a tumor suppressor syndrome characterized by bilateral vestibular schwannomas (VS) which often result in deafness despite aggressive management. Meningiomas, ependymomas, and other cranial nerve and peripheral schwannomas are also commonly found in NF2 and collectively lead to major neurologic morbidity and mortality. Traditionally, the overall survival rate in patients with NF2 is estimated to be 38% at 20 years from diagnosis. Hence, there is a desperate need for new, effective therapies. Recent progress in understanding the molecular basis of NF2 related tumors has aided in the identification of potential therapeutic targets and emerging clinical therapies. In June 2010, representatives of the international NF2 research and clinical community co...

Incidental findings of mass lesions on neuroimages in children.

Neurosurgical Focus — Thu, 01 Dec 2011 05:00:00 +0100

Authors: Perret C, Boltshauser E, Scheer I, Kellenberger CJ, Grotzer MA Abstract Increasing use of neuroimaging in children has led to more incidental findings of CNS mass lesions, the management of which is uncertain. The authors' aims in this study are to describe these mass lesions and their evolution, as well as to discuss the management options and determine the prevalence of incidental CNS mass lesions at their pediatric clinic. A retrospective study was undertaken in children with primary CNS tumors who were younger than 18 years old and were admitted to the University Children's Hospital of Zurich, Switzerland, between January 1995 and December 2010. In 19 (5.7%) of 335 patients with newly diagnosed CNS tumors, the diagnosis of a CNS mass lesion was an incidental finding. R...

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Fine needle aspiration cytology and immunocytochemistry of myxopapillary ependymoma

Cytopathology — Thu, 01 Dec 2011 05:00:00 +0100

(Source: Cytopathology)

[Extramedullary intradural spinal tumors].

Der Radiologe — Thu, 01 Dec 2011 05:00:00 +0100

Authors: Papanagiotou P Abstract The category of extramedullary intradural tumors includes a variety of lesions ranging from meningiomas originating from meningeal cells and nerve sheath tumors (neurofibromas, schwannomas) to less common primary tumors, such as lipomas, ependymomas, hemangiopericytomas, epidermoid cysts and dermoid cysts. Extramedullary metastases can occur as transcoelomic metastases in tumors of the central nervous system (CNS) or metastasization from other tumors. Magnetic resonance imaging (MRI) is the method of choice for localization and characterization of these lesions before treatment. PMID: 22198142 [PubMed - in process] (Source: Der Radiologe)

Merlin-Deficient Human Tumors Show Loss of Contact Inhibition and Activation of Wnt/β-Catenin Signaling Linked to the PDGFR/Src and Rac/PAK Pathways.

Neoplasia — Thu, 01 Dec 2011 05:00:00 +0100

In this study, we show that proliferative Wnt/β-catenin signaling is elevated as active β-catenin (dephosphorylated at serine 37 and threoine 41) localizes to the nucleus and the Wnt targets genes c-myc and cyclin D1 are upregulated in confluent human schwannoma cells. We demonstrate that Rac effector p21-activated kinase 2 (PAK2) is essential for the activation of Wnt/β-catenin signaling because depletion of PAK2 suppressed active β-catenin, c-myc, and cyclin D1. Most importantly, the link between the loss of the AJ complex and the increased proliferation in human schwannoma cells is connected by Src and platelet-derived growth factor receptor-induced tyrosine 654 phosphorylation on β-catenin and associated with degradation of N-cadherin. We also demonstrate that active merlin mainta...

Effects of EGFR blockade on ependymoma stem cells in vitro and in orthotopic mouse models

International Journal of Cancer — Mon, 28 Nov 2011 05:00:00 +0100

This study describes for the first time EGFR signaling in ependymoma‐SCs and the effects of EGFR blockade in complementary in vitro and in vivo systems. The experimental models we developed can be used to further investigate the activity of EGFR inhibitors or other antineoplastic agents in this tumor. © 2011 Wiley‐Liss, Inc. (Source: International Journal of Cancer)

Effects of epidermal growth factor receptor blockade on ependymoma stem cells in vitro and in orthotopic mouse models

International Journal of Cancer — Mon, 28 Nov 2011 05:00:00 +0100

AbstractSome lines of evidence suggest that tumors, including ependymoma, might arise from a subpopulation of cells, termed cancer stem cells (CSCs), with self‐renewal and tumor‐initiation properties. Given the strict dependence of CSCs on epidermal growth factor (EGF) through EGF receptor (EGFR), we investigated the effects of EGFR inhibitors in ependymoma‐stem cells (SCs) in vitro and in orthotopic mouse models. We established two ependymoma‐SC lines from two recurrent pediatric ependymoma. Both lines expressed markers of radial glia—the candidate SCs of ependymoma—and showed renewal ability, multipotency, and tumorigenicity after orthotopic implantation, despite markedly different expression of CD133 (94 vs. 6%). High phosphorylated‐EGFR/EGFR ratio was detected, which decr...

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Histopathological patterns of papillary tumour of the pineal region.

Folia Neuropathologica — Sun, 27 Nov 2011 11:54:03 +0100

We present the variability of the histopathological pattern in three cases of PTPR. All cases showed predominant epithelial-like morphology but with various degrees of papillary formation and intensity of cellular pleomorphism. One tumour was highly cystic and exhibited cellular sheets containing vessels covered by several layers of uniform columnar to cuboidal tumour cells. The second tumour showed distinct papillae covered by layers of polymorphous cells with atypical, often hyperchromatic nuclei. Numerous cells displayed foamy, eosinophilic or clear, sometimes vacuolated cytoplasm. The third case consisted of solid cellular areas composed of pseudostratified columnar cells, most often arranged in perivascular pseudorosette formations. The cells lining papillary structures exhibited mark...

[Intramedullary tumors.]

Der Radiologe — Thu, 24 Nov 2011 05:00:00 +0100

This article focusses on intramedullary tumors, of which the most commonly found are ependymomas and astrocytomas. PMID: 22108856 [PubMed - as supplied by publisher] (Source: Der Radiologe)

Supratentorial and spinal pediatric ependymomas display a hypermethylated phenotype which includes the loss of tumor suppressor genes involved in the control of cell growth and death

Acta Neuropathologica — Wed, 23 Nov 2011 16:39:22 +0100

In conclusion, we have generated a global view of the methylation profile of ependymoma. The data suggests epigenetic silencing of tumor suppressor genes is an important mechanism in the pathogenesis of supratentorial and spinal, but not posterior fossa ependymomas. Hypermethylation correlated with a decrease in expression of a number of tumor suppressor genes and pathways that could be playing an important role in tumor pathogenesis. Content Type Journal ArticleCategory Original PaperPages 1-15DOI 10.1007/s00401-011-0904-1Authors Hazel A. Rogers, Children’s Brain Tumour Research Centre, D Floor Medical School, Queen’s Medical Centre, University of Nottingham, Nottingham, NG7 2UH UKJohn-Paul Kilday, Children’s Brain Tumour Research Centre, D Floor Medical School, Queen’s ...

Central nervous system (CNS) tumor trends in children in a western Canadian province: a population-based 22-year retrospective study

Journal of Neurology — Tue, 22 Nov 2011 17:57:13 +0100

Abstract In Canada, CNS tumors accounted for nearly 22% of the new childhood cancer diagnoses during 1995–2000 in the ≤15 year age group. The study’s objective was to describe children and youth (age <20 years) diagnosed with CNS tumors in Alberta, Canada during a 22-year period using population-based data. The Alberta Cancer registry was used to extract information, including sex, age and geography, on all CNS (ICCC-3 III) tumor diagnoses during April 1, 1982, and March 31, 2004. Analyses included population summaries and rates. During 22 fiscal years, 568 Alberta children were diagnosed with CNS tumors and nearly 82% of the cases were malignant (461). The majority of cases were male (322, 57%) and the median age at diagnosis was 8 years. The crude...

Complications With Treatment for Spinal EpendymomasComplications With Treatment for Spinal Ependymomas

Medscape Today Headlines — Tue, 22 Nov 2011 11:50:24 +0100

Technological advances continue to improve surgical options for spinal ependymomas, but there are still risks for potentially serious complications. Neurosurgical Focus (Source: Medscape Today Headlines)

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Angiocentric glioma with high proliferative index: case report and review of the literature.

Annals of Clinical and Laboratory Science — Fri, 18 Nov 2011 22:18:03 +0100

We report the case of a 3-year-old child who presented with seizures and was found to have a non-enhancing parietal lobe lesion with overlying calvarial remodeling. Following complete resection of the tumor, histopathological examination revealed bipolar spindle cells centered on cortical blood vessels, forming pseudorosettes with an ependymomatous appearance. Tumor cells were glial fibrillary acidic protein (GFAP) positive, yet failed to label with synaptophysin. Scattered tumor cells had a "dot-like" cytoplasmic staining with the antibody against epithelial membrane antigen (EMA). Collectively, these features favored a diagnosis of AG. Interestingly, the monoclonal antibody against Ki-67 (MIB-1) labeling rate averaged approximately 10.0%. The child continues to be tumor- and seizure-free...

Neurofibromatosis 2011: a report of the Children’s Tumor Foundation Annual Meeting

Acta Neuropathologica — Tue, 15 Nov 2011 06:47:18 +0100

Abstract The 2011 annual meeting of the Children’s Tumor Foundation, the annual gathering of the neurofibromatosis (NF) research and clinical communities, was attended by 330 participants who discussed integration of new signaling pathways into NF research, the appreciation for NF mutations in sporadic cancers, and an expanding pre-clinical and clinical agenda. NF1, NF2, and schwannomatosis collectively affect approximately 100,000 persons in US, and result from mutations in different genes. Benign tumors of NF1 (neurofibroma and optic pathway glioma) and NF2 (schwannoma, ependymoma, and meningioma) and schwannomatosis (schwannoma) can cause significant morbidity, and there are no proven drug treatments for any form of NF. Each disorder is associated with additional mani...

Tandem high-dose chemotherapy and autologous stem cell transplantation for anaplastic ependymoma in children younger than 3 years of age

Journal of Neuro-Oncology — Fri, 11 Nov 2011 16:45:50 +0100

Abstract The present study evaluates the feasibility and effectiveness of tandem high-dose chemotherapy and autologous stem cell transplantation (HDCT/autoSCT) in very young children with anaplastic ependymoma. We aimed both to improve survival and to avoid unacceptable late adverse effects of radiation therapy (RT) by avoiding or deferring RT until 3 years of age. Five consecutive patients younger than 3 years of age with anaplastic ependymoma were enrolled from April 2006 to November 2008. Tandem HDCT/autoSCT was given following six cycles of induction chemotherapy. RT was either not given or deferred until 3 years of age if the patient was in complete response after tandem HDCT/autoSCT. Median age at diagnosis was 16 (range 12–28) months. Four patients ...

Cerebrospinal Tumor Dissemination in a Patient With Myxopapillary Ependymoma [DIAGNOSIS IN ONCOLOGY]

Journal of Clinical Oncology — Tue, 08 Nov 2011 05:00:00 +0100

(Source: Journal of Clinical Oncology)

Tanycytic ependymoma of filum terminale: A case report

Clinical Neurology and Neurosurgery — Mon, 07 Nov 2011 05:00:00 +0100

Abstract: Tanycytic ependymoma is an uncommon but well-recognized variant of ependymoma. Here we report a case of tanycytic ependymoma occurring at the region of filum terminale in a 44-year male who presented with low backache, bilateral lower limb weakness and urinary incontinence. MR imaging in this patient showed a lesion that was composed of solid and cystic components and was suggestive of ependymoma. The filum terminale region is an extremely unusual location for the occurrence of tanycytic ependymoma. To the best of our knowledge this is the third case of tanycytic ependymoma occurring in the filum terminale region. (Source: Clinical Neurology and Neurosurgery)

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[Tumors of the lateral ventricle. Review of 284 cases.]

Neuro-Chirurgie — Wed, 26 Oct 2011 04:00:00 +0100

Authors: Baroncini M, Peltier J, Le Gars D, Lejeune JP Abstract The data from 284 cases of lateral ventricle (VL) tumors treated in 18 departments of Neurosurgery in France between 1995 and 2010 were collected in this series. The mean age was 33 years with a large proportion of children (79/284). CLINICAL PRESENTATION: The mean duration of symptoms was short in time (2 months). The revelation was incidental in 10% of the cases ; for symptomatic lesions, raised intracranial pressure (ICP, due to hydrocephalus) and neuropsychological signs were the most frequent. Only one third of the patients had no CSF disorder. HISTOPATHOLOGY: The two most frequent tumors were meningiomas (40 cases, 15%) and neurocytomas (35 cases, 13%). The sub-ependymal giant cells astrocytomas, the ependymomas...

[Ependymomas of the lateral ventricle. A series of 27 cases with review of the literature.]

Neuro-Chirurgie — Mon, 24 Oct 2011 04:00:00 +0100

Authors: Lejeune JP, Reyns N, Baroncini M, Peltier J, Le Gars D Abstract Twenty-seven cases of ependymoma were collected in the French multicentric study dedicated to lateral ventricle tumors. The mean age of patients was 31,5 years. All patients underwent surgery, with complete resection of the tumor in 76% of cases. Histologic examination disclosed 23 grade 2 ependymomas and four grade 3 ependymomas. Postoperative mortality was 7%. Four patients underwent radiotherapy, and five chemotherapy. Local recurrence of the tumor occurred in seven cases, with a mean delay of 48 months. Disseminated disease within the central nervous system was found in only one patient. Median survival in all the 27 patients was 181 months, and median progression-free survival was 106 months. The relevant...

Myxopapillary Ependymoma With Pleuropulmonary Metastases and High Plasma Glial Fibrillary Acidic Protein Levels [DIAGNOSIS IN ONCOLOGY]

Journal of Clinical Oncology — Tue, 18 Oct 2011 04:00:00 +0100

(Source: Journal of Clinical Oncology)

Expression of dual angiogenic/neurogenic growth factors in human primary brain tumors

Journal of Neuro-Oncology — Fri, 07 Oct 2011 05:44:52 +0100

Abstract Brain tumors, benign or malignant, are characterized by a very high degree of vascularization. Recent accumulating evidence suggests that during development the neuronal wiring follows the same routes as the vasculature and that these two systems may share some of the same factors for guidance. Thus, expression of dual angiogenic/neurogenic growth factors was evaluated by in situ hybridization in human primary brain tumors of three different types, i.e., astrocytomas, oligodendrogliomas, and ependymomas, of increasing grades, in relation with the grade and type of the tumor. For this evaluation we selected vascular endothelial growth factor (VEGF-A) and its receptors VEGF-R1 and VEGF-R2 and the neuropilins 1 and 2 (NRP-1 and NRP-2), which have proangioge...

Cervical intramedullary ependymoma masquerading as cervical spondylotic myelopathy on MRI analysis

Journal of Orthopaedic Science — Thu, 06 Oct 2011 05:50:31 +0100

Content Type Journal ArticleCategory Case ReportPages 1-4DOI 10.1007/s00776-011-0165-9Authors Osahiko Tsuji, Department of Orthopaedic Surgery, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582 JapanMasaya Nakamura, Department of Orthopaedic Surgery, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582 JapanKanehiro Fujiyoshi, Department of Orthopaedic Surgery, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582 JapanKen Ishii, Department of Orthopaedic Surgery, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582 JapanKota Watanabe, Department of Advanced Therapy for Spine and Spinal Cord Disorders, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku, Tokyo, Japan...

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Papillary ependymoma of the lateral ventricle: a rare low‐grade variant of an uncommon neoplasm in the adult

ANZ Journal of Surgery — Sat, 01 Oct 2011 04:00:00 +0100

(Source: ANZ Journal of Surgery)

Complications associated with the treatment for spinal ependymomas.

Neurosurgical Focus — Sat, 01 Oct 2011 04:00:00 +0100

Authors: Nagasawa DT, Smith ZA, Cremer N, Fong C, Lu DC, Yang I Abstract Spinal cord ependymomas are rare neoplasms, comprising approximately 5% of all CNS tumors and 15% of all spinal cord tumors. Although surgery was once reserved for diagnosis alone, the evolution of surgical practices has elevated resection to the treatment of choice for these lesions. While technological advances continue to improve the capacity for gross-total resections and thus decrease the risk of recurrence, ependymoma spinal surgery still contains a variety of potential complications. The presence of neurological deficits and deterioration are not uncommonly associated with spinal cord ependymoma surgery, including sensory loss, dorsal column dysfunction, dysesthetic syndrome, and bowel and bladder dysfu...

[Leptomeningeal spread of an intramedullary cervical pilocytic astrocytoma: case report and literature review.]

Neurocirugia — Sat, 01 Oct 2011 04:00:00 +0100

CONCLUSION. Leptomeningeal spread is a rare phenomenon and when it happens usually doesn't change the primary tumor's behavior. In our case the aggressivenes could be explained by a potential malignization of the primary tumor that it wasn't documented because of the partial resectionss from the lasts surgeries or instead the tumor was actually a monomorphous pilomyxoid tumor. PMID: 22031164 [PubMed - as supplied by publisher] (Source: Neurocirugia)

Analysis of survival and prognostic factors of pediatric patients with brain tumor.

Jornal de Pediatria — Fri, 30 Sep 2011 04:00:00 +0100

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. PMID: 21964994 [PubMed - as supplied by publisher] (Source: Jornal de Pediatria)

Prospective assessment of patient morbidity from prone sacral positioning.

Journal of Neurosurgery.Spine — Fri, 30 Sep 2011 04:00:00 +0100

Conclusions A positioning protocol using head suspension on an open radiolucent frame facilitates oncological sacral surgery with reasonable patient morbidity. Morbid obesity and procedure times in excess of 10 hours are risk factors for positioning-related complications. To the authors' knowledge, this is the first report of surgical positioning morbidity in this patient population. PMID: 21962033 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery.Spine)

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Predictors of survival among older adults with ependymoma

Journal of Neuro-Oncology — Wed, 28 Sep 2011 05:54:36 +0100

Abstract The biological process of aging encompasses a multitude of complex physiological and lifestyle changes that may alter the way typical prognostic factors affect survival among older ependymoma patients. Because very little is known about the clinical significance of traditional prognostic factors and the magnitude of their effects among older individuals, the purpose of this study was to evaluate the associations between survival and demographic and tumor characteristics among patients with ependymoma who were 60 years of age or older. Using the 1973–2007 dataset from the Surveillance, Epidemiology and End Results (SEER) program, we evaluated the impact of several factors on both overall and ependymoma-specific survival, utilizing multivariable Cox proportio...

New Strategy Likely To Speed Drug Development For Rare Cancers

Health News from Medical News Today — Fri, 16 Sep 2011 08:00:00 +0100

Researchers have identified promising new therapies for ependymoma, a rare tumor with few treatment options. St. Jude Children's Research Hospital investigators led the effort, which used a new, faster drug development system that combines the latest drug screening technology with the first accurate animal model of the tumor. Investigators identified several dozen new and existing drugs as possible ependymoma treatment candidates... (Source: Health News from Medical News Today)

Speeding Drug Development for Rare Cancers Including Ependymoma

Disabled World — Fri, 16 Sep 2011 01:38:23 +0100

New strategy likely to speed drug development for rare cancers - Research led by St. Jude Children's Research Hospital investigators used a pioneering approach to drug development and identified dozens of potential new treatments of ependymoma, a rare tumor of the brain and spinal cord. (Source: Disabled World)

Presacral parachordoma causing intestinal obstruction in a patient with renal failure: Report of a case

Surgery Today — Thu, 15 Sep 2011 15:52:41 +0100

Abstract Parachordoma is usually lobulated and pseudoencapsulated, grows slowly, and is only locally invasive. It rarely occurs in the retroperitoneal area. Differential diagnoses include chordoma, extraskeletal myxoid chondrosarcoma, and subcutaneous sacrococcygeal myxopapillary ependymoma. We herein report our experience with a huge presacral parachordoma causing intestinal obstruction. A 48-year-old woman was a hemodialysis-dependent patient with end-stage renal disease. She had been diagnosed with uterine myomas several years prior. The patient presented with signs of intestinal obstruction. A presacral tumor with severe compression on the rectum resulting in rectal stricture was found. A resection of the presacral tumor was difficult owing to its large size and the di...

Discrimination of paediatric brain tumours using apparent diffusion coefficient histograms

European Radiology — Thu, 15 Sep 2011 05:54:19 +0100

Conclusions ADC histograms are useful in differentiating paediatric brain tumours, in particular, the common posterior fossa tumours of childhood. PNETs were differentiated from supratentorial ATRTs, in all cases, which has important implications in terms of clinical management. Key Points • MR based apparent diffusion coefficient histograms can help differentiate paediatric brain tumours • ADC histogram parameters correctly classified the great majority of posterior fossa tumours Content Type Journal ArticleCategory OncologyPages 1-11DOI 10.1007/s00330-011-2255-7Authors Jonathan G. Bull, Imaging and Biophysics Unit, UCL Institute of Child Health, 30 Guilford Street, London, WC1N 1EH UKDawn E. Saunders, Department of Radiology, Great...

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New strategy likely to speed drug development for rare cancers

EurekAlert! - Medicine and Health — Thu, 15 Sep 2011 04:00:00 +0100

(St. Jude Children's Research Hospital) Researchers have identified promising new therapies for ependymoma, a rare tumor with few treatment options. St. Jude Children's Research Hospital investigators led the effort, which used a new, faster drug development system that combines the latest drug screening technology with the first accurate animal model of the tumor. (Source: EurekAlert! - Medicine and Health)

Neuroendoscopic Management of Intraventricular Germinoma at the Foramen of Monro: Case Report and Review of the Literature

min - Minimally Invasive Neurosurgery — Thu, 15 Sep 2011 04:00:00 +0100

This report suggests that in selected cases endoscopic resection of an intraventricular tumor under frameless neuronavigation guidance is feasible and safe. The target can be precisely located and procedure-related adverse events can be minimized.[...]Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals:Table of contents | Abstract | Full text (Source: min - Minimally Invasive Neurosurgery)

An Integrated In Vitro and In Vivo High-Throughput Screen Identifies Treatment Leads for Ependymoma

Cancer Cell — Tue, 13 Sep 2011 00:00:00 +0100

Jennifer M. Atkinson, Anang A. Shelat, Angel Montero Carcaboso, Tanya A. Kranenburg, Leggy A. Arnold, Nidal Boulos, Karen Wright, Robert A. Johnson, Helen Poppleton, Kumarasamypet M. Mohankumar, Clementine Féau, Timothy Phoenix, Paul Gibson, Liqin Zhu, Yiai Tong, Chris Eden, David W. Ellison, Waldemar Priebe, Dimpy Koul, W. K. Alfred Yung, Amar Gajjar, Clinton F. Stewart, R. Kiplin Guy, Richard J. Gilbertson. Using a mouse model of ependymoma—a chemoresistant brain tumor—we combined multicell high-throughput screening (HTS), kinome-wide binding assays, and in vivo efficacy studies, to identify potentia.... (Source: Cancer Cell)

Phase I Trial of MK-0752 in Children With Refractory CNS Malignancies: A Pediatric Brain Tumor Consortium Study [Pediatric Oncology]

Journal of Clinical Oncology — Thu, 08 Sep 2011 04:00:00 +0100

Conclusion MK-0752 is well-tolerated in children with recurrent CNS malignancies. The recommended phase II dose using the 3 days on followed by 4 days off schedule is 260 mg/m2/dose once daily. (Source: Journal of Clinical Oncology)

Extramedullary spinal ependymoma: A diagnostic challenge and review of the literature

Clinical Neurology and Neurosurgery — Thu, 25 Aug 2011 23:00:00 +0100

Abstract: Of the 15 cases of intradural extramedullary ependymomas in the literature, only 3 patients were male. The authors report the fourth case to be diagnosed in a male patient and discuss the pathogenesis, presentation, and treatment of this rare form of ependymoma. These cases most commonly show a similar clinical preoperative course to that of a benign meningioma. Although most instances have been reported in females, hormonal influence may not completely explain this neoplasm's pathogenesis. Close follow-up is warranted because of potential recurrence, metastasis, and anaplastic transformation. An ependymoma should be included in the differential diagnosis of intradural extramedullary tumors. (Source: Clinical Neurology and Neurosurgery)

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Temozolomide in relapsed pediatric brain tumors: 14 cases from a single center

Child's Nervous System — Wed, 24 Aug 2011 16:03:39 +0100

Conclusions Relapsed brain tumors in childhood have an unfavorable prognosis. These data suggest that temozolomide might be an active agent against recurrent medulloblastoma. Although overall objective response rate was low, further multicentric studies with temozolomide may be warranted in children with recurrent brain tumors. Content Type Journal ArticleCategory Original PaperPages 1-5DOI 10.1007/s00381-011-1561-3Authors Canan Akyüz, Institute of Oncology, Department of Pediatric Oncology, Hacettepe University, 06100 Ankara, TurkeyHacı Ahmet Demir, Institute of Oncology, Department of Pediatric Oncology, Hacettepe University, 06100 Ankara, TurkeyAli Varan, Institute of Oncology, Department of Pediatric Oncology, Hacettepe University, 06100 Ankara, TurkeyBilgehan...

Malignant Brain Tumors In Children Found To be Two Different Diseases

Health News from Medical News Today — Wed, 24 Aug 2011 08:00:00 +0100

Ependymomas are the second most frequent type of malignant brain tumor in children. Ependymoma develops from precursor cells of the tissue that lines the hollow cavities of the brain. Therapy results of ependymoma vary immensely: While in some patients tumor growth comes to a standstill after surgery and radiotherapy, in other children the disease rapidly takes a severe course. In about half of those affected the tumor continues to grow and the patients often succumb to the disease. "It is the patients with a severe course, in particular, who urgently need better therapies... (Source: Health News from Medical News Today)

Pediatric infratentorial ependymoma: prognostic significance of anaplastic histology

Journal of Neuro-Oncology — Wed, 24 Aug 2011 05:55:38 +0100

Abstract Pediatric infratentorial ependymomas are difficult to cure. Despite the availability of advanced therapeutic modalities for brain tumors, total surgical resection remains the most important prognostic factor. Recently, histological grade emerged as an independent prognostic factor for intracranial ependymoma. We retrospectively reviewed the treatment outcome of 33 pediatric patients with infratentorial ependymoma. Progression-free survival (PFS) and overall survival (OS) rates were calculated and relevant prognostic factors were analyzed. Fourteen patients (42%) were under the age of 3 at diagnosis. Gross total resection was achieved in 16 patients (49%). Anaplastic histology was found in 13 patients (39%). Adjuvant therapies were delayed until progression in 12 p...

A novel human high-risk ependymoma stem cell model reveals the differentiation-inducing potential of the histone deacetylase inhibitor Vorinostat

Acta Neuropathologica — Tue, 23 Aug 2011 15:52:56 +0100

Abstract Incompletely resectable ependymomas are associated with poor prognosis despite intensive radio- and chemotherapy. Novel treatments have been difficult to develop due to the lack of appropriate models. Here, we report on the generation of a high-risk cytogenetic group 3 and molecular group C ependymoma model (DKFZ-EP1NS) which is based on primary ependymoma cells obtained from a patient with metastatic disease. This model displays stem cell features such as self-renewal capacity, differentiation capacity, and specific marker expression. In vivo transplantation showed high tumorigenic potential of these cells, and xenografts phenotypically recapitulated the original tumor in a niche-dependent manner. DKFZ-EP1NS cells harbor transcriptome plasticity, en...

Brain tumors found to have a 2-tier system

EurekAlert! - Medicine and Health — Tue, 23 Aug 2011 04:00:00 +0100

(Helmholtz Association of German Research Centres) Scientists of the German Cancer Research Center (Deutsches Krebsforschungszentrum, DKFZ) and Heidelberg University Hospitals have led the largest ever molecular-biological analysis of ependymoma, a dangerous brain tumor in children. They were able to define two distinct subgroups of ependymoma which differ both genetically and clinically. The researchers will now use these results to gain a better understanding of the causes of ependymoma and to develop more targeted treatment approaches. (Source: EurekAlert! - Medicine and Health)

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Analysis of the prognostic significance of selected morphological and immunohistochemical markers in ependymomas, with literature review.

Folia Neuropathologica — Mon, 22 Aug 2011 23:16:03 +0100

Authors: Zawrocki A, Iżycka-Świeszewska E, Papierz W, Liberski PP, Zakrzewski K, Biernat W Abstract Aim: Ependymal tumours are relatively uncommon primary neoplasms of the central nervous system. Histological criteria distinguishing ependymoma and anaplastic ependymoma are not clear-cut and other parameters are required to allow more precise prognostication in these tumours. We analysed the histological and immunohistochemical features of these tumours (Ki-67, cyclin D1, EGFR, hTERT, Olig2) and correlated them with the clinical outcome. Material and methods: We analysed 39 patients with grade II ependymoma (30) and anaplastic ependymoma (9). Twenty-eight tumours developed in children and the remaining 11 patients were adults with intracranial and intraspinal tumours. Eighteen pat...

Papillary tumor of the pineal region: two case studies and a review of the literature.

Annals of Clinical and Laboratory Science — Fri, 19 Aug 2011 23:04:06 +0100

Authors: Rickard KA, Parker JR, Vitaz TW, Plaga AR, Wagner S, Parker JC Abstract Papillary tumor of the pineal region (PTPR) is a newly recognized distinct entity in the 2007 World Health Organization nomenclature. This tumor is characterized by epithelial-appearing areas with papillary features and more densely cellular areas that often display ependymal-like differentiation. Ultrastructurally, this rare neuroepithelial tumor possesses neuroendocrine, secretory, and ependymal organelles that likely originate from the subcommissural organ (SCO) near the aqueduct of Sylvius. To date, approximately fifty-seven described cases worldwide have been recognized, with ages ranging from 5 years to 66 years (mean age=32 years). Clinical presentation most often includes headache and obstructi...

Incidental brain lesions in children: to treat or not to treat?

Journal of Neuro-Oncology — Fri, 19 Aug 2011 05:49:36 +0100

Abstract Central nervous system (CNS) lesions that are discovered incidentally when imaging children for problems that were unrelated to the detected lesion pose a dilemma to physicians. Because there are few data on the outcome of such cases, we retrospectively reviewed the clinical course of a group of children followed at our institution with brain lesions found incidentally on neuro-imaging. A database of all children with brain lesions followed at the University of Rochester medical center from 2000 to 2010 was reviewed. Data were obtained regarding presentation, magnetic resonance imaging (MRI) features, treatment, progression-free survival, and overall survival of children with brain lesions found incidentally. Of the 244 children with brain lesions seen over this t...

Posterior Fossa Ependymomas: A Tale of Two Subtypes

Cancer Cell — Tue, 16 Aug 2011 00:00:00 +0100

Tenley C. Archer, Scott L. Pomeroy. Ependymomas are common childhood brain tumors, but little is known about their underlying biology. In this issue of Cancer Cell, Witt et al. present that posterior fossa ependymomas compris.... (Source: Cancer Cell)

Delineation of Two Clinically and Molecularly Distinct Subgroups of Posterior Fossa Ependymoma

Cancer Cell — Tue, 16 Aug 2011 00:00:00 +0100

Hendrik Witt, Stephen C. Mack, Marina Ryzhova, Sebastian Bender, Martin Sill, Ruth Isserlin, Axel Benner, Thomas Hielscher, Till Milde, Marc Remke, David T.W. Jones, Paul A. Northcott, Livia Garzia, Kelsey C. Bertrand, Andrea Wittmann, Yuan Yao, Stephen S. Roberts, Luca Massimi, Tim Van Meter, William A. Weiss, Nalin Gupta, Wiesia Grajkowska, Boleslaw Lach, Yoon-Jae Cho, Andreas von Deimling, Andreas E. Kulozik, Olaf Witt, Gary D. Bader, Cynthia E. Hawkins, Uri Tabori, Abhijit Guha, James T. Rutka, Peter Lichter, Andrey Korshunov, Michael D. Taylor, Stefan M. Pfister. Despite the histological similarity of ependymomas from throughout the neuroaxis, the disease likely comprises multiple independent entities, each with a distinct molecular pathogenesis. Transcrip.... (Source: C...

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Intraoperative squash cytology: accuracy and impact on immediate surgical management of central nervous system tumours

Cytopathology — Sun, 14 Aug 2011 23:00:00 +0100

Conclusion: Squash cytology is a rapid, reliable, simple technique for intraoperative consultation in neurosurgical practice with high overall accuracy. Causes causing an adverse impact on surgical management were rare and potential avoidable reasons for them were identified. (Source: Cytopathology)

Primary myxopapillary ependymoma of the fourth ventricle with cartilaginous metaplasia: a case report and review of the literature

Brain Tumor Pathology — Fri, 12 Aug 2011 06:17:08 +0100

We report an additional case of intracranial MPE, which is the third reported case in the fourth ventricle. The tumor manifested in a 50-year-old lady, who presented with features of raised intracranial pressure. A gross total resection of the tumor was achieved. Histologically, the tumor had characteristic features of MPE with focal metaplastic cartilaginous deposit. On further evaluation, there was no evidence of a primary tumor in the spinal cord. Intracranial MPE needs further evaluation by craniospinal MRI to exclude an unrecognized primary in the spinal region, which could warrant surgical attention. Content Type Journal ArticlePages 1-6DOI 10.1007/s10014-011-0059-8Authors Shrijeet Chakraborti, Department of Neuropathology, National Institute of Mental Health and Neurosci...

Pediatric intracranial ependymoma: the roles of surgery, radiation and chemotherapy

Journal of Neuro-Oncology — Tue, 09 Aug 2011 05:43:43 +0100

In conclusion, for localized intracranial pediatric ependymomas, adjuvant RT is associated with improved PFS, even after adjusting for EOR. Our findings suggest the benefit of RT even in the presence of GTR. Future prospective studies with larger sample number are needed to validate our findings. Content Type Journal ArticlePages 1-9DOI 10.1007/s11060-011-0671-9Authors Sunanda Pejavar, Departments of Radiation Oncology, Neurosurgery, and Pediatrics, University of California, San Francisco and UCSF Benioff Children’s Hospital, 1600 Divisadero Street, Suite H1031, San Francisco, CA 94115-1708, USAMei-Yin Polley, Departments of Radiation Oncology, Neurosurgery, and Pediatrics, University of California, San Francisco and UCSF Benioff Children’s Hospital, 1600 Divisadero Street, Su...

Comparative analysis on the diagnosis and treatments of multisegment intramedullary spinal cord tumors between the different age groups

Urosurgical Review — Sat, 06 Aug 2011 05:59:40 +0100

Abstract Multisegment intramedullary spinal cord tumors (MSICT) are a special type of spinal cord tumor. Up to now, no comparative clinical study of MSICT has been performed according to different age groups. Seventy-seven patients underwent microsurgery for MSICT. As grouped with two different methods, the parametric and nonparametric data of MSICT and patients were comparatively analyzed using statistically correlative methods. Forty-eight patients were males and 29 were females, ranging in age from 4 to 64 years (mean, 32.9 years). Among the six groups, being divided with intervals of 10 years, the whole difference in the initial symptoms of patients (Z = 17.4, P = 0.004) and in the histological classification of tumors (Z = 12.5, P = 0.03)...

Pituicytoma with unusual histological features

Pathology International — Sun, 31 Jul 2011 23:00:00 +0100

Pituicytoma is a rare low‐grade glial neoplasm that originates in the neurohypophysis or infundibulum. Because of its rare occurrence, the morphology and differentiation of pituicytoma have not been fully clarified. Here, we report a case of pituicytoma with unusual histological features mimicking ependymoma, but exhibiting the diverse morphology and differentiation of pituicytoma. The 1.4 cm‐sized suprasellar mass was incidentally found in the magnetic resonance image of a 42‐year‐old Korean woman who had had a traffic accident. Four years later, she presented with symptoms of hypopituitarism and the follow‐up images revealed slight enlargement of the mass. After gross total resection, microscopic examination revealed oval to elongated cells with abundant eosinophilic cytoplas...

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Subcutaneous myxopapillary ependymal rest: A potential sign of spinal dysraphism

Journal of the American Academy of Dermatology — Fri, 29 Jul 2011 04:00:00 +0100

We report a case which presented as a flesh-colored, pedunculated papule near the gluteal cleft. The presence of a congenital lesion near the midline of the spine should alert the clinician to the possibility of spinal dysraphism and necessitates imaging before biopsy. Subcutaneous myxopapillary rests are benign but must be distinguished from their histologic mimic, subcutaneous myxopapillary ependymomas, which are low-grade tumors with metastatic potential. (Source: Journal of the American Academy of Dermatology)

Survival of european patients with central nervous system tumors

International Journal of Cancer — Thu, 28 Jul 2011 23:00:00 +0100

We present estimates of population‐based five‐year relative survival for adult Europeans diagnosed with central nervous system tumors, by morphology (14 categories based on cell lineage and malignancy grade), sex, age at diagnosis, and region (UK and Ireland, Northern, Central, Eastern and Southern Europe) for the most recent period with available data (2000‐2002). Sources were 39 EUROCARE cancer registries with continuous data from 1996 to 2002. Survival time trends (1988 to 2002) were estimated from 24 cancer registries with continuous data from 1988.Overall five‐year relative survival was 85.0% for benign, 19.9% for malignant tumors. Benign tumor survival ranged from 90.6% (Northern Europe) to 77.4% (UK and Ireland); for malignant tumors the range was 25.1% (Northern Europe) to ...

Unusual caloric responses in a patient with a fourth ventricular ependymoma

Neurological Sciences — Thu, 28 Jul 2011 15:54:17 +0100

We describe a patient with a tumor originating in the floor of the fourth ventricle who presented with premature reversal after cold stimulation on one side and perverted nystagmus after cold stimulation of the other side. Content Type Journal ArticlePages 1-3DOI 10.1007/s10072-011-0713-2Authors Hyun-Ah Kim, Department of Neurology, Keimyung University School of Medicine, 194 Dongsan dong, Daegu, 700-712 South KoreaHyung Lee, Department of Neurology, Keimyung University School of Medicine, 194 Dongsan dong, Daegu, 700-712 South KoreaHyon-Ah Yi, Department of Neurology, Keimyung University School of Medicine, 194 Dongsan dong, Daegu, 700-712 South KoreaRobert W. Baloh, Department of Neurology, UCLA School of Medicine, Los Angeles, CA, USA Journal Neurological SciencesOnline ...

Rare histological variants in ependymomas: histopathological analysis of 13 cases

Virchows Archiv — Tue, 26 Jul 2011 15:58:16 +0100

Abstract Ependymomas are rare brain tumors representing about 3% of all intra-cerebral and spinal neoplasms. The WHO classification recognizes various rare histological ependymoma variants (i.e., lipidized ependymoma, giant cell ependymoma, etc.). However, a detailed analysis of a larger series of such cases is still lacking. We analyzed 13 case of ependymoma presenting unusual histological features. The data analysis of our series and its comparison to the cases published in literature did not reveal any close association between these features and the clinical parameters (such as age or localization). Moreover, some of these features can be found combined in individual tumors, suggesting that these variants may represent a spectrum of differentiation rather than true spe...

Platelet-derived growth factor receptor (PDGFR) expression in primary spinal cord gliomas

Journal of Neuro-Oncology — Tue, 26 Jul 2011 05:48:24 +0100

In this study we perform immunohistochemical analysis of PDGFRα expression in a series of 33 primary intramedullary spinal cord gliomas of different types and grades. PDGFRα was seen to be expressed in a significant subset of these tumors across all major glioma types including ependymoma, oligodendroglioma, pilocytic astrocytoma, astrocytoma, and glioblastoma. These results support the hypothesis that growth factor signaling through the PDGFR may be important for the development of at least a subset of human spinal cord gliomas. Further studies investigating the prognostic significance of PDGFR expression as well as the role of PDGF signaling on the development of intramedullary spinal cord gliomas are warranted. Content Type Journal ArticlePages 1-8DOI 10.1007/s11060-011-0666...

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Surgical treatment of rare cauda equina tumours

Acta Neurochirurgica — Mon, 25 Jul 2011 15:47:33 +0100

Conclusions Roughly one in six CET were neither schwannomas nor benign ependymomas. This study demonstrated the efficiency of surgery for rare benign CET with a low local recurrence rate. Surgical treatment of rare malignant CET led to a high rate of increased postoperative neurological deficit in patients with a reduced life expectancy. Content Type Journal ArticlePages 1-10DOI 10.1007/s00701-011-1094-2Authors Pierre-Louis Hénaux, Department of Neurosurgery, Pontchaillou University Hospital, 2, rue Henri le Guilloux, 35033 Rennes Cedex 9, FranceIlyess Zemmoura, Department of Neurosurgery, Bretonneau University Hospital, Boulevard Tonnellé, 37000 Tours Cedex, FranceLaurent Riffaud, Department of Neurosurgery, Pontchaillou University Hospital, 2, rue Henri le Guill...

Intraoperative ultrasound assistance in treatment of intradural spinal tumours

Clinical Neurology and Neurosurgery — Fri, 22 Jul 2011 01:49:58 +0100

Conclusions: IOUS is a sensitive intraoperative tool. When appropriately applied to assist surgical procedures, it offers additional intraoperative information that helps to improve surgical precision and therefore might reduce the procedure related morbidity. (Source: Clinical Neurology and Neurosurgery)

Anaplastic ependymoma simulating glioblastoma in the cerebrum of an adult

Brain Tumor Pathology — Thu, 21 Jul 2011 18:16:53 +0100

Abstract A case of anaplastic ependymoma of the cerebral hemisphere in which the histopathological features closely simulated those of glioblastoma is reported. The patient was a 72-year-old woman with a large, well-demarcated tumor in the left temporal lobe. The tumor was totally extirpated, but recurred 18 months later, and the patient died after 4 months. The extirpated tumor was well circumscribed from the surrounding brain tissue and consisted of a sheet-like, dense proliferation of atypical, short spindle or polygonal cells. Extensive geographic necrosis with nuclear pseudopalisading was seen. Although perivascular pseudorosettes were observed in many areas, true ependymal rosettes were absent. Immunohistochemistry for glial fibrillary acidic protein and ep...

A procedure to statistically evaluate agreement of differential expression for cross-species genomics

Bioinformatics — Thu, 14 Jul 2011 23:00:00 +0100

Motivation: Animal models play a pivotal role in translation biomedical research. The scientific value of an animal model depends on how accurately it mimics the human disease. In principle, microarrays collect the necessary data to evaluate the transcriptomic fidelity of an animal model in terms of the similarity of expression with the human disease. However, statistical methods for this purpose are lacking. Results: We develop the agreement of differential expression (AGDEX) procedure to measure and determine the statistical significance of the similarity of the results of two experiments that measure differential expression across two groups. AGDEX defines a metric of agreement and determines statistical significance by permutation of each experiment's group labels. Additionally, AGDEX ...

Primary Ependymoma in the Posterior Mediastinum.

Annals of Thoracic and Cardiovascular Surgery — Tue, 12 Jul 2011 23:00:00 +0100

Authors: Maeda S, Takahashi S, Koike K, Sato M Abstract A 46-year-old woman was referred to our hospital because of back pain and an abnormality on chest imaging. Chest computed tomography showed a well-delineated tumor in the left paravertebral space. Histological analysis of the resected tumor revealed perivascular pseudorosettes, and immunoreactivity for glial fibrillary acidic protein established the diagnosis of ependymoma. A few cases have been reported in the ovary, broad ligament, sacrococcygeal region, lungs, and mediastinum, but the pathogenesis has not yet been clarified. Female predominance in these tumors and organogenesis of the sites may suggest a key to the pathogenesis. PMID: 21881382 [PubMed - as supplied by publisher] (Source: Annals of Thoracic and Cardiovas...

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[Spinal tumors - Part 2: Intradural Tumors. Epidemiology, Clinical Aspects and Therapy.]

Praxis — Tue, 05 Jul 2011 23:00:00 +0100

Authors: Spirig J, Fournier JY, Hildebrandt G, Gautschi OP Intradural spinal tumors are classified in extra- and intramedullary tumors. The most frequent intradural-extramedullary tumors are meningiomas and neurinomas. Among the intradural-intramedullary tumors the most frequent ones are ependymomas and astrocytomas. Independent of their origin, spinal tumors usually manifest with progressive local or radicular pain and neurological deficits. The treatment of choice for most of these tumors is a complete surgical resection. In tumors with infiltrative growth into the intramedullary area, a marginal tumor tissue has to be left in situ in order to avoid additional neurological deficits. In particular if neurological deficits appear, a fast surgical intervention is indicated, since the pr...

Early magnetic resonance imaging detection of a cavernous angioma after cranial radiotherapy for an anaplastic ependymoma in a boy.

Radiologia — Sun, 03 Jul 2011 23:00:00 +0100

Authors: Martínez León MI Radiotherapy forms part of most therapeutic, preventive, and conditioning regimens in pediatric oncology. Numerous late secondary effects of cranial radiation are well known. However, radiation-induced cavernous angiomas (RICA) have been reported only sporadically and even fewer cases of earlier presentation of RICA have been reported. In this brief report, we describe a RICA that appeared in a boy treated for a CNS tumor (an infratentorial anaplastic ependymoma) after a short latency period between the end of radiotherapy and the development of the RICA. We comment on the different variables proposed to explain the formation of these lesions, as well as on their imaging features, treatment, prognosis, and follow-up. PMID: 21733537 [PubMed - as supplied ...

Elevated expression of macrophage migration inhibitory factor correlates with tumor recurrence and poor prognosis of patients with gliomas

Journal of Neuro-Oncology — Sat, 02 Jul 2011 21:31:40 +0100

Abstract Macrophage migration inhibitory factor (MIF) plays a critical role in tumorigenesis. We aim to examine the association of MIF with tumor recurrence and survival of gliomas, and to determine whether MIF is a valuable prognostic predictor for glioma patients. The expression of MIF and interleukin 8 (IL-8) was evaluated in 36 high-grade gliomas (20 glioblastoma multiforme, 13 anaplastic astrocytoma, and 3 anaplastic oligoastrocytoma) and 32 low-grade gliomas (18 fibrillary astrocytoma, 5 pilocytic astrocytoma, 5 oligodendroglioma, 3 ependymoma and 1 pleomorphic xanthoastrocytoma) by immunostaining. Intratumoral microvessel density (IMD) of tumors in relation to immunostainings and clinicopathological factors were analyzed statistically as well as the follow-up data o...

Intracranial extraaxial ependymoma in children: a rare case report and review of the literature

Neurological Sciences — Mon, 27 Jun 2011 17:48:15 +0100

We present a pediatric patient with IEAE misdiagnosed as a meningioma preoperatively, successfully treated surgically with a favorite outcome. The literature about IEAEs was briefly reviewed. Thereafter we discuss the clinical characteristics of the disease. Content Type Journal ArticlePages 1-4DOI 10.1007/s10072-011-0664-7Authors Lu Ma, Department of Neurosurgery, West China hospital, Sichuan University, Chengdu, 610041 Sichuan Province, People’s Republic of ChinaShi-yin Xiao, Department of Neurosurgery, West China hospital, Sichuan University, Chengdu, 610041 Sichuan Province, People’s Republic of ChinaXue-song Liu, Department of Neurosurgery, West China hospital, Sichuan University, Chengdu, 610041 Sichuan Province, People’s Republic of ChinaChao You, Department of Neuros...

Multiple chromosomal monosomies are characteristic of giant cell ependymoma

Human Pathology — Mon, 20 Jun 2011 04:00:00 +0100

Summary: Giant cell ependymoma, a rare ependymoma subtype, was recently recognized as a separate diagnostic entity with variations both in malignant potential and course of disease. We analyzed the first supratentorial giant cell ependymoma using G-band karyotyping, DNA ploidy analysis, and array comparative genomic hybridization. The tumor was hypodiploid, and the karyotype showed multiple monosomies. This novel cytogenetic pattern seems specific for giant cell ependymoma as the only previous cytogenetic analysis of a giant cell ependymoma found similar monosomies. We were also able to analyze cytogenetically the subsequent recurrent tumor, phenotypically an anaplastic ependymoma, allowing a first insight into the genetic events involved in disease progression. (Source: Human Pathology)

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Concomitant Intramedullary Pilocytic Astrocytoma and Conus Medullaris Myxopapillary Ependymoma: A Case Report

Zentralblatt fur Neurochirurgie - Central European Neurosurgery — Thu, 16 Jun 2011 23:00:00 +0100

Cen Eur NeurosurgDOI: 10.1055/s-0030-1270439© Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals:Table of contents | Full text (Source: Zentralblatt fur Neurochirurgie - Central European Neurosurgery)

Pathology of Pineal Parenchymal Tumors

Neurosurgery Clinics of North America — Thu, 16 Jun 2011 23:00:00 +0100

Tumors of the pineal region can arise from multiple cellular origins and thus represent a very heterogeneous group of pathologies. Such tumors include pineal parenchymal tumors, germ cell tumors, astrocytomas, ependymomas, and papillary pineal tumors. Within the subgroup of pineal parenchymal tumors, there is a histopathologic spectrum ranging from pineocytoma to pineal parenchymal tumors of intermediate differentiation to pineoblastoma. The current World Health Organization classification and the pathologic features of each of the pineal parenchymal tumor subtypes are reviewed in this article. (Source: Neurosurgery Clinics of North America)

Myxopapillary ependymoma: correlation of clinical and imaging features with surgical resectability in a series with long-term follow-up

Spinal Cord — Mon, 06 Jun 2011 23:00:00 +0100

Authors: A Al-Habib, O O Al-Radi, P Shannon, H Al-Ahmadi, Y Petrenko & M G Fehlings (Source: Spinal Cord)

A case of anaplastic clear-cell ependymoma presenting with high erythropoietin concentration and 1p/19q deletions

Brain Tumor Pathology — Sat, 04 Jun 2011 05:52:49 +0100

We describe a 19-year-old woman with onset of epileptic seizure, and a small mural nodule and multicystic lesions with severe brain edema located in the right frontal lobe. At surgery, the tumor and a clear margin was removed, and symptoms improved postoperatively. Extended local radiotherapy (60 Gy) was performed. Histopathological examination revealed oligodendroglioma-like tumor cells with a perinuclear halo. The tumor cells extended processes toward CD34-positive proliferating vessels, which resemble a basement membrane. These proliferating vessels formed a tumor membrane so that there was a clear margin between the tumor and brain tissue. Tumor cells were positive for epithelial membrane antigen in a dot-like pattern. MIB-1 staining index was 50.6%. Electron microscopy show...

Post-operative radiation improves survival in children younger than 3 years with intracranial ependymoma

Journal of Neuro-Oncology — Fri, 03 Jun 2011 05:55:28 +0100

Abstract Concerns regarding long-term toxicities have led to the avoidance of post-operative radiation (PORT) in young children with intracranial ependymoma. We investigated the association between post-operative radiation therapy and overall survival (OS) in children younger than 3 years and compared their survival to other age groups. The study sample from the SEER database included 804 patients with intracranial ependymoma, grades 2–3, and diagnosed between 1988 and 2005. OS was estimated using the Kaplan–Meier method, and hazard ratios (HR) and 95% confidence limits (CL) were calculated based on multivariable Cox proportional hazards models. A total of 804 patients were selected and PORT was administered to 35% of patients younger than 3 years. With a med...

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New Grant To Study How Pediatric Brain Tumor, Ependymoma, Develops

Health News from Medical News Today — Thu, 02 Jun 2011 13:00:00 +0100

Armed with new grant support, investigators at Nationwide Children's Hospital plan to examine how a common gene of the nervous system leads to the development of a devastating brain tumor, ependymoma. Robert A. Johnson, PhD, principal investigator in the Center for Childhood Cancer at The Research Institute at Nationwide Children's, has received a one-year $75,000 grant from the Matthew Larson Foundation for this research. Ependymoma, an aggressive tumor that affects the central nervous system, is the first most common brain tumor in children... (Source: Health News from Medical News Today)

New grant to study how pediatric brain tumor, ependymoma, develops

EurekAlert! - Medicine and Health — Thu, 02 Jun 2011 04:00:00 +0100

(Nationwide Children's Hospital) Armed with new grant support, investigators at Nationwide Children's Hospital plan to examine how a common gene of the nervous system leads to the development of a devastating brain tumor, ependymoma. Robert A. Johnson, PhD, principal investigator in the Center for Childhood Cancer at The Research Institute at Nationwide Children's, has received a one-year $75,000 grant from the Matthew Larson Foundation for this research. (Source: EurekAlert! - Medicine and Health)

Histopathological grading of pediatric ependymoma: reproducibility and clinical relevance in European trial cohorts

Journal of Negative Results in BioMedicine — Mon, 30 May 2011 23:00:00 +0100

Conclusions: We conclude that concordance on grading ependymomas can be improved by using a more prescribed scheme based on the WHO classification. Unfortunately, this appears to have utility in limited clinical settings. (Source: Journal of Negative Results in BioMedicine)

Treatment Results in Patients with Intracranial Ependymomas

Zentralblatt fur Neurochirurgie - Central European Neurosurgery — Mon, 30 May 2011 23:00:00 +0100

Conclusions: Surgery alone, as the primary treatment, achieves a good outcome in most patients with E II. Good results can be achieved with surgery and adjuvant local radiotherapy in patients with AE III.[...]© Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals:Table of contents | Abstract | Full text (Source: Zentralblatt fur Neurochirurgie - Central European Neurosurgery)

The Transcription Factor Evi-1 Is Overexpressed, Promotes Proliferation, and Is Prognostically Unfavorable in Infratentorial Ependymomas.

Clinical Cancer Research — Mon, 09 May 2011 23:00:00 +0100

CONCLUSIONS: To conclude, the transcription factor Evi-1 is overexpressed in infratentorial ependymomas, promotes proliferation of ependymal tumor cells, and is prognostically unfavorable. Clin Cancer Res; 17(11); 1-7. ©2011 AACR. PMID: 21493867 [PubMed - as supplied by publisher] (Source: Clinical Cancer Research)

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Clinical course of adult patients with ependymoma

Cancer — Wed, 27 Apr 2011 23:00:00 +0100

CONCLUSIONS:Treatment for adult patients with ependymoma is not standardized. Despite the low recurrence rate, patients reported significant symptoms and disability. Cancer 2011;. © 2011 American Cancer Society. (Source: Cancer)

Magnetic resonance imaging of infratentorial anaplastic ependymoma in children.

Radiologia — Wed, 27 Apr 2011 23:00:00 +0100

CONCLUSIONS: The MRI characteristics cannot definitively distinguish between grade II ependymomas and anaplastic grade III ependymomas. Only a few details about diffusion and dissemination to the cerebrospinal fluid, if present, can distinguish between these types at imaging. PMID: 21530988 [PubMed - as supplied by publisher] (Source: Radiologia)

Use of a side-cutting aspiration device for resection of tumors during endoscopic endonasal approaches.

Neurosurgical Focus — Thu, 31 Mar 2011 23:00:00 +0100

Conclusions The side-cutting tissue resector is a safe, easy to use, and effective tool for internal debulking and extracapsular dissection of nonvascularized tumors that are too firm for bimanual suction or blunt ring curette dissection. It is particularly useful when working through a deep and narrow corridor such as is encountered in endoscopic endonasal skull base surgery. PMID: 21456924 [PubMed - in process] (Source: Neurosurgical Focus)

Targets for therapy in ependymoma

Targeted Oncology — Tue, 29 Mar 2011 07:01:17 +0100

Abstract Ependymomas are among the rarest type of glioma and display significant heterogeneity based on patient age and tumor location. Treatment strategies include surgery and radiation, but the use of chemotherapy remains more controversial. Chemotherapy has been widely utilized in the pediatric population due to more aggressive disease in this cohort, and has become of interest in the adult population as well. Unfortunately, relapses are common, and responses to cytotoxic chemotherapy are often disappointing. As a result, attention has turned to specific targets in the pathogenesis of ependymoma. This paper summarizes the current understanding of promising molecular pathways and targets under study for future application in ependymoma. Content Type Journal ArticlePa...

A pediatric intramedullary spinal cord tumor with unusual solid‐cystic and papillary features: A case report

Neuropathology — Mon, 28 Mar 2011 23:00:00 +0100

We report a novel case of pediatric intramedullary spinal cord tumor with unusual solid‐cystic and papillary features. Clinically, the patient presented at the age of 3 years with motor deficit and urinary incontinence, and MRI demonstrated multilocular cystic lesions in the thoracic spine. Histologically the tumor consisted of solid, sheet‐like components and branching papillary structures, and immunohistochemistry demonstrated positive reactivity for epithelial membrane antigen, cytokeratins (7, AE1/3, CAM5.2), E‐cadherin and transthyretin, and negativity for GFAP, S‐100 protein, synaptophysin and neurofilament. These histological and immunohistochemical findings appeared to be unique, and were not compatible with the features of classical ependymoma or choroid plexus papilloma. ...

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Missense mutations in the NF2 gene result in the quantitative loss of merlin protein and minimally affect protein intrinsic function [Medical Sciences]

Proceedings of the National Academy of Sciences — Tue, 22 Mar 2011 00:00:00 +0100

Neurofibromatosis type 2 (NF2) is a multiple neoplasia syndrome and is caused by a mutation of the NF2 tumor suppressor gene that encodes for the tumor suppressor protein merlin. Biallelic NF2 gene inactivation results in the development of central nervous system tumors, including schwannomas, meningiomas, ependymomas, and astrocytomas. Although a wide variety of missense germline mutations in the coding sequences of the NF2 gene can cause loss of merlin function, the mechanism of this functional loss is unknown. To gain insight into the mechanisms underlying loss of merlin function in NF2, we investigated mutated merlin homeostasis and function in NF2-associated tumors and cell lines. Quantitative protein and RT-PCR analysis revealed that whereas merlin protein expression was significantl...

Incidence patterns for primary malignant spinal cord gliomas: a Surveillance, Epidemiology, and End Results study.

Journal of Neurosurgery.Spine — Fri, 11 Mar 2011 00:00:00 +0100

Conclusions This study demonstrates an increasing overall incidence of primary, malignant spinal cord glioma over the past 3 decades. Notably, for ependymoma the incidence has increased, whereas the incidence of most other glioma subtypes remained stable. This may be due to improved diagnostic and surgical techniques, changes in histological classification criteria, and changes in neuropathology diagnostic criteria. Although primary, malignant spinal cord gliomas are rare, an improved understanding of the incidence will assist investigators and clinicians in planning potential studies and preparing for allocation of resources to care for these challenging patients. PMID: 21395394 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery.Spine)

Supratentorial ependymoma in children: To observe or to treat following gross total resection?

Pediatric Blood and Cancer — Thu, 03 Mar 2011 15:20:56 +0100

ConclusionsRadiation therapy was avoided in five patients following gross total resection, four of whom had anaplastic histology. In some children with completely resected supratentorial ependymoma, surgery alone may be an acceptable treatment option. Pediatr Blood Cancer © 2011 Wiley‐Liss, Inc. (Source: Pediatric Blood and Cancer)

77 Year Old Long Term Care Resident with Ependymoma

Journal of the American Medical Directors Association — Tue, 01 Mar 2011 00:00:00 +0100

Introduction/Objective: Medical decision-making can be difficult in the long-term care (LTC) setting. This case report describes the presentation and clinical course of an ependymoma in a 77 yr old LTC resident in which the management changed after more than five years. Ependymomas are glial-based neoplasms arising from the ependymal lining of the ventricular system and central canal of the spinal cord. Ependymomas comprise between 1- 8 % of all intracranial tumors, and may occur in any region of the central nervous system. Ependymomas may occur in any age group. They are the third most common pediatric CNS tumors. However, they are seen infrequently in adults. (Source: Journal of the American Medical Directors Association)

Initial testing (stage 1) of the polyamine analog PG11047 by the pediatric preclinical testing program

Pediatric Blood and Cancer — Sat, 26 Feb 2011 15:20:21 +0100

ConclusionsFurther pediatric development of PG11047 will require better defining a target population and identifying combinations for which there is a tumor‐selective cytotoxic effect. The regression observed for an ependymoma xenograft and the exquisite sensitivity of some Ewing sarcoma cell lines to the antiproliferative effects of PG11047 provide leads for further preclinical investigations. Pediatr Blood Cancer © 2011 Wiley‐Liss, Inc. (Source: Pediatric Blood and Cancer)

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Neurothekeoma of the cauda equina: MR and CT Myelogram findings

European Journal of Radiology Extra — Mon, 21 Feb 2011 00:00:00 +0100

We describe MR and CT Myelogram findings of an intraspinal neurothekeoma occurring in a 49-year-old white female who presented with back pain. MR imaging showed a well-circumscribed avidly enhancing intrathecal mass at L1–L2 lumbar spine level while CT Myelogram imaging showed an intradural soft tissue density mass filling the thecal sac at L1–L2 level. Neurothekeomas mimic ependymoma, schwanoma, and paragangliomas in radiologic appearance and may be included in the differential diagnosis of soft-tissue masses of cauda equina in an adult female patient. Additionally, neurosurgeons and neuroradiologists should be familiar with the benign nature of these masses. (Source: European Journal of Radiology Extra)

Primary cerebellar myxopapillary ependymoma

Journal of Neuro-Oncology — Sat, 19 Feb 2011 07:00:25 +0100

Content Type Journal ArticlePages 1-2DOI 10.1007/s11060-011-0535-3Authors Konstantinos Margetis, Department of Neurosurgery, University of Athens, Evangelismos Hospital, Ipsilantou 45, 10676 Athens, GreeceChristos Koutsarnakis, Department of Neurosurgery, University of Athens, Evangelismos Hospital, Ipsilantou 45, 10676 Athens, GreeceGeorge Stranjalis, Department of Neurosurgery, University of Athens, Evangelismos Hospital, Ipsilantou 45, 10676 Athens, Greece Journal Journal of Neuro-OncologyOnline ISSN 1573-7373Print ISSN 0167-594X (Source: Journal of Neuro-Oncology)

Adult Primary Intradural Spinal Cord Tumors: A Review

Current Neurology and Neuroscience Reports — Wed, 16 Feb 2011 06:59:36 +0100

Abstract Primary spinal cord tumors constitute 2% to 4% of all central nervous system neoplasms and are characterized based on their location as intramedullary, intradural extramedullary, and extradural. A contemporary literature review of primary intradural spinal cord tumors was performed. Among intramedullary tumors, ependymomas are more common and often can be surgically resected. However, astrocytomas infiltrate the spinal cord and complete resection is rare. Intradural extramedullary tumors include schwannomas, neurofibromas, and meningiomas and are usually amenable to surgical resection. Radiotherapy is reserved for malignant variants and recurrent gliomas, whereas chemotherapy is administered for recurrent primary spinal cord tumors without surgical or radiotherapy...

Shared molecular targets in pediatric gliomas and ependymomas

Pediatric Blood and Cancer — Fri, 04 Feb 2011 00:00:00 +0100

ConclusionsThe development of new drugs targeting up‐regulated pathways may be useful for the treatment of pediatric brain tumors. As new drugs are developed, gliomas and ependymomas may be treated with similar compounds. Pediatr Blood Cancer © 2011 Wiley‐Liss, Inc. (Source: Pediatric Blood and Cancer)

Spinal ependymomas in neurofibromatosis Type 2: a retrospective analysis of 55 patients.

Journal of Neurosurgery.Spine — Fri, 04 Feb 2011 00:00:00 +0100

Conclusions Neurofibromatosis Type 2-related ependymomas exhibit an indolent growth pattern with tumor progression limited to a minority of patients. The authors believe that surveillance is reasonable for asymptomatic ependymomas, including those with cystic areas that expand the cord. For symptomatic tumors, resection may be warranted depending on age, overall clinical status, and ease of resectability. PMID: 21294614 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery.Spine)

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Glycogen-rich pleomorphic xanthoastrocytoma with clear-cell features: Confirmatory report of a rare variant with implications for differential diagnosis.

Pathology, Research and Practice — Sat, 29 Jan 2011 00:00:00 +0100

We describe a prevailing clear-cell change in an epileptogenic left temporal pleomorphic xanthoastrocytoma surgically resected from a 36-year-old man. Mostly subarachnoid and focally calcified, the tumor was composed of fascicles of moderately atypical spindle cells with optically lucent cytoplasm that tended to intermingle with a desmoplastic mesh of reticulin fibers. Immunohistochemically, coexpression of S100 protein, vimentin, GFAP, and CD34 was noted. Conversely, neither punctate staining for EMA nor positivity for CD68 was seen. Mitotic activity was absent, and the MIB1 labeling index was 2-3% on average. Diastase-sensitive PAS-positive granula indicated clear-cell change to proceed from glycogen storage. Electron microscopy showed tumor cell cytoplasm to be largely obliterated by no...

[Intracranial ependymomas: Retrospective study of 16 cases.]

Cancer Radiotherapie — Thu, 20 Jan 2011 00:00:00 +0100

CONCLUSION: Ependymomas are rare tumors and complete resection is the standard treatment followed by postoperative radiotherapy. The place of chemotherapy remains to be defined. PMID: 21256791 [PubMed - as supplied by publisher] (Source: Cancer Radiotherapie)

DNA Methylation, Isocitrate Dehydrogenase Mutation, and Survival in Glioma

JNCI — Tue, 18 Jan 2011 00:00:00 +0100

Conclusion The homogeneity of methylation classes for gliomas with IDH mutation, despite their histological diversity, suggests that IDH mutation is associated with a distinct DNA methylation phenotype and an altered metabolic profile in glioma. (Source: JNCI)

Semicontinuous Low-Dose-Rate Teletherapy for the Treatment of Recurrent Glial Brain Tumors: Final Report of a Phase I/II Study

International Journal of Radiation Oncology * Biology * Physics — Fri, 14 Jan 2011 05:00:00 +0100

Conclusion: The delivery of SLDR is feasible in patients with recurrent gliomas and resulted in improved outcomes for patients who underwent re-resection. There were 2 long-term survivors (>48 months). This pilot study supports the notion that reduced dose rate influences the efficacy and tolerance of reirradiation in the treatment of recurrent gliomas. (Source: International Journal of Radiation Oncology * Biology * Physics)

Cortical ependymoma: an unusual epileptogenic lesion.

Journal of Neurosurgery — Fri, 14 Jan 2011 00:00:00 +0100

Conclusions Cortical ependymomas represent a rare type of ependymoma occurring superficially in the cortex. Morphologically, these tumors are protean, varying from classic to epithelioid, clear cell, and tanycytic. Some also exhibited features typical of AG. Most tumors were low grade and cured with resection. Anaplastic tumors occur and may recur locally despite provision of radiation therapy. Cortical ependymomas frequently, but not always, present with seizures, but despite their high association with epilepsy, none occurred in the temporal lobe in any of the authors' 9 patients. Overall, CEs appear to have a relatively favorable prognosis compared with other supratentorial ependymomas. PMID: 21235315 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery)

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Extraventricular anaplastic ependymoma with metastasis to scalp and neck

Journal of Neuro-Oncology — Tue, 11 Jan 2011 07:31:31 +0100

We report a case of anaplastic ependymoma with extracranial metastases in a 22-year-old female. The patient originally presented with headaches and dysarthria. Neuroimaging revealed a large solid and cystic right fronto-temporal lesion. It was located completely extraventricularly and a glioblastoma was suspected based on the neuroimaging findings. A gross total resection was achieved. Histopathologic examination revealed an anaplastic ependymoma. The patient was treated with radiotherapy. Approximately 1 year after the initial surgery, the patient presented with metastatic disease to the scalp. At 2 years, an intraparotid metastasis was detected. Subsequent neck dissection revealed positive lymph nodes at several levels. It was followed by radiotherapy to the neck. 5 ...

Apurinic/apyrimidinic endonuclease is inversely associated with response to radiotherapy in pediatric ependymoma

International Journal of Cancer — Tue, 04 Jan 2011 00:00:00 +0100

AbstractApurinic/apyrimidinic endonuclease (Ap endo) is a key DNA repair activity that confers radiation resistance in human cells. Here we examined the association between Ap endo activity and response to radiotherapy in pediatric ependymomas, tumors for which treatment options are limited and survival rates are only about 50%. We assayed Ap endo activity in 36 ependymomas and expression of Ape1/Ref‐1, the predominant Ap endo activity in humans, in 44 tumors by immunostaining. Cox proportional hazards regression models were used to analyze the association of activity or expression with progression‐free survival or with overall survival. Activity varied 13‐fold and was not associated with tumor or patient characteristics. In univariate models with Ap endo activity entered as a contin...

Meningioma of the conus medullaris mimicking neurofibroma—possibly radiation induced

The Spine Journal — Mon, 03 Jan 2011 00:00:00 +0100

Conclusions: The reported tumor might have developed secondary to irradiation for urinary bladder cancer because meningiomas are the most common radiation-induced central nervous system tumors. Although location at the level of the conus medullaris is atypical for meningioma, and dumbbell-shaped configuration is rather characteristic for neurogenic tumors, they should not exclude a diagnosis of meningioma. (Source: The Spine Journal)

Ovarian ependymomas of extra-axial type or central immunophenotypes

Human Pathology — Mon, 03 Jan 2011 00:00:00 +0100

We report the differential clinicopathologic and immunophenotypical features of 2 pure ovarian ependymomas of extra-axial type with a predominant microcystic, anaplastic pattern occurring in patients aged 22 and 32 years and a unique myxopapillary pigmented ependymoma that originated within an ovarian mature cystic teratoma in a 35-year-old woman. The latter had a central nervous system phenotype different from that previously reported in ovarian ependymomas of extra-axial types, being negative for estrogen and progesterone receptors, epithelial membrane antigen and cytokeratin 34βE12, cell adhesion molecule 5.2, and cytokeratin 7. Furthermore, its benign behavior contrasted with the aggressive course of the other 2 ependymomas of extra-axial types, in which peritoneal invasion was presen...

Central nervous system.

Cancer Biomarkers : Section A of Disease Markers — Sat, 01 Jan 2011 05:00:00 +0100

Authors: Adamson DC, Rasheed BA, McLendon RE, Bigner DD Abstract Several different types of tumors, benign and malignant, have been identified in the central nervous system (CNS). The prognoses for these tumors are related to several factors, such as the age of the patient and the location and histology of the tumor. In adults, about half of all CNS tumors are malignant, whereas in pediatric patients, more than 75% are malignant. For most benign CNS tumors that require treatment, neurosurgeons can offer curative resections or at least provide significant relief from mass effect. Unfortunately, we still lack effective treatments for most primary and secondary malignant CNS tumors. However, the past decade has witnessed an explosion in the understanding of the early molecular events ...

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Giant cell ependymoma of a cervical spinal cord.

Indian Journal of Pathology and Microbiology — Sat, 01 Jan 2011 00:00:00 +0100

Authors: Trivedi P, Gupta A, Pasricha S, Patel D PMID: 21393921 [PubMed - in process] (Source: Indian Journal of Pathology and Microbiology)

OLIG2 is differentially expressed in pediatric astrocytic and in ependymal neoplasms

Journal of Neuro-Oncology — Fri, 31 Dec 2010 06:46:11 +0100

Abstract The bHLH transcription factor, OLIG2, is universally expressed in adult human gliomas and, as a major factor in the development of oligodendrocytes, is expressed at the highest levels in low-grade oligodendroglial tumors. In addition, it is functionally required for the formation of high-grade astrocytomas in a genetically relevant murine model. The pediatric gliomas have genomic profiles that are different from the corresponding adult tumors and accordingly, the expression of OLIG2 in non-oligodendroglial pediatric gliomas is not well documented within specific tumor types. In the current study, the pattern of OLIG2 expression in a spectrum of 90 non-oligodendroglial pediatric gliomas varied from very low levels in the ependymomas (cellular and tanycytic) to high...

Double myxopapillary ependymomas of the filum terminale.

The Canadian Journal of Neurological Sciences — Sat, 25 Dec 2010 17:40:36 +0100

Authors: McLaughlin N, Guiot MC, Jacques L PMID: 21156449 [PubMed - in process] (Source: The Canadian Journal of Neurological Sciences)

Clinicopathological analysis of central and extraventricular neurocytoma: A report of 17 cases

Journal of Huazhong University of Science and Technology -- Medical Sciences -- — Wed, 22 Dec 2010 21:17:27 +0100

This study aimed to examine the clinicopathological features and differential diagnosis of central and extraventricular neurocytoma. The clinical and histopathological data of 17 patients (male: female=7:10; age: 4–41 years; mean age: 27.4 years) with central or extraventricular neurocytoma were retrospectively analyzed. These patients showed typical radiological, histopathological and immunohistochemical features of neurocytoma. The tumor tissue was found to be composed of small uniform cells with round nuclei and clear cytoplasm resembling that of oligodendroglioma and ependymoma. Immunohistochemistry revealed the tumor tissues were positive for neuronal markers such as synaptophysin (SYN) and neuronal nuclear antigen (NeuN). It was concluded histopathological features of neurocy...

Nervous system tumors in adult immigrants to Sweden by subsite and histology

European Journal of Neurology — Wed, 22 Dec 2010 00:00:00 +0100

Conclusion: Significant differences between risk of NS tumors amongst immigrants and the native Swedes may suggest different risk factor profiles for glioma compared to meningioma indicating a higher etiological role of genetic background or childhood environmental risk factors rather than exposures after immigration. (Source: European Journal of Neurology)

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Inhibin B and Antimüllerian Hormone as Markers of Gonadal Function after Treatment for Medulloblastoma or Posterior Fossa Ependymoma during Childhood

The Journal of Pediatrics — Mon, 20 Dec 2010 00:00:00 +0100

Objective: To evaluate the roles of hypothalamic-pituitary and spinal irradiations and chemotherapy in gonadal deficiency after treatment for medulloblastoma or posterior fossa ependymoma by measuring levels of plasma inhibin B and antimüllerian hormone (AMH).Study design: A total of 34 boys and 22 girls were classified as having normal levels of plasma follicle-stimulating hormone (FSH; 9 IU/L) and luteinizing hormone (LH; 5 IUL).Results: Two boys had partial gonadotropin deficiency, combined with testicular deficiency in one boy. Six boys had increased levels of FSH, indicating tubular deficiency, combined with Leydig cell deficiency in 5 boys. The 7 boys with inhibin B levels (Source: The Journal of Pediatrics)

The role of adjuvant radiation therapy in the treatment of spinal myxopapillary ependymomas.

Journal of Neurosurgery.Spine — Wed, 08 Dec 2010 00:00:00 +0100

Conclusions Radiation therapy may have a role as salvage therapy in delaying recurrences of spinal MPEs. PMID: 21142463 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery.Spine)

Multifocal intradural extramedullary ependymoma.

Journal of Neurosurgery.Spine — Wed, 08 Dec 2010 00:00:00 +0100

Authors: Iunes EA, Stávale JN, de Cássia Caldas Pessoa R, Ansai R, Onishi FJ, de Paiva Neto MA, de Pádua Bonatelli A, Cavalheiro S, Fleury Malheiros SM In this paper, the authors present the case of a patient with multifocal intradural extramedullary ependymoma, and they review 18 previously reported cases. A 32-year-old man presented to the authors' institution with a 1-month history of partial medullary syndrome. Magnetic resonance imaging of the neuraxis revealed multifocal intradural extramedullary lesions at the bulbomedullary junction and C2-3, T5-11, L-2, L-4, L-5, and sacrum. Histological examination revealed a WHO Grade II ependymoma. The literature survey yielded 18 cases of ependymoma at the same location; none of them were multifocal at presentation. The authors analyzed...

Neurofibromatosis-2 and spinal cord ependymomas: Report of two cases and review of the literature

Child's Nervous System — Mon, 06 Dec 2010 14:43:42 +0100

Conclusions We conclude from our two cases and review of the existing literature that NF-2 associated spinal ependymomas have an indolent course and typically can be observed or treated by surgical excision alone. Content Type Journal ArticleDOI 10.1007/s00381-010-1351-3Authors Dolly G. Aguilera, Aflac Cancer Center and Blood Disorders Service at Children’s Health Care of Atlanta, Emory University School of Medicine, 2015 Upper Gate Drive, Suite 442, Atlanta, GA 30322, USAClaire Mazewski, Aflac Cancer Center and Blood Disorders Service at Children’s Health Care of Atlanta, Emory University School of Medicine, 2015 Upper Gate Drive, Suite 442, Atlanta, GA 30322, USAMatthew J. Schniederjan, Department of Pathology, Emory University School of Medicine, Atlanta, GA U...

Gone FISHing: Clinical Lessons Learned in Brain Tumor Molecular Diagnostics over the Last Decade

Brain Pathology — Sat, 04 Dec 2010 04:39:34 +0100

AbstractFluorescence in situ hybridization (FISH) is a powerful, morphology‐based technique to assess targeted copy number alterations or gene rearrangements in formalin‐fixed, paraffin‐embedded tissues. It has a wide range of applications in routine clinical contexts to identify cytogenetic biomarkers for more accurate diagnosis and prognostic stratification. This review and update addresses practical uses of FISH as a molecular diagnostic tool in the setting of brain tumors, including gliomas, embryonal neoplasms, ependymomas and meningiomas, focusing on key genetic biomarkers, such as 1p19q codeletion, epidermal growth factor receptor (EGFR) gene amplification, BRAF rearrangement and many others. Also discussed are lessons learned over the past decade, including common technical i...

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Pediatric anaplastic parenchymal ependymoma: case report

Child's Nervous System — Thu, 25 Nov 2010 20:06:14 +0100

Content Type Journal ArticleDOI 10.1007/s00381-010-1346-0Authors Murat Kutlay, Department of Neurosurgery, GATA Haydarpasa Training Hospital, Istanbul, TurkeyAhmet Cetinkal, Department of Neurosurgery, GATA Haydarpasa Training Hospital, Istanbul, TurkeySerdar Kaya, Department of Neurosurgery, Gülhane Military Medical Academy, Ankara, TurkeyMehmet N. Demircan, Department of Neurosurgery, GATA Haydarpasa Training Hospital, Istanbul, TurkeyMurat Velioglu, Department of Radiology, GATA Haydarpasa Training Hospital, Istanbul, TurkeyUfuk Berber, Department of Pathology, GATA Haydarpasa Training Hospital, Istanbul, Turkey Journal Child's Nervous SystemOnline ISSN 1433-0350Print ISSN 0256-7040 (Source: Child's Nervous System)

A phase II study of metronomic oral topotecan for recurrent childhood brain tumors

Pediatric Blood and Cancer — Thu, 25 Nov 2010 01:54:14 +0100

ConclusionsDaily oral topotecan at a dose of 0.8 mg/m2/day can be safely administered to children with recurrent or refractory brain tumors. This regimen identified activity in recurrent PNET. The prolonged progression free survival (PFS) in two PNET patients justifies consideration of this regimen in more advanced clinical trials. Pediatr Blood Cancer. 2010;56:39–44. © 2010 Wiley‐Liss, Inc. (Source: Pediatric Blood and Cancer)

Inguinal lymph nodal metastasis of myxopapillary ependymoma confirmed by fine‐needle aspiration cytology, biopsy, and immunohistochemistry: Case report

Diagnostic Cytopathology — Mon, 22 Nov 2010 00:00:00 +0100

We report a man aged 38 years who underwent surgery for lumbosacral myxopapillary EP at the age of 22 years and was treated with several cycles of radiotherapy. The patient was reoperated for residual tumor and received two complete cycles of radiotherapy for 11 years. Biopsies were always diagnosed as myxopapillary EP. Five years after the last surgical excision, the patient developed abdominal pain and inguinal lymphadenopathy. Biopsy was performed by fine‐needle aspiration and was proven malignant epithelial neoplasm with a myxoid background, was diagnosed as metastasis of EP. Biopsy showed an anaplastic EP grade III. EP is often recurrent at the primary site but can seed on the entire cerebrospinal axis. We describe the clinical features of this rare lesion and particularly emphasize...

Health-related quality of life following spinal cordectomy for syringomyelia

Acta Neurochirurgica — Tue, 16 Nov 2010 07:08:47 +0100

Conclusions Spinal cordectomy may increase the quality of life and can be considered as an ultimo ratio therapy in a selective group of patients with intractable symptoms caused by syringomyelia. Content Type Journal ArticleDOI 10.1007/s00701-010-0869-1Authors Oliver Pascal Gautschi, Department of Neurosurgery, State Hospital, St. Gallen, SwitzerlandMartin Alexander Seule, Department of Neurosurgery, State Hospital, St. Gallen, SwitzerlandDieter Cadosch, Division of Trauma Surgery, University Hospital Zurich, Zurich, SwitzerlandMichael Gores, Department of Neurosurgery, State Hospital, St. Gallen, SwitzerlandChristian Ewelt, Department of Neurosurgery, University Hospital, Münster, GermanyGerhard Hildebrandt, Department of Neurosurgery, State Hospital, St. Gallen, S...

mTORC1 activation in childhood ependymoma and response to sirolimus

Journal of Neuro-Oncology — Sat, 13 Nov 2010 06:46:08 +0100

Abstract Recurrent ependymomas are considered rarely responsive to chemotherapy and often have a dismal prognosis after tumor progression. Below is a brief report of a 6 year old child with a multiply progressive ependymoma whose tumor had a near complete response to sirolimus that was durable for 18 months. Immunohistochemistry for phosphorylated S6, which has been reported to be associated with tumor sensitivity to mTORC1 inhibitors, was positive in this patient’s tumor. Content Type Journal ArticleDOI 10.1007/s11060-010-0455-7Authors Daniel C. Bowers, Department of Pediatrics, University of Texas Southwestern Medical School at Dallas, Dallas, TX 75390, USABlanka Kucejova, Department of Internal Medicine, University of Texas Southwestern Medical School at...

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Mutation-specific IDH1 antibody differentiates oligodendrogliomas and oligoastrocytomas from other brain tumors with oligodendroglioma-like morphology

Acta Neuropathologica — Wed, 10 Nov 2010 17:23:43 +0100

Abstract Isocitrate dehydrogenase 1 (IDH1) mutations are frequent in astrocytomas, oligoastrocytomas and oligodendrogliomas. We previously reported the generation of a mutation-specific antibody that specifically detects R132H mutated IDH1 protein (clone H09). Here, we investigate the feasibility of H09 immunohistochemistry to differentiate between oligodendrogliomas/oligoastrocytomas and other tumors with similar morphology. A total of 274 brain tumors presenting with focal or extensive clear cell morphology were investigated. High numbers of H09-positive cases were observed in adult grade II oligodendrogliomas (67 of 74, 91%), grade III oligodendrogliomas (65 of 69, 94%), grade II oligoastrocytomas (11 of 14, 79%) and grade III oligoastrocytomas (10 of 11, 91%). All cases...

Cerebellar mutism

Child's Nervous System — Tue, 09 Nov 2010 07:49:00 +0100

Conclusion The incidence of cerebellar mutism is well documented in children with medulloblastoma, but precise figures for those with astrocytoma and ependymoma are lacking. Further anatomical, functional imaging and neuropsychological studies are needed to clarify the pathophysiological mechanisms in order to define preventive measures during surgery. Randomized, controlled trials of the effects of different medication and post-operative speech therapy are necessary for improving treatment. Content Type Journal ArticleDOI 10.1007/s00381-010-1328-2Authors Thora Gudrunardottir, Department of Pediatrics, The University Hospital Rigshospitalet, 2100 Copenhagen, DenmarkAstrid Sehested, Department of Pediatrics, The University Hospital Rigshospitalet, 2100 Copenhagen, D...

Smear preparation of intracranial lesions: A retrospective study of 306 cases

Diagnostic Cytopathology — Tue, 09 Nov 2010 00:00:00 +0100

AbstractA cytohistological correlation with determination of accuracy rate of smear preparation result was done in a retrospective study of 306 cases of intracranial tumors. Cytomorphology of few new entities of CNS tumors are described.The cytological features and WHO grading of the tumors were described on smear preparation. The cases with discrepancy in cytological and histological diagnosis were reviewed again and a final possible diagnosis on smear preparation which should have been given is discussed. The clinical details like the age, sex, and site of the tumors were analyzed.The age range of the patients was from 3 years to 63 years with male:female ratio of 1.5:1. Of the total 306 cases, a cytohistological correlation was seen in 93% cases. Twenty‐two (7.3%) cases showed discrep...

Comparative metabolic profiling of paediatric ependymoma, medulloblastoma and pilocytic astrocytoma.

International Journal of Molecular Medicine — Sat, 06 Nov 2010 05:25:12 +0100

In this study, we present metabolic profiles by HR-MAS of 20 intact tissue samples from paediatric brain tumours. Tumour types include ependymoma, medulloblastoma and pilocytic astrocytoma. The metabolic characterization of paediatric brain tumour tissue by HR-MAS spectroscopy provided differential patterns for these tumours. The metabolic composition of the tumour tissue was highly consistent with previous in vivo and ex vivo studies. Some resonances detected in this work and not previously observed by in vivo spectroscopy also show potential in determining tumour type and grade (fatty acids, phenylalanine, glutamate). Overall, this work suggests that the additional information obtained by NMR metabolic profiling applied to tissue from paediatric brain tumours may be useful for assessing ...

Survey of MicroRNA expression in pediatric brain tumors

Pediatric Blood and Cancer — Wed, 03 Nov 2010 00:00:00 +0100

ConclusionsMicroRNAs are differentially expressed between pediatric CNS neoplasms and normal tissue suggesting that they may play a significant role in oncogenesis. A greater understanding of aberrant miRNA expression in pediatric brain tumors may aid in the development of novel therapies. The characterization of tumor‐specific miRNA signatures may aid in the discovery of biomarkers with diagnostic or prognostic utility. Pediatr Blood Cancer. © 2010 Wiley‐Liss, Inc. (Source: Pediatric Blood and Cancer)

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Diffuse Cerebral Vasospasm After Resection of a Posterior Fossa Ependymoma

Neurocritical Care — Tue, 02 Nov 2010 15:21:50 +0100

Conclusions Neurologic deterioration in the post-operative period following tumor resection, unexplained by other causes, should raise the concern for possible cerebral vasospasm. Vasospasm in these cases can be diffuse. Early recognition and prompt treatment using both hemodynamic augmentation and endovascular techniques can significantly improve patient outcome. Content Type Journal ArticleDOI 10.1007/s12028-010-9464-9Authors Jeffrey T. Jacob, Department of Neurologic Surgery, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN 55905, USAChristopher H. Hunt, Department of Radiology, Mayo Clinic College of Medicine, Rochester, MN USAEelco F. Wijdicks, Department of Neurology, Mayo Clinic College of Medicine, Rochester, MN USAAlejandro A. Rabinstein,...

Infant Brain Tumors: Incidence, Survival, and the Role of Radiation Based on Surveillance, Epidemiology, and End Results (SEER) Data

International Journal of Radiation Oncology * Biology * Physics — Mon, 01 Nov 2010 04:00:00 +0100

Purpose: To evaluate the incidence of infant brain tumors and survival outcomes by disease and treatment variables.Methods and Materials: The Surveillance, Epidemiology, and End Results (SEER) Program November 2008 submission database provided age-adjusted incidence rates and individual case information for primary brain tumors diagnosed between 1973 and 2006 in infants less than 12 months of age.Results: Between 1973 and 1986, the incidence of infant brain tumors increased from 16 to 40 cases per million (CPM), and from 1986 to 2006, the annual incidence rate averaged 35 CPM. Leading histologies by annual incidence in CPM were gliomas (13.8), medulloblastoma and primitive neuroectodermal tumors (6.6), and ependymomas (3.6). The annual incidence was higher in whites than in blacks (35.0 vs...

Evaluating the incidence and utility of microscopic metastatic dissemination as diagnosed by lumbar cerebro-spinal fluid (CSF) samples in children with newly diagnosed intracranial ependymoma

Journal of Neuro-Oncology — Sun, 31 Oct 2010 16:48:14 +0100

Abstract Ependymomas are the third most common central nervous system (CNS) tumor in childhood. After resection, the standard evaluation of intracranial ependymomas includes a post-contrast spine MRI and a lumbar CSF sample to evaluate for metastasis. Although it is estimated that 10–30% of patients will present with metastatic disease, it is unclear what percentage of metastatic disease is solely identified microscopically via lumbar cytology versus that identified as bulky disease on post-contrast spinal MRIs. We retrospectively evaluated all patients at our institution with intracranial ependymoma diagnosed between January 1991 and June 2008 in an effort to evaluate prognostic factors, survival outcomes and incidence of metastatic disease. Sixty-one evaluable patients...

Pineal Tumors

Advances in Anatomic Pathology — Tue, 26 Oct 2010 04:48:16 +0100

Pineal tumors are a rare and heterogeneous group of primary central nervous system neoplasms, including pineal parenchymal tumors (pineocytomas, pineal parenchymal tumors of intermediate differentiation, and pineoblastomas), germ cell tumors, and neuroepithelial tumors, such as astrocytomas, ependymomas, and papillary tumor of the pineal region. Their classification has evolved over time, with several updates incorporated into the most recent World Health Organization classification, published in 2007. This review highlights the most recent classification and grading scheme for pineal parenchymal tumors and discusses the newly recognized papillary tumor of the pineal region, including clinicopathologic features, differential diagnosis, and management options. (Source: Advances in Anatomic ...

[Imaging of demyelinating and neoplastic diseases of the spinal cord.]

Der Radiologe — Fri, 22 Oct 2010 23:00:00 +0100

Authors: Mueller-Mang C The clinical symptoms of myelopathy are variable and non-specific. Demyelinating as well as neoplastic spinal cord diseases can cause paresthesia, progressive sensomotoric deficits and bowel and bladder dysfunction. Imaging of the spine, especially with magnetic resonance imaging (MRI), is an essential component in the diagnostic assessment of myelopathy and makes a substantial contribution to achieving the correct diagnosis. Although intramedullary neoplasms are far less common than demyelinating spinal cord diseases, radiologists should be familiar with the three most common entities, astrocytoma, ependymoma and hemangioblastoma, which represent over 70% of all spinal cord neoplasms. An early diagnosis and therapy is essential with neoplastic and demyelinating...

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Giant schwannoma of the cauda equina without neurological deficits - case report and review of the literature.

Wiener Klinische Wochenschrift — Thu, 21 Oct 2010 23:00:00 +0100

We present the case of a giant schwannoma in a 75-year-old lady extending from the level of lower D12 to upper L3 vertebra with low-back pain as the only symptom. Microsurgical removal of the tumour was accomplished via an L1-L2 laminotomy without permanent neurological deficits. Giant schwannoma of the cauda equina is a rare tumour with variable symptoms. Early diagnosis is crucial to obtain good postoperative results. Total removal without additional neurological deficits can be achieved by appropriate microsurgical techniques. PMID: 20963637 [PubMed - as supplied by publisher] (Source: Wiener Klinische Wochenschrift)

Frye-Halloran Symposium

DF/HCC: Latest News — Mon, 18 Oct 2010 17:57:31 +0100

SAVE the DATENovember 11-12, 2010MOLECULAR TARGETS IN PEDIATRIC BRAIN TUMORS THE TENTH ANNUAL FRYE-HALLORAN BRAIN TUMOR SYMPOSIUMMassachusetts General HospitalThe Frye-Halloran Symposium is an annual event that aims to facilitate the transition of promising innovations from the laboratory to the care of the patient. Noteworthy past symposia have included the introduction of micro dialysis for real-time in situ measurement of activated drugs, the identification of novel MRI signal changes as markers of the affect of angiogenesis inhibitors, and the development of therapies based upon viral vectors and cell-based immunizations.The 2010 symposium, taking place on November 11 and 12, will focus on exploitable signaling pathways and molecular signatures in pediatric brain tumors. Two tumo...

Long-Term Outcomes of Patients With Spinal Cord Gliomas Treated by Modern Conformal Radiation Techniques

International Journal of Radiation Oncology * Biology * Physics — Wed, 13 Oct 2010 23:00:00 +0100

This study retrospectively examines the long-term therapeutic outcomes of 32 patients with primary spinal cord gliomas at Massachusetts General Hospital between 1991 and 2005 treated by either photon intensity-modulated radiotherapy or conformal proton radiotherapy.Methods and Materials: Individual patient tumor types included 14 ependymomas, 17 astrocytomas, and one oligodendroglioma. Twenty-two patients were treated with photon beam radiation therapy, and 10 patients were treated with proton beam therapy. The overall survival and time to progression were analyzed. Average radiation dose for patients was 51 Gy in 1.8 median daily fractions over 29 treatments.Results: For all 32 patients, the overall 5-year survival was 65% and the progression-free survival was 61%, respectively. Overall s...

Herpes simplex encephalitis following spinal ependymoma resection: case report and literature review

Journal of Neuro-Oncology — Tue, 12 Oct 2010 16:50:10 +0100

Abstract Herpes simplex encephalitis (HSE) is a rare complication of neurosurgical procedures but must be considered in early deterioration of the postoperative patient. This is the first report of HSE following spinal cord tumor resection. A 65-year-old woman had C2–C5 laminectomy for subtotal resection of intramedullary ependymoma. Six days postoperatively she developed fever, vomiting and rapid decline in mental status. Brain MRI revealed enhancement of left insular cortex. Polymerase chain reaction on cerebrospinal fluid (CSF) identified herpes simplex virus type 1 (HSV-1) as the causal agent. Twenty-one days of acyclovir led to improvement. Three subsequent admissions to neurological intensive care unit were required for deterioration in mental status, including pne...

Value and Limitations of Diffusion-Weighted Imaging in Grading and Diagnosis of Pediatric Posterior Fossa Tumors [PEDIATRICS]

American Journal of Neuroradiology — Fri, 08 Oct 2010 15:01:53 +0100

SUMMARY: DWI reportedly accurately differentiates pediatric posterior fossa tumors, but anecdotal experience suggests limitations. In 3 years, medulloblastoma and JPA were differentiated by DWI alone in 23/26 cases (88%). Ependymoma (n = 5) could not be reliably differentiated from medulloblastoma or JPA. A trend toward increased diffusion restriction in higher grade tumors (1/14 grade I, 7%; 9/12 grade IV, 75%) had too much overlap to predict the grade of individual cases. The overlap in ADC between tumor types appeared partly due to technical factors (in small, heterogeneous, calcific, or hemorrhagic tumors) but also likely reflected true histologic variability, given that our 3 overlap cases included a desmoplastic medulloblastoma, an anaplastic ependymoma, and a JPA with restricted dif...

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Observed magnetic resonance imaging changes in pediatric patients treated with stereotactic radiosurgery for intracranial tumors

Child's Nervous System — Wed, 06 Oct 2010 16:43:54 +0100

Conclusion Lesion enlargement following SRS for pediatric intracranial tumors is common, and a proportion of patients meeting requirements for PD at early radiographic follow-up may later develop complete resolution of their lesions. Physicians should be aware of these radiographic changes to avoid unwarranted medical and surgical interventions. Content Type Journal ArticleDOI 10.1007/s00381-010-1288-6Authors Sameer K. Nath, Department of Radiation Oncology and Center for Advanced Radiotherapy Technologies, Rebecca and John Moores Cancer Comprehensive Cancer Center, University of California San Diego, La Jolla, CA USARuben Carmona, Department of Radiation Oncology and Center for Advanced Radiotherapy Technologies, Rebecca and John Moores Cancer Comprehensive Cancer ...

[Filum terminale ependymomas. Analysis of a serie of 20 consecutive cases.]

Neurocirugia — Fri, 01 Oct 2010 00:00:00 +0100

CONCLUSIONS. Filum terminale ependimomas are slow growing tumours of the cauda equina with a high incidence in young adults. The most common presentation is with low back pain long time evolution. Although ependymomas of the filum terminale are thought to be benign, local recurrence is not uncommon. PMID: 21042689 [PubMed - as supplied by publisher] (Source: Neurocirugia)

Neural stem cell‐like gene expression in a mouse ependymoma cell line transformed by human BK polyomavirus

Cancer Science — Thu, 30 Sep 2010 23:00:00 +0100

Summary (Source: Cancer Science)

Erratum to: Intensity modulated radiation therapy or stereotactic fractionated radiotherapy for infratentorial ependymoma in children: a multicentric study

Journal of Neuro-Oncology — Mon, 20 Sep 2010 19:58:38 +0100

Content Type Journal ArticleDOI 10.1007/s11060-010-0416-1Authors Damien C. Weber, Département de l’Imagerie Médical et Science de l’Information (DIMSI), Geneva University Hospital, 1211 Geneva 14, SwitzerlandThomas Zilli, Department of Radiation Oncology, Geneva University Hospital, Geneva, SwitzerlandHans Peter Do, Radiation Oncology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, SwitzerlandPhilippe Nouet, Department of Radiation Oncology, Geneva University Hospital, Geneva, SwitzerlandFabienne Gumy Pause, Children’s Hospital, Geneva University Hospital, Geneva, SwitzerlandAlessia Pica, Radiation Oncology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland Journal Journal of Neuro-OncologyOnline ISSN 1573-7373Print ISSN 0167-594X (Source...

Phase I Trial of Lapatinib in Children With Refractory CNS Malignancies: A Pediatric Brain Tumor Consortium Study [Pediatric Oncology]

Journal of Clinical Oncology — Thu, 16 Sep 2010 22:02:57 +0100

Conclusion Lapatinib is well tolerated in children with recurrent CNS malignancies, with rash, diarrhea, and fatigue identified as DLTs. The recommended phase II dose, regardless of steroid use, is 900 mg/m2 twice daily. (Source: Journal of Clinical Oncology)

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Frequency variations in the methylated pattern of p73/p21 genes and chromosomal aberrations correlating with different grades of glioma among south Indian population

Medical Oncology — Wed, 15 Sep 2010 16:58:48 +0100

This study was designed to determine the frequency of aberrant CpG island methylation in the promoter regions of p21 and p73 in different grades of glioma and to explore their respective chromosomal aberrations. Total of 160 patients with histologically confirmed grades of glioma (I, II, III, and IV) were included in the study. DNA samples from blood and brain tissues, including benign lesions were subjected to sodium bisulfite conversion and hypermethylation detection using methylation-specific PCR followed by RT–PCR. Western blotting was also carried out for p21 and its related protein, p53. A total of 124 of 160 glioma samples (77.5%) displayed CpG island hypermethylation of both p73, p21 genes associated with the loss of mRNA expression (P < 0.001) and the loss of pr...

Diffusion tensor imaging tractography in patients with intramedullary tumors: comparison with intraoperative findings and value for prediction of tumor resectability.

Journal of Neurosurgery.Spine — Tue, 31 Aug 2010 23:00:00 +0100

Conclusions These preliminary data suggest that DT imaging in patients with spinal cord tumors is capable of predicting the resectability of the lesion. A further prospective study is needed to confirm these results and any effect on patient outcome. PMID: 20809733 [PubMed - in process] (Source: Journal of Neurosurgery.Spine)

NGAL immunohistochemical expression in brain primary and metastatic tumors.

Clinical Neuropathology — Tue, 31 Aug 2010 23:00:00 +0100

In conclusion, our findings suggest that NGAL expression is restricted to high grade gliomas among primary brain tumors, and that brain metastases do not express this protein. Considering the correlation between NGAL expression in tumors and its urinary levels, if our observations will be further validated, NGAL urinary detection might be used as an additional tool in the pre-surgical definition of brain lesions involving difficult differential diagnosis. PMID: 20860895 [PubMed - in process] (Source: Clinical Neuropathology)

Endoscopic third ventriculostomy versus ventriculoperitoneal shunt in the treatment of obstructive hydrocephalus due to posterior fossa tumors in children

Child's Nervous System — Wed, 25 Aug 2010 06:08:51 +0100

Conclusion The shorter duration of surgery, the lower incidence of morbidity, the absence of mortality, the lower incidence of procedure failure, and the significant advantage of not becoming shunt dependent make ETV be recommended as the first choice in the treatment of pediatric patients with marked obstructive hydrocephalus due to midline posterior fossa tumors. Content Type Journal ArticleDOI 10.1007/s00381-010-1263-2Authors Nasser M. F. El-Ghandour, Department of Neurosurgery, Faculty of Medicine, Cairo University, 81 Nasr Road, Nasr City, Cairo Egypt Journal Child's Nervous SystemOnline ISSN 1433-0350Print ISSN 0256-7040 (Source: Child's Nervous System)