Revisiones (todas) *** Reviews (all)



(Conceptos / Keywords: Gliomas; Glioblastoma multiforme; Oligodendroglioma; Astrocytoma, Ependymoma; Medulloblastoma; etc).

February - March 2013


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TÍTULO / TITLE:  - Outcomes for patients with anaplastic astrocytoma treated with chemoradiation, radiation therapy alone or radiation therapy followed by chemotherapy: a retrospective review within the era of temozolomide.

RESUMEN / SUMMARY:  - Enlace al Resumen / Link to its Summary

REVISTA / JOURNAL:  - J Neurooncol. 2013 Mar 23.

            ●● Enlace al texto completo (gratuito o de pago) 1007/s11060-013-1116-4

AUTORES / AUTHORS:  - Shonka NA; Theeler B; Cahill D; Yung A; Smith L; Lei X; Gilbert MR

INSTITUCIÓN / INSTITUTION:  - 987680 Nebraska Medical Center, University of Nebraska Medical Center, Omaha, NE, 68198-7680, USA, nshonka@unmc.edu.

RESUMEN / SUMMARY:  - Treatment for anaplastic astrocytoma (AA) is controversial. To assess three primary treatment approaches, patients from a single institution were retrospectively evaluated. To represent modern treatment selection, patients diagnosed with AA from December 2003 to December 2009 were selected. Those with insufficient data, incomplete pathology, and transformation or reclassification to glioblastoma in fewer than 6 months were excluded. A total of 163 patients were included in the final analyses. Median follow-up time was 4.2 years (range 0.5-7.8 years). Median age and Karnofsky performance status at diagnosis were 39.2 years and 90, respectively. 23.6 % of patients underwent biopsy, and 72.2 %  underwent resection. Approximately 31 % received concurrent chemoradiation (CRT), 26.1 % had radiation therapy alone (RT), 38.2 % had radiation therapy followed by chemotherapy (RT-C), and 3 % were treated only with chemotherapy. Temozolomide was used almost exclusively during CRT (94.2 %) and adjuvantly. A median of 9.5 cycles of adjuvant chemotherapy was given. The combination of radiation and chemotherapy, either concurrent or sequential trended toward a higher rate of radiation necrosis. Median progression free survival (PFS) favored RT (not reached) over CRT (1.5 years) and RT-C (3.6 years) adjusted for pairwise comparison (p = 0.033, p = 0.050). Median overall survival (OS) was 5.7 years, and did not differ significantly by treatment group. OS for patients with AA did  not vary by initial treatment selection. Although the longer PFS in those receiving RT versus CRT may be confounded by pseudoprogression, the equivalent OS among groups supports RT.




TÍTULO / TITLE:  - Chemotherapy plus radiotherapy versus radiotherapy alone in patients with anaplastic glioma: a systematic review and meta-analysis.

RESUMEN / SUMMARY:  - Enlace al Resumen / Link to its Summary

REVISTA / JOURNAL:  - J Cancer Res Clin Oncol. 2013 Feb 10.

            ●● Enlace al texto completo (gratuito o de pago) 1007/s00432-013-1387-3

AUTORES / AUTHORS:  - Zhang L; Wu X; Xu T; Luo C; Qian J; Lu Y

INSTITUCIÓN / INSTITUTION:  - Department of Neurosurgery, Changzheng Hospital, Second Military Medical University, Shanghai, 200003, China.

RESUMEN / SUMMARY:  - OBJECT: The aim of this study was to answer whether overall survival and progression-free survival are increased in patients with anaplastic glioma who are treated with radiotherapy plus chemotherapy as compared with those who treated with radiotherapy alone. METHODS: Searches of the MEDLINE (PubMed), Embase and Cochrane Library from January 2001 to May 2012 for relevant trials were undertaken. Selected studies based on the following criteria: First, only randomized clinical trial of adjuvant radiotherapy plus chemotherapy versus radiotherapy alone was permitted. Second, overall survival and/or progression-free survival was compared with patients in the studies. Third, cases were medically confirmed of anaplastic glioma. RESULTS: 4 randomized clinical trials were found eligible for this article (involving a total of 963 patients).  The meta-analysis showed a significant increase in overall survival in patients treated with radiotherapy plus chemotherapy (HR = 0.84, 95 % CI 0.72-0.98, P = 0.031). CONCLUSIONS: Results of our meta-analysis indicated that adjuvant chemotherapy played a beneficial role in the treatment for anaplastic gliomas. But the role of adjuvant chemotherapy in the treatment for anaplastic astrocytoma or anaplastic oligodendroglioma/anaplastic oligoastrocytoma still needs further large randomized trials to demonstrate.




TÍTULO / TITLE:  - Bariatric surgery following treatment for craniopharyngioma: a systematic review  and individual-level data meta-analysis.

RESUMEN / SUMMARY:  - Enlace al Resumen / Link to its Summary

REVISTA / JOURNAL:  - J Clin Endocrinol Metab. 2013 Mar 26.

            ●● Enlace al texto completo (gratuito o de pago) 1210/jc.2012-4184

AUTORES / AUTHORS:  - Bretault M; Boillot A; Muzard L; Poitou C; Oppert JM; Barsamian C; Gatta B; Muller H; Weismann D; Rottembourg D; Inge T; Veyrie N; Carette C; Czernichow S

INSTITUCIÓN / INSTITUTION:  - 1Department of Nutrition, Ambroise Pare Hospital (AP-HP); University of Versailles St Quentin en Yvelines, 9 avenue Charles-de-Gaulle, 92100 Boulogne-Billancourt, France;

RESUMEN / SUMMARY:  - Objectives:Craniopharyngiomas are rare low-grade tumors located in the hypothalamic or/and the pituitary region. Hypothalamic involvement and treatment  resulting in hypothalamic damage are known to lead to development of “hypothalamic” obesity (HyOb) in 50% of cases. The management of HyOb, associated with eating disorders and rapid comorbidities, is an important issue. Bariatric surgery is the most effective therapy for weight loss in patients with severe exogenous obesity. The aim of this systematic review and meta-analysis was to determine the 12 month outcome of bariatric surgery for HyOb due to craniopharyngioma treatment.Methods and Results:Relevant studies were identified  by searches of the MEDLINE and EMBASE databases until January 2013. A total of 21 cases were included: 6 with adjustable gastric banding, 8 with sleeve gastrectomy, 6 with Roux en Y gastric bypass, and 1 with biliopancreatic diversion. After data pooling, mean weight difference was -20.9 kg after 6 months [95% CI: - 35.4, -6.3] and -15.1 kg after 12 months [95% CI: -31.7, +1.4]. The maximal mean weight loss was achieved by the gastric bypass group: -31.0 kg [95%  CI: -77.5, +15.5] and -33.7 kg [95% CI: -80.7, +13.3] after 6 and 12 months, respectively.Conclusions:In this largest ever published study on the effect of bariatric surgery on obesity following craniopharyngioma treatment, we observed an important weight loss after one year of follow-up. Larger studies are warranted to establish appropriate selection criteria and the best surgical technique to perform bariatric surgery.




TÍTULO / TITLE:  - The combination of carmustine wafers and temozolomide for the treatment of malignant gliomas. A comprehensive review of the rationale and clinical experience.

RESUMEN / SUMMARY:  - Enlace al Resumen / Link to its Summary

REVISTA / JOURNAL:  - J Neurooncol. 2013 Mar 28.

            ●● Enlace al texto completo (gratuito o de pago) 1007/s11060-013-1110-x

AUTORES / AUTHORS:  - Gutenberg A; Lumenta CB; Braunsdorf WE; Sabel M; Mehdorn HM; Westphal M; Giese A

INSTITUCIÓN / INSTITUTION:  - Department of Neurosurgery, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany.

RESUMEN / SUMMARY:  - Current treatment strategies in patients with newly-diagnosed glioblastoma include surgical resection with post-operative radiotherapy and concomitant/adjuvant temozolomide (the “Stupp protocol”) or resection with implantation of 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU) wafers in the surgical cavity followed by radiotherapy. In clinical practice, patients with malignant glioma treated with BCNU wafer often also receive adjuvant temozolomide. However, current treatment guidelines are unclear on whether and how these treatment practices can be combined, and no prospective phase 3 study has assessed the safety and efficacy of combining BCNU wafers with temozolomide and radiation in high-grade malignant glioma. The rationale for multimodal therapy comprising surgical resection with adjunct local BCNU wafers followed by  radiotherapy and temozolomide is based on complementary and synergistic mechanisms of action between BCNU and temozolomide in preclinical studies; a shared primary resistance pathway, methylguanine-DNA methyltransferase (MGMT); and the opportunity to overcome resistance through MGMT depletion to boost cytotoxic activity. A comprehensive review of the literature identified 19 retrospective and prospective studies investigating the use of this multimodal strategy. Median overall survival in 14 studies of newly-diagnosed patients suggested a modest improvement versus resection followed by Stupp protocol or resection with BCNU wafers, with an acceptable and manageable safety profile.




TÍTULO / TITLE:  - Screening Key Genes and Pathways in Glioma Based on Gene Set Enrichment Analysis  and Meta-analysis.

RESUMEN / SUMMARY:  - Enlace al Resumen / Link to its Summary

REVISTA / JOURNAL:  - J Mol Neurosci. 2013 Mar 15.

            ●● Enlace al texto completo (gratuito o de pago) 1007/s12031-013-9981-z

AUTORES / AUTHORS:  - Tang Y; He W; Wei Y; Qu Z; Zeng J; Qin C

INSTITUCIÓN / INSTITUTION:  - Department of neurology, First Affiliated Hospital, Guangxi Medical University, No. 22, Shuang Yong Lu, Nanning, 530021, Guangxi, China.

RESUMEN / SUMMARY:  - Glioma is a highly invasive, rapidly spreading form of brain cancer, while its etiology is largely unknown. A few recently reported studies have been developed  using gene expression microarrays of glioma to identify differentially expressed  genes from several to hundreds. This study was designed to analyze vast amounts of glioma-related microarray data and screen the key genes and pathways related to the development and progression of glioma. We used gene set enrichment analysis (GSEA) and meta-analysis of seven included studies after standardized microarray preprocessing, which increased concordance between these gene datasets. After GSEA, there were 14 mixing pathways including 13 up- and 1 down-regulated pathways. Based on the meta-analysis, 268 significant genes were screened out (P < 0.05); there were 249 genes identified by Kyoto Encyclopedia of Genes and Genomes (KEGG), and 27 KEGG pathways closely related to the set of the  imported genes were identified. At last, six consistent pathways and key genes in these pathways related to glioma were obtained with combined GSEA and meta-analysis. The gene pathways that we identified could provide insight concerning the development of glioma. Further studies are needed to determine the biological function for the positive genes.




TÍTULO / TITLE:  - Microcystic/reticular schwannoma of the proximal sigmoid colon: case report with  review of literature.

RESUMEN / SUMMARY:  - Enlace al Resumen / Link to its Summary

REVISTA / JOURNAL:  - Arch Pathol Lab Med. 2013 Feb;137(2):284-8. doi: 10.5858/arpa.2011-0386-CR.

            ●● Enlace al texto completo (gratuito o de pago) 5858/arpa.2011-0386-CR

AUTORES / AUTHORS:  - Trivedi A; Ligato S

INSTITUCIÓN / INSTITUTION:  - Department of Pathology, Hartford Hospital, Hartford, Connecticut 06102, USA. atrivedi@harthosp.org

RESUMEN / SUMMARY:  - We report a case of microcystic/reticular schwannoma of the proximal sigmoid colon in a 61-year-old man. A 12-mm polyp was detected while the patient was undergoing screening for colorectal neoplasm. This rare variant of schwannoma was initially described in 2008 and shows a predilection for the visceral organs, predominantly the gastrointestinal tract. We also review 11 other reported cases  of microcystic/reticular schwannomas in the gastrointestinal tract. Unlike conventional gastrointestinal schwannomas, which are more common in the stomach,  this variant appears to be more common in the large intestine. Histologic examination of this polyp showed predominant lipoblast-like vacuolated cells within a myxoid stroma with focal spindle cell areas. Features suggestive of malignancy, like nuclear pleomorphism, mitosis, or necrosis, were absent. Immunohistochemistry for S100 protein showed strong nuclear and cytoplasmic positivity, whereas cytokeratin and CD117 stains were negative. It is important to entertain microcystic/reticular schwannoma in the differential diagnosis of a  signet ring cell adenocarcinoma or a myxoid gastrointestinal stromal tumor, particularly on small biopsy specimens.




TÍTULO / TITLE:  - Diagnostic Value and Safety of Stereotactic Biopsy for Brainstem Tumors: A Systematic Review and Meta-analysis of 1480 Cases.

RESUMEN / SUMMARY:  - Enlace al Resumen / Link to its Summary

REVISTA / JOURNAL:  - Neurosurgery. 2013 Feb 19.

            ●● Enlace al texto completo (gratuito o de pago) 1227/NEU.0b013e31828bf445

AUTORES / AUTHORS:  - Kickingereder P; Willeit P; Simon T; Ruge MI

INSTITUCIÓN / INSTITUTION:  - 1Department of Stereotactic and Functional Neurosurgery, University Hospital of Cologne, Cologne, Germany 2Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom 3Department of Neurology, Medical University Innsbruck, Innsbruck, Austria 4Department of Pediatric Hematology and Oncology, University Hospital of Cologne, Cologne, Germany.

RESUMEN / SUMMARY:  - BACKGROUND:: The feasibility and safety of stereotactic biopsy for brainstem tumors (BSTs) are controversial. Although MRI has been reported as the preferred  diagnostic tool, histopathological analysis is frequently necessary to establish  a definitive diagnosis. Recent advances in molecular characterization of brainstem gliomas - accounting for the majority of BSTs - have revealed several potential targets for molecular-based therapies. Hence, a molecular stereotactic  biopsy that combines histopathological diagnosis with molecular-genetic analysis  will become increasingly important for patients with BSTs. OBJECTIVE:: We conducted a systemic review and meta-analysis to determine the risks and benefits of stereotactic biopsy for BSTs. METHODS:: A systematic search in PubMed, EMBASE  and the Web of Science yielded 3766 potentially eligible abstracts. Meta-analysis was conducted on 38 studies describing 1480 biopsy procedures for BSTs. Primary outcome measures were diagnostic success and procedure-related complications. Data were analyzed according to standard meta-analytic techniques. RESULTS:: The  weighted average proportions across the analyzed studies were: 96.2% (95%CI: 94.5-97.6%) for diagnostic success, 7.8% (95%CI: 5.6-10.2%) for overall morbidity, 1.7% (95%CI: 0.9-2.7%) for permanent morbidity, and 0.9% (95%CI: 0.5-1.4%) for mortality. Meta-regression revealed a significant correlation between diagnostic success rates and the number of biopsy procedures performed annually in each center (p=0.011). Other factors did not affect the outcome measures. CONCLUSION:: Stereotactic biopsy of BSTs is safe. It allows exact histopathological diagnosis as a prerequisite for adequate treatment and opens new perspectives for the molecular characterization of these tumors as a crucial  first step towards more individualized treatment concepts.




TÍTULO / TITLE:  - Prognostic significance of IDH mutation in adult low-grade gliomas: a meta-analysis.

RESUMEN / SUMMARY:  - Enlace al Resumen / Link to its Summary

REVISTA / JOURNAL:  - J Neurooncol. 2013 Mar 16.

            ●● Enlace al texto completo (gratuito o de pago) 1007/s11060-013-1107-5

AUTORES / AUTHORS:  - Sun H; Yin L; Li S; Han S; Song G; Liu N; Yan C

INSTITUCIÓN / INSTITUTION:  - Department of Neurosurgery, Beijing Sanbo Brain Hospital, Capital Medical University, Beijing, 10093, People’s Republic of China.

RESUMEN / SUMMARY:  - Mutations in the gene encoding isocitrate dehydrogenase (IDH) have been identified in approximately 65-90 % of low-grade gliomas (LGGs). Various studies  examining the relationship between IDH mutation with the clinical outcome in patients with LGGs have yielded inconclusive results. The purpose of the present  meta-analysis of literature is to determine this effect. We conducted a meta-analysis of 10 studies (937 patients) that evaluated the correlation between IDH mutation and overall survival (OS). For the quantitative aggregation of the survival results, the IDH mutation effect was measured by hazard ratio (HR). Overall, the pooled HR was 0.585 (95 % CI, 0.376-0.911, p = 0.025, random effect  model) for patients with IDH mutation vs patients without IDH mutation. IDH mutation was associated with better overall survival of LGGs. At least this trend was observed in our analysis.




TÍTULO / TITLE:  - Multicentric oligodendroglioma: Case report and review of the literature.

RESUMEN / SUMMARY:  - Enlace al Resumen / Link to its Summary

REVISTA / JOURNAL:  - Seizure. 2013 Mar 22. pii: S1059-1311(13)00064-2. doi: 10.1016/j.seizure.2013.02.018.

            ●● Enlace al texto completo (gratuito o de pago) 1016/j.seizure.2013.02.018

AUTORES / AUTHORS:  - Garcia Pulido P; Neal J; Halpin S; Hamandi K

INSTITUCIÓN / INSTITUTION:  - Foundation Year 2, University Hospital of Wales, Cardiff CF14 4XW, United Kingdom.




TÍTULO / TITLE:  - ADC values and prognosis of malignant astrocytomas: does lower ADC predict a worse prognosis independent of grade of tumor?--a meta-analysis.

RESUMEN / SUMMARY:  - Enlace al Resumen / Link to its Summary

REVISTA / JOURNAL:  - AJR Am J Roentgenol. 2013 Mar;200(3):624-9. doi: 10.2214/AJR.12.8679.

            ●● Enlace al texto completo (gratuito o de pago) 2214/AJR.12.8679

AUTORES / AUTHORS:  - Zulfiqar M; Yousem DM; Lai H

INSTITUCIÓN / INSTITUTION:  - The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins Medical Institution, 600 N Wolfe St, Phipps B100F, Baltimore, MD 21287, USA.

RESUMEN / SUMMARY:  - OBJECTIVE: The purpose of this article is to determine via meta-analysis whether  apparent diffusion coefficient (ADC) predicts astrocytoma prognosis independent of grade. MATERIALS AND METHODS: Survival data were subjected to Mantel Haenszel  analysis in four qualifying studies. Stratification by tumor grade was also performed. RESULTS: The survival rates of malignant astrocytomas, grade 3 and 4 (p, 0.004 and < 0.0001, respectively) were worse below a specific ADC value, independent of grade. CONCLUSION: Low ADC values correlate with poor survival in  malignant astrocytomas independent of tumor grade.




TÍTULO / TITLE:  - Extranodal marginal zone lymphoma of the cranial dura mater: report of three cases and systematic review of the literature.

RESUMEN / SUMMARY:  - Enlace al Resumen / Link to its Summary

REVISTA / JOURNAL:  - Leuk Lymphoma. 2013 Mar 8.

            ●● Enlace al texto completo (gratuito o de pago) 3109/10428194.2013.771399

AUTORES / AUTHORS:  - Beltran BE; Kuritzky B; Quinones P; Morales D; Alva JC; Lu G; Goswami M; Miranda RN; Castillo JJ

INSTITUCIÓN / INSTITUTION:  - Department of Oncology and Radiotherapy, Edgardo Rebagliati Martins Hospital , Lima , Peru.




TÍTULO / TITLE:  - Dual gliomas with syringomyelia in a child: case report and literature review.

RESUMEN / SUMMARY:  - Enlace al Resumen / Link to its Summary

REVISTA / JOURNAL:  - Pediatr Neurosurg. 2012;48(3):168-73. doi: 10.1159/000346258. Epub 2013 Feb 8.

            ●● Enlace al texto completo (gratuito o de pago) 1159/000346258

AUTORES / AUTHORS:  - Patibandla MR; Kumar A; Bhattacharjee S; Sahu BP; Uppin M; Challa S

INSTITUCIÓN / INSTITUTION:  - Department of Neurosurgery, Nizam’s Institute of Medical Sciences, Hyderabad, India.

RESUMEN / SUMMARY:  - Background and Importance: The occurrence of multiple tumors of different histopathologies in the central nervous -system is rare. Here, we report a case of a child with dual neuroepithelial tumors of different histological cell types  and -review the available literature for analyzing the causal hypo-thesis. Case Report: A 7-year-old girl presented with history of headaches associated with multiple episodes of early morning projectile vomiting and visual blurring. Magnetic resonance imaging (MRI) showed a well-defined lesion in the hypothalamic region. The patient underwent resection of the tumor by the transcallosal transfornicial approach. Histopathology was suggestive of pilocytic astrocytoma.  After 3 years, the patient presented with low back pain radiating to the right lower limb followed by sudden onset of weakness in both lower limbs. Recent MRI brain and spine scans showed a small residual lesion at the hypothalamus with D1  to D10 syrinx. A T1 hypointense and T2 hyperintense cystic lesion from D10 to S2  with intensely enhancing solid component at the S1, S2 region was also detected.  The patient underwent L4 to S2 laminectomy and the histopathological examin-ation revealed myxopapillary ependymoma. Conclusion: The presence of multiple neuroepithelial tumors of different histopathology in the same patient is extremely rare, and we report one such case of dual gliomas with hypothalamic pilocytic astrocytoma and cauda equina myxopapillary ependymoma in a 10-year-old  patient. During the course of development, displacement and dedifferentiation of  primitive totipotent neuroepithelial germ cells may be a causal factor for the appearance of the different neuroepithelial tumors in neuraxis concomitantly or subsequently, which might be substantiated by common cytogenetic abnormalities in different neuroepithelial tumor histogenesis.




TÍTULO / TITLE:  - Spinal meningiomas: Surgical outcome and literature review.

RESUMEN / SUMMARY:  - Enlace al Resumen / Link to its Summary

REVISTA / JOURNAL:  - Neurochirurgie. 2013 Feb;59(1):30-4. doi: 10.1016/j.neuchi.2012.10.137. Epub 2013 Feb 8.

            ●● Enlace al texto completo (gratuito o de pago) 1016/j.neuchi.2012.10.137

AUTORES / AUTHORS:  - Riad H; Knafo S; Segnarbieux F; Lonjon N

INSTITUCIÓN / INSTITUTION:  - Departement de neurochirurgie, hopital Gui-de-Chauliac, 80, avenue Augustin-Fliche, 34091 Montpellier cedex 05, France.

RESUMEN / SUMMARY:  - BACKGROUND AND PURPOSE: To evaluate the incidence, clinical presentation, operative techniques and long-term outcome of spinal meningiomas following surgery. METHODS: Fifteen patients harboring spinal meningiomas were treated between 1998 and 2005 in our department. Diagnosis was made on magnetic resonance imaging and confirmed histologically. Microsurgical resection was carried out through a posterior approach in all cases. RESULTS: Follow-up extended from 60 to 156 months (mean: 99 and median 105 months). The most common site of spinal meningiomas was the thoracic region. Tumors were strictly intradural and extramedullary in 14 patients (93%) and macroscopic resection was considered as complete in all cases. Neurological improvement was observed in 13 patients (87%). There was no operative mortality and morbidity was low (20%). No patient underwent radiotherapy and the recurrence rate is 8%. CONCLUSION: Spinal meningiomas are benign tumors for which advances in imaging tools and microsurgical techniques have yielded better results. The goal of surgery should  be the total resection, which significantly reduces the risk of recurrence with an acceptable morbidity.




TÍTULO / TITLE:  - De novo suprasellar arachnoid cyst: case report and review of the literature.

RESUMEN / SUMMARY:  - Enlace al Resumen / Link to its Summary

REVISTA / JOURNAL:  - Pediatr Neurosurg. 2012;48(3):199-203. doi: 10.1159/000345636. Epub 2013 Feb 13.

            ●● Enlace al texto completo (gratuito o de pago) 1159/000345636

AUTORES / AUTHORS:  - Invergo D; Tomita T

INSTITUCIÓN / INSTITUTION:  - Division of Pediatric Neurosurgery, Ann and Robert H. Lurie Children’s Hospital of Chicago and Northwestern University Feinberg School of Medcine, Chicago, Ill., USA.

RESUMEN / SUMMARY:  - Purpose: We present a case of a 4-year-old child who was incidentally found to have a suprasellar arachnoid cyst (SAC) after initial CT imaging at 6 weeks of age but who demonstrated no anomalies. This is only the sixth case of intracranial de novo ACs documented in the English literature and only the second case of SAC to arise de novo. Methods: Case review after an SAC was found on an MRI scan at 4 years of age which had not been present on a previous CT of the head. Results: Apparent de novo SAC formation in a healthy 4-year-old female without a history of intracranial infection, surgery or trauma. Conclusion: The pathophysiology leading to the formation of the cyst might well be congenital, although there is some question as to how early in development the cysts are formed as our child was a 32-week GA preemie with an initial scan at 38 weeks GA. With the use of fast MRI scans instead of CT scans and the continued neuroimaging of premature infants, we can take a better look at the anatomy and better determine the timing of development of the SAC.




TÍTULO / TITLE:  - Significance of radical resection for pilomyxoid astrocytoma of the cerebellum: a case report and review of the literature.

RESUMEN / SUMMARY:  - Enlace al Resumen / Link to its Summary

REVISTA / JOURNAL:  - Childs Nerv Syst. 2013 Mar 17.

            ●● Enlace al texto completo (gratuito o de pago) 1007/s00381-013-2082-z

AUTORES / AUTHORS:  - Okano A; Oya S; Fujisawa N; Tsuchiya T; Indo M; Nakamura T; Chang HS; Matsui T

INSTITUCIÓN / INSTITUTION:  - Department of Neurosurgery, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan.

RESUMEN / SUMMARY:  - BACKGROUND: Pilomyxoid astrocytoma (PMA) was recently classified as a variant of  pilocytic astrocytoma (PA) with significantly more aggressive clinical features than those of PA. Like PAs, PMAs frequently arise in the chiasmatic/hypothalamic  regions. The cerebellum is also a common site of occurrence for PAs but not for PMAs. CASE DESCRIPTION: We present the case of a 31-month-old boy with cerebellar PMA that showed rapid regrowth during the 3 months following the first subtotal resection. Gross total resection was achieved in the second surgery, followed by  radiation to the tumor bed. RESULTS: During follow-up over the next 12 years, there has been no evidence of recurrence on magnetic resonance imaging. CONCLUSIONS: Although the prognosis of cerebellar PMAs remains unknown because of the paucity of cases, the relevant literature reports a more favorable outcome for cerebellar PMAs than for PMAs occurring at other locations. The results of this case study and a review of the relevant literature advocate radical resection, sometimes involving multiple surgeries, for cerebellar PMAs because gross total or near total resection is more feasible in the cerebellum than in other locations.




TÍTULO / TITLE:  - Dumbbell ganglioneuroma mimicking lumbar neurofibroma: A case report and review of the literature.

RESUMEN / SUMMARY:  - Enlace al Resumen / Link to its Summary

REVISTA / JOURNAL:  - Br J Neurosurg. 2013 Feb 27.

            ●● Enlace al texto completo (gratuito o de pago) 3109/02688697.2013.771142

AUTORES / AUTHORS:  - Sobowale O; Ibrahim I; du Plessis D; Herwadkar A; Tzerakis N

INSTITUCIÓN / INSTITUTION:  - Department of Neurosurgery, Greater Manchester Neurosciences Centre, Salford Royal Hospital , Salford, Greater Manchester , UK.

RESUMEN / SUMMARY:  - Spinal ganglioneuromas may grow in a dumbbell fashion. We report the first case of an intradural, extramedullary ganglioneuroma in the lumbar spine and review the pertinent literature. Although rare, we propose that ganglioneuroma be considered a differential diagnosis in patients presenting with a large mass occupying both intraspinal and extraspinal compartments.




TÍTULO / TITLE:  - Metastatic paraganglioma of the spine: Case report and review of the literature.

RESUMEN / SUMMARY:  - Enlace al Resumen / Link to its Summary

REVISTA / JOURNAL:  - Clin Neurol Neurosurg. 2013 Feb 8. pii: S0303-8467(13)00021-8. doi: 10.1016/j.clineuro.2013.01.006.

            ●● Enlace al texto completo (gratuito o de pago) 1016/j.clineuro.2013.01.006

AUTORES / AUTHORS:  - Lau D; La Marca F; Camelo-Piragua S; Park P

INSTITUCIÓN / INSTITUTION:  - Department of Neurosurgery, University of Michigan, Ann Arbor, MI, USA.

RESUMEN / SUMMARY:  - Paragangliomas are relatively rare tumors, accounting for only about 0.3% of all  neoplasms. Most paragangliomas are defined as benign in nature, but 10-20% possess metastatic potential. There have been scattered reports of metastatic paraganglioma in the literature, but in rare circumstances, paragangliomas can metastasize to the spinal column causing destruction or compression of the spinal cord, clinically manifesting as pain or neurological deficit. We report a case of metastatic paraganglioma in which a 47-year-old man had spinal metastasis from a  primary abdominal paraganglioma and was found to be positive for SDHB mutation, portraying negative implications for prognosis. Long-term follow-up is reported.  In addition, we review the literature on the topic of metastatic paraganglioma, management of paragangliomas involving spine, and touch on the importance of the  presence of SDHB mutations in these cases.




TÍTULO / TITLE:  - Third ventricle, cerebral aqueduct, and fourth ventricle mixed ependymal neurocytoma: a case report and review of the literature.

RESUMEN / SUMMARY:  - Enlace al Resumen / Link to its Summary

REVISTA / JOURNAL:  - Childs Nerv Syst. 2013 Mar 12.

            ●● Enlace al texto completo (gratuito o de pago) 1007/s00381-013-2064-1

AUTORES / AUTHORS:  - Campbell JP; Pieper D

INSTITUCIÓN / INSTITUTION:  - Department of Neurosurgery, Providence Hospital and Medical Center, 16001 W 9 Mile Rd, Southfield, MI, 48075, USA, docjaymz@aol.com.

RESUMEN / SUMMARY:  - PURPOSE: A case report of an 8-year-old female who underwent interhemispheric transcallosal approach to the third ventricle, cerebral aqueduct, and fourth ventricle for resection of a mixed ependymal neurocytoma and review of the literature was evaluated. METHODS: An Ovid MEDLINE review of the literature was conducted starting in 1946 to current using search terms as described in our keywords. RESULTS: A total of 16 neurocytoma have been described in the literature as either posterior third ventricle or posterior fossa in origin. Of these lesions, five have been described as mixed glial-neuronal and all of these  were located in the fourth ventricle. To our knowledge, this is the first described mixed glial-neuronal tumor located in the posterior third ventricle and aqueduct.




TÍTULO / TITLE:  - Intraoperative fluorescent imaging of intracranial tumors: A review.

RESUMEN / SUMMARY:  - Enlace al Resumen / Link to its Summary

REVISTA / JOURNAL:  - Clin Neurol Neurosurg. 2013 Mar 20. pii: S0303-8467(13)00072-3. doi: 10.1016/j.clineuro.2013.02.019.

            ●● Enlace al texto completo (gratuito o de pago) 1016/j.clineuro.2013.02.019

AUTORES / AUTHORS:  - Behbahaninia M; Martirosyan NL; Georges J; Udovich JA; Kalani MY; Feuerstein BG; Nakaji P; Spetzler RF; Preul MC

INSTITUCIÓN / INSTITUTION:  - Neurosurgery Research Laboratory, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, AZ, United States.

RESUMEN / SUMMARY:  - A review of fluorescent imaging for intracranial neoplasms is presented. Complete resection of brain cancer is seldom possible because of the goal to preserve brain tissue and the inability to visualize individual infiltrative tumor cells.  Verification of histology and identification of tumor invasion in macroscopically normal-appearing brain tissue determine prognosis after resection of malignant gliomas. Therefore, imaging modalities aim to facilitate intraoperative decision-making. Intraoperative fluorescent imaging techniques have the potential to enable precise histopathologic diagnosis and to detect tumor remnants in the operative field. Macroscopic fluorescence imaging is effective for gross tumor detection. Microscopic imaging techniques enhance the sensitivity of the macroscopic observations and provide real-time histological information. Further  development of clinical grade fluorescent agents specifically targeting tumor cells could improve the diagnostic and prognostic yield of intraoperative imaging.




TÍTULO / TITLE:  - Primary Hodgkin lymphoma of the central nervous system: Two case reports and review of the literature.

RESUMEN / SUMMARY:  - Enlace al Resumen / Link to its Summary

REVISTA / JOURNAL:  - Neuropathology. 2013 Mar 27. doi: 10.1111/neup.12035.

            ●● Enlace al texto completo (gratuito o de pago) 1111/neup.12035

AUTORES / AUTHORS:  - Kresak JL; Nguyen J; Wong K; Davis R

INSTITUCIÓN / INSTITUTION:  - Department of Pathology, University of South Florida; Tampa General Hospital, Tampa, Florida.

RESUMEN / SUMMARY:  - CNS involvement by systemic Hodgkin lymphoma (HL) is quite rare, but the disease  limited to the CNS is an exceptionally rare entity. The incidence of CNS-HL has been estimated at 0.2-0.5% of cases, but a more recent study has modified that figure to less than 0.02%. Like the conventional form, the diagnosis of primary CNS-HL rests upon distinct morphological and immunohistochemical characteristics, including diagnostic Reed-Sternberg cells, in addition to staging studies demonstrating a lack of disease elsewhere. The paucity of cases in the literature precludes reliable clinical and demographic data, as well as a consensus on treatment and prognosis. We present two cases of primary cerebellar HL, one with  10-year follow-up, and a relevant review of the literature.




TÍTULO / TITLE:  - 5-aminolevulinic acid (5-ALA) fluorescence guided surgery of high-grade gliomas in eloquent areas assisted by functional mapping. Our experience and review of the literature.

RESUMEN / SUMMARY:  - Enlace al Resumen / Link to its Summary

REVISTA / JOURNAL:  - Acta Neurochir (Wien). 2013 Mar 7.

            ●● Enlace al texto completo (gratuito o de pago) 1007/s00701-013-1660-x

AUTORES / AUTHORS:  - Della Puppa A; De Pellegrin S; d’Avella E; Gioffre G; Rossetto M; Gerardi A; Lombardi G; Manara R; Munari M; Saladini M; Scienza R

INSTITUCIÓN / INSTITUTION:  - Department of Neurosurgery, University Hospital of Padova, Via Giustiniani 2, Azienda Ospedaliera di Padova, 35128, Padova, Italy, alessandro.dellapuppa@sanita.padova.it.

RESUMEN / SUMMARY:  - BACKGROUND: Only few data are available on the specific topic of 5-aminolevulinic acid (5-ALA) guided surgery of high-grade gliomas (HGG) located in eloquent areas. Studies focusing specifically on the post-operative clinical outcome of such patients are yet not available, and it has not been so far explored whether  such approach could be more suitable for some particular subgroups of patients. METHODS: Patients affected by HGG in eloquent areas who underwent surgery assisted by 5-ALA fluorescence and intra-operative monitoring were prospectively  recruited in our Department between June 2011 and August 2012. Resection rate was reported as complete resection of enhancing tumor (CRET), gross total resection (GTR) >98 % and GTR > 90 %. Clinical outcome was evaluated at 7, 30, and 90 days  after surgery. RESULTS: Thirty-one patients were enrolled. Resection was complete (CRET) in 74 % of patients. Tumor removal was stopped to avoid neurological impairment in 26 % of cases. GTR > 98 % and GTR > 90 % was achieved in 93 % and 100 % of cases, respectively. First surgery and awake surgery had a CRET rate of  80 % and 83 %, respectively. Even though at the first-week assessment 64 % of patients presented neurological impairment, there was a 3 % rate of severe morbidity at the 90th day assessment. Newly diagnosed patients had a significantly lower morbidity (0 %) and post-operative higher median KPS. Both pre-operative neurological condition and improvement after corticosteroids resulted significantly predictive of post-operative functional outcome. CONCLUSIONS: 5-ALA surgery assisted by functional mapping makes high HGG resection in eloquent areas feasible , through a reasonable rate of late morbidity. This emerges even more remarkably for selected patients.




TÍTULO / TITLE:  - 3 Tesla magnetic resonance spectroscopy: cerebral gliomas vs. metastatic brain tumors. Our experience and review of the literature.

RESUMEN / SUMMARY:  - Enlace al Resumen / Link to its Summary

REVISTA / JOURNAL:  - Int J Neurosci. 2013 Mar 11.

            ●● Enlace al texto completo (gratuito o de pago) 3109/00207454.2013.774395

AUTORES / AUTHORS:  - Caivano R; Lotumolo A; Rabasco P; Zandolino A; D’Antuono F; Villonio A; Lancellotti MI; Macarini L; Cammarota A

INSTITUCIÓN / INSTITUTION:  - 1Radiology Department, I.R.C.C.S. -C.R.O.B., Rionero in Vulture , Potenza , Italy.

RESUMEN / SUMMARY:  - The aim of the present study is to report about the value of magnetic resonance spectroscopy (MRS) in differentiating brain metastases, primary high-grade gliomas (HGG) and low-grade gliomas (LGG). MRI (magnetic resonance imaging) and MRS were performed in 60 patients with histologically verified brain tumors: 32 patients with HGG (28 glioblastomas multiforme [GBM] and 4 anaplastic astrocytomas), 14 patients with LGG (9 astrocytomas and 5 oligodendrogliomas) and 14 patients with metastatic brain tumors. The Cho/Cr (choline-containing compounds/creatine-phosphocreatine complex), Cho/NAA (N-acetyl aspartate) and NAA/Cr ratios were assessed from spectral maps in the tumoral core and peritumoral edema. The differences in the metabolite ratios between LGG, HGG and  metastases were analyzed statistically. Lipids/lactate contents were also analyzed. Significant differences were noted in the tumoral and peritumoral Cho/Cr, Cho/NAA and NAA/Cr ratios between LGG, HGG and metastases. Lipids and lactate content revealed to be useful for discriminating gliomas and metastases.  The results of this study demonstrate that MRS can differentiate LGG, HGG and metastases, therefore diagnosis could be allowed even in those patients who cannot undergo biopsy.




TÍTULO / TITLE:  - The two-week wait guideline for suspected CNS tumours: a decade analysis.

RESUMEN / SUMMARY:  - Enlace al Resumen / Link to its Summary

REVISTA / JOURNAL:  - Br J Neurosurg. 2013 Mar 8.

            ●● Enlace al texto completo (gratuito o de pago) 3109/02688697.2013.771725

AUTORES / AUTHORS:  - Hamdan A; Mitchell P

INSTITUCIÓN / INSTITUTION:  - Faculty of Medical Sciences, Newcastle University , Framlington Place, Newcastle  upon Tyne , UK.

RESUMEN / SUMMARY:  - Introduction. The two-week wait (2WW) referral guideline for suspected central nervous system (CNS) tumours was implemented more than a decade ago to facilitate early cancer diagnosis with the aim of improving tumour survival rates. Short-term studies have shown poor compliance and low detection rates of the guideline. This study aimed to provide a decade analysis of referral patterns, and compliance and detection rates of the guideline. Methods. All patients referred via the 2WW pathway for suspected CNS tumour to the Newcastle Department of Neurosurgery from 1st January 2002 to 31st December 2011 were retrospectively  identified from the local cancer registry. Data from referral letters, case notes, radiographic images and final outcomes were recorded. Trends in waiting time, time to diagnosis, compliance and detection rate of the guideline in identifying CNS tumours were analysed. Results. Over the last decade, there were  no significant changes in trends in waiting time, time to diagnosis and compliance and detection rates of the guideline. Of 85 2WW referrals, 41.2% were  non-compliant and 21.2% identified CNS tumours. The detection rate was higher in  referrals that complied with the guideline compared to those that did not (32.0%  vs 5.2%, p < 0.05). The non-compliant referrals which identified CNS tumours consisted of patients with cognitive decline. The guideline sensitivity and specificity were 88.8% (63.9%-98.1%, 95% CI) and 49.3% (40.0%-61.6%), respectively. Most of CNS tumour diagnoses were made independent of the 2WW pathway (N = 1093, 98.4%). Conclusion. There have not been any major changes in terms of waiting time, time to diagnosis, compliance and detection rates of the 2WW guideline during the last decade. The 2WW pathway generated very few referrals but among these, the positive detection rate was high and the addition  of time-based cognitive decline onto the current guideline may further improve the detection rate.




TÍTULO / TITLE:  - Rehabilitation and treatment of spinal cord tumors.

RESUMEN / SUMMARY:  - Enlace al Resumen / Link to its Summary

REVISTA / JOURNAL:  - J Spinal Cord Med. 2013 Jan;36(1):4-11. doi: 10.1179/2045772312Y.0000000015.

            ●● Enlace al texto completo (gratuito o de pago) 1179/2045772312Y.0000000015

AUTORES / AUTHORS:  - Raj VS; Lofton L

INSTITUCIÓN / INSTITUTION:  - Department of Physical Medicine & Rehabilitation, Carolinas Rehabilitation, Charlotte, NC 28203, USA. vishwa.raj@carolinashealthcare.org

RESUMEN / SUMMARY:  - CONTEXT: Due to advances in acute oncological treatment, patients with spinal cord tumors exhibit improved survival. However, these patients have not received  the full benefits of rehabilitation services to address their neurological deficits and rehabilitation goals. OBJECTIVE: To evaluate the epidemiology and pathophysiology of spinal cord tumors, address methods of acute oncological management, review treatment for neurological sequelae, and understand the implications as they relate to rehabilitation. METHODS: An extensive literature review was performed regarding the epidemiology, pathophysiology, acute oncological management, neurological sequelae, and rehabilitation for patients with spinal cord tumors. Databases used included pubmed.gov and OVID, as well as  individual journal and textbook articles. RESULTS: Access to treatment should be  increased given improved survival and functional deficits for patients with spinal cord tumors. Individuals can benefit from inpatient rehabilitation programs, in spite of increased medical co-morbidity and neurological deficits. Specific areas of improvement include functionality, mood, quality of life, and survival. Adjustments to treatment plans must incorporate medical complications from cancer and its treatment, perceived quality of life, and prognosis. CONCLUSIONS: Patients with spinal cord tumors who participate in rehabilitation programs show general improvement in function, mood, quality of life, and survival. Adaptations to care plans should be made to accommodate medical co-morbidities from cancer and its treatment, patient perceptions, and prognosis.




TÍTULO / TITLE:  - Management of subependymal giant cell astrocytoma (SEGA) associated with tuberous sclerosis complex (TSC): Clinical recommendations.

RESUMEN / SUMMARY:  - Enlace al Resumen / Link to its Summary

REVISTA / JOURNAL:  - Eur J Paediatr Neurol. 2013 Feb 4. pii: S1090-3798(12)00264-4. doi: 10.1016/j.ejpn.2012.12.008.

            ●● Enlace al texto completo (gratuito o de pago) 1016/j.ejpn.2012.12.008

AUTORES / AUTHORS:  - Jozwiak S; Nabbout R; Curatolo P

INSTITUCIÓN / INSTITUTION:  - Department of Neurology and Epileptology, The Children’s Memorial Health Institute, Warsaw, Poland. Electronic address: sergiusz.jozwiak@gmail.com.

RESUMEN / SUMMARY:  - Subependymal giant cell astrocytoma (SEGA) is a type of brain tumour that develops in 10-15% of individuals with tuberous sclerosis complex (TSC). SEGAs can be unilateral or bilateral, developing from benign subependymal nodules (hamartomas) located near the foramen of Monro. These are usually slow-growing, glialneuronal tumours that develop within the first 2 decades of life. Traditionally, the management of SEGA involved monitoring using periodic neuroimaging, and surgical resection of tumours that exhibited growth and/or caused clinical signs of intracranial hypertension. Recent clinical research has  demonstrated that mammalian target of rapamycin (mTOR) inhibitors can induce partial regression of SEGA associated with TSC and so might provide an acceptable alternative to neurosurgery for these tumours. This report summarizes the clinical recommendations for the management of SEGA made by a panel of European experts in March 2012. Current treatment options and outstanding questions are outlined.




TÍTULO / TITLE:  - A multi-disciplinary consensus statement concerning surgical approaches to low-grade, high-grade astrocytomas and diffuse intrinsic pontine gliomas in childhood (CPN Paris 2011) using the Delphi method.

RESUMEN / SUMMARY:  - Enlace al Resumen / Link to its Summary

REVISTA / JOURNAL:  - Neuro Oncol. 2013 Apr;15(4):462-8. doi: 10.1093/neuonc/nos330. Epub 2013 Mar 15.

            ●● Enlace al texto completo (gratuito o de pago) 1093/neuonc/nos330

AUTORES / AUTHORS:  - Walker DA; Liu J; Kieran M; Jabado N; Picton S; Packer R; St Rose C

INSTITUCIÓN / INSTITUTION:  - Corresponding author: David A. Walker, BMBS, Professor of Paediatric Oncology, Children’s Brain Tumour Research Centre, University of Nottingham, Queen’s Medical Centre, Nottingham NG7 2UH, UK. david.walker@nottingham.ac.uk.

RESUMEN / SUMMARY:  - Astrocytic tumors account for 42% of childhood brain tumors, arising in all anatomical regions and associated with neurofibromatosis type 1 (NF1) in 15%. Anatomical site determines the degree and risk of resectability; the more complete resection, the better the survival rates. New biological markers and modern radiotherapy techniques are altering the risk assessments of clinical decisions for tumor resection and biopsy. The increasingly distinct pediatric neuro-oncology multidisciplinary team (PNMDT) is developing a distinct evidence base. A multidisciplinary consensus conference on pediatric neurosurgery was held in February 2011, where 92 invited participants reviewed evidence for clinical management of hypothalamic chiasmatic glioma (HCLGG), diffuse intrinsic pontine glioma (DIPG), and high-grade glioma (HGG). Twenty-seven statements were drafted  and subjected to online Delphi consensus voting by participants, seeking >70% agreement from >60% of respondents; where <70% consensus occurred, the statement  was modified and resubmitted for voting. Twenty-seven statements meeting consensus criteria are reported. For HCLGG, statements describing overall therapeutic purpose and indications for biopsy, observation, or treatment aimed at limiting the risk of visual damage and the need for on-going clinical trials were made. Primary surgical resection was not recommended. For DIPG, biopsy was recommended to ascertain biological characteristics to enhance understanding and  targeting of treatments, especially in clinical trials. For HGG, biopsy is essential, the World Health Organization classification was recommended; selection of surgical strategy to achieve gross total resection in a single or multistep process should be discussed with the PNMDT and integrated with trials based drug strategies for adjuvant therapies.




TÍTULO / TITLE:  - Brainstem glioma: a review.

RESUMEN / SUMMARY:  - Enlace al Resumen / Link to its Summary

REVISTA / JOURNAL:  - Curr Neurol Neurosci Rep. 2013 May;13(5):346. doi: 10.1007/s11910-013-0346-3.

            ●● Enlace al texto completo (gratuito o de pago) 1007/s11910-013-0346-3

AUTORES / AUTHORS:  - Grimm SA; Chamberlain MC

INSTITUCIÓN / INSTITUTION:  - Department of Neurology, University of Minnesota Medical School, Minneapolis, MN, 55455, USA.

RESUMEN / SUMMARY:  - Brainstem gliomas (BGs) are a heterogenous group of gliomas that occur predominately in children. They can be separated into groups on the basis of anatomy and clinical behavior: diffuse intrinsic pontine glioma (DIPG), exophytic medullary glioma, and tectal glioma. DIPG is the commonest BG. Median age at onset is 6.5 years and median survival is less than 1 year. Adults with DIPG survive longer, suggesting a less aggressive and biologically different tumor from that in children. Patients present with cranial nerve dysfunction, long tract signs, or ataxia, either in isolation or in combination. Magnetic resonance imaging shows an infiltrative lesion occupying most of the pons and contrast enhancement is usually not prominent. Standard treatment is fractionated radiotherapy. Platelet-derived growth factor receptor alpha and epidermal growth  factor receptor mutations have been identified. Inhibitors of these growth factor receptors are being evaluated in clinical trials. Exophytic medullary and tectal  gliomas are relatively indolent tumors that can often be followed closely without treatment.




TÍTULO / TITLE:  - Neurocognitive impairments in brain tumor patients.

RESUMEN / SUMMARY:  - Enlace al Resumen / Link to its Summary

REVISTA / JOURNAL:  - Folia Med (Plovdiv). 2012 Oct-Dec;54(4):14-21.

AUTORES / AUTHORS:  - Kehayov II; Kitov BD; Zhelyazkov CB; Raykov SD; Davarski AN

INSTITUCIÓN / INSTITUTION:  - Department of Neurosurgery, Medical University, Plovdiv, Bulgaria. dr.kehayov@gmail.com

RESUMEN / SUMMARY:  - There is an increased scientific interest in cognitive impairments caused by brain tumors during the last decade. It has lead to the introduction and routine  clinical usage of neuropsychological test batteries in brain tumor patients, thus making them an important clinical measure for the assessment of the efficacy of the different treatment regimens such as surgery, radiotherapy and chemotherapy.  The effect of cognitive deficit on patients’ quality of life and survival has been unequivocally proven. These are among the most common neurological symptoms  associated with brain tumors. The improvement in cognitive function and delay in  neurocognitive decline are acceptable endpoints in clinical trials. Cognition has been demonstrated to be an independent predictor of survival in patients with cerebral neoplasms.





TÍTULO / TITLE:Guia clinica de diagnostico y tratamiento del prolactinoma y la hiperprolactinemia.

TÍTULO / TITLE:  - Clinical guidelines for diagnosis and treatment of prolactinoma and hyperprolactinemia.

RESUMEN / SUMMARY:  - Enlace al Resumen / Link to its Summary

REVISTA / JOURNAL:  - Endocrinol Nutr. 2013 Mar 8. pii: S1575-0922(13)00029-6. doi: 10.1016/j.endonu.2012.11.005.

            ●● Enlace al texto completo (gratuito o de pago) 1016/j.endonu.2012.11.005

AUTORES / AUTHORS:  - Halperin Rabinovich I; Camara Gomez R; Garcia Mouriz M; Ollero Garcia-Agullo D

INSTITUCIÓN / INSTITUTION:  - Servicio de Endocrinologia y Nutricion, Hospital Clinic, Universitat de Barcelona, Barcelona, España. Electronic address: halperin@clinic.ub.es.

RESUMEN / SUMMARY:  - OBJECTIVE: To provide practical and up to date recommendations for evaluation, differential diagnosis, and treatment of prolactinoma and hyperprolactinemia in various clinical settings. PARTICIPANTS: Members of the Neuroendocrinology Working Group of the Spanish Society of Endocrinology. METHODS: Recommendations were formulated according to the Grading of Recommendations, Assessment, Development, and Evaluation system (GRADE) to describe both the strength of recommendations and the quality of evidence. A systematic search was made in Medline (Pubmed) for each subject, and authors’ considerations were added in areas where the literature provided scarce evidence. Finally, recommendations were jointly discussed by the Working Group. CONCLUSIONS: The document provides evidence-based practical and updated recommendations for diagnosis and management of hyperprolactinemia and prolactinoma, including drug-induced hyperprolactinemia, treatment options for prolactinoma (drugs, surgery, and radiotherapy), prolactinoma in pregnancy, adverse effects of dopaminergic agents, and drug-resistant and malignant prolactinomas.



TÍTULO / TITLE:  - Brainstem anaplastic glioma in patients with AIDS: a case report and review of the literature.

RESUMEN / SUMMARY:  - Enlace al Resumen / Link to its Summary

REVISTA / JOURNAL:  - British Medical J (BMJ). Acceso gratuito al texto completo.

            ●● Enlace a la Editora de la Revista bmj.com/search.dtl 

            ●● Cita: British Medical J. (BMJ): <> Case Rep. 2013 Feb 4;2013. pii: bcr2012008384. doi: 10.1136/bcr-2012-008384.

            ●● Enlace al texto completo (gratuito o de pago) 1136/bcr-2012-008384

AUTORES / AUTHORS:  - Chaudhry NS; Ahmad FU; Blieden C; Benveniste RJ

INSTITUCIÓN / INSTITUTION:  - Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, Florida, USA.

RESUMEN / SUMMARY:  - AIDS is an increasingly common diagnosis seen by neurologists and neurosurgeons alike. Although the more common brain lesions associated with AIDS are due to central nervous system lymphomas, toxoplasma encephalitis or progressive multifocal leukoencephalopathy, relatively recent clinical evidence has shown that AIDS-independent cerebral tumours can arise as well, albeit less commonly. Previous incidents have been reported with HIV and AIDS patients presenting with  cerebral astrocytomas. To our knowledge, there has never been a report in the literature of a brainstem anaplastic glioma occurring in an AIDS or HIV patient.  We report a 55-year-old patient with HIV and brainstem anaplastic glioma. Its presentation, diagnostic difficulty, scans, histology and subsequent treatment are discussed. We also review the relevant literature on gliomas in HIV/AIDS patients.



TÍTULO / TITLE:  - Spontaneous regression of non-functioning pituitary adenoma due to pituitary apoplexy following anticoagulation treatment - a case report and review of the literature.

RESUMEN / SUMMARY:  - Enlace al Resumen / Link to its Summary

REVISTA / JOURNAL:  - Endokrynol Pol. 2013;64(1):54-8.

AUTORES / AUTHORS:  - Zielinski G; Witek P; Koziarski A; Podgorski J

RESUMEN / SUMMARY:  - Pituitary apoplexy (PA) is a rare, potentially life-threatening medical condition due to acute ischaemia or haemorrhage of the pituitary gland. The main clinical features are: abrupt onset of severe headache, nausea, vomiting, deteriorating level of consciousness, visual impairment and/or endocrine deficiency. Correct and prompt diagnosis is essential for effective therapy, but there are no randomised studies or strict recommendations defining treatment modalities. We present the case of a 59 year-old woman with pituitary tumour apoplexy, presenting with severe headache, vomiting and visual field deterioration. The patient was treated conservatively because of her refusal of surgery and was followed-up for five years. In the course of treatment, recovery of the visual field defects, as well as right sixth cranial nerve paresis, was observed. Repeated magnetic resonance imaging (MRI) revealed regression of the tumour without signs of its re-growth. We discuss therapeutic modalities with particular emphasis on morbidity and review the literature relating to the management of pituitary tumour apoplexy.




TÍTULO / TITLE:  - Association between the XRCC1 polymorphisms and glioma risk: a meta-analysis of case-control studies.

RESUMEN / SUMMARY:  - Enlace al Resumen / Link to its Summary

REVISTA / JOURNAL:  - PLoS One. 2013;8(1):e55597. doi: 10.1371/journal.pone.0055597. Epub 2013 Jan 30.

            ●● Enlace al texto completo (gratuito o de pago) 1371/journal.pone.0055597

AUTORES / AUTHORS:  - Jiang L; Fang X; Bao Y; Zhou JY; Shen XY; Ding MH; Chen Y; Hu GH; Lu YC

INSTITUCIÓN / INSTITUTION:  - Department of Neurosurgery, Changzheng Hospital, Second Military Medical University, Shanghai, China.

RESUMEN / SUMMARY:  - BACKGROUND: X-ray repair cross-complementing group 1 (XRCC1) is one of the DNA repair genes encoding a scaffolding protein that participate in base excision repair (BER) pathway. However, studies on the association between polymorphisms in this gene and glioma have yielded conflicting results. This meta-analysis was  performed to derive a more precise estimation between XRCC1 polymorphisms (Arg399Gln, Arg194Trp, and Arg280His) and glioma risk. METHODS: Data were collected from several electronic databases, with the last search up to November  28, 2012. Meta-analysis was performed by critically reviewing 9 studies for Arg399Gln polymorphism (3146 cases and 4296 controls), 4 studies for Arg194Trp polymorphism (2557 cases and 4347 controls), and 4 studies for Arg280His polymorphism (1936 cases and 2895 controls). All of the statistical analyses were performed using the software programs STATA (version 11.0). RESULTS: The combined results showed that Arg399Gln polymorphism was significantly associated with glioma risk (Gln/Gln versus Arg/Arg: OR = 1.52, 95% CI = 1.03-2.23; recessive model: OR = 1.32, 95% CI = 1.01-1.73; additive model: OR = 1.21, 95% CI = 1.00-1.47), whereas Arg194Trp/Arg280His polymorphisms were all not significantly  associated with glioma risk. As for ethnicity, Arg399Gln polymorphism was associated with increased risk of glioma among Asians (Gln/Gln versus Arg/Arg: OR = 1.78, 95% CI = 1.29-2.47; Arg/Gln versus Arg/Arg: OR = 1.28, 95% CI = 1.05-1.56; recessive model: OR = 1.59, 95% CI = 1.16-2.17; dominant model: OR = 1.36, 95% CI = 1.13-1.65; additive model: OR = 1.32, 95% CI = 1.15-1.52), but not among Caucasians. Stratified analyses by histological subtype indicated that the  Gln allele of Arg399Gln polymorphism showed borderline association with the risk  of glioblastoma among Caucasians. However, no evidence was observed in subgroup analyses for Arg194Trp/Arg280His polymorphisms. CONCLUSIONS: Our meta-analysis suggested that Arg399Gln polymorphism was associated with increased risk of glioma among Asians and borderline increased risk for glioblastoma among Caucasians, whereas Arg194Trp/Arg280His polymorphisms might have no influence on  the susceptibility of glioma in different ethnicities.




TÍTULO / TITLE:Mnogie atypowe nawrotowe oponiaki po 13 latach od radioterapii z powodu jednostronnego siatkowczaka: opis przypadku i przeglad pismiennictwa.

TÍTULO / TITLE:  - Multiple atypical recurrent meningiomas 13 years after radiotherapy for unilateral retinoblastoma: case report and review of the literature.

RESUMEN / SUMMARY:  - Enlace al Resumen / Link to its Summary

REVISTA / JOURNAL:  - Neurol Neurochir Pol. 2013;47(1):80-85.

AUTORES / AUTHORS:  - Aras Y; Akcakaya MO; Aydoseli A; Meral R; Kiris T

INSTITUCIÓN / INSTITUTION:  - Mehmet Osman Akcakaya, MD, Istanbul Universitesi Istanbul Tlp Fakultesi Norosirurji Anabilim DalI, Norolojik Bilimler binasI6.kat Capa/Fatih/ inverted exclamation markstanbul 34093, phone: 00905322557774, e-mail: moakcakaya@gmail.com.

RESUMEN / SUMMARY:  - Radiotherapy is an important treatment modality for intracranial malignancies. Improved survival rates were achieved via a combination of surgery, chemotherapy  and radiotherapy. On the other hand, improved survival rates made long-term complications of radiotherapy more apparent. Secondary neoplasms due to cranial irradiation are encountered more commonly in neurosurgical practice. Radiation-induced meningiomas are recognized as a common late complication of radiotherapy. However, radiation-induced meningiomas after radiotherapy for retinoblastoma have been reported rarely. Herein we report a patient who harboured multiple meningiomas 13 years after radiotherapy for unilateral retinoblastoma, which were recurrent despite surgical removal and chemotherapy.




TÍTULO / TITLE:  - Genetic aspects of pheochromocytoma.

RESUMEN / SUMMARY:  - Enlace al Resumen / Link to its Summary

REVISTA / JOURNAL:  - Adv Clin Exp Med. 2012 Nov-Dec;21(6):821-9.

AUTORES / AUTHORS:  - Kolackov K; Tupikowski K; Bednarek-Tupikowska G

INSTITUCIÓN / INSTITUTION:  - Department of Endocrinology, Diabetology and Isotope Therapy, Wroclaw Medical University, Wroclaw, Poland. katarzyna.kolackov@gmail.com

RESUMEN / SUMMARY:  - Pheochromocytomas are derived from chromaffin cells of the adrenal medulla which  synthesize and secrete catecholamines, thus affecting the cardiovascular system and metabolic processes. Pheochromocytoma is a tumor of the following multicarcinoma hereditary syndromes: type 2 multiple endocrine neoplasia, von Hippel-Lindau disease, type 1 neurofibromatosis and the pheochromocytomas/paragangliomas syndrome. Pheochromocytomas are relatively rare, and because of non-specific manifestation of these tumors and the possible lack of signs and symptoms for extended periods of time, the diagnosis may be delayed, which may, in turn, lead to death. Pheochromocytomas may occur sporadically. However, due to the frequent incidence of hereditary forms of these cancers, the  presymptomatic genetic testing of family members with a positive family history is indicated, thus allowing for selecting people with higher risk of cancer. Early detection of the syndrome and the coexisting tumors (which may be malignant) may lead to a correct diagnosis, regular surveillance, preventive examinations and implementation of appropriate early treatment. Recent examinations have shown significant involvement of RET, VHL, NF1, SDHB and SDHD as well as the newly discovered KIF1Bbeta, TMEM127 and MAX genes in pathogenesis  of these tumors. The microarray-gene expression studies, based on the analysis of cellular pathways, have revealed two distinct clusters indicating two different routes of tumorgenesis. The genotype-phenotype correlations are still being studied and future research can give us clearer information about the function of these genes, which may prove crucial from the clinical point of view.



TÍTULO / TITLE:  - Association between polymorphisms in interleukin-4Ralpha and interleukin-13 and glioma risk: A meta-analysis.

RESUMEN / SUMMARY:  - Enlace al Resumen / Link to its Summary

REVISTA / JOURNAL:  - Cancer Epidemiol. 2013 Feb 6. pii: S1877-7821(13)00007-6. doi: 10.1016/j.canep.2013.01.003.

            ●● Enlace al texto completo (gratuito o de pago) 1016/j.canep.2013.01.003

AUTORES / AUTHORS:  - Sun G; Wang X; Shi L; Yue X; Fu L; Chen C; Li Z; Pan T; Wan Z

INSTITUCIÓN / INSTITUTION:  - Department of Neurosurgery, The First People’s Hospital of Yancheng affiliated with Nantong University, Yancheng 224001, PR China. Electronic address: yc_sunguan@163.com.

RESUMEN / SUMMARY:  - Introduction: It has been suggested that allergies are inversely associated with  glioma risk. Single nucleotide polymorphisms in two allergy-related genes [interleukin (IL)-4Ralpha, IL-13] have been implicated in susceptibility to glioma; however, results from the published studies remained inconclusive. Methods: To derive a more precise relationship, we conducted a meta-analysis including seven case-control studies that investigated the influence of IL-4Ralpha rs1801275 and IL13 rs20541 polymorphisms on glioma risk. Data were extracted from these studies and pooled odds ratios (OR) with 95% confidence intervals (CI) were used to investigate the strength of the association. Results: Overall, the pooled analysis showed that there was no significant association between the IL-4Ralpha rs1801275 polymorphism and glioma risk (OR=0.99, 95%CI: 0.79-1.25, AG/GG vs. AA). However, we found that the IL13 rs20541 variant genotypes (GA/AA) were significantly associated with reduced risk for glioma (OR=0.85, 95%CI: 0.75-0.97, GA/AA vs. GG). In the stratified analyses by ethnicity, marginally significant association between the IL13 rs20541 polymorphism and decreased glioma risk was found among Asian populations in dominant models (OR=0.84, 95%CI: 0.70-1.00, GA/AA vs. GG). Conclusions: This meta-analysis suggests that the IL13 rs20541 but not the IL-4Ralpha rs1801275 polymorphism may be a genetic predictor for glioma. More studies with larger sample size are warranted to further elucidate the impact of the IL13 rs20541 polymorphism on glioma risk.



TÍTULO / TITLE:  - Intraoperative magnetic resonance imaging for high grade glioma resection: Evidence-based or wishful thinking?

RESUMEN / SUMMARY:  - Enlace al Resumen / Link to its Summary

REVISTA / JOURNAL:  - Surg Neurol Int. 2013;4:1. doi: 10.4103/2152-7806.106114. Epub 2013 Jan 15.

            ●● Enlace al texto completo (gratuito o de pago) 4103/2152-7806.106114

AUTORES / AUTHORS:  - Kubben PL; van Santbrink H

INSTITUCIÓN / INSTITUTION:  - Department of Neurosurgery, Maastricht University Medical Center, The Netherlands.



TÍTULO / TITLE:  - Glioma in the third trimester of pregnancy: Two cases and a review of the literature.

RESUMEN / SUMMARY:  - Enlace al Resumen / Link to its Summary

REVISTA / JOURNAL:  - Oncol Lett. 2013 Mar;5(3):943-946. Epub 2013 Jan 4.

            ●● Enlace al texto completo (gratuito o de pago) 3892/ol.2013.1106


INSTITUCIÓN / INSTITUTION:  - Department of Anesthesiology, Xuanwu Hospital, Capital Medical University, Beijing 100053, P.R. China.

RESUMEN / SUMMARY:  - We present two cases of glioma (WHO grade III) in pregnant females presenting in  the third trimester. Gliomas during pregnancy are rare. At present, the association between gliomas and pregnancy is poorly understood and little has been reported with regard to the management of patients with gliomas in pregnancy. Management of these cases presents a medical dilemma. Gliomas during pregnancy pose a risk to maternal and fetal life. The benefit-to-risk ratio should be carefully evaluated and discussed prior to surgery. In the present cases, caesarean section (CS) followed by craniotomy was performed under the same general anesthesia at 34 weeks’ gestation. The mothers received radiotherapy and  chemotherapy following surgery. They have been followed up to the present date and remain in good health. These two cases indicate that early CS followed by craniotomy is an effective choice in pregnant patients with gliomas at >/=34 weeks’ gestation. In the present study, we describe these two cases and review the literature with regard to gliomas during pregnancy.



TÍTULO / TITLE:  - Multidisciplinary management of vestibular schwannomas: state of the art.

RESUMEN / SUMMARY:  - Enlace al Resumen / Link to its Summary

REVISTA / JOURNAL:  - B-ENT. 2012;8(4):235-40.

AUTORES / AUTHORS:  - Somers T; Van Havenbergh T

INSTITUCIÓN / INSTITUTION:  - Department of ENT, Sint-Augustinus Hospital, Wilrijk, Antwerp, Belgium. Thomas.somers@gza.be

RESUMEN / SUMMARY:  - The preferred setting for the treatment for vestibular schwannoma these days is multidisciplinary and multimodal. A balance has to be struck between a wait-and-scan attitude and a more active approach (surgery or radiotherapy). An initial wait-and-scan attitude is a reasonable management option because many tumours do not grow during a prolonged period of observation. The different surgical approaches may or may not involve attempts to preserve hearing. Stereotactic radiotherapy as treatment of choice is often considered in the elderly patient presenting with a vestibular schwannoma smaller than 2.5 cm with  documented growth. This paper will review current treatment modalities and the respective pros and cons. A decisional algorithm as currently adopted by our skull base team is presented at the end of the paper.



TÍTULO / TITLE:  - Retreatment of recurrent adult medulloblastoma with radiotherapy: a case report and review of the literature.

RESUMEN / SUMMARY:  - Enlace al Resumen / Link to its Summary

REVISTA / JOURNAL:  - J Med Case Rep. 2013 Mar 8;7(1):64. doi: 10.1186/1752-1947-7-64.

            ●● Enlace al texto completo (gratuito o de pago) 1186/1752-1947-7-64

AUTORES / AUTHORS:  - Buglione M; Triggiani L; Grisanti S; Liserre R; Buttolo L; Gipponi S; Bonetti F; Todeschini A; Spiazzi L; Magrini SM

INSTITUCIÓN / INSTITUTION:  - Radiation Oncology Department, Brescia University, P,le Spedali Civili 1, 25123 Brescia, Italy. buglione@med.unibs.it.

RESUMEN / SUMMARY:  - INTRODUCTION: Medulloblastoma, the most frequent brain tumor in childhood, also occurs with a wide range of characteristics in adult patients. Late relapse is common in adult medulloblastoma, and the overall survival of relapsed patients usually ranges from 12 to 15 months. Treatment at recurrence is still debated and after reoperation includes stereotactic or normofractionated radiotherapy, and high-dose chemotherapy with autologous bone marrow transplantation. CASE PRESENTATION: We report on the case of a 31-year-old Caucasian woman who underwent re-irradiation for a recurrence of medulloblastoma at nine years after  first irradiation (56Gy), focusing on the radiobiological background and a review of previous studies involving re-irradiation of recurrent medulloblastoma. After  surgical excision of the relapsed tumor and medical multi-agent treatment, the site of recurrence was treated using three-dimensional conformal radiotherapy to  a total dose of 52.8Gy (1.2Gy/fraction/twice daily). A total biological equivalent dose of 224.6Gy (alpha:beta = 2 Gy) was delivered to the posterior fossa (first and second treatments). No radionecrosis or local recurrence was evident at 18 months after re-irradiation. CONCLUSION: Re-irradiation can be considered a possible and safe treatment in selected cases of recurrent medulloblastoma in adults. The reported radiobiological considerations could be useful in other cases involving re-irradiation of brain tumors.



TÍTULO / TITLE:  - The prognostic value of MGMT promoter methylation in Glioblastoma multiforme: a meta-analysis.

RESUMEN / SUMMARY:  - Enlace al Resumen / Link to its Summary

REVISTA / JOURNAL:  - Fam Cancer. 2013 Feb 9.

            ●● Enlace al texto completo (gratuito o de pago) 1007/s10689-013-9607-1

AUTORES / AUTHORS:  - Zhang K; Wang XQ; Zhou B; Zhang L

INSTITUCIÓN / INSTITUTION:  - Department of Forensic Medicine, Zun Yi Medical College, Zun Yi, 563003, People’s Republic of China, newman-zhk@163.com.

RESUMEN / SUMMARY:  - The prognostic significance of O(6)-methylguanine-DNA methyltransferase (MGMT) promoter methylation on Glioblastoma multiforme (GBM) remains controversial. A meta-analysis of published studies investigating the effects of MGMT promoter methylation on both progression-free survival (PFS) and overall survival (OS) among GBM patients was performed. A total of 2,986 patients from 30 studies were  included in the meta-analysis. In all, the frequency of MGMT promoter methylation was 44.27 %. Five studies undertook univariate analyses and nine undertook multivariate analyses of MGMT promoter methylation on PFS. The pooled hazard ratio (HR) estimate for PFS was 0.72 (95 % CI 0.55-0.95) by univariate analysis and 0.51 (95 % CI 0.38-0.69) by multivariate analysis. The effect of MGMT promoter methylation on OS was evaluated in 15 studies by univariate analysis and 14 studies by multivariate analysis. The combined HR was 0.67 (95 % CI 0.58-0.78) and 0.49 (95 % CI 0.38-0.64), respectively. For GBM patients treated with Alkylating agent, the meta-risk remained highly significant by both univariate (HR = 0.58; 95 % CI 0.42-0.79) and multivariate analysis (HR = 0.42; 95 % CI 0.29-0.60). This study showed that MGMT promoter methylation was associated with  better PFS and OS in patients with GBM regardless of therapeutic intervention, and associated with longer OS in GBM patients treated with alkylating agents.



TÍTULO / TITLE:  - Malignant meningioma of the cerebellopontine angle in a 2-year-old girl: a case report and literature review.

RESUMEN / SUMMARY:  - Enlace al Resumen / Link to its Summary

REVISTA / JOURNAL:  - Chin J Cancer. 2013 Mar 8. doi: 10.5732/cjc.012.10211.

            ●● Enlace al texto completo (gratuito o de pago) 5732/cjc.012.10211

AUTORES / AUTHORS:  - Fan MC; Zhang X; Wang QL; Cheng L; Dai CY; Yu D; Sun P

INSTITUCIÓN / INSTITUTION:  - Department of Neurosurgical Intensive Care Unit (NICU), the Affiliated Hospital of Medical College, Qingdao University, Qingdao, Shandong 266003, P.R. China. fanmcchina@126.com.

RESUMEN / SUMMARY:  - Meningioma is a common intracranial tumor in adults. Pediatric cases account for  approximately 1.5% of all intracranial meningiomas, and very few cases show malignant histological features. Primary pediatric malignant meningioma in the cerebellopontine angle is extremely uncommon. Herein, we report a 2-year-old girl with malignant meningioma in the cerebellopontine angle. The clinical features, diagnosis, and treatment protocol are discussed.



TÍTULO / TITLE:  - Imaging characteristics of an unusual, high-grade angiocentric glioma: a case report and review of the literature.

RESUMEN / SUMMARY:  - Enlace al Resumen / Link to its Summary

REVISTA / JOURNAL:  - J Radiol Case Rep. 2012 Oct;6(10):1-10. doi: 10.3941/jrcr.v6i10.1134. Epub 2012 Oct 1.

            ●● Enlace al texto completo (gratuito o de pago) 3941/jrcr.v6i10.1134

AUTORES / AUTHORS:  - Aguilar HN; Hung RW; Mehta V; Kotylak T

INSTITUCIÓN / INSTITUTION:  - Department of Radiology & Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada.

RESUMEN / SUMMARY:  - Angiocentric gliomas have recently been reclassified as a separate central nervous system tumor. Few cases have been reported, and most of those correspond  to slow-growing, low-grade neoplasms in very young pediatric patients. Here we describe magnetic resonance imaging findings (including diffusion imaging, spectroscopy and tractography) in an unusual higher-grade neoplasm with pathologic features suggestive of an angiocentric glioma in a 15-year-old male. The tumor had mild heterogeneous enhancement on magnetic resonance imaging, and a low apparent diffusion coefficient (9.9 x 10(-4) mm(2)s(-1)), consistent with an  intermediate-to-high cellularity tumor. Spectroscopic imaging showed elevated choline/phosphocreatine and choline/N-acetyl aspartate ratios, suggesting an unusually aggressive tumor. We conclude that angiocentric glioma should not be excluded from consideration at primary diagnosis, particularly in teenaged patients nearing adulthood.



TÍTULO / TITLE:  - Endoscopic endonasal resection of craniopharyngiomas: a case series and review of the literature.

RESUMEN / SUMMARY:  - Enlace al Resumen / Link to its Summary

REVISTA / JOURNAL:  - J Inj Violence Res. 2012 Nov;4(3 Suppl 1). pii: Paper No. 22.

AUTORES / AUTHORS:  - Samadian M; Akbari Dilmaghani N; Samimi SH; Moghaddasi H; Farzin N; Khazanedari S

INSTITUCIÓN / INSTITUTION:  - Neurosurgery And ENT wards of Loghman Hakim Hospital, Shahid Beheshti University  of Medical Sciences , Day General Hospital, Tehran, Iran.

RESUMEN / SUMMARY:  - BACKGROUND: Transcranial approaches were historically the first established routes for craniopharyngiomas resection. Transcranial approaches commonly entail  some degree of brain retraction as well as manipulation of neurovascular structures, located between the surgeon and the pathogenic region. A more direct  route to the sellar -suprasellar region is provided by the transsphenoidal approach. Introduction of extended approaches offered a safe alternative technique for reaching suprasellar craniopharyngiomas. The next stage of development was incorporation of the endoscope in the extended approach which increased the field of view and illumination. There is a limited body of literature on the outcome of endoscopic endonasal approach in resection of craniopharyngiomas. Therefore, the present study aims to assess the outcome of endoscopic endonasal approach in resection of craniopharyngiomas. METHODS: Eight  patients underwent surgery at Loghman-Hakim and Day General Hospitals (Tehran, Iran). One patient had recurrent lesion. The gross-total resection (GTR) was attempted in 6 surgeries. Indications for intended subtotal resection included advanced age, medical comorbidities, preservation of pituitary function, and hypothalamic invasion. RESULTS: The average size of tumor diameter was 2.8 cm. GTR in 6 cases and near-total resection in 2 cases were achieved. The average follow-up period was 30 months during which one recurrence in near resection cases was observed. Vision was improved by 80%. Four cases developed diabetes insipidus (unrelated to diabetes mellitus) and 3 cases developed panhypopituitarism postoperatively. Furthermore, postoperative cerebrospinal fluid (CSF) leaks occurred in 2 patients, one of them needed reoperation for CSF  leak management. In addition, postoperative bacterial meningitis occurred in one  patient. CONCLUSIONS: Endoscopic, endonasal surgery for craniopharyngioma can be  accompanied by high rates of GTR with low rates of CSF leak. KEYWORDS: Craniopharyngioma, Endonasal, Endoscopic.



TÍTULO / TITLE:  - Giant prolactinoma: case report and review of literature.

RESUMEN / SUMMARY:  - Enlace al Resumen / Link to its Summary

REVISTA / JOURNAL:  - J Diabetes Metab Disord. 2013 Jan 8;12(1):3. doi: 10.1186/2251-6581-12-3.

            ●● Enlace al texto completo (gratuito o de pago) 1186/2251-6581-12-3

AUTORES / AUTHORS:  - Rahmanian M; Meybodi HA; Larijani B; Mohajeri-Tehrani MR

INSTITUCIÓN / INSTITUTION:  - EMRC (Endocrinology and Metabolism Research Institute), Shariati Hospital,Tehran  university of medical science, North Karegar St, Tehran, Iran. mrmohajeri@tums.ac.ir.

RESUMEN / SUMMARY:  - “Invasive giant prolactinoma” is a large prolactinoma (>4 cm in dimension) presenting with serum prolactin levels of >1000 ng/dL and mass related clinical symptoms. Here we report a patient with a giant prolactinoma presented with central hypogonadism, suppressed adrenal and thyroid function, supra sellar extension, visual field impairment and high prolactin level.The patient was treated with cabergoline, levothyroxin and prednisolone. After 18 months, tumor size markedly reduced, associated with adrenal function and visual field improvement, but central hypogonadism and secondary hypothyroidism persisted.Previous studies showed normalization of thyrotropin secretion after treatment but it remained low in our patient even after 18 months follow up.



TÍTULO / TITLE:  - Primary spinal glioblastoma: A case report and review of the literature.

RESUMEN / SUMMARY:  - Enlace al Resumen / Link to its Summary

REVISTA / JOURNAL:  - Oncol Lett. 2013 Mar;5(3):992-996. Epub 2012 Dec 14.

            ●● Enlace al texto completo (gratuito o de pago) 3892/ol.2012.1076

AUTORES / AUTHORS:  - Morais N; Mascarenhas L; Soares-Fernandes JP; Silva A; Magalhaes Z; Costa JA

INSTITUCIÓN / INSTITUTION:  - Department of Neurosurgery, Hospital de Braga, Braga;

RESUMEN / SUMMARY:  - Primary spinal glioblastoma (GBM) is a rare disease, with an aggressive course and a poor prognosis. We report a case of a 19-year-old male with a 4-week history of progressive weakness in both lower limbs, which progressed to paraparesis with a left predominance and difficulty in initiating urination over  a week. Spine magnetic resonance imaging (MRI) showed an intramedullary expansile mass localised between T6 and T11. We performed a laminotomy and laminoplasty between T6 and T11 and the tumour was partially removed. Histopathological study  was compatible with GBM. The patient was administered focal spine radiotherapy with chemotherapy with temozolamide. Serial MRI performed after the initial surgery demonstrated enlargement of the enhancing mass from T3 to T12 and subarachnoid metastatic deposits in C2 and C4, the pituitary stalk, inter-peduncular cistern, left superior cerebellar peduncle and hydrocephalus. We review the literature with regard to the disease and treatment options, and report the unique features of this case. Primary spinal GBM is an extremely rare  entity with a poor prognosis and a short survival time. An aggressive management  of the different complications as they arise and improvement of current modes of  treatment and new treatment options are required to improve survival and ensure better quality of life.



TÍTULO / TITLE:  - Incidental finding of thrombosed aneurysm inside huge pituitary macroadenoma: a case report and review of literature.

RESUMEN / SUMMARY:  - Enlace al Resumen / Link to its Summary

REVISTA / JOURNAL:  - J Inj Violence Res. 2012 Nov;4(3 Suppl 1). pii: Paper No. 69.

AUTORES / AUTHORS:  - Sharifi G; Jalessi M; Ebrahimzadeh K; Shafizad M

INSTITUCIÓN / INSTITUTION:  - Neurosurgery Department, Loghman Hakim Hospital, Shaheed Beheshti University of Medical Sciences, Tehran, Iran.

RESUMEN / SUMMARY:  - Although apoplexy and cystic formation are common inside the pituitary adenoma and hemorrhage with different times of occurrence as revealed by magnetic resonance imaging sequences can be seen within a pituitary macroadenoma, a classic saccular aneurysm and its association with carotid artery haven’t been yet reported. CASE: A 52 years old woman was referred for visual loss and headache accompanied by pituitary adenoma. She has no particular past medical history was operated her huge pituitary macroadenoma was resected by endoscopic endonasal transsphenoidal surgery. During surgery we encountered a tough saccular mass and checking imaging brought the conjecture of a thrombosed aneurysm. By careful dissection and use of intranasal Doppler sonography its association with  left internal carotid was revealed. After coagulation of its main branch that was probably a tumor feeder aneurysm resected totally and we proceed for further tumor removal. Up to our knowledge and review of the related literatures it is the first time that intra adenoma thrombosed aneurysm is reported. KEYWORDS: Intra adenoma thrombosed aneurysm, Classic saccular aneurysm, Case report, Doppler Sonography.



TÍTULO / TITLE:  - A supratentorial primitive neuroectodermal tumor presenting with intracranial hemorrhage in a 42-year-old man: a case report and review of the literature.

RESUMEN / SUMMARY:  - Enlace al Resumen / Link to its Summary

REVISTA / JOURNAL:  - J Med Case Rep. 2013 Mar 27;7(1):86.

            ●● Enlace al texto completo (gratuito o de pago) 1186/1752-1947-7-86

AUTORES / AUTHORS:  - Papadopoulos EK; Fountas KN; Brotis AG; Paterakis KN

RESUMEN / SUMMARY:  - INTRODUCTION: We report on a very rare case of a supratentorial primitive neuroectodermal tumor in an adult, which presented with intracerebral hemorrhage, and review the relevant medical literature. CASE PRESENTATION: A 42-year-old Caucasian man complained of a sudden headache and nausea-vomiting. Our patient rapidly deteriorated to coma. An emergency computed tomography scan showed an extensive intraparenchymal hemorrhage that caused significant mass effect and tonsilar herniation. During surgery, an increased intracranial pressure was recorded and extensive bilateral decompressive craniectomies were performed. A cherry-like intraparenchymal lesion was found in his right frontal lobe and resected. Our patient died in the intensive care unit after approximately 48 hours. The resected lesion was identified as a central nervous system primitive neuroectodermal tumor. CONCLUSION: Supratentorial primitive neuroectodermal tumors must be considered in the differential diagnosis of space-occupying lesions in adults. Spontaneous supratentorial hemorrhage due to primitive neuroectodermal tumors is an extremely rare but potentially lethal event.



TÍTULO / TITLE:  - Fluorescein fluorescence use in the management of intracranial neoplastic and vascular lesions: a review and report of a new technique.

RESUMEN / SUMMARY:  - Enlace al Resumen / Link to its Summary

REVISTA / JOURNAL:  - Curr Drug Discov Technol. 2013 Jun 1;10(2):160-9.

AUTORES / AUTHORS:  - Lane BC; Cohen-Gadol AA

INSTITUCIÓN / INSTITUTION:  - Indiana University, Department of Neurological Surgery, 355 W. 16th Street, Suite 5100, Indianapolis, IN 46202, USA. acohenmd@gmail.com.

RESUMEN / SUMMARY:  - The use of fluorescent technologies in neurosurgery has a substantial history with applications to vascular and tumor surgery dating back to the 1940s. This review focuses on the applications of fluorescence imaging to intracranial vascular and neoplastic lesions using sodium fluorescein. The authors performed a literature search for articles about the use of sodium fluorescein in neurosurgery. Fifty-five articles were initially retrieved, and 37 of these were  appropriate for this review. The subcategorization of these articles revealed 2 describing the properties of fluorescein, 19 articles relating to applications of fluorescein to tumor, 11 relating to vascular applications, and 5 reporting side  effects associated with fluorescein use. Articles related to use of this agent in evaluation of CSF leak were excluded. Sodium fluorescein has been reported to be  a useful surgical adjunct in resection of neoplastic lesions based on differential fluorescence between normal and neoplastic tissue. There are many reports on the utility of fluorescein in vascular imaging relating to arteriovenous malformations, aneurysms, and vessel anastomosis; however, these reports do not examine primary outcomes. Sodium fluorescein has been judged as generally safe with few reports of severe complications. Sodium fluorescein has demonstrated promise as a useful surgical adjunct in neurosurgery for vascular and neoplastic lesions. It is well tolerated, but further study is required to determine its full utility. Finally, we will introduce a new practical technology that could potentially improve intraoperative application of sodium fluorescein by improving its fluorescence visualization while using substantially lower doses of this dye.



TÍTULO / TITLE:  - Pituitary adenoma nitroproteomics: current status and perspectives.

RESUMEN / SUMMARY:  - Enlace al Resumen / Link to its Summary

REVISTA / JOURNAL:  - Oxid Med Cell Longev. 2013;2013:580710. doi: 10.1155/2013/580710. Epub 2013 Mar 7.

            ●● Enlace al texto completo (gratuito o de pago) 1155/2013/580710

AUTORES / AUTHORS:  - Zhan X; Wang X; Desiderio DM

INSTITUCIÓN / INSTITUTION:  - Key Laboratory of Cancer Proteomics of Chinese Ministry of Health, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan 410008, China ; Hunan Engineering Laboratory for Structural Biology and Drug Design, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan 410008, China ; State Local Joint Engineering Laboratory for Anticancer Drugs, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan 410008, China.

RESUMEN / SUMMARY:  - Oxidative stress is extensively associated with tumorigenesis. A series of studies on stable tyrosine nitration as a marker of oxidative damage were performed in human pituitary and adenoma. This paper reviews published research on the mass spectrometry characteristics of nitropeptides and nitroproteomics of  pituitary controls and adenomas. The methodology used for nitroproteomics, the current status of human pituitary nitroproteomics studies, and the future perspectives are reviewed. Enrichment of those low-abundance endogenous nitroproteins from human tissues or body fluid samples is the first important step for nitroproteomics studies. Mass spectrometry is the essential approach to  determine the amino acid sequence and locate the nitrotyrosine sites. Bioinformatics analyses, including protein domain and motif analyses, are needed  to locate the nitrotyrosine site within the corresponding protein domains/motifs. Systems biology techniques, including pathway analysis, are necessary to discover signaling pathway networks involving nitroproteins from the systematically global point of view. Future quantitative nitroproteomics will discover pituitary adenoma-specific nitroprotein(s). Structural biology techniques such as X-ray crystallography analysis will solidly clarify the effects of tyrosine nitration on structure and functions of a protein. Those studies will eventually address the mechanisms and biological functions of tyrosine nitration in pituitary tumorigenesis and will discover nitroprotein biomarkers for pituitary adenomas and targets for drug design for pituitary adenoma therapy.



TÍTULO / TITLE:  - Pituitary adenomas: a review.

RESUMEN / SUMMARY:  - Enlace al Resumen / Link to its Summary

REVISTA / JOURNAL:  - J Inj Violence Res. 2012 Nov;4(3 Suppl 1). pii: Paper No. 56.

AUTORES / AUTHORS:  - Sharif-Alhoseini M; Rahimi-Movaghar V

INSTITUCIÓN / INSTITUTION:  - Sina Trauma and Surgery Research Center, Department of Neurosurgery, Tehran University of Medical Sciences, Tehran, Iran.

RESUMEN / SUMMARY:  - Pituitary adenomas, as the majority of pituitary neoplasms, are typically benign, slow-growing tumors that arise from cells in the pituitary gland. Those are classified based on secretory products. The functioning (endocrine-active) tumors include almost 70% of pituitary tumors which produce 1 or 2 hormones that are measurable in the serum and cause definite clinical syndromes, that are classified based on their secretory product(s). But non-functioning adenomas are  endocrine-inactive tumors. The purpose of this study is to review all types of functioning pituitary adenoma (prolactin, ACTH, GH, TSH, LH and FSH secreting) and non-secreting ones from studies indexed in electronic databases. We describe  the symptoms, epidemiology, diagnosis, management, outcome and complications of them separately. Because of physiologic effects of excess hormones, the functioning tumors present earlier than non-functioning adenomas. Therefore patients usually present with symptoms related to a specific hormone imbalance. On the other hand, the mass effect from large pituitary adenomas (often due to non-secreting tumors) may lead to the pressure symptoms, such as headaches, visual field defects (typically loss of peripheral vision first), cranial nerve deficits, hypopituitarism (compression of the normal pituitary gland), pituitary  apoplexy (sudden bleeding or outgrowing blood supply), or stalk effect. Apart from prolactinomas, primary treatment for the pituitary adenomas is usually transsphenoidal surgery, and adjunctive treatment may include supervoltage radiation, and occasionally, pharmacologic agents. The most of prolactinomas can  be effectively treated with dopaminergic drugs as a primary therapy. Transsphenoidal surgery is an alternative for patients who are intolerant of or resistant to dopamine agonists or when hyperprolactinemia is caused by non-prolactin-secreting tumors compressing the pituitary stalk. KEYWORDS: Pituitary neoplasm, Prolactinoma, ACTH-Secreting pituitary adenoma, GH-Secreting  pituitary adenoma.