CNS OncologyPub Date : 2023-03-01DOI: 10.2217/cns-2022-0019
Marie-Sophie Minot-This, Thomas Grinda, Nicolas Epaillard, David Guyon, Rita El Jawiche, Gabriel Garcia, Barbara Pistilli
{"title":"Intracranial hypotension in a breast cancer patient treated with epidural blood patches.","authors":"Marie-Sophie Minot-This, Thomas Grinda, Nicolas Epaillard, David Guyon, Rita El Jawiche, Gabriel Garcia, Barbara Pistilli","doi":"10.2217/cns-2022-0019","DOIUrl":"https://doi.org/10.2217/cns-2022-0019","url":null,"abstract":"<p><p>We report the case of a patient with metastatic breast cancer who presented with an orthostatic headache. After a comprehensive diagnostic workup including MRI and lumbar puncture, we maintained the diagnosis of intracranial hypotension (IH). The patient was therefore treated with two consecutive non targeted epidural blood patches, resulting in the remission of IH symptoms for 6 months. IH in cancer patients is a rarer cause of headache than carcinomatous meningitis. As the diagnosis can be made by standard examination and the treatment is relatively simple and effective, IH deserves to be better known by oncologists.</p>","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":"12 1","pages":"CNS94"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fd/71/cns-12-94.PMC9996407.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9913880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CNS OncologyPub Date : 2022-12-01DOI: 10.2217/cns-2021-0018
Dahye Park, Mina Lobbous, Louis B Nabors, James M Markert, Jinsuh Kim
{"title":"Undesired impact of iron supplement on MRI assessment of post-treatment glioblastoma.","authors":"Dahye Park, Mina Lobbous, Louis B Nabors, James M Markert, Jinsuh Kim","doi":"10.2217/cns-2021-0018","DOIUrl":"https://doi.org/10.2217/cns-2021-0018","url":null,"abstract":"<p><p>Glioblastoma (GBM) is the most common malignant adult brain and has a poor prognosis. Routine post-treatment MRI evaluations are required to assess treatment response and disease progression. We present a case of an 83-year-old female who underwent MRI assessment of post-treatment GBM after intravenous iron replacement therapy, ferumoxytol. The brain MRI revealed unintended alteration of MRI signal characteristics from the iron containing agent which confounded diagnostic interpretation and subsequently, the treatment planning. Ferumoxytol injection prior to contrast enhanced MRI must be screened in post-treatment GBM patients to accurately evaluate tumor activity.</p>","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":"11 4","pages":"CNS90"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/05/4d/cns-11-90.PMC9830595.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10616899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CNS OncologyPub Date : 2022-07-12DOI: 10.2217/cns-2022-0008
Andrew Dhawan, David M Peereboom, Glen Hj Stevens
{"title":"First clinical experience with belzutifan in von Hippel-Lindau disease associated CNS hemangioblastoma.","authors":"Andrew Dhawan, David M Peereboom, Glen Hj Stevens","doi":"10.2217/cns-2022-0008","DOIUrl":"10.2217/cns-2022-0008","url":null,"abstract":"<p><p>We present two cases of von Hippel-Lindau (VHL) disease-associated hemangioblastomas in the CNS treated with the newly approved HIF-2α inhibitor, belzutifan. The first case is a 31-year-old female with confirmed pathogenic germline <i>VHL</i> mutation who presented with multiple hemangioblastomas. The patient was started on belzutifan, and a brisk reduction in perilesional edema was observed after 2 months of treatment. The second patient is a 30-year-old male with familial VHL disease. Imaging revealed multiple cerebellar hemangioblastomas, and follow-up imaging after three cycles of belzutifan revealed a reduction in perilesional edema. Both patients tolerated belzutifan well, with only anemia and fatigue. We highlight our initial experience and early imaging findings associated with belzutifan in VHL disease-associated CNS hemangioblastomas.</p>","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":" ","pages":"CNS91"},"PeriodicalIF":0.0,"publicationDate":"2022-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9280404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40494904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CNS OncologyPub Date : 2022-06-13DOI: 10.2217/cns-2021-0011
K. Le Dû, N. Alarion, H. Rabi, O. Casasnovas, P. Robert, Amandine Durand, Bénédicte Burlet, C. Tabouret-Viaud, Selim Ramla, Laurent Martin, C. Rossi
{"title":"Extranodal classical Hodgkin lymphoma involving the spinal cord: case report and review of the literature","authors":"K. Le Dû, N. Alarion, H. Rabi, O. Casasnovas, P. Robert, Amandine Durand, Bénédicte Burlet, C. Tabouret-Viaud, Selim Ramla, Laurent Martin, C. Rossi","doi":"10.2217/cns-2021-0011","DOIUrl":"https://doi.org/10.2217/cns-2021-0011","url":null,"abstract":"Primary CNS involvement is very rare in Hodgkin lymphoma. Here we present two cases of spinal cord dissemination. Two women of 40 and 65 years of age presented symptoms of spinal cord injury; imaging showed an intramedullary mass in T10 and T2, respectively, without vertebral involvement and upper diaphragmatic lymph nodes. Lymph-node biopsy confirmed the diagnosis of classical Hodgkin lymphoma in both patients. The first patient received four cycles of chemotherapy (escalated BEACOPP and ABVD) with intrathecal therapy, and the second four cycles of doxorubicin, vinblastine, dacarbazine (AVD) and local irradiation after surgery decompression. Complete metabolic response was obtained at the end of treatment. After 5 and 7 years of follow-up respectively, neurological deficits persisted in both.","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":"63 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76812257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CNS OncologyPub Date : 2022-06-09DOI: 10.2217/cns-2022-0009
P. Orduña, Cheryl Anne P Lubaton-Sacro
{"title":"Factors associated with delayed diagnosis among Filipino pediatric brain tumor patients: a retrospective review","authors":"P. Orduña, Cheryl Anne P Lubaton-Sacro","doi":"10.2217/cns-2022-0009","DOIUrl":"https://doi.org/10.2217/cns-2022-0009","url":null,"abstract":"Aim: Determine delayed diagnosis measured by prediagnostic symptomatic interval (PSI) among Filipino pediatric brain tumor patients and identify associated factors. Methods: Data was collected retrospectively on Philippine General Hospital pediatric brain tumor patients from 2015 to 2019. PSI was calculated. Associated factors were determined. Results: 196 patients were included. Median PSI was 80.5 days. Longer PSI was significantly associated with older age, supratentorial and low-grade tumors, more physician consults prior to subspecialist referral, longer interval from neuroimaging request to facilitation, and those presenting with seizures (11-month delay), poor school performance (1-year delay), behavioral changes (1.3-year delay) and secondary amenorrhea (3-year delay). Conclusion: Delayed diagnosis among Filipino brain tumor patients is associated with age, tumor characteristics and symptoms that are uncommon in this condition. Awareness of these symptoms through physician education, close monitoring of patients, early subspecialist referral and better neuroimaging access may lead to earlier diagnosis.","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81652989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CNS OncologyPub Date : 2022-06-01DOI: 10.2217/cns-2022-0001
Nuno Cubas Farinha, Wilson Teixeira, Diogo Roque, Sergio Livraghi
{"title":"Large mirror brain metastases from primary undifferentiated sarcoma of the breast: case report and review of the literature.","authors":"Nuno Cubas Farinha, Wilson Teixeira, Diogo Roque, Sergio Livraghi","doi":"10.2217/cns-2022-0001","DOIUrl":"https://doi.org/10.2217/cns-2022-0001","url":null,"abstract":"<p><p>Primary breast sarcomas are rare high-grade tumors with a reported incidence of <1% of breast malignancies. Its dissemination to the CNS is exceptional and only one is found in the literature. The authors described the case of a 22-year-old female with history of a breast undifferentiated sarcoma that present with two large bilateral retrolenticular brain metastases. Both lesions were excised in the same procedure and she underwent adjuvant therapy. She died 24 months after surgery. Despite being aggressive lesions, aggressive treatment of primary breast sarcomas including brain metastases excision, should be considered in order to improve overall survival.</p>","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":"11 2","pages":"CNS85"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b2/f9/cns-11-85.PMC9134969.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10241190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CNS OncologyPub Date : 2022-06-01Epub Date: 2022-05-18DOI: 10.2217/cns-2022-0002
Kathleen Van Dyk, Lucy Wall, Brandon F Heimberg, Justin Choi, Catalina Raymond, Chencai Wang, Albert Lai, Timothy F Cloughesy, Benjamin M Ellingson, Phioanh Nghiemphu
{"title":"Daily functioning in glioma survivors: associations with cognitive function, psychological factors and quality of life.","authors":"Kathleen Van Dyk, Lucy Wall, Brandon F Heimberg, Justin Choi, Catalina Raymond, Chencai Wang, Albert Lai, Timothy F Cloughesy, Benjamin M Ellingson, Phioanh Nghiemphu","doi":"10.2217/cns-2022-0002","DOIUrl":"10.2217/cns-2022-0002","url":null,"abstract":"<p><p><b>Aim:</b> Understanding and supporting quality of life (QoL) and daily functioning in glioma patients is a clinical imperative. In this study, we examined the relationship between cognition, psychological factors, measures of health-related QoL and functioning in glioma survivors. <b>Materials & methods:</b> We examined neuropsychological, self-reported cognition, mood and QoL correlates of work and non-work-related daily functioning in 23 glioma survivors, and carried out linear models of the best predictors. <b>Results & conclusion:</b> A total of 13/23 participants were working at the time of enrollment. The best model for worse work-related functioning (R<sup>2</sup> = .83) included worse self-reported cognitive function, depression, loneliness and brain tumor symptoms. The best model for worse non-work-related functioning (R<sup>2</sup> = .61) included worse self-reported cognitive functioning, anxiety, sleep disturbance and physical functioning. Neuropsychological variables were not among the most highly correlated with function. Worse cognitive, particularly self-reported and psychosocial outcomes may compromise optimal functioning in glioma survivors.</p>","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":"11 2","pages":"CNS84"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/22/11/cns-11-84.PMC9134930.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9970553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CNS OncologyPub Date : 2022-04-04DOI: 10.2217/cns-2022-0004
T. Gupta, P. Nayak, Y. Baviskar, Meetakshi Gupta, A. Moiyadi, S. Epari, A. Janu, N. Purandare, V. Rangarajan, B. Bagal, Abhishek Chatterjee, G. Sastri
{"title":"Systemic inflammatory biomarkers in primary central nervous system lymphoma versus high-grade glioma: exploratory, comparative and correlative analysis","authors":"T. Gupta, P. Nayak, Y. Baviskar, Meetakshi Gupta, A. Moiyadi, S. Epari, A. Janu, N. Purandare, V. Rangarajan, B. Bagal, Abhishek Chatterjee, G. Sastri","doi":"10.2217/cns-2022-0004","DOIUrl":"https://doi.org/10.2217/cns-2022-0004","url":null,"abstract":"Aim: To assess systemic inflammatory biomarkers in non invasive differential diagnosis of primary central nervous system lymphoma (PCNSL) from high-grade glioma (HGG). Materials & methods: Patients with similar morphology (PCNSL or HGG) on conventional neuro-imaging were included. Systemic inflammatory indices were calculated from pretreatment complete blood counts and liver function tests and compared against histopathology as reference standard. Results: Mean values of absolute lymphocyte count and prognostic nutritional index were significantly different between PCNSL (n = 42) versus HGG (n = 16). Area under receiver operating characteristics curve for absolute lymphocyte count and prognostic nutritional index in the diagnosis of PCNSL was 0.70 and 0.72 respectively suggesting fair and acceptable diagnostic accuracy. Conclusion: Systemic inflammatory biomarkers complement established clinico-radiological features and aid in the differential diagnosis of PCNSL from HGG.","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86789680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CNS OncologyPub Date : 2022-03-01Epub Date: 2022-02-10DOI: 10.2217/cns-2021-0005
Orwa Aboud, Ritu Shah, Elizabeth Vera, Eric Burton, Brett Theeler, Jing Wu, Lisa Boris, Martha Quezado, Jennifer Reyes, Kathleen Wall, Mark R Gilbert, Terri S Armstrong, Marta Penas-Prado
{"title":"Challenges of imaging interpretation to predict oligodendroglioma grade: a report from the Neuro-Oncology Branch.","authors":"Orwa Aboud, Ritu Shah, Elizabeth Vera, Eric Burton, Brett Theeler, Jing Wu, Lisa Boris, Martha Quezado, Jennifer Reyes, Kathleen Wall, Mark R Gilbert, Terri S Armstrong, Marta Penas-Prado","doi":"10.2217/cns-2021-0005","DOIUrl":"https://doi.org/10.2217/cns-2021-0005","url":null,"abstract":"<p><p><b>Background:</b> To illustrate challenges of imaging interpretation in patients with oligodendroglioma seen at a referral center and evaluate interrater reliability. <b>Methods:</b> Two neuro-oncologists reviewed diagnostic preradiation MRIs of oligodendroglioma patients; interrater reliability was calculated with the kappa coefficient (k). A neuroradiologist measured presurgical apparent diffusion coefficient (ADC), if available. <b>Results:</b> Extensive enhancement was noted in four of 58 patients, k = 0.7; necrosis in seven of 58, k = 0.61; calcification in seven of 17, k = 1.0; diffusion restriction in two of 39 patients, k = 1.0 (all only in grade 3). ADC values with receiver operator characteristic analysis for area under the curve were 0.473, not significantly different from the null hypothesis (p = 0.14). <b>Conclusions:</b> Extensive enhancement, necrosis and calcification correlated with grade 3 oligodendroglioma in our sample. However, interrater variability is an important limitation when assessing radiographic features, supporting the need for standardization of imaging protocols and their interpretation.</p>","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":" ","pages":"CNS83"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/16/3e/cns-11-83.PMC8988255.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39906197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CNS OncologyPub Date : 2022-03-01DOI: 10.2217/cns-2021-0013
Helen Hwang, Jiayi Huang, Karam Khaddour, Omar H Butt, George Ansstas, Jie Chen, Ruth Gn Katumba, Albert H Kim, Eric C Leuthardt, Jian L Campian
{"title":"Prolonged response of recurrent <i>IDH</i>-wild-type glioblastoma to laser interstitial thermal therapy with pembrolizumab.","authors":"Helen Hwang, Jiayi Huang, Karam Khaddour, Omar H Butt, George Ansstas, Jie Chen, Ruth Gn Katumba, Albert H Kim, Eric C Leuthardt, Jian L Campian","doi":"10.2217/cns-2021-0013","DOIUrl":"https://doi.org/10.2217/cns-2021-0013","url":null,"abstract":"<p><p>Despite the improved understanding of the molecular and genetic heterogeneity of glioblastoma, there is still an unmet need for better therapeutics, as treatment approaches have remained unchanged in recent years. Research into the role of the immune microenvironment has generated enthusiasm for testing immunotherapy (specifically, immune checkpoint inhibitors). However, to date, trials of immunotherapy in glioblastoma have not demonstrated a survival advantage. Combination approaches aimed at optimally inducing response to immune checkpoint inhibitors with radiotherapy are currently being investigated. Herein, the authors describe their experience of the potential benefit and clinical outcomes of using combination pembrolizumab (an immune checkpoint inhibitor) and laser interstitial thermal therapy in a case series of patients with recurrent <i>IDH</i>-wild-type glioblastoma.</p>","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":"11 1","pages":"CNS81"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/70/8e/cns-11-81.PMC8988254.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9583438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}