CNS OncologyPub Date : 2021-03-01Epub Date: 2021-01-15DOI: 10.2217/cns-2020-0028
Breanna Taylor, Mallika P Patel, Katherine B Peters
{"title":"When tumefactive demyelination is truly a tumor: case report of a radiographic misdiagnosis.","authors":"Breanna Taylor, Mallika P Patel, Katherine B Peters","doi":"10.2217/cns-2020-0028","DOIUrl":"https://doi.org/10.2217/cns-2020-0028","url":null,"abstract":"<p><p>Oligodendrogliomas are slow-growing tumors that account for 15-20% of gliomas. This case report describes the case of an adult male patient diagnosed initially with tumefactive demyelination and multiple sclerosis, which was subsequently found to be a well-differentiated low-grade oligodendroglioma. This case emphasizes the importance of timely diagnosis in oligodendrogliomas and other brain tumors for the prompt initiation of appropriate therapy, to minimize the likelihood of disease progression, ensure symptom management and escalation of unnecessary treatments for multiple sclerosis.</p>","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fe/77/cns-10-69.PMC7962173.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38742229","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 : 2021-03-01Epub Date: 2020-12-16DOI: 10.2217/cns-2020-0020
Stephen G Bowden, Daniel N Munger, Jaclyn Thiessen, S Cody Schoettler Woll, Seunggu J Han, Edward A Neuwelt, Ramon F Barajas, Prakash Ambady
{"title":"The clinical heterogeneity of entirely nonenhancing CNS lymphoma: a case series.","authors":"Stephen G Bowden, Daniel N Munger, Jaclyn Thiessen, S Cody Schoettler Woll, Seunggu J Han, Edward A Neuwelt, Ramon F Barajas, Prakash Ambady","doi":"10.2217/cns-2020-0020","DOIUrl":"https://doi.org/10.2217/cns-2020-0020","url":null,"abstract":"<p><p>CNS lymphoma often presents with atypical imaging characteristics leading to delay in diagnosis and initiation of treatment. Among the most rarely reported of these is entirely nonenhancing CNS lymphoma, which is estimated at an incidence of about 1%. Here, we present three cases of nonenhancing CNS lymphoma in immune competent patients at both initial presentation and recurrence and in primary as well as secondary CNS lymphoma. Diffusion- and perfusion-weighted imaging was found helpful in diagnosis in some cases.</p>","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0a/50/cns-10-67.PMC7962175.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38376092","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}
{"title":"Small cell glioblastoma multiforme: a case series and clinicopathological update.","authors":"Arun Kumar Yadav, Renu Madan, Debajyoti Chatterjee, Shalin Dhiman, Shikha Goyal, Narendra Kumar, Sushanta Kumar Sahoo","doi":"10.2217/cns-2020-0016","DOIUrl":"https://doi.org/10.2217/cns-2020-0016","url":null,"abstract":"Small cell glioblastoma (scGBM) is a rare histological variant of classical glioblastoma (GBM). Presence of necrosis and microvascular proliferation is not essential for the diagnosis. It is thought to have more aggressive behavior as compared with classical GBM; however, because of its rarity standard treatment guidelines are not available. Adjuvant treatment for these cancers consists of postoperative radiotherapy with concurrent and maintenance temozolomide similar to classical GBM. Here we present a case series of five small cell glioblastoma patients along with the clinical-pathological review.","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/cns-2020-0016","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38681700","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 : 2020-12-01Epub Date: 2020-10-28DOI: 10.2217/cns-2020-0018
Kwanza T Warren, Linxi Liu, Yang Liu, Myla S Strawderman, Ali H Hussain, Heather M Ma, Michael T Milano, Nimish A Mohile, Kevin A Walter
{"title":"Time to treatment initiation and outcomes in high-grade glioma patients in rehabilitation: a retrospective cohort study.","authors":"Kwanza T Warren, Linxi Liu, Yang Liu, Myla S Strawderman, Ali H Hussain, Heather M Ma, Michael T Milano, Nimish A Mohile, Kevin A Walter","doi":"10.2217/cns-2020-0018","DOIUrl":"https://doi.org/10.2217/cns-2020-0018","url":null,"abstract":"<p><p><b>Aims:</b> To investigate wait time (WT) for chemoradiation and survival in post-op high-grade glioma (HGG) patients admitted to inpatient rehabilitation compared with those discharged home. <b>Materials & methods:</b> A total of 291 HGG patients (14.4% grade III and 84.9% grade IV) were included in this retrospective cohort study. Patients were grouped by disposition following surgery. <b>Results:</b> Median length of stay was longer in acute inpatient rehabilitation facility (AIRF) patients (10d) compared with patients discharged home (3d). AIRF admission was associated with higher odds of excessive treatment delay. Median survival for AIRF patients less than for patients discharged home (42.9 vs 72.71 weeks). WT was not associated with survival even after adjusting for prognostic factors. <b>Conclusion:</b> HGG patients discharged to rehabilitation facilities have longer length of stay, longer WT and shorter survival compared with patients discharged home.</p>","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/cns-2020-0018","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38541957","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 : 2020-12-01Epub Date: 2020-10-20DOI: 10.2217/cns-2020-0023
Leonor Fernandes, Leonor Vasconcelos de Matos, Débora Cardoso, Marlene Saraiva, Renata Medeiros-Mirra, Andreia Coelho, Helena Miranda, Ana Martins
{"title":"Endocrine therapy for the treatment of leptomeningeal carcinomatosis in luminal breast cancer: a comprehensive review.","authors":"Leonor Fernandes, Leonor Vasconcelos de Matos, Débora Cardoso, Marlene Saraiva, Renata Medeiros-Mirra, Andreia Coelho, Helena Miranda, Ana Martins","doi":"10.2217/cns-2020-0023","DOIUrl":"https://doi.org/10.2217/cns-2020-0023","url":null,"abstract":"<p><p>Leptomeningeal disease (LMD) represents a devastating complication of advanced breast cancer (ABC), with survival of <5 months with multimodal treatment. The role of endocrine therapy (ET), due to its favorable toxicity profile and first-line indication in luminal ABC, appears promising in the setting of LMD, where symptom stabilization and quality-of-life preservation are the main goals; however, evidenced-based data are lacking. We conducted a thorough review of published evidence, aiming to investigate the role of ET in LMD treatment in luminal ABC. Twenty-one of 342 articles, evaluating 1302 patients, met inclusion criteria. ET use was rarely reported. New targeted agents show CNS activity. Research is lacking on the role of ET and targeted agents in BC-LMD treatment.</p>","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/cns-2020-0023","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38510278","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 : 2020-12-01Epub Date: 2020-11-27DOI: 10.2217/cns-2020-0021
Vincent Healy, Philip J O'Halloran, Mohammed B Husien, Ciaran Bolger, Michael Farrell
{"title":"Intermixed arteriovenous malformation and hemangioblastoma: case report and literature review.","authors":"Vincent Healy, Philip J O'Halloran, Mohammed B Husien, Ciaran Bolger, Michael Farrell","doi":"10.2217/cns-2020-0021","DOIUrl":"10.2217/cns-2020-0021","url":null,"abstract":"<p><p>We report the third presentation of an intermixed arteriovenous malformation and hemangioblastoma. The rare occurrence of the diagnostic histologic features of both a neoplasm and vascular malformation in a single lesion is more common in gliomas, as angioglioma, and is termed an 'intermixed' lesion. We review the literature concerning the developmental biology of each lesion, and potential interplay in the formation of an intermixed vascular neoplasm and vascular malformation. The roles of cellular origin, genetic susceptibility, favourable microenvironment, altered local gene expression and key regulatory pathways are reviewed. Our review supports angiography and genetic profiling in intermixed lesions to inform management strategies. Consideration should be given to multimodality therapeutic interventions as required, including microsurgical resection, stereotactic radiosurgery and further research to exploit emerging molecular targets.</p>","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/31/34/cns-09-66.PMC7737198.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38310457","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 : 2020-09-01Epub Date: 2020-09-29DOI: 10.2217/cns-2020-0013
Rachna Malani
{"title":"A view on the landscape of breast cancer brain metastases.","authors":"Rachna Malani","doi":"10.2217/cns-2020-0013","DOIUrl":"https://doi.org/10.2217/cns-2020-0013","url":null,"abstract":"Introduction to breast cancer & brain metastases & why subtypes matter Metastases to the central nervous system (CNS) are an unfortunate complication of breast cancer, second only to lung cancer [1–4]. The incidence of breast cancer brain metastases (BCBM) are approximated to be 5–16% in studies [1,5–7]; however, at autopsy the incidence is in fact much higher [1,6,8]. The development of BCBM can be associated with neurologic morbidity and augurs an inferior prognosis [9–11]. Moreover, BCBM are not limited to advanced stage disease, as the CNS is a site for relapse even in early stage breast cancer [5]. Presently, routine screening is not recommended, thus there is no precise understanding of CNS disease burden at diagnosis as typically BCBMs are captured due to symptoms and/or examination findings [6,8]. Steadily, this incidence has been increasing, in part due to advancements in systemic therapies which have improved survival; patients are living longer so as to develop BCBM as well as progress in radiographic techniques which have led to enhanced detection [1,2,5,7,9,12]. Certain patient and tumor characteristics have been shown to be associated with a higher risk of developing BCBM and these include younger age (<35 years), positive nodal status, ethnicity, presence of visceral metastases, estrogen receptor negative disease, HER2 disease, grade III tumors and tumor size [1,5,6]. In addition, the number of BCBM has prognostic relevance [6] as does the size of the BCBM and the patient’s performance status [4]. Ultimately, it is necessary to not view breast cancer as a single disease but as a group of diseases [2,12,13], as its subtypes are associated with varying patterns of metastatic spread and prognosis [8,14–16]. The different subtypes based on hormone receptor status and HER2 status are associated with a difference in incidence [11,17,18]. The time from diagnosis of the initial breast cancer to the development of BCBM is longer in patients with estrogen receptor positive (ER+) disease versus those with triple-negative breast cancer (TNBC) or HER2-positive cancer [11].","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/cns-2020-0013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38430874","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}
{"title":"Can 3D-CRT meet the desired dose distribution to target and OARs in glioblastoma? A tertiary cancer center experience.","authors":"Narendra Kumar, Srinivasa Gy, Chinna B Dracham, Treshita Dey, Renu Madan, Divya Khosla, Arun Oinum, Rakesh Kapoor","doi":"10.2217/cns-2020-0010","DOIUrl":"https://doi.org/10.2217/cns-2020-0010","url":null,"abstract":"<p><p><b>Aim:</b> The purpose of the study is to perform a dosimetric analysis of the doses received by planning target volume and organ at risks in the postoperative glioblastoma by using 3D-conformal radiotherapy to a total dose of 60 Gy in 30 fractions. <b>Materials &</b> <b>Methods:</b> All patients received concurrent temozolomide every day, and this was followed by adjuvant temozolomide of 5 days of treatment per month. <b>Results:</b> More than 98% of patients were treated with a dose of 60 Gy. Doses were analyzed for the normal whole brain, tumor volume, as well as all the organs at risk. <b>Conclusion:</b> Given the grave prognosis and the limited survival of glioblastoma despite the best treatment available, makes 3D-conformal radiotherapy an equally acceptable treatment option.</p>","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/cns-2020-0010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38395395","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 : 2020-09-01Epub Date: 2020-09-29DOI: 10.2217/cns-2020-0002
Timothy J Williamson, Michael Wang, Jonathan Clark, Julia Williams, Armin Drnda
{"title":"Primary intradural Hodgkin lymphoma of the conus medullaris and cauda equina: case report.","authors":"Timothy J Williamson, Michael Wang, Jonathan Clark, Julia Williams, Armin Drnda","doi":"10.2217/cns-2020-0002","DOIUrl":"https://doi.org/10.2217/cns-2020-0002","url":null,"abstract":"<p><p>Primary Hodgkin lymphoma of the central nervous system is an exceedingly rare condition with very few cases reported in the literature. Isolated intradural involvement of the spine is rarer still, with only two prior cases located in the extramedullary cervical and lumbosacral spine. We present a 48-year-old female who was presented with back pain, radiculopathy and a short history of sphincter disturbance and was subsequently found to have a lobulated homogenously enhancing exophytic lesion involving the conus medullaris and cauda equina on magnetic resonance imaging. Histopathological examination demonstrated the features of classic Hodgkin lymphoma. In this report, we present a case of primary intramedullary Hodgkin lymphoma involving the conus medullaris and cauda equina.</p>","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/52/94/cns-09-52.PMC7546171.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38430873","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 : 2020-09-01Epub Date: 2020-07-27DOI: 10.2217/cns-2020-0014
Dalissa Tejera, Marina Kushnirsky, Sakir H Gultekin, Min Lu, Lori Steelman, Macarena I de la Fuente
{"title":"Ivosidenib, an IDH1 inhibitor, in a patient with recurrent, <i>IDH1</i>-mutant glioblastoma: a case report from a Phase I study.","authors":"Dalissa Tejera, Marina Kushnirsky, Sakir H Gultekin, Min Lu, Lori Steelman, Macarena I de la Fuente","doi":"10.2217/cns-2020-0014","DOIUrl":"https://doi.org/10.2217/cns-2020-0014","url":null,"abstract":"<p><p>Glioblastoma is the most common and aggressive primary brain tumor. Despite standard multimodality therapy, median overall survival remains poor with a 5-year survival rate of approximately 5% in most studies (range 4.7-13.0%). Strong interest in targeting IDH mutations has led to a variety of studies in both hematologic malignancies and solid tumors and to the approval of IDH inhibitors such as ivosidenib, an IDH1 inhibitor, in hematologic malignancies. Here, we present the first case study of a patient with a recurrent <i>IDH1</i>-mutant glioblastoma who experienced improved seizure control and radiographic stable disease for more than 4 years while treated with ivosidenib. Such findings support the further development of IDH inhibitors as single agents and/or in combination for the treatment of <i>IDH</i>-mutant glioma.</p>","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/cns-2020-0014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38204728","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}