Brain tumor research and treatment最新文献

{"title":"Pituitary Neuroendocrine Tumor: Is It Benign or Malignant?","authors":"Chae Heuck Lee","doi":"10.14791/btrt.2023.0015","DOIUrl":"10.14791/btrt.2023.0015","url":null,"abstract":"<p><p>The World Health Organization (WHO) updated the classification of pituitary tumors in 2022. The new classification presents detailed histological subtyping of a pituitary neuroendocrine tumor (PitNET) based on the tumor cell lineage, cell type, and related characteristics. The immunohistochemistry for pituitary transcription factors (PIT1, TPIT, SF1, GATA3, and ERα) is routinely needed in this classification. The controversy regarding the change of behavior code of all PitNET/pituitary adenoma from \"0\" for benign tumors to \"3\" for primary malignant tumors is a topic of debate among experts, nowadays. Some authors represent that pituitary adenoma has a tendency for hemorrhage and necrosis and frequent invasion of the cavernous sinus. However, most small PitNET/pituitary adenoma do not need any treatment because of benign biologic behavior or less than 5% recurrence after gross total removal. Pituitary apoplexy is also benign nature but has a tendency of cranial nerve compression or panhypopituitarism. Most of cavernous invasion is compression of the cavernous sinus. Aggressive PitNET/pituitary adenoma with malignant biological behavior is less than 1%.</p>","PeriodicalId":72453,"journal":{"name":"Brain tumor research and treatment","volume":"11 3","pages":"173-176"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a8/34/btrt-11-173.PMC10409618.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10325335","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":"Radiologic Follow-up of Ruptured Arachnoid Cysts With or Without Hemorrhage: Five Case Reports and a Review of the Literature.","authors":"Ga-Eun Kim,&nbsp;Su-Jee Park,&nbsp;Yeong Jin Kim,&nbsp;Seul-Kee Kim,&nbsp;Tae-Young Jung","doi":"10.14791/btrt.2023.0013","DOIUrl":"https://doi.org/10.14791/btrt.2023.0013","url":null,"abstract":"<p><p>Arachnoid cysts are usually asymptomatic and discovered incidentally. However, cysts may occasionally rupture because of minor head trauma. We describe the radiologic follow-up of 5 patients with ruptured arachnoid cysts featuring spontaneous resolution, subdural hygroma formation, and cystic and subdural hemorrhage. From January 2004 through July 2020, 5 patients (1.3%) with ruptured arachnoid cysts were evaluated out of 388 patients with arachnoid cysts encountered at our institution at that time. The 5 patients were all male, and they ranged in age from 6-17 years (median, 12 years). The median duration of radiologic follow-up was 3.5 years (range, 2.3-10.1 years). All of the ruptured arachnoid cysts were overlying the temporal lobe with Galassi type II. The median cyst diameter was 4.9 cm (range, 4.4-8.9 cm). Four patients had a history of recent minor head trauma. There were no particular neurologic symptoms in their past medical history in all patients. In the follow-up, two patients' cysts resolved spontaneously without hemorrhage. One patient's cyst resolved post-burr-hole drainage for chronic subdural hemorrhage. Another patient, whose cyst led to a hemorrhage and chronic subdural hemorrhage, recovered following a craniotomy, hematoma removal, and cyst fenestration. Another patient, presenting with hygroma, cystic hemorrhage, and chronic subdural hemorrhage, was treated with burr-hole drainage. Three patients recovered postoperatively. Arachnoid cysts rarely rupture, and surgical intervention is required for some cases associated with hemorrhage. Postoperatively, all patients had good outcomes without complications in this series.</p>","PeriodicalId":72453,"journal":{"name":"Brain tumor research and treatment","volume":"11 3","pages":"210-215"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8f/f4/btrt-11-210.PMC10409616.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10026364","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":"Delayed Detection of a 5-Aminolevulinic Acid <i>In Vivo</i>: A Case of Metastatic Breast Cancer.","authors":"Hyung Min Kim,&nbsp;Min Ho Lee,&nbsp;Tae-Kyu Lee","doi":"10.14791/btrt.2023.0014","DOIUrl":"https://doi.org/10.14791/btrt.2023.0014","url":null,"abstract":"<p><p>A 44-year-old female patient who had been diagnosed with breast cancer visited our oncology department. She had developed right-side weakness and mild dysarthria, and MRI revealed a 4-cm cystic-enhancing lesion in her left frontal lobe. Her surgery was postponed 48 hours after receiving 5-aminolevulinic acid (5-ALA), because a problem with thyroid function that had not been noticed before was discovered. The main lesion was enhanced on navigation and appeared to be a gross tumor; its 5-ALA uptake was very high. Specimens obtained from this location were histologically confirmed to contain tumor cells. The operation was completed, and removal of all enhancing lesions was confirmed by MRI within 24 hours postoperatively. The pathology report confirmed metastatic ductal carcinoma. The clinical efficacy of 5-ALA was confirmed even 48 hours after administration into a metastatic brain tumor from breast cancer.</p>","PeriodicalId":72453,"journal":{"name":"Brain tumor research and treatment","volume":"11 3","pages":"216-218"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/46/33/btrt-11-216.PMC10409620.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10026363","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":"The Korean Society for Neuro-Oncology (KSNO) Guideline for the Management of Brain Tumor Patients During the Crisis Period: A Consensus Recommendation Using the Delphi Method (Version 2023.1).","authors":"Min-Sung Kim, Se-Il Go, Chan Woo Wee, Min Ho Lee, Seok-Gu Kang, Kyeong-O Go, Sae Min Kwon, Woohyun Kim, Yun-Sik Dho, Sung-Hye Park, Youngbeom Seo, Sang Woo Song, Stephen Ahn, Hyuk-Jin Oh, Hong In Yoon, Sea-Won Lee, Joo Ho Lee, Kyung Rae Cho, Jung Won Choi, Je Beom Hong, Kihwan Hwang, Chul-Kee Park, Do Hoon Lim","doi":"10.14791/btrt.2023.0009","DOIUrl":"10.14791/btrt.2023.0009","url":null,"abstract":"<p><strong>Background: </strong>During the coronavirus disease 2019 (COVID-19) pandemic, the need for appropriate treatment guidelines for patients with brain tumors was indispensable due to the lack and limitations of medical resources. Thus, the Korean Society for Neuro-Oncology (KSNO), a multidisciplinary academic society, has undertaken efforts to develop a guideline that is tailored to the domestic situation and that can be used in similar crisis situations in the future.</p><p><strong>Methods: </strong>The KSNO Guideline Working Group was composed of 22 multidisciplinary experts on neuro-oncology in Korea. In order to reach consensus among the experts, the Delphi method was used to build up the final recommendations.</p><p><strong>Results: </strong>All participating experts completed the series of surveys, and the results of final survey were used to draft the current consensus recommendations. Priority levels of surgery and radiotherapy during crises were proposed using appropriate time window-based criteria for management outcome. The highest priority for surgery is assigned to patients who are life-threatening or have a risk of significant impact on a patient's prognosis unless immediate intervention is given within 24-48 hours. As for the radiotherapy, patients who are at risk of compromising their overall survival or neurological status within 4-6 weeks are assigned to the highest priority. Curative-intent chemotherapy has the highest priority, followed by neoadjuvant/adjuvant and palliative chemotherapy during a crisis period. Telemedicine should be actively considered as a management tool for brain tumor patients during the mass infection crises such as the COVID-19 pandemic.</p><p><strong>Conclusion: </strong>It is crucial that adequate medical care for patients with brain tumors is maintained and provided, even during times of crisis. This guideline will serve as a valuable resource, assisting in the delivery of treatment to brain tumor patients in the event of any future crisis.</p>","PeriodicalId":72453,"journal":{"name":"Brain tumor research and treatment","volume":"11 2","pages":"123-132"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/26/8a/btrt-11-123.PMC10172012.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9803270","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":"A Meningioma With Extensive Peritumoral Edema Mimicking Metastatic Brain Tumor: A Case Report.","authors":"Princi D Demaisip,&nbsp;Dan Neftalie Juangco,&nbsp;Nic Junn C Tambal,&nbsp;Nina Alvarez","doi":"10.14791/btrt.2022.0029","DOIUrl":"https://doi.org/10.14791/btrt.2022.0029","url":null,"abstract":"<p><p>Meningioma is the most common brain tumor among all histologically reported malignant and non-malignant tumors of the central nervous system. Angiomatous meningioma is one of the subtypes of meningioma that is rarely reported. In this paper, we present a case of a 67-year-old female patient who sought consultation due to seizure, cognitive decline, and parkinsonism. Contrast-enhanced MRI showed a well-defined tumor in the left frontal lobe convexity with extensive perilesional edema. A tumor excision was done and histopathology studies revealed an angiomatous meningioma subtype. This case is reportable because angiomatous meningioma is a recognized rare entity. It is important to share this entity with other medical professionals and start to consider this condition in differential diagnosis when diagnosing a patient with an intracranial mass with an extensive peritumoral edema. Furthermore, the patient's unusual presentation of parkinsonian features and its occurrence with colorectal cancer history suggest a possible association between these conditions.</p>","PeriodicalId":72453,"journal":{"name":"Brain tumor research and treatment","volume":"11 2","pages":"140-144"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/69/8f/btrt-11-140.PMC10172010.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9803268","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":"Octogenarian Brain Tumor Registry: Single-Institution Surgical Outcomes and Mortality Study.","authors":"Katharine R Phillips,&nbsp;Aristotelis Filippidis,&nbsp;Charles E Mackel,&nbsp;Alejandro Enriquez-Marulanda,&nbsp;Rafael A Vega","doi":"10.14791/btrt.2023.0007","DOIUrl":"https://doi.org/10.14791/btrt.2023.0007","url":null,"abstract":"<p><strong>Background: </strong>Surgical intervention for brain tumor patients aged 80 to 89 years is controversial, as the comorbidities and physiology associated with aging are often thought to increase surgical risks. Surgical outcomes, however, are not well characterized for octogenarians. This review therefore assessed the outcomes and mortality risk associated with tumor removal in octogenarians at our academic institution.</p><p><strong>Methods: </strong>Retrospective review of patients aged 80 to 89 who underwent craniotomy for tumor resection (CTR) at our institution between 2004-2021 and who were diagnosed with meningioma, glioblastoma, or metastatic disease. Primary outcome was 30-day mortality.</p><p><strong>Results: </strong>Sixty-one CTRs were included in analysis. Median age was 83 (interquartile range 81-85) years, and the most common preoperative comorbidity was hypertension (n=44). Most patients (n=35) had a preoperative modified Rankin Scale (mRS) score between 0-2. Seventeen (27.9%) patients experienced postoperative complications (i.e., urinary tract infection, deep venous thrombosis, etc.), and 26.2% (n=16) experienced new-onset neurologic deficits postoperatively (i.e., aphasia, motor deficits, etc.). Upon discharge, most patients (n=43) had an mRS score of 3-4. Within 30 days of surgery, 14.8% (n=9) of patients were readmitted to the hospital and 8.2% (n=5) of patients died: 2 with meningioma, 1 with glioblastoma, and 2 with metastatic disease. The most common cause of death was intracranial hemorrhage (n=3). Three-month mortality was 23.0% (n=14). Mean survival after surgery was 33 months for meningioma patients, 6.9 months for glioblastoma patients, and 15 months for patients with metastatic lesions.</p><p><strong>Conclusion: </strong>Our review found a 30-day mortality rate of 8.2% across all tumor types, and mean survival was similar to that previously reported for patients across all age groups. Surgical intervention for octogenarian tumor patients is therefore feasible, safe, and likely worthwhile for extending and improving lives.</p>","PeriodicalId":72453,"journal":{"name":"Brain tumor research and treatment","volume":"11 2","pages":"114-122"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6c/d2/btrt-11-114.PMC10172014.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9803273","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":"Epigenetic and Metabolic Changes in Diffuse Intrinsic Pontine Glioma.","authors":"Jiyoon Park,&nbsp;Chan Chung","doi":"10.14791/btrt.2023.0011","DOIUrl":"https://doi.org/10.14791/btrt.2023.0011","url":null,"abstract":"<p><p>Diffuse midline glioma (DMG), hitherto known as diffuse intrinsic pontine glioma (DIPG), is a rare and aggressive form of brain cancer that primarily affects children. Although the exact cause of DMG/DIPG is not known, a large proportion of DMG/DIPG tumors harbor mutations in the gene encoding the histone H3 protein, specifically the H3K27M mutation. This mutation decreases the level of H3K27me3, a histone modification that plays a vital role in regulating gene expression through epigenetic regulation. The mutation also alters the function of polycomb repressive complex 2 (PRC2), thereby preventing the repression of genes associated with cancer development. The decrease in H3K27me3 caused by the histone H3 mutation is accompanied by an increase in the level of H3K27ac, a post-translational modification related to active transcription. Dysregulation of histone modification markedly affects gene expression, contributing to cancer development and progression by promoting uncontrolled cell proliferation, tumor growth, and metabolism. DMG/DIPG alters the metabolism of methionine and the tricarboxylic acid cycle, as well as glucose and glutamine uptake. The role of epigenetic and metabolic changes in the development of DMG/DIPG has been studied extensively, and understanding these changes is critical to developing therapies targeting these pathways. Studies are currently underway to identify new therapeutic targets for DMG/DIPG, which may lead to the development of effective treatments for this devastating disease.</p>","PeriodicalId":72453,"journal":{"name":"Brain tumor research and treatment","volume":"11 2","pages":"86-93"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f0/05/btrt-11-86.PMC10172016.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9803272","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":"Radiotherapy for Diffuse Intrinsic Pontine Glioma: Insufficient but Indispensable.","authors":"Hyun Ju Kim,&nbsp;Chang-Ok Suh","doi":"10.14791/btrt.2022.0041","DOIUrl":"https://doi.org/10.14791/btrt.2022.0041","url":null,"abstract":"<p><p>Diffuse intrinsic pontine gliomas (DIPGs) account for 10%-20% of all central nervous system tumors in children and are the leading cause of death in children with brain tumors. Although many clinical trials have been conducted over the past decades, the survival outcome has remained unchanged. Over 90% of children die within 2 years of the diagnosis, and radiotherapy remains the standard treatment to date. To improve the prognosis, hyperfractionated and hypofractionated radiotherapy and/or addition of radiosensitizers have been investigated. However, none of the radiotherapy approaches have shown a survival benefit, and the overall survival of patients with DIPG is approximately 11 months. Here, we comprehensively review the management of DIPG with focus on radiotherapy.</p>","PeriodicalId":72453,"journal":{"name":"Brain tumor research and treatment","volume":"11 2","pages":"79-85"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fa/d0/btrt-11-79.PMC10172015.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9803274","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":"Distinct Specialized Center of Excellence, the Story of Hwasun Neurosurgery at Chonnam National University Hwasun Hospital.","authors":"Shin Jung,&nbsp;In-Young Kim,&nbsp;Kyung-Sub Moon,&nbsp;Tae-Young Jung,&nbsp;Woo-Youl Jang,&nbsp;Yeong Jin Kim,&nbsp;Tae-Kyu Lee,&nbsp;Sue Jee Park,&nbsp;Sa-Hoe Lim","doi":"10.14791/btrt.2023.0005","DOIUrl":"https://doi.org/10.14791/btrt.2023.0005","url":null,"abstract":"<p><p>The paper provides a comprehensive overview of the growth and development of Hwasun Neurosurgery at Chonnam National University Hwasun Hospital over the past 18 years. As the first brain tumor center in Korea when it was established in April 2004, Hwasun Neurosurgery has since become one of the leading institutions in brain tumor education and research in the country. Its impressive clinical and basic research capabilities, dedication to professional education, and numerous academic achievements have all contributed to its reputation as a top-tier institution. We hope this will become a useful guide for other brain tumor centers or educational institutions by sharing the story of Hwasun Neurosurgery.</p>","PeriodicalId":72453,"journal":{"name":"Brain tumor research and treatment","volume":"11 2","pages":"94-102"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1b/c2/btrt-11-94.PMC10172013.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9803267","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":"Awake Craniotomy and Intraoperative Musical Performance for Brain Tumor Surgery: Case Report and Literature Review.","authors":"Charles E Mackel,&nbsp;Eduardo E Orrego-Gonzalez,&nbsp;Rafael A Vega","doi":"10.14791/btrt.2023.0002","DOIUrl":"https://doi.org/10.14791/btrt.2023.0002","url":null,"abstract":"<p><p>Music experience and creation is a complex phenomenon that involves multiple brain structures. Music mapping during awake brain surgery, in addition to standard speech and motor mapping, remains a controversial topic. Music function can be impaired selectively, despite overlap with other neural networks commonly tested during direct cortical stimulation. We describe the case of a 34-year-old male patient presenting with a glioma located within eloquent cortex, who is also a professional musician and actor. We performed an awake craniotomy (AC) that mapped the standard motor and speech areas, while the patient played guitar intraoperatively and sang. Outcomes were remarkable with preservation of function and noted improvements in his musical abilities in outpatient follow-up. In addition, we performed a review of the literature in which awake craniotomies were performed for the removal of brain tumors in patients with some background in music (e.g., score reading, humming/singing). To date, only 4 patients have played a musical instrument intraoperatively during an AC for brain tumor resection. Using awake cortical mapping techniques and paradigms for preserving speech function during an intraoperative musical performance with singing is feasible and can yield a great result for patients. The use of standard brain mapping over music processing mapping did not yield a negative outcome. More experience is needed to understand and standardize this procedure as the field of brain mapping continues to grow for tumor resections.</p>","PeriodicalId":72453,"journal":{"name":"Brain tumor research and treatment","volume":"11 2","pages":"145-152"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a6/5a/btrt-11-145.PMC10172011.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9505098","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}