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Central nervous system neoplasms
Published in Ibrahim Natalwala, Ammar Natalwala, E Glucksman, MCQs in Neurology and Neurosurgery for Medical Students, 2022
Ibrahim Natalwala, Ammar Natalwala, E Glucksman
FALSE – Mostly affect children and/or young adults but they are curable by resection. For this reason pilocytic astrocytomas are classified as grade I. They are most frequently located in the cerebellum, hypothalamus or optic nerve.
Pediatric Oncology
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
Stephen Lowis, Rachel Cox, John Moppett, Helen Rees
Complete surgical resection of a grade II astrocytoma has a good prognosis, and no further therapy is required. Patients with residual disease have a significant likelihood of recurrence, and may show grade progression; for this reason, a more aggressive approach is often taken, although a single strategy is not agreed. The authors’ own practice is to recommend focal radiotherapy (54 Gy) and adjuvant PCV chemotherapy as reported by Buckner et al.179
Precision medicine for brain gliomas
Published in Debmalya Barh, Precision Medicine in Cancers and Non-Communicable Diseases, 2018
Gliomas are the most common primary intracranial tumors, representing about 80% of malignant brain tumors (Zong et al., 2012; Rajesh et al., 2017). Three different types of gliomas have been described in the brain as astrocytoma, oligodendroglioma, and ependymoma (Izci, 2014). Astrocytoma is the most frequent histological type of glioma and arises from the astrocytes (Figures 4.1 and 4.2) (Zong et al., 2012). About 10% of the gliomas are oligodendrogliomas (Figure 4.3). Mixed gliomas, primarily oligoastrocytomas, account for about 5%–10% of all gliomas. Ependymomas arise from the ependymal cells, which lie in the ventricular system and the central canal of the spinal cord. It is relatively rare in adults, accounting for 2%–3% of primary brain tumors, but it is frequent in children. Today, biological markers help pathologists separate oligodendrogliomas from other types of gliomas. Glioma has a poor prognosis (Perry and Wesseling, 2016). Although relatively rare, it causes significant mortality and morbidity. Glioblastoma is the most common and malignant histological type of glioma (approximately 45% of all gliomas) (Akay et al., 2002; Zong et al., 2012). It may be solitary or multicentric in the brain (Izci et al., 2005). Glioblastoma may present with different clinical and radiological characteristics and has a 5-year relative survival of about 5% (Akay et al., 2002; Izci et al., 2005; Bondy et al., 2008; de Robles et al., 2015).
Fahr’s disease associated with anaplastic ependymoma: a case report and review of the literature
Published in British Journal of Neurosurgery, 2023
Abdussamet Batur, Ömer Faruk Topaloğlu
In the literature, the association of Fahr’s disease and brain tumor is not frequently defined. In a recent study by Lin et al. the fifth case of brain tumor associated with Fahr’s disease was presented and all were reported as low-grade glioma.3 Also, Jaworski et al. described coexistence of Fahr’s syndrome with low-grade brain tumors such as astrocytoma and pineal body gangliocytoma.19 Histopathology studies in patients with Fahr’s disease have noted extensive calcification accompanied by hypertrophy and hyperplasia of astrocytes. Furthermore, several genetic alterations such as platelet-derived growth factor β polypeptide gene, have also been demonstrated to be involved in the development of glioma.3 For all that, whether the occurrence of astrocytoma could be linked etiologically to long-standing astroglial proliferation remains speculative. According to our knowledge, the study showing the association of anaplastic ependymoma and Fahr’s disease in the literature has not been previously presented. However, we do not have sufficient data neither in the literature to prove that the cause of the tumor is Fahr’s disease. There are publications stating that the disease is associated with astrocyte proliferation, but we could not reach data to show its relationship with ependymia.
Racial and ethnic disparities in brain tumour survival by age group and tumour type
Published in British Journal of Neurosurgery, 2022
Arash Delavar, Arvin R. Wali, David R. Santiago-Dieppa, Omar M. Al Jammal, Reilly L. Kidwell, Alexander A. Khalessi
Brain tumours are the leading cause of cancer death for children and adolescents, and remain one of the most aggressive cancer sites for all age groups.1,2 An estimated 23,890 new diagnoses of brain and other nervous system cancers occurred during 2020, as well as 18,020 deaths.1 Brain tumours have a combined five-year survival rate of 35.8%, which varies greatly depending on tumour type – from 94.4% for pilocytic astrocytoma to 6.8% for glioblastoma.3 There is evidence that survival varies by other factors as well, including socioeconomic status (SES: which is typically characterised by education, employment, and income),4,5 place of residence,6,7 and race/ethnicity.4
Diagnostic accuracy of diffusion-weighted imaging in differentiating glioma recurrence from posttreatment-related changes: a meta-analysis
Published in Expert Review of Anticancer Therapy, 2022
Xiaoli Du, Qian He, Boli Zhang, Na Li, Xuewen Zeng, Wenbo Li
The five-year survival rate of patients with high-grade glioma, such as glioblastoma, is less than 5%, and that of patients with anaplastic astrocytoma is less than 30% [3]. Presently, the standard treatment for high-grade glioma is surgical resection and postoperative concurrent chemoradiotherapy, supplemented by 6 cycles of temozolomide [4]. Patients receiving postoperative radiotherapy and chemotherapy for glioma may have posttreatment-related changes (pseudoprogression and radiation necrosis) and recurrence. The timing and clinical manifestations of the two are similar. Routine imaging examination shows newly enhanced lesions, which are difficult to distinguish in the early stage [5]. The clinical treatment and prognosis for recurrent glioma and pseudoprogression and radiation necrosis are different. Although secondary surgery is the gold standard to perform a pathological diagnosis, its use is limited because of its invasiveness. Therefore, early application of noninvasive imaging to evaluate postoperative recurrence and pseudoprogression of glioma is critical to select the appropriate treatment and determine patient prognosis.