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Non-traumatic neurological conditions in medico-legal work
Published in Helen Whitwell, Christopher Milroy, Daniel du Plessis, Forensic Neuropathology, 2021
A detailed description of tumours of the CNS is out with the scope of this book and the interested reader is referred to recent specialist accounts (Louis et al.). However, CNS tumours may be encountered at post-mortem examination, and the role of brain neoplasms as a cause of sudden death has been reviewed (Matschke and Tsokos 2005; Tsokos 2004). The tumours may be either primary or secondary; metastatic tumours to the CNS are common, whereas primary intrinsic tumours are rare. The epithelial tumours that metastasise most commonly to the nervous system are of the bronchus and breast, followed by melanoma (Delattre et al. 1988). In general, prostatic and female genital tract tumours rarely metastasise to the brain or meninges, although prostatic carcinomas do frequently cause neurological complications secondary to cord compression after vertebral body metastasis and collapse. Diffuse infiltration of the leptomeninges (malignant meningitis/meningeal carcinomatosis) may be seen with haematological malignancies (lymphoma and leukaemia) and epithelial malignancies such as breast and bronchial carcinomas.
High-grade Glioma
Published in David A. Walker, Giorgio Perilongo, Roger E. Taylor, Ian F. Pollack, Brain and Spinal Tumors of Childhood, 2020
Donald C. Macarthur, Christof M. Kramm, Matthias A. Karajannis
PBT offers the advantages of an absent exit irradiation dose, a highly conformal dose distribution within the radiation field, and especially a reduced irradiation exposure of normal tissue surrounding the brain tumor.78,79 The latter is an obvious reason why children with brain tumors increasingly get PBT to reduce radiotherapy-associated long-term sequelae like neuropsychological deficits, endocrinological disorders, vasculopathy, and secondary brain neoplasms. First single-center reports on potentially reduced incidences of vasculopathies after PBT of pediatric brain tumors are available.78 But in general, systematic high-quality analyses and prospective trials on toxicity as well as efficacy of PBT for pediatric brain and other tumors are still lacking.80
Radiology of Brain Tumors
Published in Swati Goyal, Neuroradiology, 2020
Imaging diagnosis of brain neoplasms is based on: Location of lesion (supra- vs. infratentorial/intra- vs. extra-axial)Morphological analysis (size, margins, enhancement pattern)Associated secondary changes, like edema, calcification, hemorrhage, etc.
Prognostic value of O-(2-[18F]-fluoroethyl)-L-tyrosine PET in relapsing oligodendroglioma
Published in Acta Oncologica, 2020
Florian Schneider, Fabian Wolpert, Paul Stolzmann, Abdulrahman A. Albatly, David Kenkel, Jonathan Weller, Michael Weller, Spyros S. Kollias, Elisabeth J. Rushing, Patrick Veit-Haibach, Martin W. Huellner
The diagnostic and prognostic value of 18F-FET-PET is well established in different types of brain tumors for initial staging and follow-up imaging [3,8,23,32,35]. Important complementary information on brain neoplasms can be derived from 18F-FET-PET in addition to MR imaging [1,36]. The use of 18F-FET for discriminating between brain tumors and other neurological pathologies, such as multiple sclerosis, neurosarcoidosis or radiation necrosis, has been investigated in recent years [37–39]. Previous studies investigating the use of PET specifically in initial or relapsing oligodendroglioma have used 11C-MET and 18F-FDG as radiotracers for this purpose [40,41]. Pertinent reports on 18F-FET-PET are still rare, however. Our study reports an association of TBRmax, SUVmax and BTV with PFS (Figure 4(A,B)).
Multi-Targeting by β-Elemene and Its Anticancer Properties: A Good Choice for Oncotherapy and Radiochemotherapy Sensitization
Published in Nutrition and Cancer, 2020
Hongxuan Tong, Yihua Liu, Lijie Jiang, Jingshang Wang
Glioblastoma is the most common and aggressive primary malignant brain tumor, accounting for nearly 52% of all primary intracranial tumor and 20% of all brain neoplasms; therefore, the prognosis of glioblastoma remains very poor (65–68). A study demonstrated that β-elemene can cross the blood–brain barrier and exhibit effects in brain carcinomas (69). β-elemene inhibited the proliferation of glioblastoma cells by the activation of GMFβ, mutually compensatory activation of MKK3 and MKK6 and phosphorylated p38 MAPK, ultimately reducing cell cycle arrest in the G0/G1 phase (8,70–72). In addition, β-elemene disassembled the Hsp90/Raf-1 complex, causing the inactivation of Raf-1 and inhibition of the ERK pathway, and finally leading to apoptosis of glioblastoma cells. β-elemene can also reverse malignant phenotypes by suppressing the β-catenin pathway which plays a crucial role in tumor cell proliferation and epithelial-mesenchymal transition (EMT) initiation and progression (73). Furthermore, β-elemene can reinforce the radiosensitivity and chemosensitivity of glioblastoma cells in a multiple target manner (71,72,74) such as the inhibition of the EGFR signaling pathway (75), inactivation of ERK1/2-Bcl-2/survivin pathway (76), and/or inhibition of the ATM signaling pathway (74).
Prospects of biological and synthetic pharmacotherapies for glioblastoma
Published in Expert Opinion on Biological Therapy, 2020
David B. Altshuler, Padma Kadiyala, Felipe J. Nuñez, Fernando M. Nuñez, Stephen Carney, Mahmoud S. Alghamri, Maria B. Garcia-Fabiani, Antonela S. Asad, Alejandro J. Nicola Candia, Marianela Candolfi, Joerg Lahann, James J. Moon, Anna Schwendeman, Pedro R. Lowenstein, Maria G. Castro
Gliomas are a group of primary brain neoplasms, which include genotypically and phenotypically heterogeneous brain tumor subtypes. They represent 27% of the tumors of the central nervous system (CNS) and 80% of the malignant brain tumors [1]. They are classified according to the World Health Organization (WHO) classification, which assigns a grade (WHO grades I-IV) based on their degree of anaplasia and clinical characteristics [2]. WHO grade I is assigned to tumors with slower progression and better prognosis; and WHO grade IV is assigned to aggressive brain tumor lesions, which are designated as high-grade gliomas (HGG) or glioblastomas (GBM) [2,3]. The histopathological features are also considered by the WHO for glioma classification, defining astrocytoma, oligodendroglioma, and GBM as principal histologic groups[4]. Recently, analysis of molecular profiles in glioma patients has improved this classification, introducing the genomic alterations as criteria to differentiate glioma subtypes [3,5]. The distribution of molecular markers, including alterations in TP53, IDH1, PI3K, ATRX, EGFR, H3F3A TERT, PDGFR, PTEN [4,6], distinguishes these tumor types based on their association with recurrent genetic lesions and histology [4,7,8].