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Infiltrative Optic Neuropathies
Published in Vivek Lal, A Clinical Approach to Neuro-Ophthalmic Disorders, 2023
Aniruddha Agarwal, Sabia Handa, Vishali Gupta
Optic nerve glioma of childhood presents with painless and slowly progressive proptosis associated with vision loss. Most common visual field defect is a central scotoma, but bitemporal field loss may occur if the chiasmal portion of optic nerve gets involved. Optic nerve head may appear edematous, infiltrated with tumor, or it can present in the stage of atrophy. Besides the optic nerve, this tumor can involve the chiasma, hypothalamus and optic tracts.3,5,11 Patients with NF1 tend to typically have lesser proptosis and visual loss. Bilateral optic nerve gliomas can occur in patients with NF1.13 Adults with Glioblastoma multiforme typically present with rapidly progressive visual loss, which can be associated with pain.14
Brain
Published in Joseph Kovi, Hung Dinh Duong, Frozen Section In Surgical Pathology: An Atlas, 2019
Joseph Kovi, M.D. Hung Dinh Duong
Glioblastoma multiforme is a necrotic, hemorrhagic lesion which blends imperceptibly into the surrounding brain tissue. Astrocytoma is gray-white in color, usually not necrotic or hemorrhagic. A well circumscribed round nodule in the brain adjacent to the cortex is suggestive of metastatic neoplasm. Meningioma derives from the brain coverings, and does compress or distort, but does not infiltrate the brain substance.
Perfusion Imaging: Physical Principles and Applications in the Brain
Published in Andrei I. Holodny, Functional Neuroimaging, 2019
Malignant gliomas, particularly recurrent anaplastic gliomas and glioblastoma multiforme (GBM), are highly refractory to therapy. A key feature of malignant gliomas, such as GBM, is their tendency to infiltrate surrounding tissues. This invasive property often precludes total surgical resection and makes it difficult to treat with radiation without damaging normal brain parenchyma. Because of the difficulty in obtaining total eradication, patients with GBM have a median survival of less than one year, despite aggressive treatment. Of the approximately 35,000 Americans diagnosed with primary brain cancer each year, almost half with high-grade (WHO class III and IV) gliomas will succumb to their disease within two years if treated and in less than six months if untreated. This extremely poor prognosis has not changed despite 30 years of research, technological progress, and clinical trials. These gliomas are highly vascular and are likely the result of the tumoral upregulation of angiogenic growth factors, such as VEGF. Angiogenesis appears to play a major role in the recurrent and refractory nature of these high-grade tumors. As a result, pharmaceutical companies have invested heavily into researching and developing effective antiangiogenesis agents. One of the few agents currently approved by the FDA is Avastin or Bevacizumab.
Targeting interleukin-13 receptor α2 (IL-13Rα2) for glioblastoma therapy with surface functionalized nanocarriers
Published in Drug Delivery, 2022
Ruijia Liang, Cheng Wu, Shiming Liu, Wenyan Zhao
Glioblastoma multiforme is a lethal and aggressive brain tumor accompanied by low efficacy treatment standards. Surgery, radiation, chemotherapy, and concomitant radio-chemotherapy have been evaluated as treatment options for the treatment and management of glioblastoma. However, low efficacy of these treatment strategies has shown poor therapeutic outcome. Immunotherapy and nanotherapy have shown promising outputs in the treatment of glioblastoma providing long half-lives with sustained release effects to the therapeutic moieties at tumor side. Furthermore, the fabrication of surface functionalized nanocarriers has indeed provided certain unique features from nanotechnology platform including, low off target effects, increased retention time at tumor site, high specificity for the target and enhanced permeation to the glioblastoma tumors. IL13α2R receptors due to absence in the normal surrounding tissues and overexpression at the surface of glioblastoma tissue has made it the most potential target in the treatment of glioblastoma. In recent time, IL13α2R receptors are targeted through therapeutic moieties loaded surface functionalized nanocarriers that have shown a significant therapeutic effect showing it potential therapeutic target for GBM therapy. However, very less literature and studies are available in this regard that need further exploration for the sack of improvement in life quality of glioblastoma patients.
Disseminated cryptococcal infection in a patient with glioblastoma multiforme on treatment with lomustine and bevacizumab
Published in Baylor University Medical Center Proceedings, 2021
Adrienne M. Gonzales, Tauqeer Yousuf
Glioblastoma multiforme is a high-grade glioma and the most common malignant primary brain tumor, with an incidence of 3.19 per 100,000 persons per year.1 Initial treatment consists of a combination of resection and chemoradiation, as well as corticosteroids to help reduce cerebral edema. Our patient was originally started on temozolomide but was switched to lomustine and bevacizumab once his tumor burden returned. While this dual therapy has not been shown to increase overall survival, it has been shown to improve progression-free survival.2 However, addition of these drugs is not without risk of adverse side effects, namely increased susceptibility to opportunistic infections, including disseminated Cryptococcus. This case focuses on the neurologic complications of disseminated cryptococcal infection in a chemotherapy patient with a history of glioblastoma. We believe this is the first case of disseminated cryptococcal infection in a patient on active chemotherapy treatment with lomustine and bevacizumab.
Nanoparticle-mediated therapeutic compounds delivery to glioblastoma
Published in Expert Opinion on Drug Delivery, 2020
Glioblastoma multiforme is the most common and the most aggressive primary brain tumor, with a very poor prognosis, besides providing the best possible treatment, leading to a median survival of 14 months and minimal survival expectations at 5 years. This dismal prognostic has turned research toward nanomedicine as a new therapeutic approach that can deliver new therapeutic compounds or standard antitumoral drugs to GBM. This approach is based on the use of nanocarriers as versatile platforms that can incorporate ligands on its surface with different purposes such as increasing bioavailability of antitumoral small drugs by facilitating BBB crossing, selectively delivering therapeutic molecules to glioblastoma by targeted delivery through specific receptors which would deliver encapsulated cargoes (chemotherapeutic drugs, therapeutic biomolecules or molecules for diagnosis) directly to GBM cells which would decrease antitumoral-drugs-related side-effects, protect the cargo from degradation, and decrease immunogenicity.