Choroid Plexus Tumors

2018 ◽  
Author(s):  
Eric Sribnick ◽  
Jeffrey Leonard
Keyword(s):  
Family History ◽  
Magnetic Resonance ◽  
Choroid Plexus ◽  
Preoperative Planning ◽  
Choroid Plexus Carcinoma ◽  
Resonance Spectroscopy ◽  
Evidence Based ◽  
History Of ◽  
Based Medicine ◽  
Choroid Plexus Carcinomas

This chapter presents the case of an 11-month-old male with a history of macrocephaly, anorexia, and right upper extremity tremors. His family history was significant for a father with anaplastic astrocytoma. Physical exam was notable for left asymmetric macrocephaly and a full/tense fontanelle. The chapter reviews the differential diagnoses for macrocephaly. Imaging, including magnetic resonance spectroscopy, revealed a highly vascular intraventricular mass with some areas of likely necrosis, suggesting choroid plexus carcinoma. The authors review the preoperative planning and surgical management of this case, including potential complications and their management. Finally, choroid plexus carcinomas are reviewed in light of evidence-based medicine and clinical outcomes.

Differentiation of choroid plexus tumors by advanced magnetic resonance spectroscopy

2005 ◽  
Vol 18 (6) ◽  
pp. 1-4 ◽  
Author(s):  
Mark D. Krieger ◽  
Ashok Panigrahy ◽  
J. Gordon McComb ◽  
Marvin D. Nelson ◽  
Xiaodong Liu ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Choroid Plexus ◽  
Mr Spectroscopy ◽  
Resonance Spectroscopy ◽  
Tumor Type ◽  
Choroid Plexus Tumors ◽  
Cns Neoplasms ◽  
Choroid Plexus Carcinomas ◽  
Choroid Plexus Papillomas

Object The management of pediatric intraventricular tumors is highly dependent on identification of the tumor type. Choroid plexus papillomas, a common intraventricular tumor in children, can be difficult to distinguish radiographically from choroid plexus carcinomas and other common pediatric central nervous system (CNS) tumors. In this study to overcome the limitations of current noninvasive imaging modalities, the authors use novel magnetic resonance (MR) spectroscopy techniques in vivo to elucidate the identifying biochemical features of choroid plexus tumors that may facilitate diagnosis and treatment. Methods Based on an Internal Review Board–approved protocol, six children with newly diagnosed, untreated intraventricular brain tumors were identified. On retrospective review, this series included three choroid plexus papillomas and three choroid plexus carcinomas. Single-voxel proton MR spectroscopy with a short echo time was performed, and absolute metabolite concentrations (in mmol/kg) were determined using fully automated quantitation. These results were compared with MR spectroscopy profiles obtained in 54 other untreated CNS neoplasms in children. The myo-inositol (mI) level was significantly higher in choroid plexus papillomas (> 10 mmol/kg), uniquely distinguishing these tumors from choroid plexus carcinomas and all other tumors. Choroid plexus carcinomas, on the other hand, had significantly elevated levels of choline when compared with choroid plexus papillomas. Conclusions In this study the authors find that mI is a biochemical constituent that uniquely identifies choroid plexus papillomas and can be used as a noninvasive means of diagnosis and for follow-up evaluations in patients with this disease.

Simultaneous choroid plexus carcinoma and pilocytic astrocytoma in a pediatric patient

2010 ◽  
Vol 5 (1) ◽  
pp. 104-112 ◽  
Author(s):  
Kristophe J. Karami ◽  
Janet Poulik ◽  
Raja Rabah ◽  
Joshua Krass ◽  
Sandeep Sood
Keyword(s):  
Choroid Plexus ◽  
Pediatric Patient ◽  
Pilocytic Astrocytoma ◽  
Choroid Plexus Carcinoma ◽  
Prior History ◽  
Posterior Fossa Tumors ◽  
First Case ◽  
History Of ◽  
Tumor Types ◽  
Choroid Plexus Carcinomas

Simultaneous primary brain tumors in pediatric patients without prior chemotherapy or radiotherapy, phacomatosis, or known familial history are a rare occurrence. The authors report the case of a 4-year-old boy with simultaneous choroid plexus carcinoma and pilocytic astrocytoma with features of oligodendroglioma. Magnetic resonance imaging studies revealed diffuse heterogeneously enhancing left intraventricular and posterior fossa tumors initially believed most consistent with multicentric choroid plexus carcinomas. A multiple staged resection was carried out for each tumor and gross-total resection was achieved. Upon gross inspection intraoperatively as well as postoperative histological analysis, 2 distinct simultaneous tumors were identified: choroid plexus carcinoma and pilocytic astrocytoma. To the authors' knowledge this is the first case report published identifying 2 distinct tumor types with similar radiological appearances in a pediatric patient with no prior history of radiotherapy, chemotherapy, or phacomatosis.

Biological NMR Spectroscopy

1997 ◽  
Keyword(s):  
Nuclear Magnetic Resonance ◽  
Nmr Spectroscopy ◽  
Magnetic Resonance ◽  
Magnetic Resonance Spectroscopy ◽  
State Of The Art ◽  
Critical Assessment ◽  
Resonance Spectroscopy ◽  
History Of ◽  
Structure Of Proteins

This book presents a critical assessment of progress on the use of nuclear magnetic resonance spectroscopy to determine the structure of proteins, including brief reviews of the history of the field along with coverage of current clinical and in vivo applications. The book, in honor of Oleg Jardetsky, one of the pioneers of the field, is edited by two of the most highly respected investigators using NMR, and features contributions by most of the leading workers in the field. It will be valued as a landmark publication that presents the state-of-the-art perspectives regarding one of today's most important technologies.

scholarly journals Miasmas, mental models and preventive public health: some philosophical reflections on science in the COVID-19 pandemic

2021 ◽  
Vol 11 (6) ◽  
Author(s):  
Trisha Greenhalgh
Keyword(s):  
Mental Models ◽  
Relative Weight ◽  
Evidence Based ◽  
Science And Policy ◽  
Hierarchy Of Evidence ◽  
John Snow ◽  
History Of ◽  
Support Policy ◽  
Preventive Public Health ◽  
Based Medicine

When the history of the COVID-19 pandemic is written, it is likely to show that the mental models held by scientists sometimes facilitated their thinking, thereby leading to lives saved, and at other times constrained their thinking, thereby leading to lives lost. This paper explores some competing mental models of how infectious diseases spread and shows how these models influenced the scientific process and the kinds of facts that were generated, legitimized and used to support policy. A central theme in the paper is the relative weight given by dominant scientific voices to probabilistic arguments based on experimental measurements versus mechanistic arguments based on theory. Two examples are explored: the cholera epidemic in nineteenth century London—in which the story of John Snow and the Broad Street pump is retold—and the unfolding of the COVID-19 pandemic in 2020 and early 2021—in which the evidence-based medicine movement and its hierarchy of evidence features prominently. In each case, it is shown that prevailing mental models—which were assumed by some to transcend theory but were actually heavily theory-laden—powerfully shaped both science and policy, with fatal consequences for some.

Evidence-Based Medicine

2016 ◽  
Author(s):  
Emily R. Winslow
Keyword(s):  
Evidence Based Medicine ◽  
Critical Appraisal ◽  
Reporting Guidelines ◽  
Evidence Based ◽  
Treatment Benefits ◽  
Therapeutic Decisions ◽  
History Of ◽  
Evidence Based Surgery ◽  
Key Resources ◽  
Based Medicine

Descriptions of “evidence-based” approaches to medical care are now ubiquitous in both the popular press and medical journals. The term evidence-based medicine (EBM) was first coined in 1992, and over the last two decades, the field has experienced rapid growth, and its principles now permeate both graduate medical education and clinical practice. The field of EBM has been in constant evolution since its introduction and continues to undergo refinements as its principles are tested and applied in a wide variety of clinical circumstances. This review presents a brief history of EBM, EBM: fundamental tenets, a critical appraisal of a single study, reporting guidelines for single studies, a critical appraisal of a body of evidence, evidence-based surgery, and limitations in EBM. Tables list strength of evidence for treatment decisions (EBM working group), Oxford Centre for Evidence-Based Medicine revised levels of evidence for treatment benefits , “4S” approach to finding resources for EBM, critical appraisal of individual studies examining therapeutic decisions, reporting guidelines by study design, and key resources for evidence-based surgery. This review contains 6 tables and 85 references

Internal Mammary Artery Ligation versus Sham Sternotomy for Angina Pectoris

2017 ◽  
Author(s):  
Michael P. Catanzaro
Keyword(s):  
Angina Pectoris ◽  
Internal Mammary Artery ◽  
Historical Study ◽  
Evidence Based ◽  
Artery Ligation ◽  
Sham Surgery ◽  
Internal Mammary ◽  
History Of ◽  
Clinical Questions ◽  
Based Medicine

This chapter provides a summary of a landmark historical study in cardiac surgery related to internal mammary artery ligation versus sham sternotomy for angina pectoris. It describes the history of the procedure and a summary of the study including study design and results, and relates the study to a modern-day principle of evidence-based medicine: blinding and sham surgery. Whether or not sham surgery is ethical remains under debate. Proponents for sham surgery agree that it should be used only when a question cannot be answered adequately by other methods. Cobb and his colleagues were among the first to demonstrate the value of sham studies in addressing important clinical questions.

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