scholarly journals Choroid plexus carcinoma in an adolescent male: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Patel Zeeshan Jameel ◽  
Ashish Varma ◽  
Pooja Kumari ◽  
Keta Vagha ◽  
Jayant Vagha ◽  
...  
Keyword(s):  
Choroid Plexus ◽  
Postoperative Radiotherapy ◽  
Central India ◽  
Clonic Seizure ◽  
Choroid Plexus Carcinoma ◽  
Gross Total Resection ◽  
Adolescent Male ◽  
Pathological Examination ◽  
Total Resection ◽  
Neck Stiffness

Abstract Introduction/background Although central nervous system tumors are the most common etiology of malignancies in the pediatric age group, choroid plexus carcinomas are rare, with an annual incidence rate of 0.10 per 100,000 children. Case presentation We report the case of an adolescent male belonging to central India who had presented with a history of persistent headache, projectile vomiting, neck stiffness, and an episode of generalized tonic-clonic seizure. Neurological examination was suggestive of a space-occupying lesion. Further neuroimaging was suggestive of a large left-sided choroid plexus carcinoma, later confirmed on pathological examination. Gross total resection was achieved and followed by radiation therapy. His recovery was satisfactory without any major events despite suffering from such a malignancy with a poor prognosis. Conclusion In the absence of a global consensus on choroid plexus carcinoma management, our patient underwent a successful gross total resection and received postoperative radiotherapy. He made a satisfactory recovery with a further plan to review with gadolinium-enhanced neuroimaging at a later date. We conclude that, when possible, achieving gross total resection is of utmost importance.

scholarly journals Gross total resection improves overall survival in children with choroid plexus carcinoma

2013 ◽  
Vol 116 (1) ◽  
pp. 179-185 ◽  
Author(s):  
Matthew Z. Sun ◽  
Michael E. Ivan ◽  
Aaron J. Clark ◽  
Michael C. Oh ◽  
Arthur R. Delance ◽  
...  
Keyword(s):  
Overall Survival ◽  
Choroid Plexus ◽  
Choroid Plexus Carcinoma ◽  
Gross Total Resection ◽  
Total Resection

scholarly journals Long-term efficacy of surgical resection with or without adjuvant therapy for treatment of secondary glioblastoma in adults

2020 ◽  
Vol 2 (1) ◽  
Author(s):  
Ruoyu Huang ◽  
Guanzhang Li ◽  
Yiming Li ◽  
Yinyan Wang ◽  
Pei Yang ◽  
...  
Keyword(s):  
Survival Analysis ◽  
Prognostic Factors ◽  
Adjuvant Therapy ◽  
Clinical Outcomes ◽  
Cox Regression ◽  
Postoperative Radiotherapy ◽  
Gross Total Resection ◽  
Subtotal Resection ◽  
Total Resection ◽  
Secondary Glioblastoma

Abstract Background There are limited studies on treatment strategies and associated clinical outcomes in patients with secondary glioblastoma (sGBM). We sought to investigate the prognostic factors and treatment decisions in a retrospective cohort of patients with sGBM. Methods One hundred and seventy-one patients with sGBM who met the screening criteria were included in this study. Kaplan–Meier survival analysis and Cox survival analysis were used to detect prognostic factors. R (v3.5.0) and SPSS software (v25.0, IBM) were used to perform statistical analyses. Results The median overall survival was 303 days (range 23–2237 days) and the median progression-free survival was 229 days (range 33–1964 days) in patients with sGBM. When assessing the relationship between adjuvant treatment outcome and extent of resection (EOR), the results showed that patients underwent gross total resection can benefit from postoperative radiotherapy and chemotherapy, but not in patients underwent subtotal resection. In addition, we also found that aggressive adjuvant therapy can significantly improve clinical outcomes of IDH1-mutated patients but no significant prognostic value for IDH1-wildtyped patients. The univariate Cox regression analyses demonstrated that EOR, adjuvant therapy, and postoperative Karnofsky Performance Scores were prognostic factors for patients with sGBM, and multivariate COX analysis confirmed that adjuvant therapy and EOR were independent prognostic factors. Conclusions For patients with sGBM, aggressive postoperative adjuvant therapy after gross total resection was recommended. However, we did not detect a benefit in IDH1-wildtype patients in our cohort.

The relative patient benefit of gross total resection in adult choroid plexus papillomas

2013 ◽  
Vol 20 (6) ◽  
pp. 808-812 ◽  
Author(s):  
Michael Safaee ◽  
Michael C. Oh ◽  
Michael E. Sughrue ◽  
Arthur R. DeLance ◽  
Orin Bloch ◽  
...  
Keyword(s):  
Choroid Plexus ◽  
Gross Total Resection ◽  
Patient Benefit ◽  
Total Resection ◽  
Choroid Plexus Papillomas

Factors affecting outcome following treatment of patients with cavernous sinus meningiomas

2010 ◽  
Vol 113 (5) ◽  
pp. 1087-1092 ◽  
Author(s):  
Michael E. Sughrue ◽  
Martin J. Rutkowski ◽  
Derick Aranda ◽  
Igor J. Barani ◽  
Michael W. McDermott ◽  
...  
Keyword(s):  
Cavernous Sinus ◽  
Postoperative Radiotherapy ◽  
Meta Analysis ◽  
Survival Rates ◽  
Extent Of Resection ◽  
Gross Total Resection ◽  
Cranial Neuropathy ◽  
Tumor Control ◽  
Subtotal Resection ◽  
Total Resection

Object Although there is a considerable volume of literature available on the treatment of patients with cavernous sinus meningiomas (CSMs), most of the data regarding tumor control and survival come from case studies or single-institution series. The authors performed a meta-analysis of reported tumor control and survival rates of patients described in the published literature, with an emphasis on specific prognostic factors. Methods The authors systematically analyzed the published literature and found more than 3000 patients treated for CSMs. Separate meta-analyses were performed to calculate pooled rates of recurrence and cranial neuropathy after 1) gross-total resection, 2) subtotal resection without adjuvant postoperative radiotherapy or radiosurgery, and 3) stereotactic radiosurgery (SRS) alone. Results were expressed as pooled proportions, and random-effects models were used to incorporate any heterogeneity present to generate a pooled proportion. Individual studies were weighted using the inverse variance method, and 95% CIs for each group were calculated from the pooled proportions. Results A total of 2065 nonduplicated patients treated for CSM met inclusion criteria for the analysis. Comparisons of the 95% CIs for recurrence of these 3 cohorts revealed that SRS-treated patients experienced improved rates of recurrence (3.2% [95% CI 1.9–4.5%]) compared with either gross-total resection (11.8% [95% CI 7.4–16.1%]) or subtotal resection alone (11.1% [95% CI 6.6–15.7%]) (p < 0.01). The authors found that the pooled mixed-effects rate of cranial neuropathy was markedly higher in patients undergoing resection (59.6% [95% CI 50.3–67.5%]) than for those undergoing SRS alone (25.7% [95% CI 11.5–38.9%]) (p < 0.05). Conclusions Radiosurgery provided improved rates of tumor control compared with surgery alone, regardless of the subjective extent of resection.

Bevacizumab (BEV) use in disseminated choroid plexus papilloma (DCCP).

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e13039-e13039
Author(s):  
Mark Daniel Anderson ◽  
Brett James Theeler ◽  
Morris D. Groves ◽  
Marta Penas-Prado ◽  
W. K. Alfred Yung
Keyword(s):  
Disease Progression ◽  
Choroid Plexus ◽  
Choroid Plexus Papilloma ◽  
Radicular Pain ◽  
Gross Total Resection ◽  
Leptomeningeal Disease ◽  
Total Resection ◽  
Ventricular Mass ◽  
Common Location ◽  
Plexus Papilloma

e13039 Background: Choroid plexus papilloma (CCP) is a rare primary neuro-ectodermal tumor of the choroid plexus, representing less than 1% of intracranial tumors in adults. The most common location in adults is the 4th ventricle and treatment is gross total resection (GTR). Leptomeningeal disease (LMD) can rarely occur, even when the tumor retains benign histology. Because of the rarity of DCCP, there is no standard treatment, with less than 20 published cases. There have no previous descriptions of the use of BEV therapy in DCCP. Methods: We present 2 patients (pts) with DCCP, who received gross total resection, radiation and chemotherapy with continued progression, who received treatment with BEV therapy. Results: Pt 1 presented with a 4th ventricular mass and evidence of LMD. GTR of the posterior fossa lesion revealed an atypical CCP. The pt received craniospinal radiation with concurrent temozolomide (TMZ) therapy. After 4 years, there was leptomeningeal disease progression and the pt developed progressive radicular pain and weakness, unresponsive to typical treatments. He was initiated on TMZ and BEV therapy, but the TMZ was discontinued due to thrombocytopenia and the pt was continued on BEV alone. While the MRI showed stable disease at, the pt had complete remission of pain and some improvement of ataxia. When BEV was held due to toxicity, the pain returned until BEV was restarted. Carboplatin was added to BEV with progression of LMD at 21 months. Pt 2 is a 58-year-old man who present with a 4th ventricular mass, shown to be CCP after gross total resection. The pt received radiotherapy for diffuse sacral recurrence. After three years of surveillance, the pt received lomustine and 6-thioguanine for disease progression, limited to 5 cycles by thrombocytopenia. After 5 years, the pt noted continued progressive radicular pain in his lower extremities. The pt completed a planned course of 10 doses of bevacizumab and had improvement in pain control and stable imaging at 11 months. Conclusions: While bevacizumab resulted in stable imaging when used in DCCP, there was significant improvement in debilitating radicular symptoms. The complications of BEV therapy must be considered with the potential benefit of symptomatic relief. Prospective studies are needed.

scholarly journals Clinical, radiological, and histological features and treatment outcomes of supratentorial extraventricular ependymoma: 14 cases from a single center

2018 ◽  
Vol 128 (5) ◽  
pp. 1396-1402 ◽  
Author(s):  
Shoujia Sun ◽  
Junwen Wang ◽  
Mingxin Zhu ◽  
Rajluxmee Beejadhursing ◽  
Pan Gao ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Postoperative Radiotherapy ◽  
Gross Total Resection ◽  
Biological Behavior ◽  
Total Resection ◽  
Who Grade ◽  
Histological Features ◽  
Temporal Lobes ◽  
Radiological Features ◽  
Subtotal Removal

OBJECTIVEReports on supratentorial extraventricular ependymoma (STE) are relatively rare. The object of this study was to analyze the clinical, radiological, and histological features and treatment outcomes of 14 patients with STE.METHODSOverall, 227 patients with ependymoma underwent surgical treatment in the authors’ department between January 2010 and June 2015; 14 of these patients had STE. Data on clinical presentation, radiological studies, histopathological findings, surgical strategies, and treatment outcomes in these 14 cases were retrospectively analyzed.RESULTSThe patients consisted of 6 women and 8 men (sex ratio 0.75). Mean age at diagnosis was 24.5 ± 13.5 years (range 3–48 years). Tumors were predominantly located in the frontal and temporal lobes (5 and 4 cases, respectively). Typical radiological features were mild to moderate heterogeneous tumor enhancements on contrast-enhanced MRI. Other radiological features included well-circumscribed, “popcorn” enhancement and no distinct adjoining brain edema. Gross-total resection was achieved in 12 patients, while subtotal removal was performed in 2. Radiotherapy was administered in 7 patients after surgery. Seven tumors were classified as WHO Grade II and the other 7 were verified as WHO Grade III. The mean follow-up period was 22.6 months (range 8–39 months). There were 3 patients with recurrence, and 2 of these patients died.CONCLUSIONSSupratentorial extraventricular ependymoma has atypical clinical presentations, various radiological features, and heterogeneous histological forms; therefore, definitive diagnosis can be difficult. Anaplastic STE shows malignant biological behavior, a higher recurrence rate, and a relatively poor prognosis. Gross-total resection with or without postoperative radiotherapy is currently the optimal treatment for STE.

scholarly journals P14.24 Bevacizumab treatment in atypical disseminated choroid plexus papilloma in adult patients

2019 ◽  
Vol 21 (Supplement_3) ◽  
pp. iii72-iii72
Author(s):  
F Colò ◽  
L Larrouquere ◽  
R Rivoirard ◽  
H Loiseau ◽  
A Lortholary ◽  
...  
Keyword(s):  
Choroid Plexus ◽  
Surgical Resection ◽  
Choroid Plexus Papilloma ◽  
Gross Total Resection ◽  
Low Grade ◽  
Total Resection ◽  
Vp Shunt ◽  
Spinal Dissemination ◽  
Clinical Stabilization ◽  
Plexus Papilloma

Abstract BACKGROUND Choroid plexus tumours represent less than 1% of brain tumours. Low-grade papilloma may be treated with gross total surgical resection, while in disseminated progressive atypical choroid plexus papilloma (APP), there is no standard treatment: various chemotherapy regimens have been reported. Since this tumour is characterized by a rich vascular component, antiangiogenic therapy is an attractive treatment. The use of Bevacizumab has already been reported in three patients. Authors expand this experience with 5 further patients diagnosed with progressive APP treated with bevacizumab. MATERIAL AND METHODS Patients were recruited through the weekly Adolescent Young Adult French web conference. They have been treated with bevacizumab 10 mg/kg by intravenous injection each 2 to 3 weeks. Their clinical status and radiological response are reported: Karnofsky Index (KI), Pain Scale (PS) and RANO criteria were used. RESULTS All our patients had a progressive disease prior to bevacizumab. Pt 1: 41 years old; APP with cranio-spinal dissemination; Previous treatments: local and cranio-spinal irradiation in 2012 and in 2014; surgery: complete and partial resection in 2010, 2014, and VP shunt in 2018; Bevacizumab: total of 33 cures in 18 months. Result: radiological and clinical stabilization. Pt 2: 58 years old; APP with cranio-spinal dissemination; Previous treatments: surgery: VP shunt and gross total resection, in 2006; VP shunt, in 2011. Bevacizumab: total of 4 cures, in 2 months. Result: radiological and clinical stabilization. Pt 3: 34 years old; APP with cranio-spinal dissemination; Previous treatments: surgery: gross total resection, in 1992, and shunt in 2008. Bevacizumab: total of 21 cures, in 21 months. Result: radiological and clinical stabilization. Pt 4: 63 years old; APP with cranio-spinal dissemination; Previous treatments: surgery: surgical resection and VP shunt in 2013; chemotherapy: temozolomide. Bevacizumab: 29 months (still treated). Result: radiological and clinical stabilization. Pt 5: 62 years old; APP with cranio-spinal dissemination; Previous treatments: surgery: gross total resection in 1999 and VP shunt in 2009; chemotherapy: Carboplatin Vespesid. Bevacizumab: 23 cures, in 14 months. Result: radiological stabilization and clinical amelioration. CONCLUSION Despite their previous worsening disease, all patients obtained a stabilization or amelioration of their IK and PS under bevacizumab. Bevacizumab should be evaluated in a multicentric trial as standard therapy for disseminated metastasized progressive choroid plexus tumours.

scholarly journals Lipomatous, vascular, and chondromatous benign tumors of the peripheral nerves

2007 ◽  
Vol 22 (6) ◽  
pp. 1-8 ◽  
Author(s):  
Claude-Edouard Châtillon ◽  
Marie-Christine Guiot ◽  
Line Jacques
Keyword(s):  
Peripheral Nerve ◽  
Peripheral Nerves ◽  
Postoperative Radiotherapy ◽  
Symptomatic Relief ◽  
Gross Total Resection ◽  
Benign Tumors ◽  
Preoperative Embolization ◽  
Total Resection ◽  
Peripheral Nerve Lesions ◽  
The Right

Benign peripheral nerve lesions of lipomatous, vascular, and chondromatous origin are very rare. Only one previous case of brachial plexus involvement by such a tumor has been reported. The authors report on their experience with peripheral nerve tumors in three patients and review the available literature on these topics. The three cases discussed include a 44-year-old woman with an intraneural lipoma of the right middle trunk, a 40-year-old woman with an intraneural hemangioma infiltrating the right posterior cord, and a newborn male with a predominantly cartilaginous hamartoma originating from the right C-5 nerve root. The literature review yielded six previous cases of intraneural lipoma, approximately 50 cases of lipofibromatous hamartoma, 13 cases of intraneural hemangioma, and no previous case of cartilaginous hamartoma originating from a nerve. Intraneural lipomas are well encapsulated, and gross-total resection can be achieved. Lipofibromatous hamartomas are diffusely infiltrative; decompressive debulking and neurolysis is often the most appropriate initial approach for patients with symptomatic lesions. Resection of intraneural hemangiomas can be achieved but may require nerve resection and repair in some cases. Debulking has been reported to provide prolonged symptomatic relief in these lesions, and preoperative embolization and postoperative radiotherapy were beneficial in the case presented here. To the authors' knowledge, this is the first reported case of a cartilaginous hamartoma infiltrating a peripheral nerve. Gross-total resection of symptomatic intraneural lipomas is feasible and apparently curative. The optimal treatment for lipofibromatous hamartomas and vascular and chondromatous lesions of the peripheral nerves is uncertain and should be guided by the severity of symptoms.

scholarly journals Outcomes After Surgery and Radiotherapy for Spinal Myxopapillary Ependymoma

Neurosurgery ◽  
2014 ◽  
Vol 75 (3) ◽  
pp. 205-214 ◽  
Author(s):  
Chiaojung Jillian Tsai ◽  
Yucai Wang ◽  
Pamela K. Allen ◽  
Anita Mahajan ◽  
Ian E. McCutcheon ◽  
...  
Keyword(s):  
Cox Regression ◽  
Postoperative Radiotherapy ◽  
Gross Total Resection ◽  
Entire Group ◽  
Subtotal Resection ◽  
Myxopapillary Ependymoma ◽  
Adjuvant Radiation ◽  
Total Resection ◽  
Cox Regression Analysis

Abstract BACKGROUND: The role of radiotherapy after surgery for myxopapillary ependymoma (MPE) is unclear. OBJECTIVE: To review long-term outcomes after surgery, with or without radiation, for spinal MPE. METHODS: Fifty-one patients with spinal MPE treated from 1968 to 2007 were included. Associations between clinical variables and overall survival (OS), progression-free survival (PFS), and local control (LC) were tested with Cox regression analysis. RESULTS: The median age at diagnosis was 35 years (range, 8-63 years). Twenty patients (39%) had surgery alone, 30 (59%) had surgery plus radiotherapy (RT), and 1 (2%) had RT only. At a median follow-up of 11 years (range, 0.2-37 years), 10-year OS, PFS, and LC for the entire group were 93%, 63%, and 67%, respectively. Nineteen patients (37%) had disease recurrence, and the recurrence was mostly local (79%). Twenty-eight of 50 patients who had surgery (56%) had gross total resection; 10-year LC was 56% after surgery vs 92% after surgery and RT (log-rank P = .14); the median time of LC was 10.5 years for patients receiving gross total resection plus RT, and 4.75 years for gross total resection only (P = .03). Among 16 patients with subtotal resection and follow-up data, 10-year LC was 0% after surgery vs 65% for surgery plus RT (log-rank P = .008). On multivariate analyses adjusting for resection type, age older that 35 years at diagnosis and receipt of adjuvant radiation were associated with improved PFS (hazard ratio [HR]: 0.14, P = .003 and HR: 0.45, P = .009) and LC (HR: 0.22, P = .02 and HR: 0.45, P = .009). CONCLUSION: Postoperative radiotherapy after resection of MPE was associated with improved PFS and LC.

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