Clinical and pathological analysis of benign brain tumors resected after Gamma Knife surgery

ObjectThe goal of this study was to assess the clinical and pathological features of benign brain tumors that had been treated with Gamma Knife surgery (GKS) followed by resection.MethodsIn this retrospective chart review, the authors identified 61 patients with intracranial benign tumors who had undergone neurosurgical intervention after GKS. Of these 61 patients, 27 were male and 34 were female; mean age was 49.1 years (range 19–73 years). There were 24 meningiomas, 18 schwannomas, 14 pituitary adenomas, 3 hemangioblastomas, and 2 craniopharyngiomas. The interval between GKS and craniotomy was 2–168 months, with a median of 24 months; for 7 patients, the interval was 10 years or longer. For 21 patients, a craniotomy was performed before and after GKS; in 9 patients, pathological specimens were obtained before and after GKS. A total of 29 patients underwent GKS at the Beijing Tiantan Hospital. All specimens obtained by surgical intervention underwent histopathological examination.ResultsMost patients underwent craniotomy because of tumor recurrence and/or exacerbation of clinical signs and symptoms. Neuroimaging analyses indicated tumor growth in 42 patients, hydrocephalus in 10 patients with vestibular schwannoma, cystic formation with mass effect in 7 patients, and tumor hemorrhage in 13 patients, of whom 10 had pituitary adenoma. Pathological examination demonstrated that, regardless of the type of tumor, GKS mainly induced coagulative necrosis of tumor parenchyma and stroma with some apoptosis and, ultimately, scar formation. In addition, irradiation induced vasculature stenosis and occlusion and tumor degeneration as a result of reduced blood supply. GKS-induced vasculature reaction was rarely observed in patients with pituitary adenoma. Pathological analysis of tumor specimens obtained before and after GKS did not indicate increased tumor proliferation after GKS.ConclusionsRadiosurgery is effective for intracranial benign tumors of small size and deep location and for tumor recurrence after surgical intervention; it is not effective for intracranial tumors with symptomatic mass effect. The radiobiological effects of stereotactic radiosurgery on the benign tumors are mainly caused by cellular and vascular mechanisms. Among the patients in this study, high-dose irradiation did not increase tumor proliferation. GKS can induce primary and secondary effects in tumors, which could last more than 10 years, thereby warranting long-term follow-up after GKS.

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Seizure burden pre- and postresection of low-grade gliomas as a predictor of tumor progression in low-grade gliomas

Neuro-Oncology Practice ◽

10.1093/nop/npy022 ◽

2018 ◽

Vol 6 (3) ◽

pp. 209-217 ◽

Cited By ~ 2

Author(s):

Fernando Santos-Pinheiro ◽

Mingjeong Park ◽

Diane Liu ◽

Lawrence N Kwong ◽

Savannah Cruz ◽

...

Keyword(s):

Seizure Frequency ◽

Tumor Recurrence ◽

Surgical Intervention ◽

Tumor Resection ◽

Frequency Change ◽

Low Grade ◽

Low Grade Gliomas ◽

Before And After ◽

Early Tumor ◽

Early Tumor Recurrence

Abstract Background Low-grade gliomas (LGGs) are slow-growing, infiltrative tumors frequently associated with seizures. Predicting which patients will develop early tumor recurrence based on clinical indicators following initial surgical intervention remains a challenge. Seizure recurrence following surgery may be an early indicator of tumor recurrence, especially in patients presenting with increase in seizure frequency. Methods This study analyzed 148 patients meeting inclusion criteria (age >18 years, LGG diagnosis, at least 1 seizure event recorded before and after initial surgical intervention). All patients were treated at the Brain and Spine Center at The University of Texas MD Anderson Cancer Center from January 2000 to March 2013. Seizure frequency in a 6-month period before and after tumor resection was categorized as none, 1, few (2 to 3 seizures) or several (>3 seizures). Immediately postoperative seizures (up to 48 hours from surgery) were not included in the analysis. Results A total of 116 (78.4%) patients had seizures at initial presentation and most (95%) were started on antiepileptic drugs (AEDs). We found 2 clinical variables with a significant impact on progression-free survival (PFS): Higher seizure frequency during the 6-month postoperative period and seizure frequency increase between the 6-month pre- and the 6-month postoperative periods were both correlated to higher risk of early tumor recurrence (P = .007 and P = .004, respectively). Conclusion Seizure frequency following surgical resection of LGGs and the seizure frequency change between the 6-month preoperative and postoperative periods may serve as clinical predictors of early tumor recurrence in patients with LGGs who are also afflicted by seizures.

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Volumetric Growth of Cervical Schwannoma as a Predictor of Surgical Intervention

Otolaryngology ◽

10.1177/0194599816669500 ◽

2016 ◽

Vol 156 (1) ◽

pp. 152-155 ◽

Cited By ~ 2

Author(s):

A. Sean Alemi ◽

Chase M. Heaton ◽

William R. Ryan ◽

Ivan El-Sayed ◽

Steven J. Wang

Keyword(s):

Growth Rate ◽

Gamma Knife ◽

Surgical Intervention ◽

Academic Medical Center ◽

Benign Tumors ◽

Entire Group ◽

Average Growth ◽

Significant Difference ◽

Surgical Group

Objective Cervical schwannomas are benign tumors that commonly present as asymptomatic masses and are managed with observation, radiation, or surgery. To our knowledge, the rate of volumetric change seen on serial imaging is not currently used to determine surgical candidacy. We assess average growth rates and determine whether growth rate of cervical schwannoma predicts having undergone surgery. Study Design Case series with chart review. Setting Quaternary academic medical center. Subjects and Methods Patients were identified with at least 2 imaging studies and pathologic or imaging characteristics of cervical schwannoma. Volume was calculated with the formula 4/3π xyz, with x, y, and z representing the 3 orthogonal dimensions. Volume and rate of volume change were compared among observed, surgical, and gamma knife groups. Results Thirteen patients were identified and divided into subgroups: surgical (n = 5), observation (n = 6), and gamma knife (n = 2). Mean follow-up time was 21 months (range, 1-80 months) and not significantly different among subgroups. The average changes in volume were 3.61 cm3/mo (entire group), –2.75 cm3/mo (observation), 11.97 cm3/mo (surgery), and 1.78 cm3/mo (gamma knife). Average initial volume for the entire group was 124.4 cm3 (range, 5-608 cm3) and 142 cm3 (range 5-613) at follow-up. The surgical group had a statistically significant change in volume ( P = .03). A statistically significant difference in growth rate was seen between the surgical and observation groups ( P = .016) and between the surgical group and all nonsurgical patients ( P = .011). Conclusions Rate of tumor growth can be used in the evaluation of patients with cervical schwannoma, and it may predict surgical intervention.

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Episyndrome course at the brain tumors before and after the surgical intervention

Ukrainian Neurosurgical Journal ◽

10.25305/unj.128609 ◽

2005 ◽

Vol 0 (4) ◽

pp. 94-96

Author(s):

Ya. I. Sydor

Keyword(s):

Brain Tumors ◽

Surgical Intervention ◽

Before And After ◽

The Brain

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Semiquantitative Analysis Using Thallium-201 SPECT for Differential Diagnosis Between Tumor Recurrence and Radiation Necrosis After Gamma Knife Surgery for Malignant Brain Tumors

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2012.03.008 ◽

2013 ◽

Vol 85 (1) ◽

pp. 47-52 ◽

Cited By ~ 20

Author(s):

Shigeo Matsunaga ◽

Takashi Shuto ◽

Hajime Takase ◽

Makoto Ohtake ◽

Nagatsuki Tomura ◽

...

Keyword(s):

Differential Diagnosis ◽

Brain Tumors ◽

Gamma Knife ◽

Tumor Recurrence ◽

Radiation Necrosis ◽

Thallium 201 ◽

Gamma Knife Surgery ◽

Semiquantitative Analysis ◽

Malignant Brain Tumors

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Differentiation between Tumor Recurrence and Radiation Injury after Gamma Knife Radiosurgery for Metastatic Brain Tumors : Value of Serial Thallium-201 Chloride SPECT

Japanese Journal of Neurosurgery ◽

10.7887/jcns.10.726 ◽

2001 ◽

Vol 10 (11) ◽

pp. 726-732 ◽

Cited By ~ 3

Author(s):

Toru Serizawa ◽

Junichi Ono ◽

Masaru Odaki ◽

Shinji Hirai ◽

Motoki Sato ◽

...

Keyword(s):

Brain Tumors ◽

Gamma Knife ◽

Tumor Recurrence ◽

Radiation Injury ◽

Gamma Knife Radiosurgery ◽

Thallium 201 ◽

Metastatic Brain Tumors

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The role of inflammation in pathogenesis and treatment of colorectal cancer

Research n Practical Medicine Journal ◽

10.17709/2409-2231-2018-5-4-4 ◽

2018 ◽

Vol 5 (4) ◽

pp. 36-45

Author(s):

T. N. Garmanova ◽

M. I. Bredikhin ◽

I. A. Tulina ◽

P. V. Tsarkov

Keyword(s):

Colorectal Cancer ◽

Surgical Treatment ◽

Immune Cells ◽

Tumor Recurrence ◽

Surgical Intervention ◽

Factors Affecting ◽

Inflammatory Status ◽

Before And After ◽

The Impact

One of the factors affecting the effectiveness of treatment and determining the prognosis of a patient with colorectal cancer may be inflammatory status both before and after surgical treatment. The review is devoted to the description of possible mechanisms of relationa between patient's inflammatory status and oncogenesis. Particular attention is paid to the ability of tumor cells to modify the immune cells from the antioncogenic to prooncogenic status. The paper makes an attempt to present a unified concept of the impact of postoperative complications on tumor recurrence in the light of the inflammatory response to surgical intervention.

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A rare case of cavernous hemangioma of neck mimicking lipoma

International Surgery Journal ◽

10.18203/2349-2902.isj20170235 ◽

2017 ◽

Vol 4 (2) ◽

pp. 797

Author(s):

Aditya Parimal Lad ◽

Paras Batra ◽

Iresh Shetty ◽

Ishant Rege ◽

Gaurav Batra ◽

...

Keyword(s):

Head And Neck ◽

Cavernous Hemangioma ◽

Surgical Intervention ◽

Neck Region ◽

Vascular Tumors ◽

Benign Tumors ◽

Neck Movement ◽

Head And Neck Region ◽

Pathological Analysis ◽

Posterior Triangle

Intramuscular hemangiomas of the head and neck are rare congenital vascular tumors and are sparsely reported. Hemangiomas account for approximately 7% of benign tumors and usually present as a mass that suddenly enlarges. Hemangiomas are mostly seen on the trunk and extremities, but can also appear on the head and neck region. A 28 year old female presented in OPD with 5x4 cm mass in Right posterior triangle of neck. CT scan showed 5x4x4 cm swelling in right posterior triangle involving sternocleidomastoid muscle. The mass was totally extracted by surgical intervention and pathological analysis revealed that it was a cavernous hemangioma. The patient’s neck movement returned to normal after surgery.

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Ten-Year Follow-Up of Collision Tumors Composed of Craniopharyngioma and Pituitary Adenoma: A Case Report and Literature Review

Case Reports in Medicine ◽

10.1155/2019/8080163 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7 ◽

Cited By ~ 3

Author(s):

Takeshi Miyazaki ◽

Kentaro Kowari ◽

Hirotake Eda ◽

Mizuki Kambara ◽

Riruke Maruyama ◽

...

Keyword(s):

Pituitary Adenoma ◽

Gamma Knife ◽

Residual Tumor ◽

Mass Effect ◽

Gamma Knife Surgery ◽

Biological Behavior ◽

Suprasellar Cyst ◽

Collision Tumors ◽

Consciousness Disturbance

Although craniopharyngioma (CP) and pituitary adenoma (PA) are common tumors of the parasellar lesions, the coexistence of CP and PA is very rare. A 48-year-old male visited our hospital because of consciousness disturbance. The neuroimaging revealed a sellar tumor contact with a massive suprasellar cyst including calcification. Preoperative diagnosis was CP, and the patient underwent craniotomy to resolve the suprasellar mass effect. The histological examination disclosed adamantinomatous CP, and subsequently a transsphenoidal approach was chosen for the residual intrasellar tumor. Against expectations, the histological diagnosis was not CP but PA. The patient underwent gamma knife surgery for the residual tumor, and the postoperative course was good. After a 10-year follow-up, both lesions were still completely controlled. If we had suspected and diagnosed the tumor involved as not only CP but also PA at the first operation, the second operation could have been avoided because we would have chosen gamma knife surgery for the residual tumor. We should draw attention to this rare situation for differential diagnosis of parasellar tumor to avoid unnecessary surgery and to decide the best strategy for treatment. In addition, the biological behavior of collision tumors composed of CP and PA is probably the same as solitary CP or PA based on a long-term follow-up of our case.

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