Long-term survival of a patient with giant cell glioblastoma

✓ The authors report on a patient who had undergone resection of a left-sided temporal giant cell glioblastoma at the age of 69 years and who survived for more than 17 years. This man had not undergone postoperative radiotherapy or adjuvant chemotherapy. He died at the age of 86 years without clinical evidence of tumor recurrence. Histologically, the lesion was characterized by highly pleomorphic tumor cells (including bizarre multinucleated giant cells) with high mitotic activity, large necroses, and prominent mononuclear infiltration. A point mutation in the TP53 tumor suppressor gene (c.524G>A: R175H) and no epidermal growth factor receptor gene amplification were revealed on molecular genetic analysis. No diagnostic chromosomal imbalances were identified on comparative genomic hybridization, although the average ratio profile for chromosome 10 indicated loss of 10p15 in a subpopulation of tumor cells. This patient is exceptional because tumor resection, probably in conjunction with a marked antitumor immune response, apparently resulted in eradication of the lesion.

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Statistical analysis of clinicopathological features, radiotherapy, and survival in 170 cases of oligodendroglioma

Journal of Neurosurgery ◽

10.3171/jns.1987.67.2.0224 ◽

1987 ◽

Vol 67 (2) ◽

pp. 224-230 ◽

Cited By ~ 80

Author(s):

Karl-Fredrik Lindegaard ◽

Sverre J. Mørk ◽

Geir E. Eide ◽

Tore B. Halvorsen ◽

Reidulv Hatlevoll ◽

...

Keyword(s):

Survival Time ◽

Median Survival ◽

Postoperative Radiotherapy ◽

Survival Rates ◽

Tumor Resection ◽

Survival Times ◽

Term Survival ◽

Content Type ◽

Postoperative Irradiation

✓ The postoperative survival time of 170 nonrandomized patients treated for cerebral oligodendrogliomas in Norway from 1953 to 1977 was studied. Survival times were significantly prolonged if postoperative irradiation was performed in addition to surgery (median survival time 26.5 vs. 38 months, p = 0.039). In the group without postoperative radiotherapy, the 5-year rate of survival was 27% compared with 36% in the irradiated patients. The respective survival rates after 8 years were 14% versus 17%; thus, there was little effect on long-term survival. Irradiation appears not to be of benefit after “total” removal. Patients with partly resected lesions appeared to benefit from postoperative radiotherapy; the median survival period after subtotal tumor resection was 37 months with and 26 months without radiotherapy (p = 0.0089). The findings also indicate that irradiation doses between 40 and 50 Gy were as effective as doses between 50 and 60 Gy in increasing the patients' probability of surviving 5 years after subtotal tumor resection. Since the risk of radiation necrosis is proportional to the dose applied, the lower dose is recommended. These conclusions were also valid when adjustments were made for prognostically significant histological and clinical features.

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Primary Intracranial Leiomyosarcoma Secondary to Glioblastoma: Case Report and Literature Review

Frontiers in Oncology ◽

10.3389/fonc.2021.642683 ◽

2021 ◽

Vol 11 ◽

Author(s):

Liyan Zhao ◽

Yining Jiang ◽

Yubo Wang ◽

Yang Bai ◽

Ying Sun ◽

...

Keyword(s):

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Giant Cell ◽

Temporal Lobe ◽

Postoperative Radiotherapy ◽

Tumor Resection ◽

Pathological Examination ◽

Total Resection ◽

The Right ◽

Giant Cell Glioblastoma

BackgroundLeiomyosarcoma is a highly malignant soft-tissue sarcoma with a poor prognosis. In recent years, treatment for leiomyosarcoma has not shown much progress. Primary intracranial leiomyosarcoma (PILMS) is a much rarer type of neoplasm, which occurs more frequently in immunocompromised patients. PILMS cases reported in the literature are scarce and treatment strategy and prognosis are still under debate. In this study, a case of PILMS secondary to the total resection of giant cell glioblastoma is reported.Case DescriptionA 38-year-old male was hospitalized with a three-month history of a temporal opisthotic bump. His medical history included a total resection of a tumor located in the right temporal lobe performed 4 years earlier. Pathological examination led to a diagnosis of giant cell glioblastoma, and the patient underwent postoperative chemotherapy with temozolomide for 6 weeks plus simultaneous radiotherapy with 63.66 Gary. Four years later, during regular follow-up, a preoperative MRI brain scan resulted in a well-defined signal pointing out two nodule-like features located at the right temporal lobe and subcutaneous soft tissue, respectively, and near the area where the previous giant cell glioblastoma was located. The mass was completely removed by a transtemporal approach and postoperative pathology revealed that the mass was a leiomyosarcoma. The patient underwent postoperative radiotherapy and no recurrence occurred until now.ConclusionsTo date, research on soft-tissue sarcoma, especially PILMS, has not made much progress, and a limited number of studies have provided few details on the management of PILMS. The treatment of choice for PILMS is aggressive multimodal treatment based on total tumor resection and radiotherapy. Moreover, systemic treatment with chemotherapy and targeted therapy, such as olaratumab, as well as further research still needs to be performed as many questions are left unanswered. To our knowledge, this is the first report on a case of PILMS secondary to glioblastoma, which might serve as a potential reference for clinicians and clinical studies.

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Molecular Genetic Analysis of Flow-Sorted and Microdissected Ovarian Tumor Cells: Improved Detection of Loss of Heterozygosity

Ovarian Cancer ◽

10.1385/1-59259-071-3:315 ◽

2003 ◽

pp. 315-321

Author(s):

Edwin C. A. Abeln ◽

Willem E. Corver

Keyword(s):

Genetic Analysis ◽

Tumor Cells ◽

Loss Of Heterozygosity ◽

Ovarian Tumor ◽

Molecular Genetic ◽

Molecular Genetic Analysis ◽

Ovarian Tumor Cells

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The influence of sex and the presence of giant cells on postoperative long-term survival in adult patients with supratentorial glioblastoma multiforme

Journal of Neurosurgery ◽

10.3171/jns.2004.101.2.0219 ◽

2004 ◽

Vol 101 (2) ◽

pp. 219-226 ◽

Cited By ~ 57

Author(s):

Naoki Shinojima ◽

Masato Kochi ◽

Jun-Ichiro Hamada ◽

Hideo Nakamura ◽

Shigetoshi Yano ◽

...

Keyword(s):

Glioblastoma Multiforme ◽

Giant Cell ◽

Adult Patients ◽

Term Survival ◽

Long Term Survival ◽

Content Type ◽

Free Interval ◽

Younger Age ◽

Fine Print

Object. Glioblastoma multiforme (GBM) remains incurable by conventional treatments, although some patients experience long-term survival. A younger age, a higher Karnofsky Performance Scale (KPS) score, more aggressive treatment, and long progression-free intervals have been reported to be positively associated with long-term postoperative patient survival. The aim of this retrospective study was the identification of additional favorable prognostic factors affecting long-term survival in surgically treated adult patients with supratentorial GBM. Methods. Of 113 adult patients newly diagnosed with histologically verified supratentorial GBM who were enrolled in Phase III trials during the period between 1987 and 1998, six (5.3%) who survived for longer than 5 years were defined as long-term survivors, whereas the remaining 107 patients served as controls. All six were women and were compared with the controls; they were younger (mean age 44.2 years, range 31–60 years), and their preoperative KPS scores were higher (mean 85, range 60–100). Four of the six patients underwent gross-total resection. In five patients (83.3%) the progression-free interval was longer than 5 years and in three a histopathological diagnosis of giant cell GBM was made. This diagnosis was not made in the other 107 patients. Conclusions. Among adult patients with supratentorial GBM, female sex and histopathological characteristics consistent with giant cell GBM may be predictive of a better survival rate, as may traditional factors (that is, younger age, good KPS score, more aggressive resection, and a long progression-free interval).

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The role of surgery in the management of supratentorial intermediate and high-grade astrocytomas in adults

Journal of Neurosurgery ◽

10.3171/jns.1990.73.3.0331 ◽

1990 ◽

Vol 73 (3) ◽

pp. 331-344 ◽

Cited By ~ 222

Author(s):

Jules M. Nazzaro ◽

Edward A. Neuwelt

Keyword(s):

Surgical Management ◽

Survival Data ◽

Postoperative Radiotherapy ◽

High Grade ◽

Survival Times ◽

Term Survival ◽

Content Type ◽

The Relationship

✓ In this analysis, the authors review studies over the last 50 years addressing the association between long-term survival and type of surgical management in adults with supratentorial intermediate or high-grade astrocytomas. Earlier reports are included because they are repeatedly referenced in current works and clearly are an important basis upon which present attitudes are predicated. Because recent work has definitively demonstrated the significance of prognostic variables on outcome, the handling of such factors in studies that investigated survival data according to degree of surgery is emphasized. Study design, experimental methods used, and methods of data analysis are also examined. This analysis shows that there is little justification for dogmatic statements concerning the relationship between increasing patient survival times and aggressive surgical management in adults with supratentorial intermediate or high-grade astrocytomas, if patients receive postoperative radiotherapy.

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Primary extraskeletal osteosarcoma in the pineal region

Journal of Neurosurgery ◽

10.3171/jns.2004.101.6.1061 ◽

2004 ◽

Vol 101 (6) ◽

pp. 1061-1064 ◽

Cited By ~ 5

Author(s):

Prajak Saesue ◽

Ekawut Chankaew ◽

Orasa Chawalparit ◽

Nollaporn Sudasna Na Ayudhya ◽

Sorranart Muangsomboon ◽

...

Keyword(s):

Tumor Cells ◽

Bone Structure ◽

Postoperative Radiotherapy ◽

Obstructive Hydrocephalus ◽

Pineal Region ◽

Partial Resection ◽

Tumor Control ◽

Extraskeletal Osteosarcoma ◽

Content Type ◽

Imaging Results

✓ Primary extraskeletal osteosarcoma occurring in the brain parenchyma is distinctly uncommon, with only five cases having been reported. The authors describe the case of a 45-year-old man who presented with progressive headache and diplopia. Computerized tomography scanning and magnetic resonance imaging results revealed a pineal region tumor with obstructive hydrocephalus. The patient underwent partial resection of the tumor. The histological examination showed large pleomorphic tumor cells embedded in osteoid matrix. Immunohistochemical analysis was negative for various antibodies and thus excluded a glial, germ cell, epithelial, and lymphoid tumor origin. Only vimentin showed strong positivity in most of the tumor cells. Ultrastructurally, the tumor cells were rich in dilated rough endoplasmic reticula. Clear zones between tumor cells and osteoid matrix were observed. The osteoid matrix was made up of small collagen fibrils and hydroxyapatite deposits. The tumor was not attached to the bone structure of the skull. These findings are consistent with the features of extraskeletal osteosarcoma. Data from complete medical and radiological studies excluded a metastatic origin for this tumor. Partial resection and postoperative radiotherapy had provided tumor control at 11 months after the onset of symptoms. This is the first reported case of a primary extraskeletal osteosarcoma occurring in the pineal region.

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Focal hyperperfusion in a patient with mitochondrial myopathy, encephalopathy, lactic acidosis, and strokelike episodes

Journal of Neurosurgery ◽

10.3171/jns.2001.94.1.0133 ◽

2001 ◽

Vol 94 (1) ◽

pp. 133-136 ◽

Cited By ~ 6

Author(s):

Kenichi Amagasaki ◽

Tsuneo Shimizu ◽

Yoko Suzuki ◽

Toshiyuki Kakizawa

Keyword(s):

Lactic Acidosis ◽

Genetic Analysis ◽

Mitochondrial Myopathy ◽

Molecular Genetic ◽

Molecular Genetic Analysis ◽

Metabolic Dysfunction ◽

Nucleotide Pair ◽

Content Type ◽

Typical Point ◽

Fine Print

✓ 28-year-old woman presented with mitochondrial myopathy, encephalopathy, lactic acidosis, and strokelike episodes (MELAS). The diagnosis was based on the results of molecular genetic analysis, which indicated a typical point mutation at the nucleotide pair 3243. Xenon computerized tomography scans obtained during the strokelike episodes revealed the lesion responsible for the symptoms to be an area of focal hyperperfusion, and scans obtained after the episodes revealed an area of hypoperfusion. Pathogenesis of the strokelike episodes appears to be metabolic dysfunction, although the involvement of a vascular event cannot be excluded.

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Actinoplanes Swims into the Molecular Age

Journal of Bacteriology ◽

10.1128/jb.00070-17 ◽

2017 ◽

Vol 199 (12) ◽

Author(s):

Mark J. Buttner

Keyword(s):

Life Cycle ◽

Genetic Analysis ◽

Molecular Genetic ◽

Molecular Genetic Analysis ◽

Survival Strategy ◽

Evolutionary Perspective ◽

Content Type ◽

Link Type

ABSTRACT The survival strategy of Actinoplanes is fascinating from an evolutionary perspective, combining a short motile phase in an otherwise nonmotile, filamentous life cycle and the somewhat paradoxical concept of spores—normally thought of as a resting stage—that swim. In the first paper to report a molecular genetic analysis of development in Actinoplanes, the authors identify a key regulator of the entry into development (Y. Mouri, K. Konishi, A. Fujita, T. Tezuka, Y. Ohnishi, J Bacteriol 199:e00840-16, 2017, https://doi.org/10.1128/JB.00840-16 ).

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