Histopathological findings in a surgically resected thalamic cavernous hemangioma 1 year after 40-Gy irradiation

2005 ◽  
Vol 102 (Special_Supplement) ◽  
pp. 56-58 ◽  
Author(s):  
István Nyáry ◽  
Otto Major ◽  
Zoltán Hanzély ◽  
György T. Szeifert
Keyword(s):  
Histopathological Examination ◽  
Posterior Part ◽  
Radiation Energy ◽  
Scar Tissue ◽  
Tissue Samples ◽  
Content Type ◽  
Histopathological Findings ◽  
Fractionated Radiotherapy ◽  
Cavernous Hemangiomas ◽  
Fine Print

✓ Stereotactic radiosurgery is a controversial treatment modality in the management of cerebral cavernous hemangiomas (CHs), and results vary from center to center. Even the interpretation of treatment failure is controversial. It is suggested that the systematic pathological investigation of irradiated specimens could help to resolve the controversy. A hemorrhagic lesion in the posterior part of the thalamus had been diagnosed as a tumor and was treated with 40-Gy fractionated radiotherapy. One year after this treatment the case was reconsidered based on new imaging evidence, and the lesion was removed by conventional craniotomy. Histopathological examination revealed a CH with postirradiation changes. Compared with nonirradiated control CH tissue samples, there was endothelial cell destruction and marked fibrosis with scar tissue formation in the stroma of the treated lesion. The histopathological findings in this specimen were similar to those described in arteriovenous malformations after gamma knife surgery. The results of light microscopic investigations suggest that the ionizing effect of radiation energy evokes vascular and connective tissue stroma changes in CHs as well.

Histopathological findings in a surgically resected thalamic cavernous hemangioma 1 year after 40-Gy irradiation

2005 ◽  
Vol 102 ◽  
pp. 56-58 ◽  
Author(s):  
István Nyáry ◽  
Otto Major ◽  
Zoltán Hanzély ◽  
György T. Szeifert
Keyword(s):  
Histopathological Examination ◽  
Posterior Part ◽  
Radiation Energy ◽  
Scar Tissue ◽  
Tissue Samples ◽  
Content Type ◽  
Histopathological Findings ◽  
Fractionated Radiotherapy ◽  
Cavernous Hemangiomas ◽  
Fine Print

✓ Stereotactic radiosurgery is a controversial treatment modality in the management of cerebral cavernous hemangiomas (CHs), and results vary from center to center. Even the interpretation of treatment failure is controversial. It is suggested that the systematic pathological investigation of irradiated specimens could help to resolve the controversy.A hemorrhagic lesion in the posterior part of the thalamus had been diagnosed as a tumor and was treated with 40-Gy fractionated radiotherapy. One year after this treatment the case was reconsidered based on new imaging evidence, and the lesion was removed by conventional craniotomy. Histopathological examination revealed a CH with postirradiation changes. Compared with nonirradiated control CH tissue samples, there was endothelial cell destruction and marked fibrosis with scar tissue formation in the stroma of the treated lesion.The histopathological findings in this specimen were similar to those described in arteriovenous malformations after gamma knife surgery. The results of light microscopic investigations suggest that the ionizing effect of radiation energy evokes vascular and connective tissue stroma changes in CHs as well.

Gamma knife surgery of brain cavernous hemangiomas

2005 ◽  
Vol 102 (Special_Supplement) ◽  
pp. 207-213 ◽  
Author(s):  
Roman Liscák ◽  
Vilibald Vladyka ◽  
Gabriela Simonová ◽  
Josef Vymazal ◽  
Josef Novotny
Keyword(s):  
Gamma Knife ◽  
Gamma Knife Surgery ◽  
Morbidity Rate ◽  
Lesion Volume ◽  
Lower Margin ◽  
Aged Patients ◽  
Content Type ◽  
Cavernous Hemangiomas ◽  
Prescription Dose ◽  
Fine Print

Object. The authors conducted a study to record more detailed information about the natural course and factors predictive of outcome following gamma knife surgery (GKS) for cavernous hemangiomas. Methods. One hundred twelve patients with brain cavernous hemangiomas underwent GKS between 1993 and 2000. The median prescription dose was 16 Gy. One hundred seven patients were followed for a median of 48 months (range 6–114 months). The rebleeding rate was 1.6%, which is not significantly different with that prior to radiosurgery (2%). An increase in volume was observed in 1.8% of cases and a decrease in 45%. Perilesional edema was detected in 27% of patients, which, together with the rebleeding, caused a transient morbidity rate of 20.5% and permanent morbidity rate of 4.5%. Before radiosurgery 39% of patients suffered from epilepsy and this improved in 45% of them. Two patients with brainstem cavernous hemangiomas died due to rebleeding. Rebleeding was more frequent in female middle-aged patients with a history of bleeding, a larger lesion volume, and a prescription dose below 13 Gy. Edema after GKS occurred more frequently in patients who had surgery, a larger lesion volume, and in those in whom the prescription dose was more than 13 Gy. Conclusions. Gamma knife surgery of cavernous hemangiomas can produce an acceptable rate of morbidity, which can be reduced by using a lower margin dose. Lesion regression was observed in many patients. Radiosurgery seems to remain a suitable treatment modality in carefully selected patients.

Monostotic fibrous dysplasia of the thoracic spine: clinopathological description and follow up

2004 ◽  
Vol 100 (4) ◽  
pp. 378-381 ◽  
Author(s):  
Mehmet Arazi ◽  
Onder Guney ◽  
Mustafa Ozdemir ◽  
Omer Uluoglu ◽  
Nuket Uzum
Keyword(s):  
Fibrous Dysplasia ◽  
Thoracic Spine ◽  
Histopathological Examination ◽  
En Bloc Resection ◽  
Spinal Tumors ◽  
En Bloc ◽  
Content Type ◽  
Thoracic Spinal ◽  
Fine Print

✓ The authors report the case of a 53-year-old woman with monostotic fibrous dysplasia of the thoracic spine. The patient presented with a 1-month history of pain in the thoracic spinal region. En bloc resection of the lesion was successfully performed via a transthoracic approach, and a histopathological examination confirmed the diagnosis of fibrous dysplasia. At 24-month follow-up examination, pain and vertebral instability were absent. The findings in this case illustrate that, although very rare, monostotic fibrous dysplasia of the thoracic spine should be considered in the differential diagnosis of spinal tumors. Although a consensus for management of this disease has not been achieved, the authors recommend radical removal of all involved bone as well as internal fixation or bone graft—assisted fusion to achieve long-term stabilization.

Estrogen and progestin binding by cytosolic and nuclear fractions of human meningiomas

1985 ◽  
Vol 62 (5) ◽  
pp. 750-756 ◽  
Author(s):  
Robert L. Martuza ◽  
Douglas C. Miller ◽  
David T. MacLaughlin
Keyword(s):  
Control Mechanism ◽  
Hormonal Control ◽  
Binding Assays ◽  
Tissue Samples ◽  
Content Type ◽  
Cellular Density ◽  
Equilibrium Binding ◽  
Frozen Tissue ◽  
Human Meningiomas ◽  
Fine Print

✓ Frozen tissue samples were obtained from meningiomas in 42 patients. Both cytosolic and nuclear fractions were tested for estradiol and progestin binding using equilibrium binding assays. The results were correlated with the age of the patient and the histological type and cellular density of the tumor. Cytosolic estradiol binding was noted in 25 (60%) of 42 tumors, with eight (19%) of the 42 having levels over 10 femtomoles (fM)/mg protein. Nuclear estradiol binding was detected in 16 (57%) of 28 tumors, with six (21%) of the 28 having levels over 10 fM/mg protein. Cytosolic progestin binding was noted in 16 (73%) of 22 samples, with levels in nine (41%) of 22 being greater than 10 fM/mg protein. There was no correlation between the level of cytoplasmic progestin binding and either the level of cytoplasmic estradiol binding or the level of nuclear estradiol binding. In several specimens, levels of cytoplasmic progestin binding in excess of 100 fM/mg protein were found in tissues demonstrating little or no estradiol binding by either the nucleus or the cytosol. This discrepancy differs from the situation found in other hormonally responsive tissues such as breast or uterus, and suggests either a possible derangement of the normal cellular hormonal control mechanism or that the measured hormone binder is a molecule other than a classical hormone receptor.

Volumetric thermal devascularization of large meningiomas

2004 ◽  
Vol 101 (5) ◽  
pp. 779-786 ◽  
Author(s):  
Amami Kato ◽  
Yasunori Fujimoto ◽  
Masaaki Taniguchi ◽  
Naoya Hashimoto ◽  
Azuma Hirayama ◽  
...  
Keyword(s):  
Thermal Ablation ◽  
Histopathological Examination ◽  
Three Dimensional ◽  
Target Volume ◽  
Coagulation Necrosis ◽  
Radiofrequency Energy ◽  
Content Type ◽  
Dimensional Reconstruction ◽  
Tumor Parenchyma ◽  
Fine Print

Object. Controlling hemorrhage is crucial in the safe and efficient removal of large meningiomas. Intravascular embolization is not always a satisfactory means of accomplishing this goal because of the procedure's hemostatic effect and risk of complications. The authors in this study used a volumetric thermal ablation technique incorporating radiofrequency energy, image guidance, and local temperature control to devascularize tumor tissue. Methods. Five patients with large meningiomas were treated. The target and orientation of the radiofrequency thermal ablation (RFTA) were simulated preoperatively to maximize devascularization of the lesion without thermal injury to adjacent critical structures. Image fusion, three-dimensional reconstruction, and image-guided methods provided for optimized trajectories and targets for insertion of the RFTA needle. During ablation, local temperatures of the tissue being cauterized were monitored continuously to limit the ablated lesion to within the target volume. The effects of devascularization and the softening of the tumor parenchyma facilitated lesion removal. The intracranial ablated meningioma changed into necrotic tissue and shrank within a few months. Histopathological examination of the ablated lesion revealed sharply demarcated coagulation necrosis. Conclusions. Volumetric thermal devascularization can be applied safely in the treatment of large meningiomas to facilitate surgical manipulation of the lesion as well as to reduce its size palliatively. The procedure's usefulness should be studied further in a larger number of cases with different tumor characteristics.

Gamma knife surgery for cavernous hemangiomas: an analysis of 125 patients

2005 ◽  
Vol 102 (Special_Supplement) ◽  
pp. 81-86 ◽  
Author(s):  
Kang-Du Liu ◽  
Wen-Yuh Chung ◽  
Hsiu-Mei Wu ◽  
Cheng-Ying Shiau ◽  
Ling-Wei Wang ◽  
...  
Keyword(s):  
Gamma Knife ◽  
Gamma Knife Surgery ◽  
Content Type ◽  
Cavernous Hemangiomas ◽  
Rebleeding Rate ◽  
Radiation Induced ◽  
Bleeding Episodes ◽  
The Mean ◽  
Fine Print

Object. The authors sought to determine the value of gamma knife surgery (GKS) in the treatment of cavernous hemangiomas (CHs). Methods. Between 1993 and 2002, a total of 125 patients with symptomatic CHs were treated with GKS. Ninety-seven patients presented with bleeding and 45 of these had at least two bleeding episodes. Thirteen patients presented with seizures combined with hemorrhage, and 15 patients presented with seizures alone. The mean margin dose of radiation was 12.1 Gy and the mean follow-up time was 5.4 years. In the 112 patients who had bled the number of rebleeds after GKS was 32. These rebleeds were defined both clinically and based on magnetic resonance imaging for an annual rebleeding rate of 32 episodes/492 patient-years or 6.5%. Twenty-three of the 32 rebleeding episodes occurred within 2 years after GKS. Nine episodes occurred after 2 years; thus, the annual rebleeding rate after GKS was 10.3% for the first 2 years and 3.3% thereafter (p = 0.0038). In the 45 patients with at least two bleeding episodes before GKS, the rebleeding rate dropped from 29.2% (55 episodes/188 patient-years) before treatment to 5% (10 episodes/197 patient-years) after treatment (p < 0.0001). Among the 28 patients who presented with seizures, 15 (53%) had good outcomes (Engel Grades I and II). In this study of 125 patients, symptomatic radiation-induced complications developed in only three patients. Conclusions. Gamma knife surgery can effectively reduce the rebleeding rate after the first symptomatic hemorrhage in patients with CH. In addition, GKS may be useful in reducing the severity of seizures in patients with CH.

Meningiomas arising from the falcotentorial junction

1995 ◽  
Vol 82 (5) ◽  
pp. 726-738 ◽  
Author(s):  
Shoji Asari ◽  
Tomohide Maeshiro ◽  
Susumu Tomita ◽  
Masamitsu Kawauchi ◽  
Nobuyoshi Yabuno ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Mr Imaging ◽  
Superior Sagittal Sinus ◽  
Posterior Part ◽  
Detailed Knowledge ◽  
Content Type ◽  
Sagittal Sinus ◽  
Adjacent Structures ◽  
Upward Gaze Palsy ◽  
Fine Print

✓ Meningiomas arising from the falcotentorial junction are extremely rare. The authors describe the clinical features, neuroimaging studies, and results of surgical treatment of meningiomas of the falcotentorial junction and clarify the characteristics of this lesion based on a review of the literature and seven patients treated at their institution. The most common symptoms resulted from intracranial hypertension. Upward-gaze palsy appeared in only one patient. Computerized tomography (CT) showed no specific findings, but there was no evidence of edema around the tumor. Magnetic resonance (MR) imaging revealed a round, smooth-bordered mass with a peritumoral rim, without edema, and showing marked contrast enhancement. The multiplanar capability of MR imaging delineated the relationship between the tumor and adjacent structures better than did CT. Detailed knowledge of the vascular structures, especially evidence of occlusion of the galenic venous system and the development of collateral venous channels, is critical for successful surgery; stereoscopic cerebral angiography is necessary to achieve this aim. The seven patients described developed five types of collateral venous channels: through the basal vein of Rosenthal to the petrosal vein, through the veins on the medial surface of the parietal and occipital lobes to the superior sagittal sinus, through superficial anastomotic veins, through veins of the posterior fossa to the transverse or straight sinus, and through the falcian veins to the superior sagittal sinus. The first three types mainly developed after occlusion of the galenic system. The tumors were removed through the occipital transtentorial approach with a large window at the posterior part of the falx. A favorable prognosis for patients undergoing surgical treatment of falcotentorial junction meningiomas can be expected if detailed neuroimaging studies and microsurgical techniques are used.

Effect of radiation therapy on extracerebral cavernous hemangioma in the middle fossa

1987 ◽  
Vol 67 (6) ◽  
pp. 919-922 ◽  
Author(s):  
Shobu Shibata ◽  
Kazuo Mori
Keyword(s):  
Radiation Therapy ◽  
Cavernous Hemangioma ◽  
Massive Hemorrhage ◽  
Ct Scans ◽  
Middle Fossa ◽  
Hounsfield Units ◽  
Content Type ◽  
Contrast Enhanced Ct ◽  
Cavernous Hemangiomas ◽  
Fine Print

✓ Intracerebral cavernous hemangiomas are relatively easy to remove surgically, but extracerebral cavernous hemangiomas attached to the cavernous sinus are extremely difficult to treat. The authors report three cases of extracerebral cavernous hemangioma in the middle fossa that were treated with radiotherapy. The follow-up studies with serial computerized tomography (CT) scans during and after irradiation are described. In Case 1 radiotherapy after partial removal of the tumor decreased the tumor size on the contrast-enhanced CT scans, reduced its Hounsfield units on the nonenhanced CT scans, and facilitated later total tumor removal. In Case 2 the tumor responded to irradiation with approximately 3000 rads, showing significant reduction in size and Hounsfield units of the tumor. Subtotal removal was then possible. In Case 3 the tumor responded to irradiation, and the patient's vertigo improved after delivery of approximately 3000 rads. The CT scan showed significant reduction in the size and Hounsfield units of the tumor. No surgical intervention was deemed necessary. It is concluded that, in cases of extracerebral cavernous hemangioma with massive hemorrhage, irradiation with up to 3000 rads may be the treatment of choice. Radiation therapy offers an increased probability of total removal of the tumor and the possibility of eliminating surgery.

Cerebral hemangioma with glial neoplasia (angioglioma?)

1982 ◽  
Vol 56 (3) ◽  
pp. 430-434 ◽  
Author(s):  
Edwin G. Fischer ◽  
Ana Sotrel ◽  
Keasley Welch
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
The Other ◽  
Content Type ◽  
Growth Reference ◽  
Biological Potential ◽  
Cavernous Hemangiomas ◽  
The Central Nervous System ◽  
Mass Lesions ◽  
Fine Print

✓ Two patients are reported who had intracerebral mass lesions composed of hemangioma and glial neoplasm. After excision, one recurred as an oligodendroglioma, and the remnant of the other remained static over a 5-year period. These lesions may represent a subgroup of cerebral hemangiomas that have the biological potential for future glial neoplastic growth. Reference is made to experimental work with polyoma virus which can induce cavernous hemangiomas in the central nervous system in mice, and which is a papovavirus. Other papovaviruses can induce ependymomas in hamsters.

scholarly journals Modeling of Old Scars: Histopathological, Biochemical and Thermal Analysis of the Scar Tissue Maturation

Biology ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 136
Author(s):  
Alexey Fayzullin ◽  
Natalia Ignatieva ◽  
Olga Zakharkina ◽  
Mark Tokarev ◽  
Daniil Mudryak ◽  
...  
Keyword(s):  
Histopathological Examination ◽  
Early Stage ◽  
Clinical Problem ◽  
Ventral Side ◽  
Scar Tissue ◽  
Experimental Models ◽  
Supramolecular Organization ◽  
Scanning Calorimetry ◽  
Tissue Samples ◽  
Rabbit Ear

Mature hypertrophic scars (HSs) remain a challenging clinical problem, particularly due to the absence of biologically relevant experimental models as a standard rabbit ear HS model only reflects an early stage of scarring. The current study aims to adapt this animal model for simulation of mature HS by validating the time of the scar stabilization using qualitative and quantitative criteria. The full-thickness skin and perichondrium excision wounds were created on the ventral side of the rabbit ears. The tissue samples were studied on post-operation days (PODs) 30, 60, 90 and 120. The histopathological examination and morphometry were applied in parallel with biochemical analysis of protein and glycosaminoglycans (GAGs) content and amino acid composition. The supramolecular organization of collagen was explored by differential scanning calorimetry. Four stages of the rabbit ear HS maturation were delineated and attributed with the histolomorphometrical and physicochemical parameters of the tissue. The experimental scars formed in 30 days but stabilized structurally and biochemically only on POD 90–120. This evidence-based model can be used for the studies and testing of new treatments of the mature HSs.

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