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Diffuse Low Grade Glioma

Ali S Haider, Christopher S Graffeo, Avital Perry, Lucas P Carlstrom, Terry C Burns
Insular gliomas were previously considered inoperable lesions and were typically treated via biopsy, chemotherapy and/or radiation, if not observation alone. Stereotactic biopsies of low grade insular gliomas can underestimate tumor grade or fail to establish malignancy. Moreover, the survival advantages of maximal safe resection for insular lesions are increasingly being recognized. As such, early surgical resection is increasingly being performed. As with most lesions, a differential diagnosis exists for apparent insular gliomas, with definitive diagnosis generally obtained upon resection...
January 11, 2018: Curēus
Akane Suzuki, Takashi Maruyama, Masayuki Nitta, Takashi Komori, Soko Ikuta, Mikhail Chernov, Manabu Tamura, Takakazu Kawamata, Yoshihiro Muragaki
OBJECTIVE: The objective of the present study was evaluation of the prognostic significance of DNA ploidy assessed with intraoperative flow cytometry (iFC) during resection of low-grade gliomas (LGG). PATIENTS AND METHODS: Retrospective analysis of 102 consecutive cases of newly diagnosed WHO grade II supratentorial gliomas, surgical removal of which was accompanied by iFC, was done. There were 46 diffuse astrocytomas (DA) and 56 oligodendrogliomas (OD). According to iFC, 68 tumors (67%) were considered non-aneuploid and 34 (33%) aneuploid...
February 21, 2018: Clinical Neurology and Neurosurgery
François-Xavier Ferracci, Hugues Duffau
Radical glioma resection improves overall survival, both in low-grade and high-grade glial tumors. However, preservation of the quality of life is also crucial. Areas covered: Due to the diffuse feature of gliomas, which invade the central nervous system, and due to considerable variations of brain organization among patients, an individual cerebral mapping is mandatory to solve the classical dilemma between the oncological and functional issues. Because functional neuroimaging is not reliable enough, intraoperative electrical stimulation, especially in awake patients benefiting from a real-time cognitive monitoring, is the best way to increase the extent of resection while sparing eloquent neural networks...
March 9, 2018: Expert Review of Neurotherapeutics
Meriem Ben Abdallah, Marie Blonski, Sophie Wantz-Mézières, Yann Gaudeau, Luc Taillandier, Jean-Marie Moureaux
Management of diffuse low-grade glioma (DLGG) relies extensively on tumour volume estimation from MRI datasets. Two methods are currently clinically used to define this volume: the commonly used three-diameters solution and the more rarely used software-based volume reconstruction from the manual segmentations approach. The authors conducted an initial study of inter-practitioners' variability of software-based manual segmentations on DLGGs MRI datasets. A panel of 13 experts from various specialties and years of experience delineated 12 DLGGs' MRI scans...
February 2018: Healthcare Technology Letters
Chang Shu, Qiong Wang, Xiaoling Yan, Jinhuan Wang
The aim of our study is to build a framework for a better understanding of high-grade glioma (HGG) prognostic-related biomarkers. Whole-genome gene expression microarray was performed to identify differently expressed genes between HGGs and low-grade diffuse gliomas. Several machine learning algorithms were used to filter prognostic-related genes. One hundred ninety-three HGG patients after surgical resection were selected for survival analysis. Immunohistochemistry were performed on these tumor samples to analyze IDH1 mutation status and protein expression of WEE1...
March 3, 2018: Journal of Molecular Neuroscience: MN
Anne-Laure Lemaitre, Gilles Lafargue, Hugues Duffau, Guillaume Herbet
A growing body of evidence suggests that individuals with pronounced schizotypal traits also display particular neurophysiological and morphological features - notably with regard to left frontotemporal connectivity. However, the studies published to date have focused on subclinical subjects and psychiatric patients, rather than brain-damaged patients. Here, we used the French version of the Schizotypal Personality Questionnaire to assess schizotypal traits in a sample of 97 patients having undergone surgical resection of a diffuse low-grade glioma...
February 27, 2018: Schizophrenia Research
Fuminori Miyoshi, Yuki Shinohara, Atsushi Kambe, Keita Kuya, Atsushi Murakami, Masamichi Kurosaki, Toshihide Ogawa
Background Detecting recurrence of glioma on magnetic resonance imaging (MRI) is getting more and more important, especially after administration of new anti-tumor agent. However, it is still hard to identify. Purpose To examine the utility of intravoxel incoherent motion (IVIM) MRI and arterial spin labeling-cerebral blood flow (ASL-CBF) for recurrent glioma after initiation of bevacizumab (BEV) treatment. Material and Methods Thirteen patients (7 men, 6 women; age range = 41-82 years) with glioma (high grade, n = 11; low grade, n = 2) were enrolled in the study...
January 1, 2018: Acta Radiologica
Emmanuel Mandonnet, Hugues Duffau
In the era of evidence-based medicine, clinicians aim to establish standards of care from randomized studies. Following, personalized medicine has emerged, as new individualized biomarkers could help to predict sensitivity to specific treatment. In this paper, we show that, for diffuse low-grade glioma, some specificities - dual goal of both survival and functional gain, long duration of the disease with multistep treatments, multiparametric evaluation of the onco-functional balance of each treatment modality - call for a change of paradigm...
February 2018: Critical Reviews in Oncology/hematology
Guillaume Herbet, Sylvie Moritz-Gasser, Hugues Duffau
OBJECTIVE: To identify the prefrontal cortical structures causally involved in verbal and nonverbal semantic cognition in both cerebral hemispheres. METHODS: We retrospectively screened the intraoperative brain mapping data of 584 patients who underwent neurosurgery for neoplastic tumor under local anesthesia with direct cortical electrostimulation. Patients were included if they were right-handed, recently diagnosed with a diffuse low-grade glioma, and had a positive language mapping for verbal (naming task) and nonverbal (visual semantic association task) semantic cognition in the prefrontal cortex (n = 49)...
February 14, 2018: Neurology
Martin Hasselblatt, Mohammed Jaber, David Reuss, Oliver Grauer, Annkatrin Bibo, Stephanie Terwey, Uta Schick, Heinrich Ebel, Thomas Niederstadt, Walter Stummer, Andreas von Deimling, Werner Paulus
The histological and molecular features and even the mere existence of diffuse astrocytoma, IDH-wildtype, remain unclear. We therefore examined 212 diffuse astrocytomas (grade II WHO) in adults using IDH1(R132H) immunohistochemistry followed by IDH1/IDH2 sequencing and neuroimaging review. DNA methylation status and copy number profiles were assessed by Infinium HumanMethylation450k BeadChip. Only 25/212 patients harbored tumors without IDH1/IDH2 hotspot mutations and without contrast enhancement. By DNA methylation profiling, 10/25 tumors were classified as glioblastoma, IDH-wildtype, and an additional 7 cases could not be classified using methylome analysis, but showed genetic characteristics of glioblastoma...
February 9, 2018: Journal of Neuropathology and Experimental Neurology
Jun Muto, Edouard Dezamis, Odile Rigaux-Viode, Sophie Peeters, Alexandre Roux, Marc Zanello, Charles Mellerio, Xavier Sauvageon, Pascale Varlet, Catherine Oppenheim, Johan Pallud
OBJECTIVE: We assessed the impact of surgery on postoperative cognitive function and ability to work in adult patients harboring a diffuse low-grade glioma involving eloquent brain regions and having a functional-based maximal surgical resection using intraoperative corticosubcortical mapping under awake conditions. METHODS: We prospectively included 39 consecutive diffuse IDH-mutant low-grade glioma patients without preoperative and adjuvant oncological treatment and assessed preoperative (mean 24...
February 9, 2018: World Neurosurgery
Naoki Nitta, Suzuko Moritani, Tadateru Fukami, Yayoi Yoshimura, Hisao Hirai, Kazuhiko Nozaki
BACKGROUND: Epithelioid glioblastoma, a high-grade, diffuse astrocytic tumor variant, comprises closely packed epithelioid cells and rhabdoid cells. This rare tumor usually develops in the cerebral cortex and diencephalon; however, in one woman, it was located intraventricularly. CASE DESCRIPTION: A 47-year-old woman was referred to our hospital because the patient had a right intraventricular mass that had rapidly increased in size. Upon discovery of the tumor three years earlier by the referring hospital, the mass was small, calcified and attached to the periventricular parenchyma; until 1 year before, it grew slowly, as observed in periodic, magnetic resonance imaging scans...
February 6, 2018: World Neurosurgery
Alberto Picca, Giulia Berzero, Marc Sanson
The 2016 WHO classification of Tumors of the Central Nervous System brought major conceptual and practical changes in the classification of diffuse gliomas, by combining molecular features and histology into 'integrated' diagnoses. In diffuse gliomas, molecular profiling has thus become essential for nosological purposes, as well as to plan adequate treatment strategies and identify patients susceptible of target therapy. WHO grade II (low grade) and grade III (anaplastic) diffuse gliomas form a heterogeneous group of neoplasms, also known as 'lower-grade gliomas', characterized by a wide range of malignant potential...
2018: Therapeutic Advances in Neurological Disorders
Keita Terashima
Under specific indications, chemotherapy may play an important role in the treatment of pediatric patients with intracranial gliomas. It can be effectively administered in inoperable low-grade tumors, particularly with the use of combination regimens based on carboplatin and vincristine. In very young children with high-grade gliomas (HGG), chemotherapy may result in control of tumor growth, which allows to postpone fractionated radiation therapy (FRT). At the same time, in difference with adults, there is no current evidence that addition of chemotherapy to aggressive surgical resection followed by FRT has any positive impact on survival of pediatric patients with non-pontine HGG...
2018: Progress in Neurological Surgery
Yoshitaka Narita
The effectiveness of chemotherapy or chemoradiotherapy for diffuse astrocytoma (DA) has been largely unknown until recently. However, a randomized controlled study (RTOG 9802) showed that adding of procarbazine, CCNU, and vincristine (PCV) chemotherapy to fractionated radiotherapy (FRT) in patients with "high-risk" WHO grade II gliomas, including DA, has significant positive impact on both progression-free survival and overall survival. Effectiveness of temozolomide (TMZ) in cases of low-grade gliomas was also reported, and a randomized phase III trial comparing FRT alone or in combination with TMZ in cases of unresectable DA (JCOG 1303) is currently ongoing...
2018: Progress in Neurological Surgery
Pei-Sen Yao, Guo-Rong Chen, Huang-Cheng Shang-Guan, Qing-Song Lin, Xing-Fu Wang, Shu-Fa Zheng, De-Zhi Kang
RATIONALE: Intracranial ganglioneuroblastoma represents a rare subtype of primitive neuroectodermal tumor. Here, we report a hippocampal ganglioneuroblastoma and a literature review of cerebral anglioneuroblastoma is carried out. PATIENT CONCERNS: We report a 16-year-old male patient presenting with absence seizure and high-infiltration hippocampal ganglioneuroblastoma. INTERVENTIONS: Magnetic resonance imaging (MRI) indicates a space-occupying lesion with a well-defined margin in the right temporal lobe and hippocampus...
December 2017: Medicine (Baltimore)
Gaigai Li, Yanyan Li, Yang Hu, Qian Wu, Haihan Yu, Hong Deng, Zhouping Tang
Diffuse low-grade gliomas (LGGs) include WHO grade II diffuse astrocytoma, oligodendroglioma, and oligoastrocytoma. Since the neurological symptoms of LGGs are often subtle and deceptive, LGGs are easily overlooked at their early stage. Here, we report a case of a 49-year-old female with symptoms and imaging manifestations mimicking ischemic infarct. After treatments for ischemic stroke, the symptoms initially fluctuating and then aggravated. In addition, we found that the locations of the lesions did not match the vascular distribution and no obvious abnormalities were observed by Computed Tomography Angiography (CTA) and Transcranial Doppler (TCD)...
January 31, 2018: International Journal of Neuroscience
Xin-Wei Zhao, Yun-Bo Zhan, Jian-Ji Bao, Jin-Qiao Zhou, Feng-Jiang Zhang, Yu Bin, Ya-Hui Bai, Yan-Min Wang, Zhen-Yu Zhang, Xian-Zhi Liu
Backgrounds: HOX (homologous box) is known as the dominant gene of vertebrate growth and cell differentiation. Abnormal expression of HOX gene in various tumors has attracted the attention of scholars. As a component of HOX clusters, HOXD4 plays a controversial role in the tumorigenesis of central nervous system. Results: The data demonstrated that and the results demonstrated that HOXD4 was overexpressed in glioma tissues compared to that of normal brain tissues...
December 29, 2017: Oncotarget
Riho Nakajima, Yordanka N Yordanova, Hugues Duffau, Guillaume Herbet
Recent evidence from axonal stimulation mapping studies suggests that at least two white matter connectivities in the right hemisphere may be involved in face-based mentalizing, i.e. the ability to infer complex cognitive and affective states from human faces: the inferior fronto-occipital (IFOF) and the superior longitudinal/arcuate (SLF/AF) fasciculi. However, to date, only a handful of neuropsychological studies have focused on the white matter tracts subserving mentalizing in general, and face-based mentalizing in particular...
January 19, 2018: Neuropsychologia
Juan Martino, Elsa Gomez, Enrique Marco de Lucas, David Mato, Javier Vázquez-Bourgon
BACKGROUND: Recent glioma surgery series with intraoperative electrical stimulation (IES) language mapping have demonstrated high rates of postoperative memory impairment, raising a question regarding the efficacy of this approach to preserve memory. OBJECTIVE: To evaluate if intraoperative identification and preservation of verbal memory sites with IES mapping in diffuse gliomas in eloquent areas consistently protect patients from long-term postoperative decline in short-term memory...
January 17, 2018: Neurosurgery
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