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leptomeningeal metastasis

Suzana A Kahn, Xin Wang, Ryan T Nitta, Sharareh Gholamin, Johanna Theruvath, Gregor Hutter, Tej D Azad, Lina Wadi, Sara Bolin, Vijay Ramaswamy, Rogelio Esparza, Kun-Wei Liu, Michael Edwards, Fredrik J Swartling, Debashis Sahoo, Gordon Li, Robert J Wechsler-Reya, Jüri Reimand, Yoon-Jae Cho, Michael D Taylor, Irving L Weissman, Siddhartha S Mitra, Samuel H Cheshier
Medulloblastoma is the most common malignant brain tumor of childhood. Group 3 medulloblastoma, the most aggressive molecular subtype, frequently disseminates through the leptomeningeal cerebral spinal fluid (CSF) spaces in the brain and spinal cord. The mechanism of dissemination through the CSF remains poorly understood, and the molecular pathways involved in medulloblastoma metastasis and self-renewal are largely unknown. Here we show that NOTCH1 signaling pathway regulates both the initiation of metastasis and the self-renewal of medulloblastoma...
October 8, 2018: Nature Communications
Tridu R Huynh, Conrad Lu, Doniel Drazin, Gregory Lekovic
Background: Myxopapillary ependymoma (MPE) with anaplastic features is extremely rare, with only three case reports in the literature. Case Description: We report the case of a MPE with anaplastic features in a 24-year-old female who presented with a dominant lumbar mass along with intracranial and sacral metastases. Upon gross total resection of the dominant tumor located at L2-L3, it appeared to arise from the filum terminale, and had a solid component in addition to soft or necrotic areas...
2018: Surgical Neurology International
Kali Xu, Kay T Khine, Yinn Cher Ooi, Carolyn S Quinsey
Extraneural metastasis (ENM) of primary central nervous system (CNS) tumors is an uncommon occurrence. Case reports and case series describe ENM after shunting, but this phenomenon has not been well characterized. In this review we aim to better understand the risk factors and clinical implications of ENM associated with shunting. A literature search of cases of ENM related to shunt placement in patients with primary CNS tumors reported through January 2018 was performed using PubMed and Google Scholar. We identified 106 cases of ENM of primary CNS tumors related to shunt placement...
September 27, 2018: Clinical Neurology and Neurosurgery
Brooks Udelsman, Isabel Chien, Kei Ouchi, Kate Brizzi, James A Tulsky, Charlotta Lindvall
BACKGROUND: Alone, administrative data poorly identifies patients with palliative care needs. OBJECTIVE: To identify patients with uncommon, yet devastating, illnesses using a combination of administrative data and natural language processing (NLP). DESIGN/SETTING: Retrospective cohort study using the electronic medical records of a healthcare network totaling over 2500 hospital beds. We sought to identify patient populations with two unique disease processes associated with a poor prognosis: pneumoperitoneum and leptomeningeal metastases from breast cancer...
September 22, 2018: Journal of Palliative Medicine
Ji-Woong Kwon, Joon Ho Yoon, Myong Cheol Lim, Jungnam Joo, Heon Yoo, Sang-Hoon Shin, Sang Yoon Park, Sang Hyeon Lee, Yeon-Joo Kim, Joo-Young Kim, Ho-Shin Gwak
OBJECTIVES: The most appropriate treatments for brain metastases from ovarian cancer have not been established mainly because of its rarity. The objective of this study was to describe clinical results of treatment and prognostic factors of patients with brain metastases from ovarian cancer treated at a single institution. MATERIALS AND METHODS: We retrieved information from the electronic medical records of 56 consecutive patients (2.8%) with brain metastases, from a total of 2008 patients with ovarian cancer...
October 2018: International Journal of Gynecological Cancer
Yang Liu, Bin Wang, Yongxiang Qian, Dongmei Di, Min Wang, Xiaoying Zhang
Cauda equine syndrome (CES) is a neurological condition caused by compression of the cauda equine. Here, we demonstrate a case of CES as the primary symptom of leptomeningeal metastases from non-small cell lung carcinoma without brain metastases. A 59-year-old male suffered progressive lower extremity motor dysfunction, urinary dysfunction, and lower extremity sensory dysfunction. He was clinically diagnosed with CES. Nuclear magnetic resonance imaging demonstrated several vague nodules in the area of conus medullaris and cauda equine, without lumbar or thoracic herniated discs...
2018: OncoTargets and Therapy
Ankur R Patel, Lucien Nedzi, Steven Lau, Samuel L Barnett, Bruce E Mickey, William Moore, Shivani Bindal, Zabi Wardak, Tu Dan, Robert Timmerman, Toral R Patel
OBJECTIVE: Stereotactic radiosurgery (SRS) has redefined the treatment paradigm for cerebral metastases. The benefits of SRS after surgical resection of a metastatic brain tumor have been well-defined. However, it is unclear whether preoperative SRS can improve the outcomes in select patients. The present study examined the safety and efficacy of preoperative neoadjuvant SRS (NaSRS) for the treatment of cerebral metastases. METHODS: We performed a retrospective review of 12 patients treated at The University of Texas Southwestern Medical Center...
August 24, 2018: World Neurosurgery
Evan F Garner, Laura L Stafman, Adele P Williams, Jamie M Aye, Caroline Goolsby, Venkatram R Atigadda, Blake P Moore, Li Nan, Jerry E Stewart, Anita B Hjelmeland, Gregory K Friedman, Elizabeth A Beierle
BACKGROUND: Group 3 tumors account for approximately 25-30% of medulloblastomas and have the worst prognosis. UAB30 is a novel synthetic rexinoid shown to have limited toxicities in humans and significant efficacy in the pediatric neuroectodermal tumor, neuroblastoma. We hypothesized that treatment with UAB30 would decrease tumorigenicity in medulloblastoma patient-derived xenografts (PDXs). METHODS: Three group 3 medulloblastoma PDXs (D341, D384 and D425) were utilized...
August 21, 2018: Journal of Neuro-oncology
Yunmei Wang, Shuguang Liu, Xiaohui Wei, Bin Yan, Jun Li, Zhixiang Su, Aiqin Liu, Yanjun Zhang
Rationale: Leptomeningeal metastasis (LM) is an important cause of mortality in patients with non-small cell lung cancer (NSCLC). As the symptoms of LM and its early clinical manifestations are nonspecific, early diagnosis of LM is difficult. However, there are few treatment options for LM, which leads to a poor prognosis; thus, increased clinical attention is necessary. The effects of most systemic chemotherapies on metastatic brain tumors (brain metastases and LMs) are limited as they cannot pass the blood-brain barrier; therefore, whole-brain radiation therapy is a therapeutic option...
2018: OncoTargets and Therapy
Muhammad Abdullah Zain, Abbas Raza, Muhammad Owais Hanif, Zehra Tauqir, Maryam Khan, Muhammad J Mahboob, Fariha Ashraf, Waqas Javed Siddiqui, Hasan Arif, Larry E Krevolin
BACKGROUND Patients with malignancies often have electrolyte abnormalities. We present a case of a patient with central diabetes insipidus secondary to metastatic pituitary invasion complicated by hypercalcemic nephrogenic diabetes insipidus. CASE REPORT We present a case of 40-year-old female with a history of stage IV breast cancer with skeletal and leptomeningeal metastasis, who was admitted with polyuria, polydipsia, and recent onset of confusion. The patient was found to have profound hypernatremia and severe hypercalcemia with normal parathyroid and vitamin D serum levels...
August 18, 2018: American Journal of Case Reports
Junjun Li, Xiaomei Liu, Caijun Yuan
Epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) are effective in the treatment of advanced non-small-cell lung cancer (NSCLC) with leptomeningeal metastases (LM); however, a proportion of the patients with resistant tumors do not benefit from EGFR-TKI treatment. In the present study the case of a female patient with advanced lung adenocarcinoma harboring the EGFR L858R mutation (encoded in exon 21) who developed intracranial metastases following treatment with erlotinib after gefitinib failure is reported...
September 2018: Molecular and Clinical Oncology
Suneel D Kamath, Priya U Kumthekar, Tim J Kruser, Nisha A Mohindra
Central nervous system metastasis in non-small cell lung cancer remains a therapeutic challenge and confers a poor prognosis. Here we describe a patient with lung adenocarcinoma, parenchymal brain metastases, and leptomeningeal carcinomatosis who demonstrated a sustained response to programmed death 1 inhibition combined with stereotactic radiosurgery.
August 2, 2018: Oncologist
Mustafa Aziz Hatiboglu, Kerime Akdur, Raymond Sawaya
Brain metastasis is a serious complication in patients with systemic cancer. The main goal of the treatment in patients with brain metastasis is to control the disease in the brain, to prevent death from neurological disease and provide a satisfactory quality of life. Management of a patient with brain metastasis is important and sometimes demanding, and several factors such as tumor histology, status of primary disease, number of brain lesions, size of lesions, and performance status may influence the decision making process...
July 29, 2018: Neurosurgical Review
Karima Saboundji, Jean-Bernard Auliac, Maurice Pérol, Géraldine François, Henri Janicot, Marie Marcq, Catherine Dubos-Arvis, Aldo Renault, Florian Guisier, Luc Odier, Radj Gervais, Christos Chouaïd
BACKGROUND: The prognosis of patients with non-small cell lung cancer (NSCLC) who develop leptomeningeal metastasis (LM) is poor. OBJECTIVE: To assess the clinical efficacy of osimertinib, a third-generation tyrosine-kinase inhibitor (TKI), in patients with epidermal growth-factor receptor (EGFR)-mutated NSCLCs and LM. PATIENTS AND METHODS: Retrospective study of NSCLC patients with osimertinib-treated EGFR-mutated NSCLC and LM. RESULTS: Twenty patients (mean age, 61...
August 2018: Targeted Oncology
Hisayuki Yao, Trevor T Price, Gaia Cantelli, Brandon Ngo, Matthew J Warner, Lindsey Olivere, Sarah M Ridge, Elizabeth M Jablonski, Joseph Therrien, Stacey Tannheimer, Chad M McCall, Anjen Chenn, Dorothy A Sipkins
Acute lymphoblastic leukaemia (ALL) has a marked propensity to metastasize to the central nervous system (CNS). In contrast to brain metastases from solid tumours, metastases of ALL seldom involve the parenchyma but are isolated to the leptomeninges, which is an infrequent site for carcinomatous invasion. Although metastasis to the CNS occurs across all subtypes of ALL, a unifying mechanism for invasion has not yet been determined. Here we show that ALL cells in the circulation are unable to breach the blood-brain barrier in mice; instead, they migrate into the CNS along vessels that pass directly between vertebral or calvarial bone marrow and the subarachnoid space...
August 2018: Nature
Hazem I Assi, Tala Mahmoud, Fadi S Saadeh, Haidar El Darsa
Leptomeningeal metastasis (LM), which occurs when malignant cells spread to the central nervous system, is becoming an increasingly common complication in patients with breast cancer. Diagnosis and treatment of LM is challenging. Moreover, prognosis of patients with LM is poor, with a median survival of 6 months after diagnosis. This review highlights the strengths and limitations of currently available diagnostic tools and therapies for LM. The current treatments for LM, including radiotherapy, systemic therapy, and intrathecal treatment, aim to maintain the quality of life of patients by correcting neurological deficits and arresting neurological degeneration...
September 2018: Clinical Neurology and Neurosurgery
Kaylyn D Sinicrope, Alexander B Kaplan, Priscilla K Brastianos
Pure seminoma is a histological subtype of testicular cancer that accounts for 50% of testicular germ cell tumors. It has a very low rate of metastasis to the central nervous system, with only one previously reported case of neoplastic meningitis (cancer that has spread to the cerebrospinal fluid). Traditionally, neoplastic meningitis has an ominous prognosis when associated with primary tumors that commonly spread to the leptomeninges, like breast and lung. This article highlights a unique case of pure seminoma with neoplastic meningitis and illustrates the effectiveness of craniospinal irradiation as a treatment modality...
July 16, 2018: Oncologist
J Oh, S H Choi, E Lee, D J Shin, S W Jo, R-E Yoo, K M Kang, T J Yun, J-H Kim, C-H Sohn
BACKGROUND AND PURPOSE: Contrast-enhanced 3D fast spin-echo T1 black-blood imaging selectively suppresses the signal of blood flow and could provide a higher contrast-to-noise ratio compared with contrast-enhanced 3D ultrafast gradient recalled echo (contrast-enhanced gradient recalled echo) and 2D spin-echo T1WI (contrast-enhanced spin-echo). The purpose of our study was to evaluate whether black-blood imaging can improve the diagnostic accuracy for leptomeningeal carcinomatosis compared with contrast-enhanced gradient recalled-echo and contrast-enhanced spin-echo and, furthermore, to determine whether the grade of leptomeningeal carcinomatosis evaluated on black-blood imaging is a significant predictor of progression-free survival...
August 2018: AJNR. American Journal of Neuroradiology
Zhenyu Pan, Guozi Yang, Hua He, Tingting Yuan, Yongxiang Wang, Yu Li, Weiyan Shi, Pengxiang Gao, Lihua Dong, Gang Zhao
In this study, we examined the characteristics and aimed to increase the knowledge of clinical features of leptomeningeal metastasis (LM). The clinical data, including initial diagnosis and treatment of primary tumor, clinical manifestations, neuroimaging findings, cerebrospinal fluid (CSF) examination, were analyzed. For the patients with adenocarcinoma/breast cancer, the incidence of cranial lesions and cranial nerve paralysis was obviously higher than patients with small cell lung cancer. Whereas, the incidence of involvement of intravertebral canal was obviously lower than that of small cell lung cancer...
July 11, 2018: Scientific Reports
Anshit Goyal, Iahn Cajigas, George M Ibrahim, Carole D Brathwaite, Ziad Khatib, Toba Niazi, Sanjiv Bhatia, John Ragheb
BACKGROUND: Medulloblastomas are common childhood central nervous system tumors that are prone to leptomeningeal spread. Intramedullary dissemination is rare with very few case reports existing in the available literature. CASE DESCRIPTION: The authors here present a case of a 14-year-old boy with Li-Fraumeni syndrome and medulloblastoma who underwent surgical resection of spinal intramedullary spread. Histopathology revealed the tumor to be anaplastic medulloblastoma, same as the intracranial lesions...
October 2018: World Neurosurgery
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