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Leptomeningeal disease

Raymond Y Huang, Patrick Y Wen
The Response Assessment in Neuro-Oncology (RANO) Working Group is an international multidisciplinary group whose goal is to improve response criteria and define endpoints for neuro-oncology trials. The RANO criteria for high-grade gliomas attempt to address the issues of pseudoprogression, pseudoresponse, and nonenhancing tumor progression. Incorporation of advanced MR imaging may eventually help improve the ability of these criteria to define enhancing and nonenhancing disease better. The RANO group has also developed criteria for neurologic response and evaluation of patients receiving immunologic therapies...
November 2016: Magnetic Resonance Imaging Clinics of North America
Alex E Roher, Chera L Maarouf, Tyler A Kokjohn, Christine Belden, Geidy Serrano, Marwan S Sabbagh, Thomas G Beach
INTRODUCTION: Based on the amyloid cascade hypothesis of Alzheimer's disease (AD) pathogenesis, a series of clinical trials involving immunotherapies have been undertaken including infusion with the IgG1 monoclonal anti-Aβ antibody solanezumab directed against the middle of the soluble Aβ peptide. In this report, we give an account of the clinical history, psychometric testing, gross and microscopic neuropathology as well as immunochemical quantitation of soluble and insoluble Aβ peptides and other proteins of interest related to AD pathophysiology in a patient treated with solanezumab...
2016: American Journal of Neurodegenerative Disease
Kemal Ekici, Oztun Temelli, Mustafa Dikilitas, Ibrahim Halil Dursun, Nihal Bozdag Kaplan, Ersoy Kekilli
PURPOSE: The purpose of this study was to evaluate the clinical status, prognostic factors and treatment modalities affecting survival in patients with brain metastasis. We aimed to evaluate the whole brain radiation therapy (WBRT) outcomes of patients with brain metastasis in our center. METHODS: Clinical data of 315 patients referred to our center between 2004 and 2014 with metastatic brain cancers were collected and analysed for possible relationships between survival time, age, gender, Karnofsky performance status (KPS), recursive partitioning analysis (RPA), primary tumor, number of brain lesions, surgery, radiation therapy scheme, extracranial metastatic status and primary disease control status...
July 2016: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
Elena Laakmann, Isabell Witzel, Verena Scriba, Ulrich Grzyska, Christine Zu Eulenburg, Nicole Burchardi, Tobias Hesse, Florian Würschmidt, Tanja Fehm, Volker Möbus, Gunter von Minckwitz, Sibylle Loibl, Tjoung-Won Park-Simon, Volkmar Mueller
Evidence about distribution patterns of brain metastases with regard to breast cancer subtypes and its influence on the prognosis of patients is insufficient. Clinical data, cranial computed tomography (CT) and magnetic resonance imaging (MRI) scans of 300 breast cancer patients with brain metastases (BMs) were collected retrospectively in four centers participating in the Brain Metastases in Breast Cancer Registry (BMBC) in Germany. Patients with positive estrogen (ER), progesterone (PR), or human epidermal growth factor receptor 2 (HER2) statuses, had a significantly lower number of BMs at diagnosis...
2016: International Journal of Molecular Sciences
Shyam A Patel
Acute myeloid leukemia (AML) involvement of the central nervous system is relatively rare, and detection of leptomeningeal disease typically occurs only after a patient presents with neurological symptoms. The case herein describes a 48-year-old man with relapsed/refractory AML of the mixed lineage leukemia rearrangement subtype, who presents with monocular vision loss due to leukemic eye infiltration. MRI revealed right optic nerve sheath enhancement and restricted diffusion concerning for nerve ischemia and infarct from hypercellularity...
2016: Case Reports in Hematology
Erika F Rodriguez, Jaishri Blakeley, Shannon Langmead, Alessandro Olivi, Anthony Tufaro, Abeer Tabbarah, Gail Berkenblit, Justin M Sacks, Scott D Newsome, Elizabeth Montgomery, Fausto J Rodriguez
Leptomeningeal dissemination of low grade Schwann cell neoplasms is an exceptionally rare occurrence, and has not been well documented in the literature. We encountered two cases of leptomeningeal dissemination of low grade Schwann cell neoplasms. Patient 1 was a 63-year-old woman with NF1 and a progressive low grade MPNST developing from a diffuse/plexiform orbital neurofibroma that arose in childhood. The neoplasm demonstrated local and leptomeningeal dissemination intracranially leading to the patient's death...
September 22, 2016: Human Pathology
Alvin J X Lee, Rachel Benamore, Monika Hofer, Meenali Chitnis
A 60-year-old male was diagnosed with T3, N3, M1b epidermal growth factor receptor (EGFR) mutant lung adenocarcinoma. Five months later he developed significant headaches, weakness and numbness of the left leg, and unsteadiness of gait. Magnetic resonance imaging (MRI) brain demonstrated subtle gyral enhancement indicative of early leptomeningeal infiltration. He was commenced on second-line erlotinib which improved his lower limb symptoms. Three months later he developed increased urinary frequency and redeveloped leg symptoms...
September 2016: Oxford Medical Case Reports
F Schöberl, O E Eren, F A Wollenweber, T Kraus, L Kellert
Sporadic cerebral amyloid angiopathy (CAA) is a cerebral small vessel disease in the elderly. Neuropathologically, it is characterized by deposition of amyloid-ß (Aß) in the wall of small to medium-sized arteries, capillaries and venules of the cerebral cortex and leptomeninges. Over the last years it was recognized as an important cause of spontaneous intracerebral hemorrhage and cognitive deficits in the elderly. The clinical and radiological manifestations are diverse ranging from acute onset focal neurological deficits due to intracerebral lobar hemorrhage to subacute progressive cognitive impairment due to Aß-mediated inflammation confluent subcortical edema...
September 2016: Fortschritte der Neurologie-Psychiatrie
Suresh Kumar, Sudhir Sharma, Anupam Jhobta, Ram Gopal Sood
Moyamoya disease (MMD) is a rare cerebrovascular disease characterized by idiopathic occlusion of bilateral internal carotid arteries and the development of characteristic leptomeningeal collateral vessels along anterior or posterior circulation. We present an unusual case of MMD presenting with generalized dystonia as the predominant manifestation.
April 2016: Journal of Pediatric Neurosciences
Victoria Villaflor, Brian Won, Rebecca Nagy, Kimberly Banks, Richard B Lanman, AmirAli Talasaz, Ravi Salgia
INTRODUCTION: The potential of oncogene-driven targeted therapy is perhaps most fully realized in non-small cell lung cancer (NSCLC), given the number of genomic targets and approved matched therapies. However, invasive tissue biopsy at the time of each disease progression may not be possible and is associated with high morbidity and cost. Use of newly available "liquid biopsies" can circumvent these issues. RESULTS: 83% of subjects had at least one genomic alteration identified in plasma...
September 1, 2016: Oncotarget
Olivia A Skrobot, Johannes Attems, Margaret Esiri, Tibor Hortobágyi, James W Ironside, Rajesh N Kalaria, Andrew King, George A Lammie, David Mann, James Neal, Yoav Ben-Shlomo, Patrick G Kehoe, Seth Love
There are no generally accepted protocols for post-mortem assessment in cases of suspected vascular cognitive impairment. Neuropathologists from seven UK centres have collaborated in the development of a set of vascular cognitive impairment neuropathology guidelines (VCING), representing a validated consensus approach to the post-mortem assessment and scoring of cerebrovascular disease in relation to vascular cognitive impairment. The development had three stages: (i) agreement on a sampling protocol and scoring criteria, through a series of Delphi method surveys; (ii) determination of inter-rater reliability for each type of pathology in each region sampled (Gwet's AC2 coefficient); and (iii) empirical testing and validation of the criteria, by blinded post-mortem assessment of brain tissue from 113 individuals (55 to 100 years) without significant neurodegenerative disease who had had formal cognitive assessments within 12 months of death...
September 2, 2016: Brain: a Journal of Neurology
Ji Man Hong, Yoon Hee Hong, Seong-Joon Lee, Sung Eun Lee, Jin Soo Lee, Dong Hoon Shin
To evaluate the hemodynamic contributions of collateral flow in adult patients with moyamoya disease, neurological deterioration or fluctuation during admission, Suzuki grade, various collateral routes, lesion volume, cerebral blood flow (CBF), and their associations were analyzed. Thirty patients (60 cerebral hemispheres, mean age 45 ± 25 years, and 73.3 % female) who were diagnosed with moyamoya disease or syndrome were enrolled over 3 years. Moyamoya stages from each hemisphere were stratified according to the Suzuki's criteria through six-vessel angiography into internal carotid arteries (ICAs), external carotid arteries (ECAs), and vertebral arteries (VAs)...
September 2, 2016: Neurological Sciences
Akimasa Sekine, Terufumi Kato, Tae Iwasawa, Tomohisa Baba, Akihiro Suido, Haruyasu Sakuranaka, Masaaki Futaki, Takashi Ogura
We herein report a case of a 67-year-old woman previously treated with erlotinib for adenocarcinoma with an epidermal growth factor receptor (EGFR) mutation in exon 19, which rapidly developed to progressive symptomatic leptomeningeal carcinomatosis. The primary tumor and lung metastases also worsened and the performance status (PS) score declined to 3. With a re-biopsy from the pulmonary metastases, the T790M mutation was detected by the cobas EGFR mutation test, but not the cycleave test, although an exon 19 deletion was detected by both of the tests...
2016: Internal Medicine
Chuan T Foo, Louise M Burrell, Douglas F Johnson
A 67-year old previously well male presented with a 1 week history of confusion on a background of 3 weeks of headache. Past history included two superficial melanomas excised 5 years ago. Treatment for meningoencephalitis was commenced based on lumbar puncture (LP) and non-contrast brain magnetic resonance imaging (MRI) results. Lack of a clinical response to antibiotics resulted in a second LP and contrast brain MRI which demonstrated hydrocephalus and leptomeningeal disease. Ongoing deterioration led to a whole-body computed tomographic and spinal MRI that showed widespread metastatic disease and extensive leptomeningeal involvement of the spinal cord...
August 2016: Oxford Medical Case Reports
Aki Morikawa, Lilly Jordan, Raquel Rozner, Sujata Patil, Adrienne Boire, Elena Pentsova, Andrew D Seidman
BACKGROUND: Disease presentation, prognostic factors, and treatment patterns for patients with breast cancer with leptomeningeal metastasis are not well characterized. In this study, we examined patient characteristics and prognostic factors for survival after a diagnosis of leptomeningeal metastasis. PATIENTS AND METHODS: Three hundred eighteen consecutive patients with breast cancer diagnosed with leptomeningeal metastasis from January 1998 to December 2013 at Memorial Sloan Kettering Cancer Center were identified...
July 25, 2016: Clinical Breast Cancer
A Manousopoulou, M Gatherer, C Smith, J A R Nicoll, C H Woelk, M Johnson, R Kalaria, J Attems, S D Garbis, R O Carare
AIMS: Amyloid beta (Aβ) accumulation in the walls of leptomeningeal arteries as cerebral amyloid angiopathy (CAA) is a major feature of Alzheimer's disease. In this study, we used global quantitative proteomic analysis to examine the hypothesis that the leptomeningeal arteries derived from patients with CAA have a distinct endophenotypic profile compared to those from young and elderly controls. METHODS: Freshly dissected leptomeningeal arteries from the Newcastle Brain Tissue Resource and Edinburgh Sudden Death Brain Bank from seven elderly (82...
October 5, 2016: Neuropathology and Applied Neurobiology
Zhe-Ren Tan, Xiao-Yan Long, Guo-Liang Li, Jin-Xia Zhou, Lan Long
PURPOSE: Cryptococcosis is a devastating opportunistic disease commonly encountered in organ transplant recipients and patients with acquired immunodeficiency syndrome (AIDS). Few studies have profiled the disease in immunocompetent patients. We sought to characterize the neuroimaging findings of cryptococcal meningitis among immunocompetent patients in China. MATERIALS AND METHODS: Retrospective review of all patients diagnosed with cryptococcal meningitis at our institute, on the basis of CSF culture or India Ink test, between November 2011 and February 2016, was performed...
September 15, 2016: Journal of the Neurological Sciences
Rimas V Lukas, Robin Buerki, Maciej M Mrugala
No abstract text is available yet for this article.
August 2016: Oncology (Williston Park, NY)
María Del Mar Jiménez de la Peña, Lidia Gómez Vicente, Raquel Cano Alonso, Silvia Fuertes Cabero, Antonio Maldonado Suárez, Vicente Martínez de Vega
Primary central nervous system lymphoma (PCNSL) is an uncommon variant of extranodal non-Hodgkin lymphoma, which involves the brain, leptomeninges, eyes, or spinal cord without evidence of systemic disease. In addition to a detailed history and physical examination, the evaluation of patients suspected of having a PCNSL should include a contrast-enhanced magnetic resonance imaging. Occassionaly, PCNSL shows peculiarities on magnetic resonance imaging, which delay the diagnosis and thus the start of treatment...
April 27, 2016: Current Problems in Diagnostic Radiology
Yoshiki Sekijima, Masahide Yazaki, Kazuhiro Oguchi, Naoki Ezawa, Tsuneaki Yoshinaga, Mitsunori Yamada, Hiroyuki Yahikozawa, Masahide Watanabe, Fuyuki Kametani, Shu-Ichi Ikeda
OBJECTIVE: To investigate the prevalence and clinical features of posttransplant CNS symptoms in patients with hereditary ATTR amyloidosis and their Pittsburgh compound B (PiB)-PET imaging correlates. METHODS: We monitored prevalence and type of CNS symptoms in 53 consecutive posttransplant patients with hereditary ATTR amyloidosis. (11)C-PiB-PET was performed in 15 patients with various disease durations. We also analyzed pathologic and biochemical characteristics of ATTR amyloid deposition in the brain of a posttransplant patient...
August 23, 2016: Neurology
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