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Leptomeningeal

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https://www.readbyqxmd.com/read/28231581/prognostic-markers-and-histologic-subtypes-in-patients-with-meningeal-carcinomatosis-in-breast-cancer
#1
Hussein Alnajar, Lauren Rosen, Sara Javidiparsijani, Yahya Al-Ghamdi, Paolo Gattuso
OBJECTIVE: Meningeal carcinomatosis (MC) is a rare complication in breast cancer patients. It is defined as a diffuse or multifocal leptomeningeal metastasis. STUDY DESIGN: From our institution database, we retrospectively studied 19 patients diagnosed with MC in the cerebrospinal fluid (CSF) in 1997-2015, in order to evaluate tumor prognostic markers, histologic subtypes, and clinical outcome. RESULTS: All patients were female, with a mean age of 53 years (range 36-75 years)...
February 24, 2017: Acta Cytologica
https://www.readbyqxmd.com/read/28230014/nimotuzumab-treatment-and-outcome-analysis-in-patients-with-leptomeningeal-metastasis-from-nonsmall-cell-lung-cancer
#2
Yanfang Ju, Jinliang Wang, Shengjie Sun, Shunchang Jiao
OBJECTIVE: Leptomeningeal metastasis (LM) leades a devastating consequence in patients with nonsmall cell lung cancer(NSCLC). Treatment is very limited for patients with LM. We introduced to use nimotuzumab (also known as h-R3) combined with methotrexate for treating LM in NSCLC patients. PATIENTS AND METHODS: In the present report, twenty patients with LM of NSCLC were included, and the clinicopathology information and outcomes after treatment were analyzed. RESULTS: All the twenty patients with LM were lung adenocarcinoma...
December 2016: Journal of Cancer Research and Therapeutics
https://www.readbyqxmd.com/read/28225456/efficacy-of-bevacizumab-and-erlotinib-combination-for-leptomeningeal-carcinomatosis-after-failure-of-erlotinib
#3
Ryo Ariyasu, Atsushi Horiike, Junji Koyama, Masafumi Saiki, Tomoaki Sonoda, Yosuke Kawashima, Natsuki Takano, Tomoyo Oguri, Shingo Nishikawa, Satoru Kitazono, Noriko Yanagitani, Fumiyoshi Ohyanagi, Makoto Nishio
In patients with non-small-cell lung cancer harboring an epithelial growth factor receptor (EGFR) active mutation, central nervous system progression after a response to EGFR tyrosine kinase inhibitors is frequent. Central nervous system metastasis, especially leptomeningeal carcinomatosis (LMC), is a serious complication and no standard treatment has been established for LMC. Here, we report two cases in which the addition of bevacizumab to erlotinib enhanced the efficacy against LMC; as a result, radiographic abnormalities decreased markedly and symptoms were well controlled...
February 20, 2017: Anti-cancer Drugs
https://www.readbyqxmd.com/read/28215459/leptomeningeal-metastases-presenting-exclusively-with-ocular-disturbance-in-34-patients-a-tertiary-care-cancer-hospital-experience
#4
Rory Richard Mayer, Benjamin Jay Frankfort, Ben A Strickland, James Matthew Debnam, Ian E McCutcheon, Morris D Groves, Jeffrey S Weinberg
Leptomeningeal disease (LMD) represents disseminated intracranial metastatic disease that requires early detection and initiation of therapy. Patients with LMD typically present with a variety of neurologic problems, including ocular disturbances. However, little is reported on LMD presenting exclusively with ocular-related disturbances in the absence of any other central nervous system (CNS) dysfunction. Our goal was to describe the workup for ocular disturbances in the setting of known cancer diagnosis. Retrospective case study utilizing prospectively collected database at a tertiary cancer care center for all patients with diagnosis of LMD between 2001 and 2009...
February 16, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28210185/neoplastic-leptomeningeal-disease-masquerading-as-central-serous-retinopathy-a-case-report
#5
Ibrahim Elaraoud, Hanif J Suleman, Peter Cikatricis, Helen Palmer
A 69-year-old man became aware of people's speech being out of synch with their lip movements alongside persistent headaches, both of which progressively worsened. A few weeks later, he developed progressive and painless visual loss in one eye. Initial neurological evaluation, inflammatory markers and head computed tomography scan were normal. Ophthalmological examination and OCT scan revealed right macular subretinal fluid with choroidal indentation, which prompted urgent further investigations including head MRI revealing extensive leptomeningeal disease...
July 2016: Saudi Journal of Ophthalmology: Official Journal of the Saudi Ophthalmological Society
https://www.readbyqxmd.com/read/28190444/management-of-neuro-oncologic-emergencies
#6
J T Jo, D Schiff
Patients with brain tumors and systemic malignancies are subject to diverse neurologic complications that require urgent evaluation and treatment. These neurologic conditions are commonly due to the tumor's direct effects on the nervous system, such as cerebral edema, increased intracranial pressure, seizures, spinal cord compression, and leptomeningeal metastases. In addition, neurologic complications can develop as a result of thrombocytopenia, coagulopathy, hyperviscosity syndromes, infection, immune-related disorders, and adverse effects of treatment...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28184993/pathogenic-implications-of-cerebrospinal-fluid-barrier-pathology-in-neuromyelitis-optica
#7
Yong Guo, Stephen D Weigand, Bogdan F Popescu, Vanda A Lennon, Joseph E Parisi, Sean J Pittock, Natalie E Parks, Stacey L Clardy, Charles L Howe, Claudia F Lucchinetti
Pathogenic autoantibodies associated with neuromyelitis optica (NMO) induce disease by targeting aquaporin-4 (AQP4) water channels enriched on astrocytic endfeet at blood-brain interfaces. AQP4 is also expressed at cerebrospinal fluid (CSF)-brain interfaces, such as the pial glia limitans and the ependyma and at the choroid plexus blood-CSF barrier. However, little is known regarding pathology at these sites in NMO. Therefore, we evaluated AQP4 expression, microglial reactivity, and complement deposition at pial and ependymal surfaces and in the fourth ventricle choroid plexus in 23 autopsy cases with clinically and/or pathologically confirmed NMO or NMO spectrum disorder...
February 9, 2017: Acta Neuropathologica
https://www.readbyqxmd.com/read/28184274/cerebrospinal-fluid-infection-after-lumbar-nerve-root-steroid-injection-a-case-report
#8
Kwan-Sub Kim, Young-Ki Kim, Seong-Su Kim, Sung Min Shim, Hae Jun Cho
A 45-year-old woman was admitted due to severe headache and neck stiffness. She had visited a local clinic for back pain and received a lumbar nerve root steroid injection 10 days before admission. Computed tomography and magnetic resonance imaging showed psoas abscess, pneumocephalus, and subdural hygroma. She was diagnosed with psoas abscess and meningitis. The abscess and external ventricle were drained, and antibiotics were administered. Unfortunately, the patient died on hospital day 19 due to diffuse leptomeningitis...
February 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28178712/surgical-treatment-for-leptomeningeal-disease
#9
REVIEW
Andrey A Volkov, Andreas K Filis, Frank D Vrionis
BACKGROUND: Advancements in cancer treatment have led to more cases of leptomeningeal disease, which requires a multimodal approach. METHODS: Treatment modalities are reviewed from a neurosurgical standpoint, focusing on intrathecal chemotherapy and shunting devices. Potential complications and how to avoid them are discussed. RESULTS: The Ommaya reservoir and the chemoport are used for administering intrathecal chemotherapy. Use of ventriculo-lumbar perfusion can efficiently deliver chemotherapeutic agents and improve intracerebral pressure...
January 2017: Cancer Control: Journal of the Moffitt Cancer Center
https://www.readbyqxmd.com/read/28178711/experimental-treatments-for-leptomeningeal-metastases-from-solid-malignancies
#10
REVIEW
Solmaz Sahebjam, Peter A Forsyth, Keiran S Smalley, Nam D Tran
BACKGROUND: Leptomeningeal metastasis is a consequence of advanced solid malignancies and has limited treatment options. It is possible that it is becoming more common as the leptomeninges act as a sanctuary site for recurrence from systemic cancer. METHODS: Potential targeted and immunotherapy agents for the most common types of solid-tumor leptomeningeal metastasis are reviewed, as are their dosing/delivery strategies and novel, immunological approaches. RESULTS: Historically, patients with leptomeningeal metastasis have been excluded from clinical trials, and data on the management of leptomeningeal metastasis come from single case reports and retrospective analyses...
January 2017: Cancer Control: Journal of the Moffitt Cancer Center
https://www.readbyqxmd.com/read/28178708/clinical-presentation-diagnosis-and-radiological-findings-of-neoplastic-meningitis
#11
REVIEW
Georgios Rigakos, Chrysoula I Liakou, Naillid Felipe, Dennis Orkoulas-Razis, Evangelia Razis
BACKGROUND: Neoplastic meningitis is a complication of solid and hematological malignancies. It consists of the spread of malignant cells to the leptomeninges and subarachnoid space and their dissemination within the cerebrospinal fluid. METHODS: A literature review was conducted to summarize the clinical presentation, differential diagnosis, laboratory values, and imaging findings of neoplastic meningitis. RESULTS: Neoplastic meningitis is an event in the course of cancer with a variable clinical presentation and a wide differential diagnosis...
January 2017: Cancer Control: Journal of the Moffitt Cancer Center
https://www.readbyqxmd.com/read/28176499/ct-angiography-of-collateral-vessels-and-outcomes-in-endovascular-treated-acute-ischemic-stroke-patients
#12
Beom Joon Kim, Jong Won Chung, Hong Kyun Park, Jun Yup Kim, Mi Hwa Yang, Moon Ku Han, Cheolkyu Jeong, Gyojun Hwang, O Ki Kwon, Hee Joon Bae
BACKGROUND AND PURPOSE: Measuring the extent of the collateral blood vessels using computed tomography (CT) angiography source images may promote tissue survival and functional gain in acute ischemic stroke patients who are candidates for endovascular recanalization treatment. METHODS: Of 5,558 acute stroke patients registered in a prospective clinical stroke registry, 104 met the selection criteria of endovascular recanalization treatment for internal cerebral artery or middle cerebral artery main-stem (M1) occlusions and presented for treatment ≤4 hours after the event...
January 12, 2017: Journal of Clinical Neurology
https://www.readbyqxmd.com/read/28176389/imaging-diagnosis-antemortem-detection-of-oligodendroglioma-cerebrospinal-fluid-drop-metastases-in-a-dog-by-serial-magnetic-resonance-imaging
#13
Mariana Vigeral, R Timothy Bentley, Nicholas J Rancilio, Margaret A Miller, Hock Gan Heng
An English Bulldog underwent radiation therapy of an intracranial, left lateral ventricle mass. Following resolution of the primary mass, an intraventricular fourth ventricle lesion developed. Subsequently, multiple lesions developed from the cervical central canal and leptomeninges. Serial magnetic resonance imaging documented the propagation of lesions along the cerebrospinal fluid (CSF) pathways, known as "CSF drop metastasis." Histopathology confirmed multifocal intraventricular and leptomeningeal oligodendroglioma...
February 7, 2017: Veterinary Radiology & Ultrasound
https://www.readbyqxmd.com/read/28166153/cerebral-parenchymal-photopenia-on-fdg-pet-ct-reflecting-vasogenic-edema-due-to-leptomeningeal-metastasis-in-breast-cancer
#14
Mitsutomi Ishiyama, Manuela Christina Matesan
A 61-year-old woman with metastatic breast cancer presented with migrainelike episodes over the past 10 months. FDG-PET/CT(PET/CT) showed relatively symmetric areas of photopenia predominantly in the bilateral superior parietal lobules. Subsequent contrast-enhanced MRI revealed leptomeningeal metastasis in the bilateral posterior parietal regions with associated vasogenic edema in the adjacent brain parenchyma. There was no clear evidence of parenchymal metastasis on MRI. After chemotherapy, the areas of abnormality resolved on PET/CT 8 months later, and the patient showed interval symptomatic improvement...
February 3, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28162256/pain-during-awake-craniotomy-for-brain-tumor-resection-incidence-causes-consequences-and-management
#15
D Fontaine, F Almairac
INTRODUCTION: Awake craniotomy for brain tumor resection is usually well-tolerated and most of the patients are satisfied. However, in studies reporting the patients' postoperative perception of the awake craniotomy procedure, about half of them have experienced some degree of intraoperative pain. Pain was mild (intensity between 1 and 2 on the visual analogical score) short lasting in most cases, and did not challenge the procedure. Pain was reported as moderate in about 25% and exceptionally severe...
February 2, 2017: Neuro-Chirurgie
https://www.readbyqxmd.com/read/28161339/amyloid-%C3%AE-related-angiitis-a-report-of-two-cases-with-unusual-presentations
#16
Denise W Ng, Shino Magaki, Kevin H Terashima, Adrienne M Keener, Noriko Salamon, Stellios Karnezis, Luke Macyszyn, Harry V Vinters
Amyloid-β related angiitis (ABRA) is a rare complication of cerebral amyloid angiopathy in which amyloid-β (Aβ) deposition in the leptomeningeal and cortical vessels is associated with vasculitis characterized by transmural lymphohistiocytic, often granulomatous, inflammation. Patients usually present with acute to subacute cognitive dysfunction, headaches, and focal neurologic deficits. We report two cases of ABRA with unusual clinical presentations, including one case with fatal cerebral edema leading to herniation and Duret hemorrhages, and another associated with both lobar and deep parenchymal hemorrhages with intraventricular extension as well as hypercoagulability...
February 1, 2017: Human Pathology
https://www.readbyqxmd.com/read/28154566/histological-architecture-underlying-brain-immune-cell-cell-interactions-and-the-cerebral-response-to-systemic-inflammation
#17
Atsuyoshi Shimada, Sanae Hasegawa-Ishii
Although the brain is now known to actively interact with the immune system under non-inflammatory conditions, the site of cell-cell interactions between brain parenchymal cells and immune cells has been an open question until recently. Studies by our and other groups have indicated that brain structures such as the leptomeninges, choroid plexus stroma and epithelium, attachments of choroid plexus, vascular endothelial cells, cells of the perivascular space, circumventricular organs, and astrocytic endfeet construct the histological architecture that provides a location for intercellular interactions between bone marrow-derived myeloid lineage cells and brain parenchymal cells under non-inflammatory conditions...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28151850/distinctive-patterns-on-ct-angiography-characterize-acute-internal-carotid-artery-occlusion-subtypes
#18
Ji Man Hong, Sung Eun Lee, Seong-Joon Lee, Jin Soo Lee, Andrew M Demchuk
Noninvasive computed tomography angiography (CTA) is widely used in acute ischemic stroke, even for diagnosing various internal carotid artery (ICA) occlusion sites, which often need cerebral digital subtraction angiography (DSA) confirmation. We evaluated whether clinical outcomes vary depending on the DSA-based occlusion sites and explored correlating features on baseline CTA that predict DSA-based occlusion site.We analyzed consecutive patients with acute ICA occlusion who underwent DSA and CTA. Occlusion site was classified into cervical, cavernous, petrous, and carotid terminus segments by DSA confirmation...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28149755/state-of-the-art-of-chemotherapy-for-the-treatment-of-central-nervous-system-metastases-from-non-small-cell-lung-cancer
#19
REVIEW
Alessandro Inno, Vincenzo Di Noia, Ettore D'Argento, Alessandra Modena, Stefania Gori
Chemotherapy is the mainstay of treatment of advanced non-small cell lung cancer (NSCLC) without molecular drivers. Despite a low penetration of central nervous system (CNS), chemotherapy drugs demonstrated encouraging activity against CNS metastases from NSCLC. Based on the available data, chemotherapy should be considered as an important part of the multidisciplinary treatment of CNS metastases. Particularly, platinum-based regimens represent the most active combinations and pemetrexed is associated with a meaningful clinical benefit for patients with non-squamous histology...
December 2016: Translational Lung Cancer Research
https://www.readbyqxmd.com/read/28149754/non-small-cell-lung-cancer-nsclc-and-central-nervous-system-cns-metastases-role-of-tyrosine-kinase-inhibitors-tkis-and-evidence-in-favor-or-against-their-use-with-concurrent-cranial-radiotherapy
#20
REVIEW
Panagiota Economopoulou, Giannis Mountzios
Central nervous system (CNS) metastases, including brain metastases (BM) and leptomeningeal metastases (LM) represent a frequent complication of non-small cell lung cancer (NSCLC). Patients with BM comprise a heterogeneous group, with a median survival that ranges from 3 to 14 months. However, in the majority of patients, the occurrence of CNS metastases is usually accompanied by severe morbidity and substantial deterioration in quality of life. Local therapies, such as whole brain radiotherapy (WBRT), stereotactic radiosurgery (SRS) or surgical resection, either alone or as part of a multimodality treatment are available treatment strategies for BM and the choice of therapy varies depending on patient group and prognosis...
December 2016: Translational Lung Cancer Research
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