Journal of neuro-oncology
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Journal of neuro-oncology · May 2014
ReviewImaging guidelines and findings of extracranial glioblastoma.
Extracranial manifestations of glioblastoma are uncommon and include a wide spectrum of entities, such as primary spinal cord glioblastoma, spinal leptomeningeal metastasis, seeding into the scalp following intracranial glioblastoma resection, direct extension of an intracranial glioblastoma though a craniotomy defect, dissemination via shunt catheter, and systemic metastasis, including lymphatic and hematogenous spread. Imaging plays an important role in the management of patients with extracranial glioblastomas and guidelines for the imaging evaluation of these lesions are reviewed. ⋯ In particular, advanced imaging techniques such as MR spectroscopy, MR perfusion, diffusion-weighted imaging, and diffusion-tensor imaging can be useful for early detection and characterization of these lesions. CT and (18)FDG-PET are suitable modalities for evaluating systemic and CSF shunt-related metastases.
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Journal of neuro-oncology · May 2014
Efficacy of postoperative seizure prophylaxis in intra-axial brain tumor resections.
The effectiveness of seizure prophylaxis in controlling postoperative seizures following craniotomy for tumor resection is unclear. Most patients are seizure-free before surgery. To prevent seizures, it is common to treat tumor craniotomy patients postoperatively with an antiepileptic drug (AED). ⋯ No difference was found in time-to-seizure between the two groups (hazard ratio 1.38, p = 0.3776). These data show no statistically significant benefit to prophylactic postoperative AED and a nonsignificant trend for increased seizure risk with AEDs. A randomized, placebo-controlled trial is needed to clarify the benefit of postoperative AED use for brain tumor resection.
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Journal of neuro-oncology · May 2014
TP53 and p53 statuses and their clinical impact in diffuse low grade gliomas.
TP53 is a pivotal gene frequently mutated in diffuse gliomas and particularly in astrocytic tumors. The majority of studies dedicated to TP53 in gliomas were focused on mutational hotspots located in exons 5-8. Recent studies have suggested that TP53 is also mutated outside the classic mutational hotspots reported in gliomas. ⋯ In conclusion, we have identified novel TP53 mutations in LGG. TP53 mutations outside exons 4-8 are rare. Although it remains imperfect, p53 expression with a threshold of 10% is a good surrogate marker for missense TP53 mutations and appears helpful in the setting of LGG phenotype diagnosis.
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We performed this retrospective study to analyze the outcome of patients with cavernous sinus hemangioma (CSH) after stereotactic radiosurgery (SRS). We analyzed 19 patients with CSHs who were treated with SRS between 1998 and 2011. The median age of the patients was 50 years (range, 35-73 years), and 16 (84.2%) of the patients were female. ⋯ All 14 of the cranial neuropathies observed before SRS had improved, with complete remission in 12 (85.7%) cranial nerves and partial remission in two (14.3%). There were no radiation-induced neuropathies or complications during the follow-up period. SRS appears to be an effective and safe treatment modality for the management of CSHs.