Brain Sciences

Editorial

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Open AccessEditorial

Recent Advances in the Diagnosis and Treatment of Brain Tumors

by Alberto Delaidelli and Alessandro Moiraghi

Brain Sci. 2024, 14(3), 224; https://doi.org/10.3390/brainsci14030224 - 28 Feb 2024

Cited by 1 | Viewed by 4055

Abstract

Brain tumors represent some of the most aggressive malignancies [...] Full article

(This article belongs to the Special Issue Advances in Diagnosis and Treatment of Brain Tumors and Nervous System Tumors)

Research

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17 pages, 5308 KiB

Open AccessArticle

Development and Validation of CXCR4 Nomogram-Based Immune Infiltration/Tumor Inflammation in Primary Glioblastoma

by Guannan Jiang, Zong-Qing Zheng, Jie Zhang, Zhichao Tian, Xiang Li, Zhengquan Yu, Zhong Wang, Wanchun You and Gang Chen

Brain Sci. 2023, 13(8), 1152; https://doi.org/10.3390/brainsci13081152 - 1 Aug 2023

Cited by 1 | Viewed by 1485

Abstract

Glioblastoma (GBM) is a highly malignant and aggressive tumor with poor prognosis. Therefore, the discovery of new prognostic molecular markers is of great significance for clinical prognosis. The CXC chemokine receptor (CXCR) members play a key regulatory role in many cancers. In this [...] Read more.

Glioblastoma (GBM) is a highly malignant and aggressive tumor with poor prognosis. Therefore, the discovery of new prognostic molecular markers is of great significance for clinical prognosis. The CXC chemokine receptor (CXCR) members play a key regulatory role in many cancers. In this study, we explore the clinical value and application of the CXCR members in primary glioblastoma. Two GBM datasets from The Cancer Genome Atlas (TCGA) and The China Glioma Genome Atlas (CGGA) databases were used to explore the relationship between differential expression of CXCRs and GBM subtypes as well as immune infiltration. C-X-C motif chemokine receptor 4 (CXCR4) was screened as an independent prognostic factor, and a nomogram and risk prediction model were developed and tested in the CGGA database using the TCGA database. Receiver operating curve (ROC) and decision curve analysis (DCA) found good accuracy and net benefit of the models. The correlation of CXCR4 with immune infiltration and tumor was analyzed using CancerSEA and TIMER. In in vitro experiments, we found that CXCR4 was significantly overexpressed in glioblastoma and was closely related to the inflammatory response of U251/U87 cells. CXCR4 is an excellent independent prognostic factor for glioblastoma and positively correlates with tumor inflammation. Full article

(This article belongs to the Special Issue Advances in Diagnosis and Treatment of Brain Tumors and Nervous System Tumors)

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11 pages, 896 KiB

Open AccessArticle

Differential Distribution of Brain Metastases from Non-Small Cell Lung Cancer Based on Mutation Status

by Bihong T. Chen, Taihao Jin, Ningrong Ye, Sean W. Chen, Russell C. Rockne, Stephanie Yoon, Isa Mambetsariev, Ebenezer Daniel and Ravi Salgia

Brain Sci. 2023, 13(7), 1057; https://doi.org/10.3390/brainsci13071057 - 11 Jul 2023

Cited by 1 | Viewed by 1977

Abstract

Non-small cell lung cancer (NSCLC) has a high rate of brain metastasis. The purpose of this study was to assess the differential distribution of brain metastases from primary NSCLC based on mutation status. Brain MRI scans of patients with brain metastases from primary [...] Read more.

Non-small cell lung cancer (NSCLC) has a high rate of brain metastasis. The purpose of this study was to assess the differential distribution of brain metastases from primary NSCLC based on mutation status. Brain MRI scans of patients with brain metastases from primary NSCLC were retrospectively analyzed. Brain metastatic tumors were grouped according to mutation status of their primary NSCLC and the neuroimaging features of these brain metastases were analyzed. A total of 110 patients with 1386 brain metastases from primary NSCLC were included in this study. Gray matter density at the tumor center peaked at ~0.6 for all mutations. The median depths of tumors were 7.9 mm, 8.7 mm and 9.1 mm for EGFR, ALK and KRAS mutation groups, respectively (p = 0.044). Brain metastases for the EGFR mutation-positive group were more frequently located in the left cerebellum, left cuneus, left precuneus and right precentral gyrus. In the ALK mutation-positive group, brain metastases were more frequently located in the right middle occipital gyrus, right posterior cingulate, right precuneus, right precentral gyrus and right parietal lobe. In the KRAS mutation-positive patient group, brain metastases were more frequently located in the posterior left cerebellum. Our study showed differential spatial distribution of brain metastases in patients with NSCLC according to their mutation status. Information regarding distribution of brain metastases is clinically relevant as it could be helpful to guide treatment planning for targeted therapy, and for predicting prognosis. Full article

(This article belongs to the Special Issue Advances in Diagnosis and Treatment of Brain Tumors and Nervous System Tumors)

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16 pages, 2529 KiB

Open AccessArticle

A Meaningful Strategy for Glioma Diagnosis via Independent Determination of hsa_circ_0004214

by Yinan Zhou, Yating Zhang, Jiajia Tian, Zengli Miao, Shangrui Lv and Xudong Zhao

Brain Sci. 2023, 13(2), 193; https://doi.org/10.3390/brainsci13020193 - 23 Jan 2023

Viewed by 1582

Abstract

Glioma is one of the most common primary tumors in the central nervous system. Circular RNAs (circRNAs) may serve as novel biomarkers of various cancers. The purpose of this study is to reveal the diagnostic value of hsa_circ_0004214 for glioma and to predict [...] Read more.

Glioma is one of the most common primary tumors in the central nervous system. Circular RNAs (circRNAs) may serve as novel biomarkers of various cancers. The purpose of this study is to reveal the diagnostic value of hsa_circ_0004214 for glioma and to predict its molecular interaction network. The expression of hsa_circ_0004214 was evaluated by RT-qPCR. The vector and siRNAs changed the expression of hsa_circ_0004214 to judge its influence on the migration degree of glioma cells. hsa_circ_0004214 can be stably expressed at a high level in high-grade glioma tissue (WHO III/IV). The area under the ROC curve of hsa_circ_0000745 in glioma tissue was 0.88, suggesting good diagnostic value. While used to distinguish high-grade glioma, AUC value can be increased to 0.931. The multi-factor correlation analysis found that the expression of hsa_circ_0004214 was correlated with GFAP (+) and Ki67 (+) in immunohistochemistry. In addition, the migration capacity of U87 was enhanced by overexpression of hsa_circ_0004214. Through miRNA microarray analysis and database screening, we finally identified 4 miRNAs and 9 RBPs that were most likely to interact with hsa_circ_0004214 and regulate the biological functions of glioma. Hsa_circ_0004 214 plays an important role in glioma, its expression level is a promising diagnostic marker for this malignancy. Full article

(This article belongs to the Special Issue Advances in Diagnosis and Treatment of Brain Tumors and Nervous System Tumors)

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15 pages, 2762 KiB

Open AccessArticle

Sacrifice of Involved Nerve Root during Surgical Resection of Foraminal and/or Dumbbell Spinal Neurinomas

by Alberto Vandenbulcke, Ginevra Federica D’Onofrio, Gabriele Capo, Wassim Baassiri and Cédric Y. Barrey

Brain Sci. 2023, 13(1), 109; https://doi.org/10.3390/brainsci13010109 - 7 Jan 2023

Cited by 3 | Viewed by 3485

Abstract

Even if usually needed to achieve the gross total resection (GTR) of spinal benign nerve sheath tumors (NSTs), nerve root sacrifice remains controversial regarding the risk of neurological deficit. For foraminal NSTs, we hypothesize that the involved root is poorly functional and thus [...] Read more.

Even if usually needed to achieve the gross total resection (GTR) of spinal benign nerve sheath tumors (NSTs), nerve root sacrifice remains controversial regarding the risk of neurological deficit. For foraminal NSTs, we hypothesize that the involved root is poorly functional and thus can be safely sacrificed. All spinal benign NSTs with foraminal extension that underwent surgery from 2013 to 2021 were reviewed. The impacts of preoperative clinical status and patient and tumor characteristics on long-term outcomes were analyzed. Twenty-six patients were included, with a mean follow-up (FU) of 22.4 months. Functional motor roots (C5-T1, L3-S1) were involved in 14 cases. The involved nerve root was routinely sacrificed during surgery and GTR was obtained in 84.6% of cases. In the functional root subgroup, for patients with a pre-existing deficit (n = 5/14), neurological aggravation persisted in one case at last FU (n = 1/5), whereas for those with no preop deficit (n = 9/14), a postoperative deficit persisted in one patient only (n = 1/9). Preoperative radicular pain was the only characteristic significantly associated with an immediate postoperative motor deficit (p = 0.03). The sacrifice of an involved nerve root in foraminal NSTs seems to represent a reasonable and relevant option to resect these tumors, permitting one to achieve tumor resection in an oncologic fashion with a high rate of GTR. Full article

(This article belongs to the Special Issue Advances in Diagnosis and Treatment of Brain Tumors and Nervous System Tumors)

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Review

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16 pages, 2850 KiB

Open AccessReview

From Theory to Practice: Implementing the WHO 2021 Classification of Adult Diffuse Gliomas in Neuropathology Diagnosis

by Karina Chornenka Martin, Crystal Ma and Stephen Yip

Brain Sci. 2023, 13(5), 817; https://doi.org/10.3390/brainsci13050817 - 18 May 2023

Cited by 4 | Viewed by 2743

Abstract

Diffuse gliomas are the most common type of primary central nervous system (CNS) neoplasm to affect the adult population. The diagnosis of adult diffuse gliomas is dependent upon the integration of morphological features of the tumour with its underlying molecular alterations, and the [...] Read more.

Diffuse gliomas are the most common type of primary central nervous system (CNS) neoplasm to affect the adult population. The diagnosis of adult diffuse gliomas is dependent upon the integration of morphological features of the tumour with its underlying molecular alterations, and the integrative diagnosis has become of increased importance in the fifth edition of the WHO classification of CNS neoplasms (WHO CNS5). The three major diagnostic entities of adult diffuse gliomas are as follows: (1) astrocytoma, IDH-mutant; (2) oligodendroglioma, IDH-mutant and 1p/19q-codeleted; and (3) glioblastoma, IDH-wildtype. The aim of this review is to summarize the pathophysiology, pathology, molecular characteristics, and major diagnostic updates encountered in WHO CNS5 of adult diffuse gliomas. Finally, the application of implementing the necessary molecular tests for diagnostic workup of these entities in the pathology laboratory setting is discussed. Full article

(This article belongs to the Special Issue Advances in Diagnosis and Treatment of Brain Tumors and Nervous System Tumors)

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15 pages, 4004 KiB

Open AccessEditor’s ChoiceReview

Current Advances in Papillary Craniopharyngioma: State-Of-The-Art Therapies and Overview of the Literature

by Gianpaolo Jannelli, Francesco Calvanese, Luca Paun, Gerald Raverot and Emmanuel Jouanneau

Brain Sci. 2023, 13(3), 515; https://doi.org/10.3390/brainsci13030515 - 20 Mar 2023

Cited by 9 | Viewed by 2154

Abstract

Craniopharyngiomas are commonly classified as low-grade tumors, although they may harbor a malignant behavior due to their high rate of recurrence and long-term morbidity. Craniopharyngiomas are classically distinguished into two histological types (adamantinomatous and papillary), which have been recently considered by the WHO [...] Read more.

Craniopharyngiomas are commonly classified as low-grade tumors, although they may harbor a malignant behavior due to their high rate of recurrence and long-term morbidity. Craniopharyngiomas are classically distinguished into two histological types (adamantinomatous and papillary), which have been recently considered by the WHO classification of CNS tumors as two independent entities, due to different epidemiological, radiological, histopathological, and genetic patterns. With regard to papillary craniopharyngioma, a BRAF V600 mutation is detected in 95% of cases. This genetic feature is opening new frontiers in the treatment of these tumors using an adjuvant or, in selected cases, a neo-adjuvant approach. In this article, we present an overview of the more recent literature, focusing on the specificities and the role of oncological treatment in the management of papillary craniopharyngiomas. Based on our research and experience, we strongly suggest a multimodal approach combining clinical, endocrinological, radiological, histological, and oncological findings in both preoperative workup and postoperative follow up to define a roadmap integrating every aspect of this challenging condition. Full article

(This article belongs to the Special Issue Advances in Diagnosis and Treatment of Brain Tumors and Nervous System Tumors)

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Other

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23 pages, 1937 KiB

Open AccessEditor’s ChoiceSystematic Review

Photosensitizers for Photodynamic Therapy of Brain Cancers—A Review

by Dorota Bartusik-Aebisher, Paweł Woźnicki, Klaudia Dynarowicz and David Aebisher

Brain Sci. 2023, 13(9), 1299; https://doi.org/10.3390/brainsci13091299 - 8 Sep 2023

Cited by 11 | Viewed by 2729

Abstract

On average, there are about 300,000 new cases of brain cancer each year. Studies have shown that brain and central nervous system tumors are among the top ten causes of death. Due to the extent of this problem and the percentage of patients [...] Read more.

On average, there are about 300,000 new cases of brain cancer each year. Studies have shown that brain and central nervous system tumors are among the top ten causes of death. Due to the extent of this problem and the percentage of patients suffering from brain tumors, innovative therapeutic treatment methods are constantly being sought. One such innovative therapeutic method is photodynamic therapy (PDT). Photodynamic therapy is an alternative and unique technique widely used in dermatology and other fields of medicine for the treatment of oncological and nononcological lesions. Photodynamic therapy consists of the destruction of cancer cells and inducing inflammatory changes by using laser light of a specific wavelength in combination with the application of a photosensitizer. The most commonly used photosensitizers include 5-aminolevulinic acid for the enzymatic generation of protoporphyrin IX, Temoporfin—THPC, Photofrin, Hypericin and Talaporfin. This paper reviews the photosensitizers commonly used in photodynamic therapy for brain tumors. An overview of all three generations of photosensitizers is presented. Along with an indication of the limitations of the treatment of brain tumors, intraoperative photodynamic therapy and its possibilities are described as an alternative therapeutic method. Full article

(This article belongs to the Special Issue Advances in Diagnosis and Treatment of Brain Tumors and Nervous System Tumors)

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7 pages, 5369 KiB

Open AccessCase Report

Endoscopic Ipsilateral Interhemispheric Approach for Middle-Third Falcine Meningioma: A Case Report and Literature Review

by Gang Zhang, Junwei Wang, Pan Wang and Nan Wu

Brain Sci. 2023, 13(7), 1085; https://doi.org/10.3390/brainsci13071085 - 18 Jul 2023

Viewed by 1355

Abstract

Middle-third falcine meningiomas (FMs) are usually hidden deep under the eloquent cortex and abundant bridging veins, which represent the main hindrances to surgical access. The endoscopic approach has the advantages of wide visualization and free visual axis without areas of visual blindness, which [...] Read more.

Middle-third falcine meningiomas (FMs) are usually hidden deep under the eloquent cortex and abundant bridging veins, which represent the main hindrances to surgical access. The endoscopic approach has the advantages of wide visualization and free visual axis without areas of visual blindness, which allows for the resection of FMs with good visualization in a narrow space, especially in deep operations. Here, we report a case of a middle-third FM treated using the endoscopic ipsilateral interhemispheric approach. A 55-year-old female who had suffered a headache for 6 months without other remarkable symptoms was diagnosed with middle-third FM combined with imaging evaluation. According to the imaging performance and anatomical features, we scheduled the endoscopic ipsilateral interhemispheric approach to access and remove the tumor. Consequently, gross total tumor resection was achieved without surgery-related complications. After the surgery, the patient had an uneventful recovery and was discharged with no neurological deficit. During the 24-month follow-up, the patient’s condition remained favorable, with no tumor recurrence. In our opinion, the endoscopic ipsilateral interhemispheric approach is a feasible surgical strategy for FMs, which deserves further exploration as a treatment option. Full article

(This article belongs to the Special Issue Advances in Diagnosis and Treatment of Brain Tumors and Nervous System Tumors)

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7 pages, 3000 KiB

Open AccessCase Report

A Case of Primary Intracranial Sarcoma, DICER1-Mutant, in a Child with a Germline DICER1 Mutation

by Suzanne Elizabeth Kosteniuk, George Michaiel and Christopher Dunham

Brain Sci. 2023, 13(7), 1040; https://doi.org/10.3390/brainsci13071040 - 8 Jul 2023

Cited by 1 | Viewed by 1766

Abstract

DICER1 syndrome is a tumor predisposition syndrome caused by abnormal micro-RNA processing which leads to a variety of benign and malignant neoplasms in many organ systems, including the central nervous system. This paper reports the case of a primary intracranial sarcoma, DICER1-mutant, [...] Read more.

DICER1 syndrome is a tumor predisposition syndrome caused by abnormal micro-RNA processing which leads to a variety of benign and malignant neoplasms in many organ systems, including the central nervous system. This paper reports the case of a primary intracranial sarcoma, DICER1-mutant, in a patient with a germline DICER1 variant thought most likely to be de novo. The patient is a ten-year-old boy who presented acutely with altered level of consciousness, emesis, and left-sided weakness. Imaging revealed a large right frontal hemorrhagic lesion, which was urgently debulked. Histology demonstrated a high-grade sarcomatous lesion. Molecular studies revealed compound heterozygous DICER1 variants (a frame shift insertion and a missense mutation), and a KRAS missense mutation. The final pathologic diagnosis was rendered to be “primary intracranial sarcoma, DICER1-mutant”. Germline genetic testing revealed that the patient possessed a germline DICER1 variant (parental testing was negative). A dramatic reduction in tumor size was precipitated via chemotherapy (ifosfamide, carboplatin, and etoposide) and radiotherapy (focal proton beam therapy). There was no evidence of residual disease at the primary site at the end of the therapy. Full article

(This article belongs to the Special Issue Advances in Diagnosis and Treatment of Brain Tumors and Nervous System Tumors)

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15 pages, 5369 KiB

Open AccessCase Report

Meningioangiomatosis Combined with Calcifying Pseudoneoplasms of Neuraxis

by Xiangyu Sun, Chengshi Xu, Yuxiang Cai, Zhiyong Pan and Zhiqiang Li

Brain Sci. 2023, 13(5), 786; https://doi.org/10.3390/brainsci13050786 - 11 May 2023

Viewed by 1947

Abstract

Meningioangiomatosis (MA) is a rare hamartomatous or meningovascular lesion involving the central nervous system, and is sometimes associated with intracranial meningiomas. Calcifying pseudoneoplasms of the neuraxis (CAPNON) are rare, slow-growing benign tumor-like lesions that can occur anywhere along the neuraxis. Here, we report [...] Read more.

Meningioangiomatosis (MA) is a rare hamartomatous or meningovascular lesion involving the central nervous system, and is sometimes associated with intracranial meningiomas. Calcifying pseudoneoplasms of the neuraxis (CAPNON) are rare, slow-growing benign tumor-like lesions that can occur anywhere along the neuraxis. Here, we report a rare case of MA combined with CAPNON. A 31-year-old woman was admitted to our hospital because of a high-density mass in the left frontal lobe, detected by computed tomography (CT) during a physical examination. She had a 3-year history of obsessive–compulsive disorder. We describe the imaging, histopathological, and molecular characteristics of the patient. To our knowledge, this is the first report describing MA combined with CAPNON. We reviewed the literature on MA and CAPNON over the last decade and summarized the points for differential diagnosis and treatment. It is difficult to preoperatively distinguish between MA and CAPNON. However, this coexisting condition should be considered when intra-axial calcification lesions are observed on radiological imaging. Accurate diagnosis and appropriate treatment are likely to benefit this patient group. Full article

(This article belongs to the Special Issue Advances in Diagnosis and Treatment of Brain Tumors and Nervous System Tumors)

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13 pages, 2865 KiB

Open AccessCase Report

Pediatric Posterior Fossa ATRT: A Case Report, New Treatment Strategies and Perspectives

by Luca Paun, Alexandre Lavé, Gianpaolo Jannelli, Kristof Egervari, Insa Janssen, Karl Schaller, André O. von Bueren and Andrea Bartoli

Brain Sci. 2023, 13(5), 712; https://doi.org/10.3390/brainsci13050712 - 24 Apr 2023

Cited by 1 | Viewed by 2048

Abstract

Posterior fossa atypical teratoid rhabdoid tumor (ATRT) is a rare childhood tumor usually associated with a dismal prognosis. Although upfront surgical gross total resection (GTR) has classically been the first line of treatment, new multimodal treatments, including two-stage surgery, are showing promising results [...] Read more.

Posterior fossa atypical teratoid rhabdoid tumor (ATRT) is a rare childhood tumor usually associated with a dismal prognosis. Although upfront surgical gross total resection (GTR) has classically been the first line of treatment, new multimodal treatments, including two-stage surgery, are showing promising results in terms of overall survival (OS) and complication rate. We present a case of a 9-month-old child treated with two-staged surgery and chemotherapy. When deemed risky, multimodal treatments, including staged surgeries, can be a safe alternative to reduce surgical mortality and morbidity. At 23 months old, the patient had normal global development and no major impact on quality of life. We, therefore, discuss the most recent advancements from a treatment perspective, including molecular targeting. Full article

(This article belongs to the Special Issue Advances in Diagnosis and Treatment of Brain Tumors and Nervous System Tumors)

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9 pages, 7999 KiB

Open AccessCase Report

Endoscopic Transsphenoidal Surgery with a Layered Peel Strategy for Cushing’s Disease Treatment: A Case Series

by Chuan Shao, Junwei Wang, Pan Wang and Nan Wu

Brain Sci. 2023, 13(4), 671; https://doi.org/10.3390/brainsci13040671 - 17 Apr 2023

Viewed by 1660

Abstract

Patients with Cushing’s disease (CD) who underwent endoscopic transsphenoidal surgery (ETS) with a layered peel strategy at our center were retrospectively analyzed. Records on patients’ basic characteristics, preoperative and early postoperative evaluations, perioperative complications, and follow-up were collected. A total of 12 unselected, [...] Read more.

Patients with Cushing’s disease (CD) who underwent endoscopic transsphenoidal surgery (ETS) with a layered peel strategy at our center were retrospectively analyzed. Records on patients’ basic characteristics, preoperative and early postoperative evaluations, perioperative complications, and follow-up were collected. A total of 12 unselected, consecutive patients with CD were identified. Ten of the twelve patients were female. All tumors were confirmed by magnetic resonance imaging, with a maximum tumor diameter ranging from 5 mm to 11 mm. A lower rate of surgical complications was identified postoperatively, with no cases of carotid artery injury, epistaxis, hematoma, visual disturbance, or intracranial infection, but with one case of cerebrospinal fluid rhinorrhea. Ten patients experienced immediate remission, and two had delayed remission. No recurrence events were observed during a median follow-up of 51 months. In conclusion, our preliminary experience indicated that ETS with a layered peel strategy provided a perfect remission rate, low complication rate, and no recurrence in a case series of CD patients. Given the limited number of cases, future studies are warranted to confirm its effectiveness and safety. Full article

(This article belongs to the Special Issue Advances in Diagnosis and Treatment of Brain Tumors and Nervous System Tumors)

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10 pages, 1219 KiB

Open AccessBrief Report

Navigated Transcranial Magnetic Stimulation Motor Mapping and Diffusion Tensor Imaging Tractography for Diencephalic Tumor in Pediatric Patients

by Valentina Baro, Luca Sartori, Samuel Luciano Caliri, Giulia Melinda Furlanis, Alberto D’Amico, Giulia Meneghini, Silvia Facchini, Florinda Ferreri, Maurizio Corbetta, Luca Denaro and Andrea Landi

Brain Sci. 2023, 13(2), 234; https://doi.org/10.3390/brainsci13020234 - 30 Jan 2023

Cited by 3 | Viewed by 1901

Abstract

Background. In deep-seated brain tumors, adequate preoperative planning is mandatory to assess the best surgical corridor to obtain maximal safe resection. Functional diffusor tensor imaging (DTI) tractography based on navigated transcranial magnetic stimulation (nTMS) motor mapping has proven to be a valid preoperative [...] Read more.

Background. In deep-seated brain tumors, adequate preoperative planning is mandatory to assess the best surgical corridor to obtain maximal safe resection. Functional diffusor tensor imaging (DTI) tractography based on navigated transcranial magnetic stimulation (nTMS) motor mapping has proven to be a valid preoperative examination method in adults. The aim of this paper is to present the application of nTMS and functional DTI tractography in a series of pediatric diencephalic tumors. Material and methods. Three patients affected by thalamic (one) and thalamopeduncular tumor (two) were successfully examined with nTMS motor mapping and DTI tractography between October 2020 and October 2021 (F:M 3:0, mean age 12 years ± 0.8). Cortical representation of leg, hand and mouth were determined in the affected hemisphere and the positive stimulation spots were set as seeds point for tractography. Results. Mapping of the motor cortex and tracts reconstruction for leg and hand were successful in all patients, while facial function was properly mapped in one patient only. In all cases, the procedure was well tolerated and no adverse events were recorded. Spatial relationships between tumor and functional tissue guided the surgical planning. Extent of the resection varied from 96.1% to 100% with a postoperative new motor deficit in one patient. Conclusions. nTMS and DTI fiber tracking is a feasible, effective and well-tolerated method to identify motor pathway in deep-seated lesion in pediatric population. Full article

(This article belongs to the Special Issue Advances in Diagnosis and Treatment of Brain Tumors and Nervous System Tumors)

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11 pages, 2626 KiB

Open AccessCase Report

Extra-Neural Metastases of Late Recurrent Myxopapillary Ependymoma to Left Lumbar Paravertebral Muscles: Case Report and Review of the Literature

by Ciro Mastantuoni, Fabio Tortora, Roberto Tafuto, Mario Tortora, Francesco Briganti, Raduan Ahmed Franca, Rosa Della Monica, Mariella Cuomo, Lorenzo Chiariotti, Felice Esposito and Teresa Somma

Brain Sci. 2022, 12(9), 1227; https://doi.org/10.3390/brainsci12091227 - 10 Sep 2022

Cited by 3 | Viewed by 2196

Abstract

Ependymomas are commonly classified as low-grade tumors, although they may harbor a malignant behavior characterized by distant neural dissemination and spinal drop metastasis. Extra-CNS ependymoma metastases are extremely rare and only few cases have been reported in the lung, lymph nodes, pleura, mediastinum, [...] Read more.

Ependymomas are commonly classified as low-grade tumors, although they may harbor a malignant behavior characterized by distant neural dissemination and spinal drop metastasis. Extra-CNS ependymoma metastases are extremely rare and only few cases have been reported in the lung, lymph nodes, pleura, mediastinum, liver, bone, and diaphragmatic, abdominal, and pelvic muscles. A review of the literature yielded 14 other case reports metastasizing outside the central nervous system, but to our knowledge, no studies describe metastasis in the paravertebral muscles. Herein, we report the case of a 39-year-old patient with a paraspinal muscles metastasis from a myxopapillary ependymoma. The neoplasm was surgically excised and histologically and molecularly analyzed. Both the analyses were consistent with the diagnosis of muscle metastases of myxopapillary ependymoma. The here-presented case report is first case in the literature of a paraspinal muscles metastasis of myxopapillary ependymoma. Full article

(This article belongs to the Special Issue Advances in Diagnosis and Treatment of Brain Tumors and Nervous System Tumors)

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10 pages, 791 KiB

Open AccessCase Report

Sixteen-Year Follow-Up in a Cavernous Sinus Hemangiopericytoma: Improved Outcomes over Radiotherapy Advances

by Beatrice Detti, Lilia Bardoscia, Antonio Rosario Pisani, Salvatore Cozzi, Manuele Roghi, Paolo Mammucci and Angela Sardaro

Brain Sci. 2022, 12(9), 1209; https://doi.org/10.3390/brainsci12091209 - 8 Sep 2022

Viewed by 1847

Abstract

Intracranial hemangiopericytomas are rare tumors, accounting for 1% of all central nervous system malignancies. This tumor is considered at high risk of local and also distant metastases. Surgical excision is the gold standard for treatment, but it is seldom curative by itself. Adjuvant [...] Read more.

Intracranial hemangiopericytomas are rare tumors, accounting for 1% of all central nervous system malignancies. This tumor is considered at high risk of local and also distant metastases. Surgical excision is the gold standard for treatment, but it is seldom curative by itself. Adjuvant radiotherapy is often recommended. We report an overview and update of the available literature on one such rare but aggressive mesenchymal tumor, using the case of a 46-year-old woman affected by hemangiopericytoma of the cavernous sinus surgically removed and treated with adjuvant radiotherapy at our institution. After seven years, the patient underwent a local recurrence and was treated with exeresis and Gamma Knife radiotherapy. Sixteen years after the initial diagnosis, she is still well with stable disease. Full article

(This article belongs to the Special Issue Advances in Diagnosis and Treatment of Brain Tumors and Nervous System Tumors)

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