1/8. Fetal ependymoma associated with Down's syndrome.Down's syndrome (DS) is the most common multiple malformation syndrome occurring in humans and is associated with an increased risk of childhood malignancies, in particular leukemias. However, solid tumors seem to be underrepresented in DS patients and brain tumors occurring in association with DS have so far been limited to sporadic case reports, predominantly in children and young adults. We present the first case of an ependymoma associated with DS. This is also the youngest patient with DS suffering from a brain tumor as well as the first case in the English literature of a fetal ependymoma. The tumor was discovered incidentally at autopsy in a female fetus with DS after amniocentesis and termination of pregnancy in the 19th gestational week. Neuropathological examination revealed a tumor of 3x2x1 mm attached to the medulla oblongata rostrally of the floor of the fourth ventricle. Histologically, the ependymoma was moderately cellular and well demarcated with numerous perivascular pseudorosettes. immunohistochemistry showed strong reactivity for GFAP, in particular of the fibrillary elements of the pseudorosettes, while the neuronal marker synaptophysin was not expressed. The Ki67/MIB-1 proliferation index was 0.5%.- - - - - - - - - - ranking = 1keywords = leukemia (Clic here for more details about this article) |
2/8. A graft-versus-tumor effect in a patient with ependymoma who received an allogenic bone marrow transplant for therapy-related leukemia. Case report.Graft-versus-leukemia effect is an immune-mediated antitumor phenomenon associated with allogenic bone marrow transplants (BMTs) for hematological malignancies, and recent findings have indicated that a similar effect could occur in some solid tumors such as breast cancers. The authors report on a 42-year-old man with a recurrent ependymoma who received an allogenic BMT for therapy-related leukemia. After transplantation, the patient developed chronic graft-versus-host disease, which was controlled with steroid agents. Interestingly, the recurrent ependymoma regressed steadily over the next 21 months posttransplant, until the tumor became almost undetectable on magnetic resonance images. This case indicates that the graft-versus-tumor effect, mediated by cytotoxic T cells, may be able to target intraparenchymal neuroepithelial tumors, despite the brain's generally recognized status as an immunoprivileged organ.- - - - - - - - - - ranking = 6keywords = leukemia (Clic here for more details about this article) |
3/8. Acute leukaemia following malignant ependymoma: a case report.Though an increasing number of chemotherapy- and radiotherapy-related leukaemias are being reported, acute promyelocytic leukaemia developing as a therapy-related second malignancy is still uncommon. Here we report a case of acute promyelocytic leukemia, microgranular variant, developing in a case of intracranial malignant ependymoma, 1.5 years following treatment with craniospinal radiotherapy.- - - - - - - - - - ranking = 1keywords = leukemia (Clic here for more details about this article) |
4/8. ependymoma, glioblastoma, and acute leukemia in a child.A 5-year-old boy developed an ependymoma; 3 years later, after chemotherapy and radiotherapy, he developed glioblastoma multiforme and acute myeloblastic leukemia. His maternal grandmother had died at a young age of colon cancer. Since ependymoma is not known to predispose to other cancers, the unusual sequence of malignant disease may have been due to combined therapy in a susceptible host.- - - - - - - - - - ranking = 5keywords = leukemia (Clic here for more details about this article) |
5/8. Fatal long-term sequela following radiation "cure" for ependymoma.There are no previous reports of glioblastoma occurring following central nervous system irradiation. This report describes a young girl with an ependymoma at age 13 months who was treated by radiotherapy following surgical removal. At age 6 years she presented with a new lesion in the same location. Histologically there was no evidence of recurrent ependymoma. Instead, the pathological picture suggested glioblastoma or a severe radiation-induced encephalopathy. In either case, it seems likely that the changes were radiation induced.- - - - - - - - - - ranking = 295.12343209254keywords = radiation-induced (Clic here for more details about this article) |
6/8. methotrexate osteopathy in infants with tumors of the central nervous system.methotrexate osteopathy, previously reported as a complication of maintenance-therapy for acute lymphoblastic leukemia, is characterized by osteopenia, particularly involving the lower extremities, thick, dense provisional zones of calcification, growth arrest lines, and corner fractures resembling scurvy. In attempts to postpone radiotherapy in infants under three years of age, the multicentric German therapy protocol for childhood central nervous system tumors (HIT-89 protocol) has employed high cumulative methotrexate doses. Here we describe osteopathy in three patients as a toxic side effect after administration of cumulative methotrexate doses of 20 g/m2, 80 g/m2 and 135 g/m2. The high prevalence of this adverse effect in infants with tumors of the central nervous system may be attributed to the long-term therapy with high cumulative methotrexate-doses. Both factors may favor intracellular accumulation of methotrexate and formation of methotrexate-polyglutamates and may be responsible for bone toxicity. Apparently the susceptibility of the rapidly growing skeletal structures of infants under three years of age to this toxic side effect of methotrexate is remarkably high.- - - - - - - - - - ranking = 1keywords = leukemia (Clic here for more details about this article) |
7/8. Multiple radiation-induced intracranial lesions after treatment for pituitary adenoma. Case report.This 53-year-old man presented with a syncopal episode 31 years after undergoing craniotomy and external-beam radiation for a pituitary macroadenoma. A gadolinium-enhanced magnetic resonance (MR) image of the brain demonstrated a 2.5-cm enhancing mass in the right caudate region that had not been seen on previous studies. A stereotactically guided biopsy procedure was performed to obtain specimens from the mass, which were consistent with ependymoma. The MR image also revealed two additional lesions that appeared to be within the radiation fields: a right temporal meningioma and a left frontal cavernous malformation. A review of the literature found three previous reports in which ependymomas presented after radiation therapy.- - - - - - - - - - ranking = 1180.4937283701keywords = radiation-induced (Clic here for more details about this article) |
8/8. Second malignancy following treatment of acute lymphoblastic leukemia in children.Second malignancy is one of the serious late effects among long-term survivors of acute lymphoblastic leukemia (ALL) in children. Of 83 newly diagnosed pediatric ALL patients at our hospital between January 1980 and December 1995, four patients were found to have second malignancies. These included MDS/AML after B-ALL, rhabdomyosarcoma after early pre-B ALL, ependymoma after B-ALL, and astrocytoma after early pre-B ALL. The mean duration from initial ALL to second malignancy was 5.2 years. The possible causes of second malignancy in these patients are discussed in this report, along with a review of recent literature.- - - - - - - - - - ranking = 5keywords = leukemia (Clic here for more details about this article) |