1/17. diffusion MR imaging of giant cell tumors in tuberous sclerosis.giant cell tumors were studied by diffusion MR imaging in three patients with tuberous sclerosis. diffusion MR imaging was performed on a 1.5-T unit with a gradient strength of 30 mT/m. b = 1000 seconds/mm2 images, and apparent diffusion coefficient (ADC) maps were studied. ADC values were recorded from ADC maps with particular care to obtain the values from the noncalcified regions of the giant cell tumors. ADC values of the normal brain parenchyma and hamartomas were also recorded by multiple evaluations. The ADC values in all three giant cell tumors (0.78, 0.92, and 0.92 x 10-3mm2/s) were within the ranges of the normal brain parenchyma (0.62-1.04 x 10-3mm2/s), and they were prominently less than those of parenchymal hamartomas (1.18-1.86 x 10-3mm2/s). The finding of ADC values of the noncalcified portions of the giant cell tumors being identical to those of normal brain parenchyma is consistent with the presence of normal molecular motion of water, hence relatively normal tissue integrity within these tumors. This was likely a reflection of benignity of these slowly growing tumors.- - - - - - - - - - ranking = 1keywords = sclerosis (Clic here for more details about this article) |
2/17. Anterior lateral ventricular subependymal giant cell astrocytomas. Microsurgical aspects of two cases.The surgical management of two cases of lateral ventricular subependymal giant cell astrocytoma, arising in the head of the caudate nucleus, and causing hydrocephalus due to obstruction of the foramen of Monro is described. One lesion, in a patient with tuberous sclerosis, was resected using a transcallosal approach and the other, in a patient with no stigmata of tuberous sclerosis, using a frontal, trans-cortical transcystoventricular approach. The microsurgical aspects of excision and pathological anatomy of both tumours were very similar. Following tumour excision and pellucidotomy both patients had partial resolution of their hydrocephalus with complete resolution of their preoperative symptoms. The merits of transcallosal and transcortical approaches to these lesions are discussed.- - - - - - - - - - ranking = 0.4keywords = sclerosis (Clic here for more details about this article) |
3/17. Subependymal giant cell astrocytoma: a clinicopathological study of 23 cases with special emphasis on proliferative markers and expression of p53 and retinoblastoma gene proteins.AIMS: To gain a better insight into the biological behaviour of subependymal giant cell astrocytoma (SEGA), tumour suppressor gene protein expression and various proliferative indices were studied in these tumours and correlated with histological features and clinical outcome. methods: We studied 23 cases of SEGA, 19 from our own Institute and four from the National Institute of mental health and Neurological Sciences (NIMHANS), Bangalore, india. Immunohistochemical staining for various glial and neuronal markers, proliferative markers (MIB-1, Topoisomerase II alpha PCNA) and tumour suppressor gene protein expression of p53 and retinoblastoma (Rb) were performed. RESULTS: Nineteen cases of SEGA were collected over a period of 23 years (January 1978-December 2001), which accounted for 0.16% of all intracranial tumours and 0.51% of all gliomas reported at this centre. Ages ranged from 4 to 37 years (mean 13.2 years) with a male preponderance. Nine of the 23 cases were associated with tuberous sclerosis (TS), six at the time of diagnosis, while three developed TS during the follow-up period. Treatment consisted of surgical resection (total in nine cases and subtotal in 14 cases) followed by radiotherapy in seven cases. Except for two patients who died in the immediate post-operative period of surgical complications, the remaining patients were all alive in the follow-up period (mean 37.1 months). One patient experienced recurrence 22 years after the first surgery and a second patient after 2 years. necrosis and/or mitoses were observed in five cases. Immunohistochemically, tumours were positive for both glial and neuronal markers. Interspersed inflammatory cells were a mixture of mast cells and lymphocytes of T immunophenotype. The MIB-1 labelling index (LI) ranged from 0 to 8% (mean 3.0%), topoisomerase II alpha (topo II alpha) LI from 0 to 9.5% (mean 2.9%) and PCNA LI from 10 to 59% (mean 32.5%). The difference in the labelling indices of tumours with and without mitoses and/or necrosis was not statistically significant. None of the tumours revealed loss of Rb gene protein expression. p53 immunopositivity was seen in 14 cases (labelling indices ranged from 1 to 7.3% with a mean of 2.4%). The correlation between the MIB-1 LI and topo II alpha LI, and topo II alpha LI and PCNA LI was significant (P<0.05) but not so with other parameters like p53 protein expression, duration of survival and morphological features such as mitoses and necrosis. CONCLUSIONS: SEGAs are rare intraventricular tumours associated with TS and express both neuronal and glial markers. They have a low proliferative potential. Mitoses and necrosis are not associated with a worse prognosis. In view of the low proliferative indices and long survival of these patients without recurrence, the role of post-operative radiotherapy is questionable. These patients should be followed up closely as many of them develop stigmata of tuberous sclerosis at a later stage.- - - - - - - - - - ranking = 0.4keywords = sclerosis (Clic here for more details about this article) |
4/17. Subependymal giant cell astrocytoma: a report of five cases.Five cases of intraventricular subependymal giant cell astrocytomas (SEGCA) were retrospectively reviewed. Records and detailed work-up of all five cases were well maintained in view of rare occurrence of these tumors. The five patients were males aged 10, 12 (2 cases), 14 and 18 years. The 18-year-old aged male had no stigmata of tuberous sclerosis (TSC) on examination, while the rest presented with features of TSC, intraventricular tumors and hydrocephalus. None of the five cases had renal tumors and did not reveal cardiac tumors. skin manifestations like shagreen patches were present in two, facial angiofibromas in three, periungal fibromas in two, hypopigmented macules in two and ash-leaf spot in two patients. Fundoscopic examination revealed retinal astrocytomas in two cases only. Two of the five children did not have mental compromise. A child who started throwing seizures early (at 5 months of age) had severe mental retardation. Although SEGCA is a less vascular tumor, one tumor bled profusely intraoperatively; it was excised rapidly via the transcortical route to salvage the life of the child, though he was planned for the transcallosal route like the other cases. The tumor of another child was also very vascular. Four children survived surgery and required no shunt CSF diversion, while one died of severe ventriculitis and septicemia 3 weeks after surgery.- - - - - - - - - - ranking = 0.2keywords = sclerosis (Clic here for more details about this article) |
5/17. meningioma growth and interferon beta-1b treated multiple sclerosis: coincidence or relationship?Although the coincidence of multiple sclerosis (MS) and central nervous system (CNS) tumors has been reported in over 30 cases in English literature, meningioma growth was associated with interferon-beta (INF-b) treated MS only in two of them. We report the case of a 19-year-old woman with clinically possible, laboratory supported MS, and a concomitant right intraventricular tumor with magnetic resonance imaging (MRI) characteristics consistent with meningioma (similar signal with grey matter on T1 and T2-weighted images and homogenous, intense enhancement). Two years after initiation of INF-b treatment, follow-up brain MRI revealed enlargement of the intraventricular mass and relative increase in the number of white matter lesions without significant clinical deterioration. She underwent almost total resection of the mass and histology confirmed the diagnosis of papillary meningioma. Based on the immunohistochemistry results, we speculate that INF-b resulted in meningioma growth by enhancing platelet derived growth factor (PDGF) receptors or/and down-regulating transforming growth factor receptors on the tumor itself.- - - - - - - - - - ranking = 1keywords = sclerosis (Clic here for more details about this article) |
6/17. Subependymal giant cell astrocytoma associated with tuberous sclerosis: with special reference to cell kinetic studies--case report.The authors report a case of subependymal giant cell astrocytoma associated with tuberous sclerosis in a 15-year-old boy. Computed tomographic scans showed a large intraventricular mass with peritumoral calcification and a cyst in the left lateral ventricle. Left dominant unilateral hydrocephalus was also revealed. Magnetic resonance images clearly demonstrated the lesion. The tumor was subtotally removed and a ventriculoperitoneal shunt was performed because of the hydrocephalus. The proliferation potential was assessed by measuring the bromodeoxyuridine (BUdR) labeling index employing the in vitro labeling method, and determining the deoxyribonucleic acid (dna) content by flowcytometry. BUdR-positive cells were found to be rare, and the dna histogram demonstrated no evidence of high proliferative activity or aneuploidy.- - - - - - - - - - ranking = 1keywords = sclerosis (Clic here for more details about this article) |
7/17. Subependymal giant cell astrocytoma.Subependymal giant cell astrocytomas (SEGAs) are slowly growing tumours corresponding to WHO grade I. They are intraventricular and usually occur in the setting of tuberous sclerosis complex. They often result in obstructive hydrocephalus. Treatment is usually restricted to surgical resection, recurrences are rare and long term prognosis is excellent. We present a series of three cases.- - - - - - - - - - ranking = 0.2keywords = sclerosis (Clic here for more details about this article) |
8/17. Neonatal subependymal giant cell astrocytoma associated with tuberous sclerosis: MRI, CT, and ultrasound correlation.We describe a term newborn with tuberous sclerosis who presented with a neonatal brain tumor, diagnosed as a subependymal giant cell astrocytoma. We compare the various imaging modalities used in the diagnosis of this tumor.- - - - - - - - - - ranking = 1keywords = sclerosis (Clic here for more details about this article) |
9/17. tuberous sclerosis presenting as an intraventricular tumour.We report a case of tuberous sclerosis in an 8 year old girl presenting for the first time with features of raised intracranial pressure due to a large intraventricular tumour. Occurrence of these tumours in children with tuberous sclerosis justifies cranial computerised tomography as a screening procedure to detect these tumours early.- - - - - - - - - - ranking = 1.2keywords = sclerosis (Clic here for more details about this article) |
10/17. Subependymal giant-cell astrocytoma associated with tuberous sclerosis. Do subependymal nodules grow?A case of a 10 year-old-boy with subependymal giant-cell astrocytoma associated with tuberous sclerosis is reported. Sequential CT scan showed the growth of subependymal nodules to intraventricular neoplasm, which consequently obstructed the CSF pathway. The surgical indications for this lesion and the role of CT in following up subependymal nodules of tuberous sclerosis are discussed.- - - - - - - - - - ranking = 1.2keywords = sclerosis (Clic here for more details about this article) |
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