Early versus later presentations of venous malformations: where and why?

Venous malformations (VMs) are congenital anomalies of the venous vasculature, but not all are evident at birth. The factors that lead to presentation later in life are not well understood. The objective of this retrospective cohort study of patients with VMs evaluated at the University of California at San Francisco Birthmarks and Vascular Anomalies Center from 2005 to 2009 was to investigate the clinical presentation of VMs and correlate these features with different types of tissues (e.

Modern surgical outcomes following surgery for sphenoid wing meningiomas.

Object: Cushing and Eisenhardt were the first to describe sphenoid wing meningiomas in detail, categorizing globoid tumors into 3 groups: 1) medial; 2) middle; and 3) lateral. The authors review their experience with resection of sphenoid wing meningiomas at a single center, to examine whether this classification predicts clinical presentation and postsurgical outcome.

Methods: All patients undergoing resection of sphenoid wing meningioma at the authors' institution over a 9-year period were identified.

Association of morbidity with extent of resection and cavernous sinus invasion in sphenoid wing meningiomas.

Sphenoid wing meningiomas (SWMs) typically are histologically benign, insidious lesions, but the propensity of these tumors for local invasion makes disease control very challenging. In this review, we assess whether the degree of resection and extent of cavernous sinus invasion affects morbidity, mortality, and recurrence in patients with SWM. A comprehensive search of the English-language literature was performed.

The prognostic implications of Hyam's subtype for patients with Kadish stage C esthesioneuroblastoma.

Esthesioneuroblastoma (EN) is a rare sinonasal tumor with varied aggressiveness and potential for intracranial invasion. EN is staged anatomically with radiographic evaluation using the Kadish staging system (stages A, B, and C) and histologically by using Hyam's criteria (grades 1-4). Here we show that despite radiographic evidence of aggressive features, the prognosis of patients with Kadish stage C EN is best predicted by tumor histology using Hyam's criteria.

MIB-1 labeling index predicts recurrence in intraventricular central neurocytomas.

Despite the relatively low-grade of most central neurocytomas (CN), evidence suggests the existence of an aggressive subset with a propensity for recurrence. Recent studies have found the MIB-1 labeling index to be a prognostic indicator in CN. Here we review our experience with CN to analyze the relationships between extent of resection, adjuvant therapy, tumor histology, and clinical outcomes based on aggressive histology, as defined by MIB-1 labeling.

Frequency and etiology of unexplained bilateral hydronephrosis in patients with breast cancer: results of a longitudinal CT study.

We retrospectively reviewed the records of 153 patients with breast cancer undergoing serial abdominal computed tomography (CT). During a median follow-up of 40 months, 2 (1.4%) of 153 patients developed bilateral hydronephrosis in the absence of radiologically visible obstructing pathology.

Atypia predicting prognosis for intracranial extraventricular neurocytomas.

Object: The literature, at present, provides limited information about extraventricular neurocytomas (EVNs) and is almost exclusively composed of case reports or small case series. Treatment for EVNs has largely been guided by results from central neurocytoma outcome studies. The authors present an analysis of all reported intracranial EVN cases to establish if tumor histopathological features can substratify EVN into groups with differing prognosis and help guide treatment decisions.

The long-term postsurgical prognosis of patients with pineoblastoma.

Background: For this report, the authors comprehensively summarized the existing literature on patients with pineoblastoma and identified the variables and treatments that had an impact patient on outcomes.

Methods: A comprehensive search identified 109 studies that collectively described the outcomes of patients with pineoblastoma. Individual patient data were classified based on treatment and were subjected to univariate comparisons.

Clinical features and post-surgical outcome of patients with astroblastoma.

Astroblastoma is a rare tumor, and thus experience with these lesions is very limited. The prognosis and appropriate treatment is not well understood, as few individual centers have enough experience with astroblastoma to guide treatment recommendations. We performed a systematic comprehensive search of the published English language literature on patients undergoing surgery for astroblastoma to summarize what is known about these tumors, and to provide some framework for future efforts in this area.

Clinical and surgical considerations for cerebellopontine angle meningiomas.

We retrospectively reviewed 24 patients with cerebellopontine angle (CPA) meningioma from our institution to describe the clinical and surgical significance of extensions into the internal auditory canal (IAC). Of these patients, 62% had invasion of the IAC, which was associated with high rates of unilateral hearing loss at presentation (67% versus [vs.] 22%, p<0.

Epidermal growth factor module-containing mucin-like receptor 2 is a newly identified adhesion G protein-coupled receptor associated with poor overall survival and an invasive phenotype in glioblastoma.

Epidermal growth factor (EGF) module-containing mucin-like receptor 2 (EMR2) is a member of the seven span transmembrane (TM7) adhesion G-protein coupled receptor subclass. It is abundantly expressed in immune cells of myeloid origin and appears to mediate cellular adhesion, migration, and signaling. Based on an analysis showing earlier mortality among glioblastoma patients whose tumors highly express EMR2, we studied its expression patterns in glioblastoma and potential to mediate cellular proliferation and invasion.

Anatomic location is a risk factor for atypical and malignant meningiomas.

Background: Grade II and III meningiomas have higher rates of tumor recurrence than grade I meningiomas after surgery and/or external irradiation. As the utility of noninvasive treatments for brain tumors increases, it is becoming increasingly important to assess the likelihood that a tumor is not benign before treatment initiation. Hence, the authors have reviewed a large series of their patients to determine risk factors for higher-grade pathology, with particular interest paid to tumor location.

Extent of resection and the long-term durability of vestibular schwannoma surgery.

Object: With limited studies available, the correlation between the extent of resection and tumor recurrence in vestibular schwannomas (VSs) has not been definitively established. In this prospective study, the authors evaluated 772 patients who underwent microsurgical resection of VSs to analyze the association between total tumor resection and the tumor recurrence rate.

Methods: The authors selected all cases from a prospectively collected database of patients who underwent microsurgical resection as their initial treatment for a histopathologically confirmed VS.

Implications of cystic features in vestibular schwannomas of patients undergoing microsurgical resection.

Background: Cystic vestibular schwannomas (VSs) are described as being more aggressive than solid tumors.

Objective: We examined 468 VS patients to evaluate whether the presence of cystic components in VSs may be an important feature for predicting postoperative outcome.

Methods: We selected all VS patients from a prospectively collected database (1984-2009) who underwent microsurgical resection for VS.

A critical evaluation of vestibular schwannoma surgery for patients younger than 40 years of age.

Background: There are few published prospective data sets specifically focusing on patients younger than 40 years old undergoing microsurgery for vestibular schwannoma.

Objective: We describe functional outcomes and long-term tumor control after surgery in patients younger than 40 years old enrolled in a prospectively collected database over a 25-year period.

Methods: We selected all vestibular schwannoma patients from a prospectively collected database who were younger than 40 years old at the time of surgical resection for a vestibular schwannoma.

The next step: innovative molecular targeted therapies for treatment of intracranial chordoma patients.

Background: Chordomas are rare, locally aggressive malignancies that often exhibit an insidious natural history and are difficult to eradicate. Surgery and radiotherapy are the treatment mainstays of chordoma, but the chance of local recurrence remains high. Patients who relapse or cannot undergo a complete en bloc resection generally have a poor prognosis.

Phenytoin toxicity secondary to an oxcarbazepine-phenytoin 2C19 interaction.

Background: Polytherapy is common in the management of bipolar disorder, as are the side effects associated with this treatment strategy.

Objective: The authors review the literature on drug-drug interactions involving oxcarbazepine and identify specific mechanisms that may have clinical importance.

Method: The authors provide a case report of a patient who developed phenytoin toxicity associated with an oxcarbazepine-phenytoin interaction.

A meta-analysis of tumor control rates and treatment-related morbidity for patients with glomus jugulare tumors.

Object: Because of the rarity of glomus jugulare tumors, a variety of treatment paradigms are currently used. There is no consensus regarding the optimal management to control tumor burden while minimizing treatment-related morbidity. In this study, the authors assessed data collected from 869 patients with glomus jugulare tumors from the published literature to identify treatment variables that impacted clinical outcomes and tumor control rates.

The molecular pathology of central neurocytomas.

Central neurocytomas (CN) are rare tumors. Since their first description in 1982, the number of case reports and series has been rapidly increasing. Although they are considered low-grade neoplasms, they can be associated with an aggressive primary course or recurrence after resection.

Cancer and the complement cascade.

Despite significant research on the role of inflammation and immunosurveillance in the immunologic microenvironment of tumors, little attention has been given to the oncogenic capabilities of the complement cascade. The recent finding that complement may contribute to tumor growth suggests an insidious relationship between complement and cancer, especially in light of evidence that complement facilitates cellular proliferation and regeneration. We address the hypothesis that complement proteins promote carcinogenesis and suggest mechanisms by which complement can drive the fundamental features of cancer.

Human glioma demonstrates cell line specific results with ATP-based chemiluminescent cellular proliferation assays.

Alteration of tumor cell growth kinetics is the goal of nearly all current or proposed therapies for human neoplasms. The adenosine triphosphate (ATP) chemiluminescent assay has been used for some time as a surrogate marker of in vitro cell growth. Here we present data showing that three human glioblastoma cell lines (U87, U251, G55) demonstrate significantly different cell number to luminescence relationships when subjected to this assay.

EMR-3: a potential mediator of invasive phenotypic variation in glioblastoma and novel therapeutic target.

Epidermal growth factor module-containing mucin-like hormone receptor-3 (EMR-3) is a G-protein coupled receptor with unknown ligand and cellular function. Upregulation of EMR-3 in glioblastoma (GBM) multiforme is associated with poor survival. We investigated the expression patterns and functional significance of EMR-3 in GBM using immunohistochemistry, western blot, reverse transcription PCR, and small interfering RNA knockdown in proliferation and invasion assays.

Factors associated with preservation of facial nerve function after surgical resection of vestibular schwannoma.

Avoidance of facial nerve palsy is one of the major goals of vestibular schwannoma (VS) microsurgery. In this study, we examined the significance of previously implicated prognostic factors (age, tumor size, the extent of resection and the surgical approach) on post-operative facial nerve function. We selected all VS patients from prospectively collected database (1984-2009) who underwent microsurgical resection as their initial treatment for histopathologically confirmed VS.

Hearing preservation rates after microsurgical resection of vestibular schwannoma.

Preservation of hearing is a major goal of surgery for patients with vestibular schwannoma (VS). We performed an analysis of the published literature on hearing outcome after microsurgery for VS. Our objective was to provide a comprehensive and unbiased description of published results.

Postoperative seizures following the resection of convexity meningiomas: are prophylactic anticonvulsants indicated? Clinical article.

Object: Seizures in the perioperative period are a well-recognized clinical entity in the setting of brain tumor surgery. At present, the suitability of antiepileptic prophylaxis in patients following brain tumor surgery is unclear, especially in those without prior seizures. Given the paucity of tumor-type and site-specific data, the authors evaluated the incidence of postoperative seizures in patients with convexity meningiomas and no prior seizures.