Publications by authors named "Kevin Beccaria"

Objective: Guidelines for the management of pediatric severe traumatic brain injury (TBI) recommend external ventricular drainage for CSF drainage as a first-tier treatment in the intracranial pressure (ICP) pathway. However, ventriculostomy in children can sometimes be challenging because of the small size of the lateral ventricles. External lumbar drainage (ELD) may be a useful alternative; therefore, the authors analyzed the outcome of a cohort of pediatric patients who underwent ELD to manage intracranial hypertension (ICH).

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  • Constitutional mismatch repair deficiency (CMMRD) leads to a significant cancer risk, primarily resulting in high-grade gliomas in children due to mutations in mismatch repair genes.
  • Analysis of clinical and genetic data from 12 affected children revealed that 50% of their glioma samples expressed PDL1 and exhibited an ultra-hypermutated phenotype, with numerous mutations and specific driver mutations identified.
  • The research indicates that CMMRD gliomas have distinct oncogenic properties, differing from typical glioblastomas, suggesting potential for targeted therapies, particularly those targeting MAPK pathways and PD1 inhibitors.
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Background: Rhabdoid tumors (RT) are aggressive, rare tumors predominantly affecting young children, characterized by biallelic SMARCB1 gene inactivation. While most SMARCB1 alterations are acquired de novo, a third of cases exhibit germline alterations, defining Rhabdoid Tumors Predisposition Syndrome. With the increased sensitivity of next-generation sequencing (NGS), mosaicisms in genes linked to genetic diseases are more detectable.

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Purpose: Supratentorial (ST) ependymoma subgroups are defined by two different fusions with different prognoses. Astroblastomas, MN1-altered, have ependymal-like histopathologic features and represent a differential diagnosis in children. We hypothesized that ZFTA-fused ependymoma and YAP1-fused ependymoma on the one hand, and astroblastoma, MN1-altered, on the other hand, show different MRI characteristics.

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Background: Children with constitutional mismatch repair deficiency (CMMRD) syndrome have an increased risk of high-grade gliomas (HGG), and brain imaging abnormalities. This study analyzes brain imaging features in CMMRD syndrome children versus those with HGG without CMMRD.

Methods: Retrospective comparative analysis of brain imaging in 30 CMMRD children (20 boys, median age eight years, 22 with HGG), seven with Lynch syndrome (7 HGG), 39 with type 1 neurofibromatosis (NF1) (four with HGG) and 50 with HGG without MMR or NF1 pathogenic variant ("no-predisposition" patients).

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Background: pathogenic variants (PV) have been recently identified as the most frequent variants predisposing to Sonic Hedgehog (SHH) medulloblastomas (MB); however, guidelines are still lacking for genetic counseling in this new syndrome.

Methods: We retrospectively reviewed clinical and genetic data of a French series of 29 -mutated MB.

Results: All patients developed SHH-MB, with a biallelic inactivation of found in 24 tumors.

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Objective: Adamantinomatous craniopharyngioma mainly affects children. Excessive weight gain is a major long-term complication. The primary objective of this study was to assess long-term weight changes in children treated for craniopharyngioma.

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A novel methylation class, "neuroepithelial tumor, with PLAGL1 fusion" (NET-PLAGL1), has recently been described, based on epigenetic features, as a supratentorial pediatric brain tumor with recurrent histopathological features suggesting an ependymal differentiation. Because of the recent identification of this neoplastic entity, few histopathological, radiological and clinical data are available. Herein, we present a detailed series of nine cases of PLAGL1-fused supratentorial tumors, reclassified from a series of supratentorial ependymomas, non-ZFTA/non-YAP1 fusion-positive and subependymomas of the young.

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Meningioangiomatosis (MAM) remains a poorly understood lesion responsible for epileptic disease. In the past, MAM was primarily described in the context of neurofibromatosis type 2 before being mainly reported sporadically. Moreover, the malformative or tumoral nature is still debated.

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Background: Optic pathway gliomas (OPGs) represent 5% of childhood brain tumors. Successive relapses lead to multiple treatments exposing to late complications.

Methods: We included patients treated at Gustave Roussy (GR) between January 1980 and December 2015 for OPG, before 18 years old and alive at 5 years from diagnosis.

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Erythroblastic sarcoma (ES) (previously called chloroma or granulocytic sarcoma) are rare hematological neoplams characterized by the proliferation of myeloid blasts at extramedullary sites, and primarily involve the skin and soft tissue of middle-aged adults. ES may be concomitant with or secondary to myeloid neoplasms (mostly acute myeloid leukemia (AML)) or in isolated cases (de novo) without infiltration of the bone marrow by blasts. ES share cytogenetic and molecular abnormalities with AML, including RUNX1T1 fusions.

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  • Pilocytic astrocytomas (PA) are tumors that have unique features based on where they are located in the brain or spine.
  • Doctors face challenges in telling PAs apart from similar tumors, especially in the brain's hemispheric region.
  • A study looked at different types of PAs, and found that they often affect kids and can show various patterns in medical tests, highlighting the need for careful examination for accurate diagnosis.
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Background: The co-occurrence of moyamoya vasculopathy and extra-optic pathway tumors is rare in neurofibromatosis type 1 (NF1), with only four cases described in the literature. Brain surgery in these patients may be challenging because of the risk of brain infarction after skin and dural incision. Given its percutaneous and minimally invasive nature, laser interstitial thermal therapy (LITT) is an ideal option for the treatment of brain tumors in these patients.

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  • Diffuse midline gliomas (DMGs) H3 K27-altered are aggressive brain tumors classified into four subtypes, with the H3.3-K27M subgroup exhibiting significant variability in clinical and molecular features.
  • Recent findings suggest that some patients with both H3.3-K27M and BRAF or FGFR1 mutations have a better prognosis, prompting researchers to analyze a cohort of 29 such tumors alongside 31 previously reported cases.
  • Comprehensive analyses reveal that these co-altered DMGs form a unique subtype with distinct DNA methylation profiles, higher occurrence in the thalamus, atypical radiological features, and longer median survival times, highlighting the need for tailored patient management strategies.
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Objective: This study aimed to assess the relevance of using multi-positional MRI (mMRI) to identify cranio-vertebral junction (CVJ) instability in pediatric patients with CVJ anomalies while determining objective mMRI criteria to detect this condition.

Material And Methods: Data from children with CVJ anomalies who underwent a mMRI between 2017 and 2021 were retrospectively reviewed. Mobility assessment using mMRI involved: (1) morphometric analysis using hierarchical clustering on principal component analysis (HCPCA) to identify clusters of patients by considering their mobility similarities, assessed through delta (Δ) values of occipito-cervical parameters measured on mMRI; and (2) morphological analysis based on dynamic geometric CVJ models and analysis of displacement vectors between flexion and extension.

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  • - The study identified VRK3 as a specific vulnerability in DMG-H3K27M cells, revealing that its depletion disrupts the cell cycle, especially the G1/S transition, leading to growth arrest.
  • - Knockdown of VRK3 also affected genes related to chromosome segregation and decreased phosphorylation of histone H3, suggesting issues with chromatin regulation during cell division.
  • - Additionally, the research indicated that VRK3 loss causes a metabolic shift towards oxidative phosphorylation, hinting at a potential cell survival mechanism, and proposes therapeutic strategies combining VRK3 depletion with ONC201, a ClpP protease activator.
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Objective: The outcome of endoscopic third ventriculostomy (ETV) in children who had previously received shunts and who were experiencing shunt dysfunction is still discussed in terms of efficacy (success rate from 40% to 80%) and safety (0%-32.5% of complications). Reported predictive factors of secondary ETV failure are age, early onset of hydrocephalus, and prematurity.

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  • - Atypical teratoid rhabdoid tumors (ATRT) are classified into MYC, TYR, and SHH subgroups, indicating different possible origins of these tumors.
  • - Research shows that MYC tumors may originate outside the brain, while SHH ATRT can arise from specific brain regions like the cerebellar anterior lobe and the basal ganglia, confirmed by single-cell RNA sequencing.
  • - Analysis indicates that losing the SMARCB1 gene leads to a de-differentiation in SHH ATRT, influenced by factors that suppress neuron differentiation, such as REST and the NOTCH pathway.
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Background: Diffuse midline gliomas (DMG) are pediatric tumors with negligible 2-year survival after diagnosis characterized by their ability to infiltrate the central nervous system. In the hope of controlling the local growth and slowing the disease, all patients receive radiotherapy. However, distant progression occurs frequently in DMG patients.

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  • Posterior fossa ependymomas can be split into two groups (EPN_PFA and EPN_PFB), which differ in their DNA methylation and prognoses; EPN_PFA is more common in younger patients and tends to have larger tumor volumes and more severe symptoms like hydrocephalus.* -
  • A study analyzing MRI scans of 68 patients showed that EPN_PFA tumors are typically larger (57 cm³ vs. 29 cm³), have more intratumor calcifications (93% vs. 40%), and exhibit different enhancement patterns (5% homogeneous vs. 75% for EPN_PFB).* -
  • The findings suggest that MRI characteristics vary between the two e
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Unlabelled: Patients with H3K27M-mutant diffuse midline glioma (DMG) have no proven effective therapies. ONC201 has recently demonstrated efficacy in these patients, but the mechanism behind this finding remains unknown. We assessed clinical outcomes, tumor sequencing, and tissue/cerebrospinal fluid (CSF) correlate samples from patients treated in two completed multisite clinical studies.

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