CT scans of 3,000 consecutive normal persons were examined to verify the incidence of calcification in the pineal body, the habenular commissure, and the choroid plexus of the lateral ventricle. In people over 10 years old, pineal calcification was found in 83% (male 83%, female 81%), habenular calcification in 18% (male 22%, female 60%). In people over 30 years of age, pineal calcification was found in 86%, habenular calcification in 20%, and choroid plexus calcification in 69%. There was a preponderance of male cases in almost all decades. The size and shape of the calcification in the pinealregion were examined in 29 pineal-regiontumors and other germinoma cases. There were no specific differences in calcification between normal persons and the pinealregiontumor cases. However, there was a tendency for the pineal body calcification in the pineal teratoma to deviate unilaterally.
While several computed tomographic (CT) studies of posterior third ventricular neoplasms have included descriptions of pinealtumors, few reports have concentrated on these uncommon lesions. Some authors have asserted that the CT appearance of many pinealtumors is virtually pathognomonic. A series of nine biopsy-proved pineal gland and eight other presumed tumors is presented that illustrates their remarkable heterogeneity in both histopathologic and CT appearance. These tumors included germinomas, teratocarcinomas, hamartomas, and other varieties. They had variable margination, attentuation, calcification, and suprasellar extension. Germinomas have the best response to radiation therapy. Biopsy of pinealregiontumors is now feasible and is recommended for treatment planning.
Presented is a patient with papillary tumor of the pinealregion (PTPR), an uncommon and recently recognized neoplasm. As its name implies, PTPR does not arise from the pineal gland itself. The cell of origin is thought to be the specialized ependymocytes of the subcommissural organ. Primary tumors ...
To determine the computed tomography (CT) and magnetic resonance (MR) characteristics of pinealregion germinomas, the author reviewed images from 40 patients with pinealregiontumors. These tumors were divided into two groups: those with germinomas (n=17), and those with other tumors in the pinealregion (5 with a germ cell tumor other than germinoma; 8, mixed germ cell tumor; 8, pineal parenchymal tumor; and 2, miscellaneous tumors; n=23). All cases were investigated with CT; 31 of the cases were also investigated with MR imaging. The following parameters comprised statistically significant differences between the two groups: maximum size of the tumor, tumor density of the precontrast CT, signal intensity of precontrast T1-weighted spin-echo images, and homogeneity of the tumor on both precontrast and postcontrast studies. This study found that extension patterns of pinealregiontumors into the thalamus have significant implications in differentiating germinomas from other tumors of this region. Germinomas are characterized by thalamic extension without lateral displacement of the third ventricle walls due to direct compression by tumors (p=0.0034). The analysis of tumor extension patterns, combined with the parameters mentioned above, may provide a more accurate differential diagnosis in pinealregiontumors, leading to prompt and appropriate treatment. (author)
The aim of this volume is to review the pertinent literature dealing with pinealtumors and thus aid in the handling of these rather uncommon lesions. After the first, introductory, chapter, three chapters treat the pathology and diagnosis of pinealtumors. There is also one chapter on intracranial germ cell tumors (natural history and pathogenesis) and one on the normal function of the pineal gland. With the exception of the chapter on diagnostic radiology of pinealtumors, which seems somewhat superficial, these five chapters summarize current knowledge about the nature of these complex lesions and their symptomatology very well. The next nine chapters deal with biopsy and surgery of these tumors and how to manage the patient. The first of these gives a historical review of the development of surgical techniques - from the first attempt by Horsley in 1905 to the microsurgical techniques of today. It is followed by a very important and detailed description of the microsurgical anatomy of the pinealregion.
The aim of this paper is to explain the different radio-clinical presentations of pinealregiontumors. Although MR images provide a important help to diagnosis, because of topographic analysis and evaluation of MR characteristics in the tumors, clinic, presentation tumors markers and the stereotaxic surgery are also of great importance. Radiological appearances, while not pathognomonic, are helpful in the differential diagnostic of pinealregion tumours. (authors). 44 refs.
Abstract in spanish La región pineal es un sitio inusual para el depósito de metástasis y la mayoría de las metástasis pineales son asintomáticas. Un hombre de 53 años debutó con una cefalea intensa, limitación en la supraversión y diplopia. La exploración neurológica fue irrelevante. La resonancia magnética (RM) cerebral demostró una lesión solitaria de 1,5 x 2 cm bien delimitada, en la región pineal con hidrocefalia. Fue intervenido quirúrgicamente siendo el diagnóstico a (more) natomopatológico de adenocarcinoma. Un estudio sistémico descubrió un adenocarcinoma de pulmón como tumor primario. Aunque muy raramente, las metástasis deben considerarse en el diagnóstico diferencial de tumores de la región pineal. Abstract in english The pinealregion is an unusual site for brain metastasis and most metastatic pineal lesions are asymptomatic. A 53 year-old man presented with severe headache, limitation of upward gaze and diplopia. The patient's neurological examination was unremarkable. Magnetic resonance imaging (MRI) scans of the brain demonstrated a 1,5 x 2 cm well demarcated solitary mass in the pinealregion with hydrocephalus. Surgery was performed and adenocarcinoma was diagnosed. A systemic in (more) vestigation revealed adenocarcinoma of the lung as primary lesion. Although rare, metastatic tumor should be considered in the differential diagnosis of pinealregiontumors.
Pineal germinoma is the commonest pinealregiontumor of childhood and adolescence. Metastatic germinoma most commonly occurs via the cerebrospinal fluid (CSF), and it is usually limited to the cerebrospinal axis. ExtacraniaI hematogenous metastasis is known to be very rare. We report here on a case of pineal germinoma with gradual extracranial metastases that occurred both through the CSF pathway and by hematogenous spread. The patient had multifocal CSF seeding after his surgery for pineal germinoma, and the left iliac metastasis and lung metastasis then occurred.
A 48-year-old female presented with an extremely rare primary tumor of the pinealregion with papillary features manifesting as morning headaches persisting for 1 month. Magnetic resonance imaging showed a well-defined mass, with some cystic components, in the region of the pineal gland. The tumor was completely removed through an occipital transtentorial approach in the prone position. Histological examination found a distinctive papillary growth pattern in which the vessels were covered by multiple layers of tumor cells. The histological diagnosis was papillary tumor of the pinealregion (PTPR), which has recently been described as a distinct clinicopathological entity requiring careful follow up because the prognosis is not well understood. Postoperatively, the patient has continued to do well, with no recurrence at the 8-month follow-up examination. PTPR should be considered in the differential diagnosis of pinealtumors. PTPR may have been frequently misinterpreted in the past as either ependymoma or choroid plexus papilloma due to the similar morphology.
The study cases were 804 patients who had received either CT or plain radiographs for some reasons. Their ages ranged from newborn to 15 years old. Twenty four patients had the pineal calcification, in which one patient had the pinealregiontumor and 4 patients had precocious puberty. The incidence of the pineal calcification was observed on CT as 0.2, 5.8, and 14 % in their age of 0 to 5, 6 to 10, and 11 to 15 years old, respectively. On the other hand, this finding was detected only in 0, 1.1, and 1.2 % on plain radiographs. In conclusion, pineal calcification on CT may suggest the pathological state in children. Although it is observed in a minority of normal children, such a calcification could be looked upon as not only pinealregiontumor but precocious puberty and other intracranial disorders with suspicion.
Two patients presented with metastatic pinealtumors. A 69-year-old man had gait disturbance, dementia, and urinary incontinence but no history of previous malignancy. Magnetic resonance imaging of the brain revealed a 23-mm tumor in the pinealregion and obstructive hydrocephalus. A 37-year-old man had been treated for thyroid cancer. He presented with vomiting and consciousness disturbance. Brain magnetic resonance imaging revealed a 28-mm pinealtumor associated with intratumoral hemorrhage and accompanying obstructive hydrocephalus. Both patients underwent neuroendoscopic biopsy and third ventriculostomy through the foramen of Monro, resulting in reliable histological diagnoses and subsidence of hydrocephalus.
In this letter to the editor the authors agree with Glanzmann and Seelentag that, for tumors of the pinealregion and suprasellar germinomas, empirical radiotherapy after ventriculoperitoneal shunting can give gratifying results, particularly in patients under the age of 30. On the other hand they strongly recommend an aggressive surgical approach as the initial therapeutic manoever for pinealtumors. The authors further clearly indicate in which cases radiotherapy or chemotherapy is recommended as the next therapeutic option. (author). 4 refs.
Pineoblastomas are uncommon pinealtumors, which demonstrate rapid growing and poor prognosis. We report the case of a 43-year-old man with an enhancing pinealregion mass, which showed restriction of the diffusion on diffusion-weighted (DW) MR images. The surgical biopsy defined the diagnosis of pineoblastoma and the therapy was initiated with radiation and chemotherapy. Three months later, the follow-up MR imaging showed areas suggestive of necrosis and the DW images demonstrate no significant areas of restricted diffusion. The differential diagnosis of pinealregion masses that could show restriction of diffusion is discussed. (author)
Atypical teratoid rhabdoid tumor (AT/RT) is a rare entity. In the central nervous system, AT/RT generally arises from the posterior fossa of infants and behaves aggressively. AT/RT is reported to arise from the infratentorial region (63%) and other sites, such as the suprasellar region, cerebellopontine angle, and spinal cord. The pinealregion is rare (6%) as a site of origin. Radiation-induced brain tumors are well known. In this report, we present a case of a pinealregiontumor causing acute hydrocephalus that could be pathologically diagnosed as AT/RT following prophylactic cranial irradiation for acute lymphoblastic leukemia.
Abstract Primary pineal malignant melanomas are a rare subset of primary central nervous system melanomas. This report presents the case of a 20-year-old female patient with a primary pinealregion malignant melanoma who underwent endoscopic biopsy and adjuvant therapy. Her treatment consisted of stereotactic radiation to the pinealtumor, conventional whole-brain radiation and Temodar for the disseminated disease. She required a ventriculo-peritoneal shunt for refractory ICP problems. This report details the clinical features of the case and summarizes the literature on a rare but aggressive neoplasm.Copyright Copyright 2007 S. Karger AG, Basel
Abstract in portuguese OBJETIVO: Os tumores da região pineal são incomuns e podem ser divididos em três categorias de acordo com a sua origem: células germinativas, células do parênquima e células gliais. Em sua maioria, os gliomas de pineal são astrocitomas de baixo grau, sendo que o seu correspondente maligno, glioblastoma multiforme, é o mais comum e agressivo tumor encefálico e é extremamente raro nesta localização, com apenas alguns casos relatados na literatura. CASO: Mulher (more) com 29 anos apresentando há 2 meses cefaléia, nucalgia, febre, náuseas e crises convulsivas. O exame físico mostrou rigidez de nuca, hipotonia, hipotrofia e hiperreflexia generalizadas, sinal de Babinski e paralisia do VI nervo craniano. A tomografia computadorizada revelou lesão hipodensa mal delimitada na topografia de pineal, com captação heterogênea de contraste. A ressonância magnética demonstrou lesão na região pineal com infiltração de tálamo à direita. A paciente foi submetida a craniotomia direita com ressecção parcial do tumor. O exame histológico definiu o diagnóstico de glioblastoma multiforme. No pós-operatório foi indicada radioterapia, mas a paciente recusou o tratamento e morreu dois meses depois. CONCLUSÃO: Apesar de raro nesta topografia, os glioblastomas multiformes devem ser considerados no diagnóstico diferencial de lesões agressivas localizadas na glândula pineal. Abstract in english PURPOSE: pinealregiontumors are uncommon, and comprise more frequently three categories: germ cell, parenchymal cell and glial tumors. Most pineal gliomas are low-grade astrocytomas. Glioblastoma multiforme, the most aggressive and common brain tumor, is extremely rare at this location with only few cases reported. CASE DESCRIPTION: a 29-year-old woman with a two month history of headache, nuchal pain, fever, nausea and seizures and physical examination showing nuchal r (more) igidity, generalized hypotony, hypotrophy and hyper-reflexia, Babinski sign and left VI cranial par palsy. CT scan examination revealed a ill-defined hypodense lesion at the pinealregion with heterogeneous contrast enhancement. MRI showed a lesion at the pinealregion infiltrating the right thalamic region. The patient underwent a right craniotomy with partial resection of the mass. The histological examination of paraffin-embedded material defined the diagnosis of glioblastoma multiforme. Post-operative radiotherapy was indicated but the patient refused the treatment and died two months afterwards. CONCLUSION: in spite of its rarity at this location, glioblastoma multiforme should be considered in the differential diagnosis of aggressive lesions at the pinealregion.
The CT findings of 17 germ cell tumors were studied in relation to the locations of the tumor, the pathological diagnoses, and the tumor markers (AFP and HCG). Generally, the CT findings of germ cell tumors depended on the pathological diagnoses more strongly than on the location of the tumors. On plain CT of 7 germ cell tumors in the pinealregion, all of them demonstrated heterogeneous findings. Hydrocephalus was seen in 6 cases (86%) and calcification in 6 cases (86%) of the germ cell tumors in the pinealregion. Calcification and hydrocephalus that appeared more often than in other regions were characteristic of germ cell tumors of the pinealregion. The germ cell tumors in the basal ganglia had a slightly homogenous high density, with small cysts and calcification in most of them on plain CT. On enhanced CT, the tumors were moderately enhanced in all cases located in the basal ganglia. Four cases of germ cell tumors located in the basal ganglia revealed the dilatation of lateral ventricle due to hemispheric atrophy in the tumor side. The germ cell tumors showing an increase in the tumor markers such as AFP and HCG, which were usually malignant germ cell tumors, were strongly enhanced on enhanced CT. (author).
Abstract in portuguese Pineoblastomas são tumores incomuns da glândula pineal, os quais têm crescimento rápido e prognóstico reservado. Os autores objetivam relatar o caso de um homem de 43 anos de idade com uma massa na região pineal com realce pelo contraste, a qual demonstrou restrição da difusão nas imagens de ressonância magnética (RM) pesadas em difusão. A biópsia cirúrgica definiu o diagnóstico de pineoblastoma e o tratamento foi iniciado com radio e quimioterapia. Três m (more) eses mais tarde, a RM de controle demonstrou áreas sugestivas de necrose e não mais eram observadas áreas de restrição da difusão da água. O diagnóstico diferencial das massas na região pineal que podem apresentar restrição da difusão é discutido. Abstract in english Pineoblastomas are uncommon pinealtumors, which demonstrate rapid growing and poor prognosis. We report the case of a 43-year-old man with an enhancing pinealregion mass, which showed restriction of the diffusion on diffusion-weighted (DW) MR images. The surgical biopsy defined the diagnosis of pineoblastoma and the therapy was initiated with radiation and chemotherapy. Three months later, the follow-up MR imaging showed areas suggestive of necrosis and the DW images de (more) monstrate no significant areas of restricted diffusion. The differential diagnosis of pinealregion masses that could show restriction of diffusion is discussed.
A 48-year-old female presented with headache and limitation of upward gaze. She had a history of total gastrectomy for gastric adenocarcinoma 2 years previously. Computed tomography with contrast medium and T1-weighted magnetic resonance (MR) imaging with gadolinium showed ring-like enhancement of a solitary mass in the pinealregion with obstructive hydrocephalus. T2-weighted MR imaging showed the tumor as hypointense. This MR imaging finding complicated the preoperative diagnosis, but malignancy was suspected from the medical history. The tumor was subtotally resected via the occipital transtentorial approach with a rigid endoscope. Histological examination of the surgical specimen revealed adenocarcinoma cells with extensive coagulation necrosis, which might have contributed to the hypointensity on T2-weighted MR imaging. Correct diagnosis of metastatic adenocarcinoma based only on MR imaging may be difficult in such cases, but metastatic adenocarcinoma of the pinealregion must be considered in the differential diagnosis of pinealtumors.
Abstract in portuguese Meningiomas são tumores poucos frequentes em crianças, e mais raramente encontrados na região da pineal. Relatamos dois casos de meningioma da região da pineal em crianças, uma menina de cinco anos e um menino de um ano de idade. Não foi identificada nenhuma forma de apresentação clinica ou caracteristica tomográfica, antes do tratamento, que sugerisse o diagnóstico de meningioma. As características clinicas e laboratoriais encontradas foram similares às de tu (more) mores mais frequentes da região da pineal. Ambos os pacientes foram submetidos ao tratamento cirúrgico e a remoção completa foi obtida por abordagem suboccipital transtentorial. Durante o seguimento, um dos pacientes foi reoperado por recorrencia do tumor seis anos após o tratamento inicial. Atualmente, os pacientes encontram-se livres de recorrência tumoral. Abstract in english Meningiomas are uncommon tumors in children and either more rarely encountered in the pinealregion. We report two cases of meningioma of the pinealregion in children. One of these cases was a five years-old girl and the other a one year-old boy. No specific clinical presentation or tomographic examinations findings was identified before treatment, suggestive of a diagnosis of menigioma. The clinical and laboratory features were very similar to the most common tumors of (more) the pinealregion. Prior to the surgery, the histology of these tumors was not suspected. Both patients underwent direct surgery and complete removal was achieved by a suboccipital transtentorial approach. The tumors originated from velum interpositum in both cases. At the follow up, one case presented with recurrence six years later, and she underwent a reoperation with total resection without morbidity. Long-term follow up presented no other recurrences.
Abstract in portuguese Relatamos dois pacientes com neurocitoma central com localização incomum no sistema nervoso central. O primeiro, 58 anos, masculino, apresentava sinais e sintomas de hipertensão intracraniana, tinha um tumor na região da pineal. O segundo, feminino, 21 anos, tinha um tumor na região do aqueduto de Sylvius e apresentava cefaléia migranosa progressiva e diplopia. Ambos apresentavam hidrocefalia obstrutiva tratada com terceiroventriculostomia endoscópica e biópsia da (more) lesão. Não foi feito tratamento adicional. Concluimos que os neurocitomas devem ser considerados no diagnóstico diferencial de tumores localizados na região da pineal e do aqueduto. Abstract in english We report two patients with central neurocytomas at an uncommon location in the brain. The first, a 58-year-old man presenting with signs and symptoms of increased intracranial pressure, had a tumor located at the pinealregion. The second, a 21-year-old woman with tumor in the aqueductal region had worsening migraine-like headaches and diplopia. Both patients had obstructive hydrocephalus treated by neuroendoscopic third ventriculostomy and biopsy of the tumors. No addit (more) ional treatment was done. We conclude that neurocytomas should be considered in the differential diagnosis of tumors located in the pineal and aqueductal regions.
Papillary tumor of the pinealregion (PTPR) is an uncommon tumor recently added to the WHO classification of CNS tumors. We report a case of PTPR in a young boy that was noteworthy for early CSF dissemination and relentless progression. In spite of intensive chemotherapy and comprehensive radiotherapy, the boy died. The neuroimaging appearance is unique with possible multicentric origin of the tumor and intense uptake of {sup 111}In-DTPA-pentetreotide. (orig.)
Purpose: The purpose was to analyze characteristic magnetic resonance (MR) imaging of pinealregiontumors and to explore the value of diffusion-weighted imaging (DWI) and ^1H-MR spectroscopy (^1H-MRS) in differential diagnosis among four common solid diseases: germinoma, teratoma, pineoblastoma, and glioma. Methods: Thirty-three patients with pinealregiontumors proven by pathology were prospectively studied. All of them underwent MRI SE-T1WI, FSE-T2WI, fluid-attenuated inversion recovery (FLAIR), and postcontrasted MR scan. Minimum apparent diffusion coefficient (ADC) value, and maximum MRS choline/N-acetyl-aspartate (Cho/NAA) and lipid/creatine (Lip/Cr) metabolic peak-height ratios were quantified within each lesion. Results: Most pinealregion diseases have their typical morphology, s...
Abstract in portuguese Metástases cerebrais derivadas de adenocarcinomas colorretais ocorrem em 8% dos casos. Geralmente a doença primária e as metástases em outros órgãos já são conhecidas quando do momento das manifestações neurológicas. Descrevemos um caso de metástase única na região pineal que promoveu a primeira manifestação clínica de adenocarcinoma colorretal. Uma mulher de 48 anos de idade apresentava há quinze dias de sua admissão ao nosso serviço diplopia e síndr (more) ome de Parinaud . O exame de ressonância magnética revelou lesão heterogênea localizada na região pineal. O tumor foi completamente retirado por acesso infratentorial/supracerebelar. O exame histológico revelou tumor metastático indiferenciado e o exame imuno-histoquímico demostrou adenocarcinoma do trato gastrointestinal moderadamente diferenciado. Metástases para a região pineal são extremamente raras e devem ser consideradas no diagnóstico diferencial de tumores nesta região. Abstract in english Cerebral metastases from colorectal adenocarcinomas occur in 8% of the cases. Diagnosis is usually made when primary disease and widespread metastases are already known. We report the case of a patient with single metastases in the pinealregion as the first clinical manifestation of a colorectal adenocarcinoma. A 48-year-old female with Parinaud's syndrome for 15 days prior her admission was evaluated in our clinic. She had no symptoms or signs of colorectal disease. MRI (more) examination revealed an heterogeneous lesion with peritumoral gadolinium enhancement, located in the pinealregion. The tumor was radically resected through an infratentorial/supracerebellar approach. Histology showed metastatic carcinoma and immunohistochemical examination showed gastrointestinal tract adenocarcinoma. Metastases to the pinealregion are extremely rare and should be considered in the differential diagnosis of tumors of this region.
Little is known about frequency, association with clinical characteristics, and prognostic impact of DNA copy number alterations (CNA) on survival in central primitive neuroectodermal tumors (CNS-PNET) and tumors of the pinealregion. Searches of MEDLINE, Pubmed, and EMBASE--after the original description of comparative genomic hybridization in 1992 and July 2010--identified 15 case series of patients with CNS-PNET and tumors of the pinealregion whose tumors were investigated for genome-wide CNA. One additional case study was identified from contact with experts. Individual patient data were extracted from publications or obtained from investigators, and CNAs were converted to a digitized format suitable for data mining and subgroup identification. Summary profiles for genomic imbalances were generated from case-specific data. Overall survival (OS) was estimated using the Kaplan-Meier method, and by univariable and multivariable Cox regression models. In their overall CNA profiles, low grade tumors of the pinealregion clearly diverged from CNS-PNET and pineoblastoma. At a median follow-up of 89 months, 7-year OS rates of CNS-PNET, pineoblastoma, and low grade tumors of the pinealregion were 22.9 ± 6, 0 ± 0, and 87.5 ± 12 %, respectively. Multivariable analysis revealed that histology (CNS-PNET), age (?2.5 years), and possibly recurrent CNAs were associated with unfavorable OS. DNA copy number profiling suggests a close relationship between CNS-PNET and pineoblastoma. Low grade tumors of the pinealregion differed from CNS-PNET and pineoblastoma. Due to their high biological and clinical variability, a coordinated prospective validation in future studies is necessary to establish robust risk factors. PMID:22772606
Germinoma is known to be a highly radiosensitive tumor. We investigated five cases of pineal and three cases of suprasellar germinomas in order to study the effectiveness of radiotherapy on CT. As a rule, the first 3000 rad was given to the whole brain and a further 2000 to 3000 rad to the pinealregion, or 2000 to 2500 rad to the suprasellar region. Two groups of germinoma were differentiated by the difference in the response of tumors to radiotherapy. In one type the tumor disappeared entirely, and the tumorregion was not enhanced at all, on CT after irradiation with only 1500 to 2000 rad. This type contained two cases of pineal and three cases of suprasellar germinomas. In the other type the tumor decreased in size and the CT number of the mass was lowered by 10 to 20 units after irradiation with 2000 rad, but 4000 rad or more irradiation was necessary to obtain a complete radiotherapeutic effect. The latter type included three cases of pineal germinomas.
Ten patients with tumors of the pinealregion underwent CT and MRI investigations. There were 3 germinomas, 3 teratomas and 1 of each of the following: Pineocytoma, PNET, ependymoma and meningioma. Not only were tumor size and growth compared to CT, but an attempt was made to obtain knowledge of the histology of the tumor by special T/sub 2/ calculations. The investigations did not lead to an improvement in type specific diagnosis.
Primary intracranial germ cell tumors are rare and usually localized in the pineal and the suprasellar regions. They are divided into the following histologic types: germinoma, teratoma (mature, immature, malignant), choriocarcinoma, embryonal carcinoma, endodermal sinus tumor (yolk sac tumor), and mixed tumors. Clinically, they are manifested with ocular signs or signs of obstructive hydrocephalus. Localized germinomas are treated with radiation therapy and exhibit a relatively good prognosis. Chemotherapy is reserved for disseminated germinomas. Mature teratomas are treated with surgery. The rest of germ cell tumors are managed with various combinations of surgery, chemotherapy, and radiotherapy depending on the tumor type. If the tumors secrete beta-human chorionic gonadotrophin (hCG) o...
Eighteen patients with pinealregiontumors seen from November 1960 to November 1978 were reviewed. Thirteen patients treated with radiation therapy received tumor doses in the 4000 to 5500 rad range. The five year survival and five year disease-free survival were 73 and 63% respectively. Spinal cord metastasis occurred in 2 of 13 (15%) patients. Attempts at salvage radiotherapy for these patients were unsuccessful. Computerized tomography (CT) scan provides an excellent method of evaluating the response of pinealregiontumors to radiation. Rapid regression of the tumor mass on CT scan reflects the highly radioresponsive nature of germinomas, the tumor type most likely to disseminate throughout the neuraxis. This principle can be exploited to select unbiopsied patients with a high risk of spinal cord metastasis for prophylactic spinal radiation at an early stage of treatment.
Abstract in portuguese Um menino de 17 anos de idade apresentou-se com sonolência e confusão mental. O exame físico demonstrou distúrbios motores. A investigação laboratorial revelou aumento dos níveis de alfafetoproteína no soro e no líquor. A TC de crânio revelou massa heterogênea na região pineal. À RM, a lesão era hipointensa em T1 e hiperintensa em T2, com realce após a administração de contraste. O paciente foi submetido a biópsia cirúrgica, a qual definiu o diagnóstic (more) o de tumor do seio endodérmico. Enfatizamos a correlação entre os achados patológicos e de neuroimagem deste raro tumor da região pineal. Abstract in english A 17-year-old boy presented with somnolence and mental confusion. Physical examination demonstrated motor disturbances. Laboratorial investigation showed elevated levels of alpha-fetoprotein in serum and cerebrospinal fluid. The CT scan revealed a heterogeneous mass at the pinealregion. At the MRI, this lesion was hypointense on T1 and hyperintense on T2-weighted images, enhancing after contrast administration. The patient underwent a surgical biopsy, which defined the d (more) iagnosis of yolk sac tumor. We emphasize the correlation of neuroimaging and pathological findings of this rare pinealregiontumor.
Little is known about frequency, association with clinical characteristics, and prognostic impact of DNA copy number alterations (CNA) on survival in central primitive neuroectodermal tumors (CNS-PNET) and tumors of the pinealregion. Searches of MEDLINE, Pubmed, and EMBASE?after the original description of comparative genomic hybridization in 1992 and July 2010?identified 15 case series of patients with CNS-PNET and tumors of the pinealregion whose tumors were investigated for genome-wide CNA. One additional case study was identified from contact with experts. Individual patient data were extracted from publications or obtained from investigators, and CNAs were converted to a digitized format suitable for data mining and subgroup identification. Summary profiles for genomic imbalances we...
We evaluated the efficacy of interstitial brachytherapy (IBT) using 125Iodine (125I) seeds for treatment of papillary tumors of the pinealregion. Between September 2003 and September 2010, four patients (M/F?=?2/2; median age, 57.3?years; range 29.2?69.1?years) with papillary tumors of the pinealregion underwent IBT using 125I seeds. Before brachytherapy two patients underwent endoscopic ventriculo-cisternotomy, because of occlusive hydrocephalus, and subsequent microsurgical resection was performed on one; three patients were primarily treated with IBT. Median tumor volume was 3.3?ml (range 1.6?4?ml), the tumor surface dose ranged between 50 and 65?Gy. For three patients the seeds were implanted permanently whereas one patient received temporary implants (28?days). The median follow-up ...
Abstract in portuguese Os gangliogliomas são neoplasias mistas, compostas de elementos gliais e neuronais, extremamente raros na região da glândula pineal. Na presente revisão da literatura foram encontrados oito casos publicados. Apresentamos o caso de paciente de 14 anos, masculino, com ganglioglioma da região da pineal, tratado cirurgicamente, com exérese total da lesão por via suboccipital transtentorial. O estudo histológico mostrou tratar-se de ganglioglioma grau I, confirmado por (more) imuno-histoquímica. Conclui-se que tais tumores são raros e que se deve optar pela cirurgia, objetivando a exérese total. Quando isso não for possível, ou no caso de recorrência, o paciente deve ser acompanhado clínica e radiograficamente, considerando-se a radioterapia como tratamento complementar. Abstract in english Ganglioglioma are tumors presenting neoplastic glial cells and nerve cells, very rarely found in the pinealregion. Only eight cases have been previously published in the literature. We present the case of a 14 years-old male patient with a ganglioglioma of the pinealregion. The patient was treated surgically by a suboccipital transtentorial approach with complete removal. Histopathologic specimens with immunostainning revealed a ganglioglioma grade I. We conclude that t (more) hese tumors are rare and should be treated surgically aiming total remove. If it is not possible or in case of recorrence the patient should be followed and radiotheraphy could be considered.
Pineal hemorrhage only occurs in rare cases, and this known to have several different causes such as germ cell tumors, pineal cysts and vascular malformations, including the cavernous malformations. Pineal cavernous malformations are extremely rare: to date only fifteen cases have been reported worl...
Pineal gland is a very important neuroendocrine organ with many physiological functions such as regulating circadian rhythm. Radiologically, the pineal gland volume is clinically important because it is usually difficult to distinguish small pinealtumors via magnetic resonance imaging (MRI). Althou...
Endodermal sinus tumor, or yolk sac tumor, is the most common malignant neoplasm of germ cell origin and usually occurs in infant testes or ovaries. On rare occasions, the tumor may arise from extragonadal sites, including sacrococcygeal region, uterus, vagina, prostate, retroperitoneum, liver, mediastinum, pineal gland, and third ventricle. The orbit is an unusual location for the primary development of this neoplasm.2,3 We report the case of a girl with primary orbital endodermal sinus tumor who was managed with exenteration and chemotherapy with the result of a disease-free survival of 9 years.
This is a retrospective analysis of CT and MRI findings in suprasellar germ cell tumors. The study population was comprised of 6 patients with germinomas, one with embryonal carcinoma, and one with mature teratoma. Suprasellar germinoma tended to have intratumoral low density on CT or intensity area on MRI, indicating tumor necrosis or occasionally cyst formation. Germinoma tissue may extend into the pituitary fossa. Sagittal MRI revealed that the extension was limited to the posterior part of the pituitary gland. MRI of the teratoma did not demonstrate extension of the tumor into the pituitary fossa. No germ cell tumor in this region was seen as calcification. Germinoma in this region did not always show marked homogeneous enhancement. These neuroradiological findings failed to determine subtypes of germ cell tumors. Two patients had germinomas in both the pineal and suprasellar areas. Two years after the total removal of pineal teratoma, it recurred in the suprasellar region that was not seen on the first MRI. In these two patients, germinomas called 'double midline tumors' seemed to have originated by CSF dissemination or subependymal seeding, which was not demonstrated on neuroradiological images. The teratoma case was thought to be one form of double midline tumor, because the first tumor tissue in the pinealregion had been totally and extracapsulary removed two years earlier and the suprasellar lesion could not be demonstrated on sagittal MRI or CT scans. In conclusion, not only neuroradiological findings but also clinical findings such as tumor markers may be required in preoperative diagnosis of suprasellar germ cell tumors. (N.K.).
The endoscopic approach has gained an increased popularity in recent years for the biopsy and, in selected cases, the removal of tumors of the posterior third ventricle and pinealregion. The authors report their experience on a series of 20 patients discussing also the technical limitations and complication avoidance. This is a prospective study of 20 patients with posterior third ventricle and pinealregiontumors surgically managed by endoscopic biopsy and/or excision and simultaneous third ventriculostomy. The removal of the lesion could be achieved in 12 cases whereas in 8, only a biopsy could be performed. A histological diagnosis could be obtained in all cases. No delayed third ventricular stoma failures were recorded in any patient at the latest follow-up (mean follow-up, 39 month...
Abstract in portuguese Tumores da região da pineal não são comuns. São descritos aspectos clínicos, tomográficos e dos resultados terapêuticos em 12 casos observados num período de 5 anos (1979-1984). Os autores consideram que a via de acesso supracerebelar infratentorial, descrita por Krause em 1926 e reintroduzida por Stein em 1971, é a melhor para a abordagem cirúrgica desse tipo de tumor. Abstract in english Tumours of the pinealregion are rare. Clinical and CT aspects, and results of the treatment of 12 cases observed in a 5 years period (1979-1984) are described. The authors consider the supracerebellar infratentorial approach, formerly described by Krause in 1926 and reintroduced by Stein in 1971, the best for the surgical management of these tumours.
From December 1984 to February 1990, 16 patients with tumors of pineal and suprasellar location were treated with radiation therapy. Tissue diagnoses were obtained before radiation therapy in 5 patients and 11 were irradiated without histologic confirmation. Initial treatments for these patients were craniospinal plus boost primary irradiation(six), whole brain plus boost primary irradiation(nine), primary tumor site irradiation(one). The 5 year actuarial survival rate is 71%. Three cases with elevated beta-human chorionic gonadotropin (HCG) responded favorably to radiation, but pinealtumors with elevated alpha-fetoprotein(AFP) did not respond well. Spinal metastasis developed in 2 cases (2/15) with elevated AFP : one received prophylactic spinal irradiation, another did not. Our studies suggest that more aggressive treatment would be necessary in patient with elevated AFP and in this patient, radiation therapy may be initiate without pathologic confirmation. From the result of our study, routine use of prophylactic spinal irradiation for all patients with pinealregiontumor is not indicated and use of prophylactic spinal irradiation is considered for the patients with positive craniospinal fluid cytology, meningeal seeding, disease extension along the ventricular wall and biopsy proven germinoma.
Abstract Germ cell tumors comprise 0.4-3.1% of all intracranial tumors, and teratoma constitutes 9-30% of them. Congenital intracranial tumors are very rare and only account for 0.5-1.5% of all childhood brain tumors. The most common type of these tumors present at birth is teratomas, which represent 0.5% of all intracranial tumors. Most teratomas are midline tumors located predominantly in the sellar and pinealregions. In this study, we report a neonatal intracranial immature teratoma at the lateral ventricle because of its rare location. A 5-day-old female neonate presented with a history of irritability and left eye protrusion since birth. A head computed tomographic (CT) scan and magnetic resonance imaging (MRI) disclosed a large tumor filling the left lateral ventricle and extending ...
A 45-year-old male presented with a rare pinealregion cavernoma. Magnetic resonance (MR) imaging confirmed the preoperative diagnosis. The tumor was totally excised. The patient was subsequently cured. Analysis of 15 reported cases found a slight female preponderance. The second and third decades were the most common age group. The course of pineal cavernomas can be complicated by hemorrhage, occlusion of cerebrospinal fluid pathways, and focal neurological and neuroendocrine symptoms but no specific clinical features. However, MR imaging has high sensitivity and the specificity for the diagnosis of pineal cavernoma. Total microneurosurgical excision is the treatment of choice, and patients had an excellent outcome. Stereotactic biopsy can be potentially dangerous because of the risk of hemorrhage. The use of radiosurgery requires evaluation of long-term risks and safe dose levels. Total excision of the pineal cavernoma using microsurgical techniques is the choice of treatment in young and healthy patients since there is an increased risk of recurrent hemorrhage and progressive neurological decline. A conservative approach is preferred in older patients.
The pleomorphic xanthoastrocytoma (PXA) is an infrequently occurring benign astrocytic tumor with a predilection for the temporal and parietal cortices of children and young adults. We describe its occurrence in an unusual location in a 15-year-old boy who presented with raised intracranial pressure of short duration. Imaging showed a 3??3.2??3.5?cm mass in the pinealregion extending into the quadrigeminal cistern. It had a contrast-enhancing solid component and a larger, ventrally located, peripherally enhancing cystic component. Total excision of the lesion was achieved via a modified left Poppen?s approach. Histopathology and immunochemistry were suggestive of a PXA. This is the first report in the pediatric literature describing a PXA in the pinealregion.
This article represents a review of 32 patients with pinealregiontumors seen and treated at the University of Michigan Medical Center from January 1950 to December 1980. All patients presented with manifestations of increased intracranial pressure: limitation of the upward gaze (Parinaud's syndrome), hydrocephalus and a mass in the posterior aspect of the third ventricle. The tumor was demonstrated by pneumoencephalography, ventriculography, angiography or CT scans. Ventricular decompression was performed in all patients. Twenty-seven patients received post-operative irradiation. The overall 10 year survival for evaluable patients was 16/24 (67%). Few complications were seen.
20 Gy of local irradiation was performed for the patients with pinealregiontumor. We evaluated the tumor volume on X-CT in the pre-radiation and 20 Gy of post-radiation state. If tumor is sensitive enough to radiation therapy, we add 40 Gy of whole brain and 30 to 40 Gy of whole spine irradiation. If not, we transfer patients to neurosurgeons for the purpose of tumor ressection. We call this procedure ''Diagnostic Radiation.'' We proposed the concept of TRR (Tumor Regression Ratio) in order to evaluate our protocol more objctively. TRR is as follows: TRR (%) = (1-Total Tumor Volume (at each dose) / Total Tumor Volume (at o Gy)) x 100 (%) Total Tumor Volume(mm/sup 3/) = slice thickness(mm) x siguma HDA (mm/sup 2/) on each slice: where HDA is high density area on enhanced CT. Eleven patients were studied and TRR of each patients was calculated. The relations between TRR, tumor markers, CSF seeding and prognoiss was discussed. From our study, (1) TRR at 20Gy was important and might predict approximate prognosis of each cae case. A) TRR = 100 ..-->.. very good B) TRR < 20 ..-->.. poor C) 20 <= TRR < 100 ..-->.. high possibility (2) Majority of TRR < 100 cases have turned out to be histologically in teratoma category. (3) Good correlation between the level of tumor markers and prognosis was observed. Cases with elevated level of AFP and/or HCG were radio- resistant and had poor prognosis. (4) Distant metastasis must also be kept in mind in the treatment of pinealregiontumor.
Embryonal tumor with abundant neuropil and true rosettes (ETANTR) is an increasingly recognized entity that belongs to the family of embryonal tumors of the CNS. The authors present three cases of this rare tumor that were encountered at King Hussein Cancer Center, Amman, Jordan. Discussion of the clinicopathological findings is presented along with a recent literature review. Sixteen-, 57- and 30-month-old children presented with tumors located in the pineal gland, the right fronto- parieto-temporal region and the cerebellum, respectively. The findings of hypocellular neuropil as well as the characteristic ependymoblastic rosettes were seen. In addition the third case showed an abnormal combination of patterns including melanocytic and rhabdomyoblastic differentiation. The tumors stained ...
The primary intracranial endodermal sinus tumor (EST) is regarded as a rare histological subtype that is often associated with components of other germ cell tumors, and there are no reports on the onset of intracranial ESTs after growth hormone (GH) replacement therapy. The authors report an extremely rare case of pure primary EST associated with GH replacement therapy. A 15-year-old girl with GH deficiency experienced headache, nausea, and vomiting after GH replacement therapy for a 17-month period. Magnetic resonance imaging showed 2 tumor masses located in the pinealregion and frontal horn of the right lateral ventricle, respectively. Before surgery, the authors administered 1 cycle of neoadjuvant chemotherapy, which shrank the tumor and facilitated surgical intervention. The larger mass located in the pinealregion was removed via a right occipital transtentorial approach, and postoperative histopathological analysis revealed a pure EST. While there is a clear association between the initiation of GH replacement therapy and the development of the EST in this case, the causal effect cannot be specified. Nevertheless, this case demonstrates that GH replacement therapy must be used cautiously. PMID:22208321
A 23-year-old man presented with a mass in the pinealregion and obstructive hydrocephalus. A neuroendoscopic biopsy for the lesion, ventriculoperitoneal (VP) shunting, and focal irradiation were conducted as initial treatment. Histological diagnosis of the biopsy specimen was germinoma. He underwent further irradiation and two tumor resections. Histological diagnosis was mature teratoma without a germinomatous component. After serial treatments, the intracranial lesion was controlled. However, 14?months after presentation, extraneural lesions were confirmed in the posterior mediastinum and retroperitoneal space. The biopsy specimen of the retroperitoneal space lesion was histologically diagnosed as germinoma. Although chemotherapy with cisplatin and etoposide was undertaken, extraneural l...
A 20-year-old man presented with diplopia. Neurological examination revealed mild skew deviation and upbeat nystagmus. Computed tomography showed a clover-shaped isodense mass in the pinealregion with homogeneous enhancement. The lesion was isointense on both T1- and T2-weighted magnetic resonance (MR) imaging with homogeneous enhancement by gadolinium-diethylenetriaminepenta-acetic acid. Cerebral angiography showed no tumor staining. Serum and cerebrospinal fluid were negative for ?-human chorionic gonadotropin, ?-fetoprotein, and placental alkaline phosphatase. Open biopsy was performed using a right occipital transtentorial approach. Histological examination revealed a tumor consisting of clusters of germinoma cells, but with prominent infiltration of lymphocytes, plasma cells, and macrophages, and proliferation of small vessels. The histological diagnosis was germinoma with granulomatous reaction. MR imaging showed complete disappearance of the tumor after chemoradiotherapy. Neurosurgeons should be aware of this rare tumor to avoid misdiagnosis as granulomatous inflammation.
1 Malignant Meninges, Brain, Spinal Cord, Cranial Nerves, Pituitary Gland, Craniopharyngeal Duct and Pineal Gland 2 Equivalent Terms, Definitions, Charts and Illustrations • Benign and borderline intracranial and CNS tumors have a separate set of
A retrospective analysis was performed on 23 patients with pinealregiontumors treated with radiation from 1979 through 1985 at the Department of Therapeutic Radiology, Seoul National University Hospital, Histologic confirmation was done in only one case by surgical removal, and in the remaining 22 patients, the diagnosis was based on clinical and radiological findings. The radiation volume was the primary tumor site in 1 case, whole brain in 14 cases, and the whole craniospinal axis in 8 cases. The overall 5 year survival was 71.5%. The 5 year survival was 69. 3% for whole brain treated group and 73.3% for craniospinal axis treated group. The survival for the two groups did not differ significantly. In two cases sites of recurrence were detected. One in supratentorial area, and the other in the lung. The results from this retrospective analysis and the review of other reports indicate that routine use of prophlatic spinal irradiation is not warranted in pinealregiontumor, and the craniospinal irradiation is recommended in cases with high risk for subarachnoid seeding such as positive CSF cytology, surgical removal or biopsy.
A 22-year-old woman presented with a rare case of multiple epidermoid cysts located in the pineal and extracranial regions. Magnetic resonance (MR) imaging showed a lesion in the pinealregion as hypointense on the T1-weighted image and hyperintense on the T2-weighted image, without enhancement. Neuroendoscopic treatment was performed under a diagnosis of pineal cyst. However, the cyst wall was too thick to perforate, although third ventriculostomy was performed. Diffusion-weighted MR imaging demonstrated the lesions in the pineal and extracranial regions as marked hyperintensity. The diagnosis was epidermoid cyst. Subsequently, neuroendoscopic treatment of the pineal epidermoid cyst was performed. Careful preoperative diagnosis of epidermoid cysts based on diffusion-weighted MR imaging is required.
Nuclear factor-kappa B (NFKB), a pivotal player in inflammatory responses, is constitutively expressed in the pineal gland. Corticosterone inhibits pineal NFKB leading to an enhancement of melatonin production, while tumor necrosis factor (TNF) leads to inhibition of Aa-nat transcription and the production of N-acetylserotonin in cultured glands. The reduction in nocturnal melatonin surge favors the mounting of the inflammatory response. Despite these data, there is no clear evidence of the ability of the pineal gland to recognize molecules that signal infection. This study investigated whether the rat pineal gland expresses receptors for lipopolysaccharide (LPS), the endotoxin from the membranes of Gram-negative bacteria, and to establish the mechanism of action of LPS. Here, we show that pineal glands possess both CD14 and toll-like receptor 4 (TLR4), membrane proteins that bind LPS and trigger the NFKB pathway. LPS induced the nuclear translocation of p50/p50 and p50/RELA dimers and the synthesis of TNF. The maximal expression of TNF in cultured glands coincides with an increase in the expression of TNF receptor 1 (TNFR1) in isolated pinealocytes. In addition, LPS inhibited the synthesis of N-acetylserotonin and melatonin. Therefore, the pineal gland transduces Gram-negative endotoxin stimulation by producing TNF and inhibiting melatonin synthesis. Here, we provide evidence to reinforce the idea of an immune-pineal axis, showing that the pineal gland is a constitutive player in the innate immune response. PMID:20586888
Abstract in spanish Los tumores de células germinales de origen extragonadal son descritos infrecuentemente en la literatura, siendo menos de 1.000 casos. Los sitios de origen por orden de frecuencia son mediastino, retroperitoneo, región sacro coccígea y glándula pineal. Este caso es de un germinoma primario en mediastino en un paciente de 27 años de edad. En los estudios de imagen se demostró una masa mediastinal, se tomo una biopsia para llegar al diagnóstico. Marcadores tumorales (more) normales, el ultrasonido testicular reportó la presencia de microlitiasis bilateral. El paciente fue tratado con poliquimioterapia y resección de masa residual. La evolución fue satisfactoria con respuesta completa. Abstract in english The Germ Cell tumors of extragonadal origin are infrequent cases being described in literature less than 1000 cases. The frequent origin sites are mediastinum, retroperitoneum, sacrococcygeal region, and the pineal gland. There was a primary case of germinoma in mediastinum in a 27 years patient. In the image studies a mediastinal mass was demonstrated, a biopsy was taken arriving at the diagnosis. Normal tumor markers, testicular ultrasonography reported the presence of (more) bilateral microlitiasis. It was treating with polychemotherapy and later residual mass was dried. The evolution was satisfactory with complete answer.
Abstract in portuguese Realiza-se um estudo por ressonância magnética da pineal normal e dos cistos simples da pineal e estabelece-se um protocolo para estudo da região pineal analisando-se 762 exames. A utilização da técnica com cortes finos (3 milímetros no máximo) identifica a pineal normal na maioria das vezes (84,4%) e demonstra que a pineal normal, sem cistos, apresenta sinal isointenso em Tl e T2 com realce após a injeção de gadolínio, medindo em média 6,1 milímetros no seu (more) maior diâmetro. Os cistos simples da pineal aparecem com frequência de 2,6% em relação a toda a série (762 casos) elevando-se essa frequência para 6,1% se forem consideradas somente as pineais visiblizadas (329 casos). Os cistos simples não se correlacionam nem com a idade nem com o sexo e os cistos sintomáticos são raros. Os critérios para diagnóstico diferencial dos cistos simples versus tumores da região da pineal são: dimensões menores ou iguais a 20 milímetros; espessura da parede abaixo de 2 milímetros; ausência de efeito expansivo; sinal igual ao líquido cefalorraquidiano e ausência de crescimento dos cistos. Abstract in english A magnetic resonance imaging (MRI) study of the normal pineal gland and pineal simple cysts was performed in 762 cases. A fine section technique (maximum 3 millimeters) enabled most of the times the identifying of a normal pineal in addition to demonstrating that a pineal without any cyst shows an isointense signal in Tl and T2 which, in turn, is enhanced following gadolinium. The measure of the normal pineal was of about 6.1 millimeters in its diameter length. Pineal sim (more) ple cysts were observed in a 2.6% frequency in relation to the whole series (762 cases); however reaches 6.1% when only the visualized pineals were considered (329 cases). Also, it was found out that simple cysts were not correlated to age or gender. Simple cysts characteristics are: dimension less or equal to 20 millimeters; absence of expansive effect; similar signal to that of the cerebrospinal fluid; absence of cyst growth.
Eleven patients with pathology-proven pineal area tumors were evaluated by computed tomography before and after treatment. There were 3 germinomas, 3 gliomas, 2 metastases, and 1 each of embryonal rhabdomyosarcoma, epidermoid tumor, and neuroblastoma. An accurate CT diagnosis was made in 9 of the 11 cases. Although CT findings are not pathognomonic, an accurate diagnosis is possible in most cases if the CT information is combined with the age, sex, clinical findings, and, in some patients, tumor response to irradiation. CT, a noninvasive procedure, can help in evaluating the effects of various treatment modalities on pinealtumors.
The authors present a case of germinoma that was initially found in the pinealregion and recurred 15 years later in the intramedullary cervical spinal cord after intensive chemo- and radiotherapy and diagnosis of complete remission. This 28-year-old man initially presented with seizures. Hydrocephalus and a pinealtumor were found on radiological examination, and partial resection of the tumor was performed. Histological diagnosis showed a pure germinoma. Following surgery, the patient received a combination of chemo- and radiotherapy, and a complete remission was shown. However, after 15 years of follow-up, he presented with gait disturbances. Spinal MRI showed an intramedullary mass lesion in the cervical spinal cord. The cervical lesion was biopsied, and histological examination again revealed a pure germinoma. With germinomas, the possibility of a drop metastasis from an intracranial lesion to the spinal cord must be considered during follow-up. However, in the present case, analysis of a CSF sample showed no abnormalities as in previously published cases. In recent years, multidisciplinary treatments have demonstrated good event-free survival rates in cases of pure germinomas, but long-term outcomes over the decades are not fully known. Continual follow-up of such cases is recommended even after complete remission has been achieved. PMID:22360562
Abstract in portuguese O tumor teratóide rabdóide atípico (TTRA) é uma neoplasia rara e agressiva, mais comum na infância e de mau prognóstico. Apenas 23 casos foram descritos em adultos. Permanece por estabelecer uma estratégia terapêutica, mas com ressecção macroscopicamente completa (RMC), radioterapia (RT) e quimioterapia baseada em platinos e agentes alquilantes parecem obter-se os melhores resultados. Descreve-se o caso de uma mulher de 39 anos que iniciou um quadro de cefaleias (more) , vertigens, perturbações visuais e ataxia. A RMN mostrou hidrocefalia relacionada com uma massa na região pineal. O tratamento consistiu em RMC, RT e 3 ciclos do esquema ICE. A doente permanece sem evidência de doença 30 meses após o diagnóstico. A propósito deste caso, procedeu-se a uma revisão da literatura. Abstract in english Atypical teratoid rhabdoid tumor (AT/RT) is a rare and aggressive malignancy, which is more common in early childhood and carries a poor prognosis. Only 23 cases have been described in adults. A treatment strategy is yet to be established but gross total resection (GTR), early radiotherapy (RT) and platinum and alkylator-based chemotherapy seem to be associated with better outcome. We report on a 39 year-old female who presented with headache, vertigo, blurry vision and a (more) taxia. The MRI revealed hydrocephalus related to a mass at the pinealregion. The treatment consisted of GTR, RT and 3 cycles of an outpatient-based ICE regimen. The patient remains disease-free 30 months after diagnosis. Following this case, a review of the literature is undertaken.
Between 1960 and 1985, 42 patinets with pinealregiontumors and two patients with suprasellar germinomas were treated by irradiation after shuntin gwith biopsy in five cases and subtotal resection in three cases. Ten year survival rates are: 79% in patients less than 31 years old and unbiopsied tumours, 25% in patients older than 30 years and unbiopsied tumours, 3/4 in patients with germinomas. Target volumes varied, but only three cases had craniospinal irradiation. Cumulative risk of spinal seeding in patients with germinomas and unbiolsied tumors is about 6% after cranal radiotherapy. The low risk of spinal seeding in patients with pineal tumours of unknown histology or germinomas without signs of dissemination in the CT/MR, myelography, examination of the CSF (cytology and markers) do not justify prophylactic spinal irradiation. Our data do not show a clear association between cranial target volume (whole brain or local fields) and recurrence rate 41 of 44 cases had target doses higher than 4400 cGy. There is a small but definite risk of major complications after a dose of about 5500 cGy with conventional fractionation. (author). 27 refs.; 5 figs.
We present the first report on familial pineocytoma. The propositus, a 31-year-old man, presented with incontinence due to a cystic and haemorrhagic tumour of the pinealregion. His 34-year-old sister, who had suffered from tinnitus for several years, also had a pineal tumour. Histopathology following tumour resection revealed pineocytomas (WHO grade 1). Cerebral MRI examinations of the patient?s brother and father did not reveal any pinealregion abnormalities. Their mother had developed breast cancer at the age of 43. Although not impossible, it is rather unlikely that pineocytomas occurring in siblings are pure coincidence because of the rarity of this type of tumour.
The aim of this retrospective study was to assess the treatment results of 30 patients with pinealregiontumors who were underwent radiation therapy under the diagnosis by either CT or MRI. There was no histological verification. We analyzed the prognostic factors that have a significant effect on the overall survival (OS) and disease free survival (DFS) rates. A total 30 patients with pinealregiontumors were treated between March 1983 and August 1995. After a trial radiation therapy of 20 {approx} 30 Gy/2 {approx} 3 weeks, the patients were evaluated for their clinical response and radiological response by either CT or MRI and the final treatment direction was then decided. According to their response to the trial radiation therapy and the involved site, radiation treatment was given in various field i.e., local, ventricle, whole brain and craniospinal field. The radiation dose ranged from 40.8 to 59.4 Gy (Median 50.4 Gy). The median follow up was 36.5 months (4 {approx} 172 months). An improvement or stability in the clinical symptoms was observed in 28 patients (93.3%) after the trial RT. Nineteen patients (63.3%) showed a partial or complete response by CT or MRI. The two-year and five-year survival rates of the patients were 66.7% and 55.1%, respectively. No significant difference in the survival rates according to the degree of the radiological response was observed after the trial RT. The results of univariate analysis showed that age, the primary site, the performance status(KPS {>=} 70), the degree of response after completing RT and the RT field were significant prognostic factors affecting the survival and disease free survival rates ({rho} < 0.05). The clinical and histological characteristics of pinealregiontumors are quite complex and diverse. Therefore, it is difficult to predict the histological diagnosis and the possibility of radiocurability only with the initial response to RT. We think that the development of less invasive histological diagnostic techniques and tailored treatment to the histological type of each tumor are needed.
The case is described of a 17 year-old male, who was treated because of a large tumour in the region of the pineal gland. The diagnostic and therapeutic problems are presented and discussed. (Author).
A 13-year-old girl presented with an exceedingly rare case of primary yolk sac tumor located within the lateral ventricle, manifesting as headache, nausea, and diplopia. Magnetic resonance imaging revealed a 4-cm-diameter solid enhanced mass within the left inferior horn of the lateral ventricle. The tumor was removed subtotally via left middle temporal corticotomy. The histological and immunohistochemical diagnosis was pure yolk sac tumor. The serum alpha-fetoprotein (AFP) level was elevated at 1957.2 ng/ml and the serum beta-human chorionic gonadotropin level was 4 mIU/ml after surgery. The patient underwent radiotherapy (whole brain, 30 Gy; tumor bed, 21 Gy; whole spinal axis, 30 Gy) and chemotherapy (ifosfamide, cisplatin, etoposide). After three treatment cycles, the serum AFP level had decreased to 4.5 ng/ml. However, the tumor recurred with cerebrospinal fluid dissemination after nine cycles of chemotherapy. She died 18 months after surgery. The possibility of germ cell tumor should be considered in pediatric patients with brain tumors occurring outside the pineal or suprasellar region.
Abstract: Nuclear factor-kappa B (NFKB), a pivotal player in inflammatory responses, is constitutively expressed in the pineal gland. Corticosterone inhibits pineal NFKB leading to an enhancement of melatonin production, while tumor necrosis factor (TNF) leads to inhibition of Aa-nat transcription and the production of N-acetylserotonin in cultured glands. The reduction in nocturnal melatonin surge favors the mounting of the inflammatory response. Despite these data, there is no clear evidence of the ability of the pineal gland to recognize molecules that signal infection. This study investigated whether the rat pineal gland expresses receptors for lipopolysaccharide (LPS), the endotoxin from the membranes of Gram-negative bacteria, and to establish the mechanism of action of LPS. Here, we...
In order to enable a detailed analysis of radio frequency (RF) absorption in the human pineal gland, the dielectric properties of a sample of 20 freshly removed pineal glands were measured less than 20 h after death. Furthermore, a corresponding high resolution numerical model of the brain region surrounding the pineal gland was developed, based on a real human tissue sample. After inserting this model into a commercially available numerical head model, FDTD-based computations for exposure scenarios with generic models of handheld devices operated close to the head in the frequency range 400-1850 MHz were carried out. For typical output power values of real handheld mobile communication devices, the obtained results showed only very small amounts of absorbed RF power in the pineal gland when compared to SAR limits according to international safety standards. The highest absorption was found for the 400 MHz irradiation. In this case the RF power absorbed inside the pineal gland (organ mass 96 mg) was as low as 11 {mu}W, when considering a device of 500 mW output power operated close to the ear. For typical mobile phone frequencies (900 MHz and 1850 MHz) and output power values (250 mW and 125 mW) the corresponding values of absorbed RF power in the pineal gland were found to be lower by a factor of 4.2 and 36, respectively. These results indicate that temperature-related biologically relevant effects on the pineal gland induced by the RF emissions of typical handheld mobile communication devices are unlikely.
An 11-year-old boy presented with pineal pure germinoma with spinal dissemination manifesting as a 1-month history of ocular motility disturbance and a history of abnormal sensations in the left leg persisting for several months. His past medical history was unremarkable. Craniospinal magnetic resonance imaging showed an enhanced tumor in the pineal gland and widespread leptomeningeal dissemination in the spinal canal. Biopsy of the pinealtumor was performed. Histological examination revealed a pure germinoma. Chemotherapy with carboplatin and etoposide in combination with radiotherapy induced complete remission of the tumors. He regained normal eye movement and sensation in his left leg during the chemotherapy period. Germinomas with dissemination are generally more malignant and refractory than solitary germinomas, but this patient showed a strong response to chemoradiotherapy.
Embryonal tumor with abundant neuropil and true rosettes (ETANTR) is an increasingly recognized entity that belongs to the family of embryonal tumors of the CNS. The authors present three cases of this rare tumor that were encountered at King Hussein Cancer Center, Amman, Jordan. Discussion of the clinicopathological findings is presented along with a recent literature review. Sixteen-, 57- and 30-month-old children presented with tumors located in the pineal gland, the right fronto- parieto-temporal region and the cerebellum, respectively. The findings of hypocellular neuropil as well as the characteristic ependymoblastic rosettes were seen. In addition the third case showed an abnormal combination of patterns including melanocytic and rhabdomyoblastic differentiation. The tumors stained positively for synaptophysin in the neuropil and small cell component, while the ependymoblastic rosettes stained for vimentin only. Epithelial membrane antigen and CD99 were negative in all components. One of the cases showed tetraploidy of chromosome 2. All cases exhibited an aggressive course. This is a rare and recently recognized tumor with dismal outcome, and reporting of additional new cases should help in gaining more knowledge about it. PMID:22103481
PurposeTo compare volumetric modulated arc therapy (VMAT) with 3-dimensional conformal radiation therapy (3D-CRT) in the treatment of localized intracranial germinoma. We modeled the effect of the dosimetric differences on intelligence quotient (IQ). Method and MaterialsTen children with intracranial germinomas were used for planning. The prescription doses were 23.4 Gy to the ventricles followed by 21.6 Gy to the tumor located in the pinealregion. For each child, a 3D-CRT and full arc VMAT was generated. Coverage of the target was assessed by computing a conformity index and heterogeneity index. We also generated VMAT plans with explicit temporal lobe sparing and with smaller ventricular margin expansions. Mean dose to the temporal lobe was used to estimate IQ 5 years after completion of...
Papillary tumor of the pinealregion (PTPR) is a rare variety of CNS neoplasms and, since its first definition in 2003, only 64 cases have been described. PTPR is a primary neoplasm morphologically characterized by papillary structure staining for cytokeratin, transthyretin, neurone-specific enolase and S-100 protein. We report on a case of about 4 years??? clinical history and neuroradiological follow-up of PTPR, in a 47-year-old Indian patient, with the aim of increasing the knowledge of its natural history. We describe through CT and MRI scans the natural evolution of this neoplasm, enhancing changes and morphologic structures involved, together with the final surgical treatment and pathological details. A mean growth rate average was calculated for this kind of lesion. In conclusion, ...
Abstract in portuguese Este estudo avalia o diagnóstico, a terapia e a sobrevida de 14 pacientes com tumor de células germinativas intracraniano durante o período entre 1991 e 2001. Onze pacientes eram do sexo masculino e três do feminino. A média de idade do grupo foi 12,5 anos (20 dias-18 anos). Na admissão, os mais comuns sintomas foram cefaléia (10/14), vômitos (6/14) e visuais (6/14). Os tumores estavam localizados em região hipotalâmica/hipofisária em 10 casos, suprasselar em 3 (more) casos e intraparenquimatosa em 1 caso. Histologicamente, havia 1 caso de carcinoma embrionário, 5 de germinomas, 2 de teratoma maduro, 1 de teratoma imaturo e 5 de tumores mistos. O tratamento foi variável, dependendo da histologia da lesão. Três pacientes morreram após a progressão tumoral ou recidiva e um paciente morreu devido causa não relacionada ao tumor. Os demais estão vivos e sem doença. Abstract in english This study evaluates the diagnosis, therapy and survival of 14 patients with primary intracranial germ cell tumors during the period from 1991 to 2001. There were 11 males and 3 females. Mean age was 12.2 years old (20 days-18 years). On admission, the most common symptoms were headache (10/14), vomiting (6/14) and visual (6/14). The tumor was in pineal and hypothalamic region in 10 cases, suprasellar in 3 cases, and in the cerebral parenchyma in 1 case. Histologically th (more) ere were 1 embryonal carcinoma, 5 germinomas, 2 mature teratomas, 1 immature teratoma and 5 mixed germ cell tumors. Treatment differed among the patients according to the type of tumor. Three patients died after tumor progression or relapse and one patient died from another condition. The remaining patients are alive and without disease.
Thirty-three patients with pinealregiontumors treated with radiation therapy between June 1971 and January 1986 were analyzed with respect to the treatment. The following results were obtained : 1) The five- and ten-year actuarial survival rates were 84.4 % and 69.0 % for all cases and 90.6 % and 80.5 % for 23 cases of germinoma. 2) In germinomas, intracranial relapse occurred in four patients whose treatment was limited to tumor-bearing areas and/or tumor dose was less than 40 Gy in 5 weeks. 3) Prophylactic irradiation to the spinal axis (20 Gy in 2.5 weeks) was carried out in patients exhibiting abnormal cerebrospinal fluid (CSF) findings : positive cytology for tumor cells or increased protein and cell count levels. However, no spinal metastasis was detected regardless of radiotherapy. 4) On the basis of our analysis, we recommend whole brain irradiation to 30 Gy in 4.5 weeks plus a boost of 20 Gy in 2.5 weeks to the tumor area and prophylactic spinal irradiation for the patient exhibiting the abnormal CSF findings.
Neuroepithelial papillary tumor of the pinealregion (PTPR) has been defined as a distinct entity that is increasingly being recognized, with 96 cases now reported. This tumor shares morphologic features with both ependymomas and choroid plexus tumors. PTPR is characterized by an epithelial-like growth pattern in which the vessels are covered by layers of tumor cells forming perivascular pseudorosettes. These tumors exhibit various combinations of papillary and solid architecture, making the differential diagnosis of PTPR difficult to establish. We report the detailed description of the histopathologic features of a large series of PTPRs from 20 different centers and distinguish 2 subgroups of tumors with either a striking papillary growth pattern or a papillary and solid growth pattern. We highlight the findings that PTPRs have unusual vessels with multiple lumina and frequently show detachment of the border of the tumoral cells from the vascular wall. The 2 PTPR subgroups present similar clinical characteristics and immunophenotypes. We confirmed and extended the results of previous ultrastructural studies on the presence of intercellular junctions at the apical part of tumoral cells. The expression of the tight junction proteins claudin-1, claudin-2, and claudin-3 was investigated by immunohistochemistry. Claudin-1 and claudin-3, but not claudin-2, were expressed in PTPRs and in the fetal subcommissural organ, potentially the origin of this tumor. In contrast, all 3 claudins were expressed in choroid plexus papillomas. Claudin expression may help in the diagnosis of PTPRs and can be used in combination with other markers, such as CK18, NCAM, E-cadherin, MAP-2, and Kir 7.1. PMID:22588068
Magnetic resonance imaging is a routine diagnostic measure for a suspected intracerebral mass. Computed tomography is usually also indicated. Further diagnostic procedures as well as the interpretation of the findings vary depending on the tumor location. This contribution discusses the symptoms and diagnostics for supratentorial tumors separated in relation to their intra- or extracranial location. Supratentorial tumors include astrocytoma, differentiated by their circumscribed and diffuse growth, ganglioglioma, ependyoma, neurocytoma, primitive neuroectodermal tumors (PNET), oligodendroglioma, dysembryoplastic neuroepithelial tumors (DNET), meningoangiomatosis, pinealtumors, hamartoma, lymphoma, craniopharyngeoma and metastases. The supratentorial extracranial tumors include the choroid plexus, colloid cysts, meningeoma, infantile myofibromatosis and lipoma. The most common subforms, especially of astrocytoma, will also be presented. (orig.)
Otx2 is a vertebrate homeobox gene, which has been found to be essential for the development of rostral brain regions and appears to play a role in the development of retinal photoreceptor cells and pinealocytes. In this study, the temporal expression pattern of Otx2 was revealed in the rat brain, with special emphasis on the pineal gland throughout late embryonic and postnatal stages. Widespread high expression of Otx2 in the embryonic brain becomes progressively restricted in the adult to the pineal gland. Crx (cone-rod homeobox), a downstream target gene of Otx2, showed a pineal expression pattern similar to that of Otx2, although there was a distinct lag in time of onset. Otx2 protein was identified in pineal extracts and found to be localized in pinealocytes. Total pineal Otx2 mRNA did not show day-night variation, nor was it influenced by removal of the sympathetic input, indicating that the level of Otx2 mRNA appears to be independent of the photoneural input to the gland. Our results are consistent with the view that pineal expression of Otx2 is required for development and we hypothesize that it plays a role in the adult in controlling the expression of the cluster of genes associated with phototransduction and melatonin synthesis.
In a 27-year-old patient with Gilles de la Tourette's syndrome a pinealtumor had been found 10 years previously and was apparently a coincidental finding. Minute calcifications were later detected around the third ventricle and the mesencephalic periaqueductal gray matter by high resolution compute...
To evaluate the incidence and characteristic findings of pineal cyst incidentally detected on magnetic resonance (MR) imaging. Brain MR images obtained in 2432 patients were retrospectively reviewed to determine the incidence and MR findings of pineal cysts, which were evaluated according to their size, shape, location, signal intensity, interval change, contrast enhancement and mass effect on adjacent structures. Cysts were encountered in 107(4.4 %) of 2432 patients evaluated. their size ranged from 1 X 1 X 1 to 15 X 8 X 9 (mean, 5.97 X 3.82 X 4.82)mm. All were spherical (n=53) or oval (n=54) in shape. Their margin was smooth and they were homogeneous in nature. On T1-weighted images, the cysts were seen to be hyperintense (n=57) or isointense (n=50) to cerebrospinal fluid, but less so than brain parenchyma. T2-weighted images showed them to be isointense (n=51)or hyperintense (n=56) to cerebrospinal fluid. The cysts were centrally located in 65 cases and eccentrically in 42. Compression of the superior colliculi of the tectum was demonstrated in 17 cases (15.9 %). NO patients presented clinical symptoms or signs related to either pineal or tectal lesions. Peripheral enhancement around the cyst after Gd-DTPA injection was demonstrated in 51 cases(100 %). Follow-up examinations in 19 cases demonstrated no interval change. The incidence of pineal cysts was 4.4 %. The MR characteristics of simple pineal cysts include: (1) an oval or spherical shape, (2) a smooth outer margin and homogeneous nature, (3) isosignal or slightly high signal intensity to cerebrospinal fluid on whole pulse sequences, (4) ring enhancement after contrast injection, (5) an absence of interval change, as seen during follow up MR study. These MR appearances of pineal cysts might be helpful for differentiating them from pinealtumors.
The histological features of germinomas were investigated to differentiate tumors which completely disappear immediately after irradiation and those that persist. Eighteen previously untreated patients underwent germinoma biopsy and irradiation or combined irradiation and chemotherapy. Four tumors were located only in the pineal gland, eight in the suprasellar region, two in multiple locations, one in the basal ganglia, and three in other regions. Histologically, the germinomas could be divided into type A found in 13 cases which consisted mainly of large neoplastic cells and small lymphocytes, the so-called two-cell pattern, and type B found in five cases which consisted predominantly of fibrous tissue and granulomatous reaction containing occasional neoplastic cells. Follow-up computed tomography or magnetic resonance imaging showed the enhanced mass lesion disappeared in all cases of type A germinomas within 1 month after treatment, but persisted in all cases of type B germinomas for at least 1 month. Type B tumors required up to 12 months to show complete radiographic resolution. Persistent germinomas consisted predominantly of fibrous tissue and granulomatous reaction containing occasional neoplastic cells.
Tumor-specific immunohistochemical markers are valuable in the differential diagnosis of malignant small round cell tumors (MSRCTs). The cone-rod homeobox-containing gene (CRX) is a transcription factor that is preferentially expressed in retinal photoreceptor cells. It has been shown that the CRX antibody is a good immunohistochemical marker to differentiate retinoblastoma from other intracranial MSRCTs. Outside of the central nervous system, however, the usefulness of CRX immunohistochemistry in establishing a diagnosis of metastatic retinoblastoma is uncertain, as the expression of CRX in primitive neuroectodermal tumor/Ewing sarcoma (PNET/ES), neuroblastoma, and other MSRCTs is unknown. Archival specimens from resections, core biopsies, and bone marrow biopsies of 41 neuroblastomas, 24 PNET/ES, 19 embryonal rhabdomyosarcomas, 17 alveolar rhabdomyosarcomas, 17 Wilms tumors, 14 desmoplastic small round cell tumors, 20 medulloblastomas, 9 pinealtumors, 17 melanocytic tumors (compound and Spitz nevi), and 8 retinoblastomas were immunostained for CRX. All retinoblastomas had strong diffuse nuclear immunoreactivity for CRX; 8 of the 20 medulloblastomas showed strong nuclear immunoreactivity either in occasional clusters of tumor cells or in rare single scattered tumor cells; 3 of the 9 pinealtumors showed strong nuclear immunoreactivity in approximately 40% to 50% of the tumor cells. Neuroblastomas, PNET/ES, embryonal rhabdomyosarcomas, alveolar rhabdomyosarcomas, Wilms tumors, desmoplastic small round cell tumors, and melanocytic tumors were all negative. Scant nonspecific cytoplasmic staining was observed in some tumors, mostly PNET/ES. These findings suggest that CRX is a useful marker to discriminate metastatic retinoblastoma from other, more common, MSRCTs of childhood. PMID:22790857
To determine the characteristic MR imaging findings of pineal germinoma, and differential diagnosis from other germ cell tumors. MR images of patients with histopathologically proven pineal germinoma(n=3D14) and other pineal germ cell tumors(n=3D10) were retrospectively analyzed with regard to size, signal intensity and homogeneity, enhancing features, cyst formation, and multiplicity of lesions. Other pineal germ cell tumors were the mixed germ cell tumors (n=3D4), malignant teratomas (n=3D3), choriocarcinoma(n=3D1), embryonal carcinoma(n=3D1), and endodermal sinus tumor(n=3D1). Tumor markers were evaluated. On T1-weighted images, germinomas showed homogeneous(86%) or iso signal intensity (93%), while other germ cell tumors showed inhomogeneous(70%) or iso signal intensity(70%). On T2-weighted images, germinomas showed homogeneous(64%) or iso signal intensity(57%), while other germ cell tumors showed inhomogeneous(70%) or high signal intensity(80%). On Gd-DTPA enhanced images, germinomas showed homogeneous (93%) or strong enhancement (64%), while other germ cell tumors showed homogeneous(60%) or strong enhancement (70%). Cyst formation was noted in ten Patients (71%) with germinoma and in six (60%) with other germ cell tumors. Invasion on surrounding structures was seen in 11 patients (79%) with germinoma and in five (50%) with other germ cell tumors. Lesions were multiple in three patients(21%) with germinoma. Thirteen of 14 patients with germinoma had normal serum {alpha}-FP(tetoprotein) and {beta}-HCG(human chononic gonafotrophin) levels. Two of four patients with mixed germ cell tumors had elevated serum {beta}-FP and {alpha}-HCG levels; in the ther two, elevated serum {alpha}-FP or {beta}-HCG levels were noted. In the malignant teratoma and embryonal carcinoma patients, serum {alpha}-FP and {beta}-HCG levels were normal. The patient with choriocarcinoma had an elevated serum {beta}-HCG level. On T1W1, the only significant differential point (p<0.01) between germinomas and other germ cell tumors was homogeneity. Germinomas were frequently homogeneous, and iso signal intensity on T1WI and T2WI, strong enhancement, and the formation of small cysts(<3mm) was noted. This MR imaging finding, combined with assay for tumor markers, is helpful for the differential diagnosis of pineal germinoma and other germ cell tumors.=20.
20 cases of midline pinealtumors and 3 suprasellar germinomas received radiation therapy at Yonsei University Medical College, Severance hospital from 1971 to 1982 were reviewed. 12 cases were pathologically proved; 10 germinomas, 1 pineoblastoma, and 1 pineocytoma. 11 cases received radiotherapy without biopsy confirmation. Although treatment fields varied from small field to whole brain irradiation, but not to the spinal cord, most patients received 4000-5000 rads irradiation to the primary tumor site. 17 patients are alive without evidence of disease and 5 year actuarial NED survival is 73.2%. 9 of 10 biopsy proved germinomas and all 6 presumed germinomas are alive and well. Optimum radiation dose, adequate irradiation field, tumor response to radiation observed in serial CT scan and role of radiation therapy in the management of pinealtumors are also discussed.
An 18-year-old male presented with a pinealregion germinoma with hearing impairment as the chief complaint. Magnetic resonance image demonstrated a well-enhanced multi-cystic tumor extending into the upper fourth ventricle and wall of the bilateral lateral ventricles. Audiometry revealed bilateral mild hearing impairment in the low frequencies. Auditory brainstem response recording showed low amplitudes in all waves (IV-V/I ratio < 1) with prolong latencies (I-V and III-V) on the right but no discernable wave at 60 dB clicks on left. Hearing impairment and audiometric findings were improved after ventriculoperitoneal shunt operation. The hearing impairment appeared to be a mixed (conductive and sensorineural) type. The tumor was responsible for the sensorineural deafness because of invasion and compression of the central auditory structures. The inferior brachium was maximally compressed anterolaterally by the dilated bilateral lateral ventricles and posteromedially by the tumor. Hydrocephalus caused conductive deafness by halting or arresting the footplate of stapes movement, as a consequence of high-pressure transmission through the cochlear aqueduct.
NeuroD1/BETA2, a member of the bHLH transcription factor family, is known to influence the fate of specific neuronal, endocrine and retinal cells. We report here that NeuroD1 mRNA is highly abundant in the developing and adult rat pineal gland. Pineal expression begins in the 17-day embryo at which time it is also detectable in other brain regions. Expression in the pineal gland increases during the embryonic period and is maintained thereafter at levels equivalent to those found in the cerebellum and retina. In contrast, NeuroD1 mRNA decreases markedly in non-cerebellar brain regions during development. Pineal NeuroD1 levels are similar during the day and night, and do not appear to be influenced by sympathetic neural input. Gene expression analysis of the pineal glands from neonatal NeuroD1 knockout mice identifies 127 transcripts that are down-regulated (>twofold, p twofold, p <0.05). According to quantitative RT-PCR, the most dramatically down-regulated gene is kinesin family member 5C ( approximately 100-fold) and the most dramatically up-regulated gene is glutamic acid decarboxylase 1 ( approximately fourfold). Other impacted transcripts encode proteins involved in differentiation, development, signal transduction and trafficking. These findings represent the first step toward elucidating the role of NeuroD1 in the rodent pinealocyte.
Image-guided stereotactic biopsy of pinealregion tumours requires careful appreciation of neuroanatomy and avoidance of the deep cerebral venous system. A patient with a pinealregion lesion obstructing the third ventricle and causing obstructive hydrocephalus required stereotactic biopsy after cerebrospinal fluid (CSF) diversion. The presence of a pacemaker precluded MR Venography. Fine-cut CT Venography was performed in its stead and merged with image guidance software, and a trajectory was planned avoiding the venous anatomy. Stereotactic biopsy was successfully performed without complication, revealing a pineocytoma. PMID:23163299
Primary tumors of the pineal body can produce dyscoordinative movements of the eye, pupillary dilatation, paralysis of adduction during convergence and nystagmus. Obstruction of the aqueduct can cause hydrocephalus, increased intracranial pressure and papilledema. Diabetes insipidus may be a presenting symptom. Pinealocytes and the photoreceptors of the eye contain several autoantigens. In man, the best known is the S-antigen. This antigen can be detected in the cerebrospinal fluid of patients with primary tumors of the pineal body. The S-antigen, and possibly other related autoantigens, can elicit an autoimmune mediated reaction causing inflammatory eye symptoms. This recently described paraneoplastic neurologic syndrome shares properties in common with other known cancer-associated ophthalmologic syndromes characterised by rapid development of eye symptoms, rapid loss of sight and by eye manifestations prior to evident appearance of symptoms related to primary tumor growth. A primary tumor of the pineal body should be considered in patients where a monosymptomatic uveoretinitis presents without associated provoking factors. Furthermore, analyses of S-antigen in the spinal fluid can be useful in the clinical diagnosis of the same primary tumors.
Trilateral retinoblastoma (TRb) is a rare disease associating intraocular retinoblastoma with intracranial primitive neuroectodermal tumor. Treatment is difficult and prognosis is poor. This multicenter study evaluates clinical findings and MR imaging characteristics of associated intracranial tumors in Rb patients. Clinical data of 17 patients (16 TRb and 1 quadrilateral Rb patients) included time intervals between Rb and TRb diagnosis and presence of baseline brain-imaging (BBI). Two reviewers reviewed all images individually and one reviewer per center evaluated their images. Consensus was reached during a joint scoring session. Studies were reviewed for tumor location, size and imaging characteristics (signal intensity (SI) on T1- and T2-weighted images, enhancement pattern and cystic appearance). Of 18 intracranial tumors, 78 % were located in the pineal gland and 22 % suprasellar. All tumors showed well-defined borders with mostly heterogenous enhancement (72 %) and isointense SI on T1- (78 %) and T2-weighted images (72 %) compared to gray matter. The majority of pineal TRbs showed a cystic component (57 %). TRb detected synchronously with the intraocular tumors on BBI (n = 7) were significantly smaller (P = 0.02), and mainly asymptomatic than TRb detected later on (n = 10). Overall, 5-year-survival of TRb patients detected on BBI was 67 % (95 % CI 29-100 %) compared to 11 % (95 % CI 0-32 %) for the group with delayed diagnosis. TRb mainly develops in the pineal gland and frequently presents with a cystic appearance that could be misinterpreted as benign pineal cysts. Routine BBI in all newly diagnosed Rb patients can detect TRb at a subclinical stage. PMID:22802019
100 human pineal bodies (=epiphyses, =pineal glands) were examined by neutron activation analysis for the concentration of Ca, K, Na, Rb, Fe, Co, Se and Zn. Comparing the results with the values from other brain areas, the Ca-content was 90 times higher, Co-content was double and Zn-concentration three times as high as those in the brain. The K, Na, Rb, Fe and Se values were found to be similar to those of other brain regions. Element concentration and age gave no significant correlation for the elements investigated. The K-content was taken as a parameter for cellular vitality and the pineal bodies were grouped into three classes of vitality. The normal K and Na, and the varying trace element concentrations refer to some specific biochemical and physiological functions of the organ.
The results obtained from contrast-enhanced MRI in 21 patients with masses in the pinealregion are reported. The use of gadolinium-DTPA results in intensive contrast uptake by the tumour; this produces better definition of the tumour and more exact delineation from neighbouring structures. This is of importance in judging resectability and in choosing the operative approach. During chemotherapy or radiotherapy, it provides reliable demonstration of the success of treatment and accurately demonstrates the size of the tumour and the presence of necrosis. On the other hand, histologic classification of pineal tumours is possible only occasionally. (orig.).
Radiosurgery is stereotactic neurosurgery in which the usual rigid needles or probes are replaced with beams of ionizing radiation directed toward an intracranial target so as to achieve local tissue destruction. No skin incision or skull opening is required. Lars Leksell originally defined the concept and over a prolonged research and development period created the Gamma Knife. The Gamma Knife is a self-contained unit with 201 cobalt 60 sources arranged in a hemispheric array such that the emitted beams of radiation reach a common point of intersection. Interchangeable collimating devices allow variation of the diameter of the 50% isodose distribution from 5.0 to 24.2 mm. Larger radiation dose distributions can be achieved by multiple overlapping exposures. Initial radiation dose rate is between 300 and 400 cGy/min. Obliteration of arteriovenous malformations has been shown angiographically in 80% to 86% of optimally treated patients two years later. Growth arrest or actual decrease in tumor size has occurred in 86% of acoustic neuromas treated. Other lesions treated with the Gamma Knife have included pituitary adenomas, craniopharyngiomas, pinealregiontumors, and ocular melanomas, as well as functional disorders. 28 references.
The authors report a rare case involving the occurrence of metachronous pure germinomas long after treatment of a mixed germ cell tumor (GCT) categorized as having a poor prognosis. A neurohypophysial germinoma occurred 4 years and 6 months after the initial treatment of a mixed pineal GCT containing a yolk sac tumor and a germinoma. Furthermore, intramedullary germinomas occurred 21 years after the initial treatment of the mixed GCT and 15 years after the second treatment of the neurohypophysial germinoma. The neurohypophysial germinoma was not confirmed histopathologically, but the intramedullary germinoma was histopathologically diagnosed as a pure germinoma. Serum ?-fetoprotein levels at the second neurohypophysial and third intramedullary occurrences of the germinomas were less than 10 ng/ml. Therefore, no yolk sac components seemed to be contained in the tumors. The second neurohypophysial and third intramedullary germinomas might be recurrences of the germinoma component of the pineal mixed GCT, which consisted of a yolk sac tumor and a germinoma. However, it seems very unlikely that only the germinoma, categorized in the good prognosis group, would be the only one to recur. Hence, it seems plausible that both the second and the third occurrences of pure germinoma were de novo metachronous GCTs arising after the pineal mixed GCT was cured. The authors' case indicates the possibility of multicentric GCTs in the CNS. PMID:23082803
AbstractBackground Marked elevations of AFP and bHCG in serum or CSF may serve as surrogate diagnostic markers in lieu of histology for primary CNS mixed, malignant germ cell tumors. There is less information on the diagnostic sensitivity of bHCG assays in germinoma. Procedure We report baseline serum and lumbar CSF bHCG values in 58 newly diagnosed, histologically confirmed germinoma patients gathered from two prospective clinical trials which required that patients have a normal AFP and bHCG -50-mIU/ml in serum and lumbar CSF. Results The location of the primary tumors was: suprasellar(23); pineal(20); suprasellar/pineal(9); and other sites(6). The mean age of the study population was 13.5 (4.3-25.9) years. A total of 23(40%) patients had elevations of bHCG in either serum or CSF, 20(34....
Cell proliferation in the pineal organ of the immature rainbow trout Oncorhynchus mykiss was investigated by immunocytochemical demonstration of the proliferating cell nuclear antigen (PCNA) together with photoreceptor-specific opsin. Numerous PCNA-immunoreactive cells were found throughout the pineal end-vesicle and stalk. Two types of PCNA-immuno-reactive cells were distinguished: intensely stained, large ovoid and round cells, and mildly stained, slender fusiform cells. The ovoid type of the former cell was found often in the apical region and the round type in the basal region of the epithelium, while the latter fusiform cells were scattered through the apical and middle regions. Occasionally, close approaches were found between the opsin-immunoreactive photoreceptor outer segments and the PCNA-immunoreactive cells, which expressed mildly stained, nuclear and cytoplasmic signals. In addition, overlaps of the opsin-immunoreactive outer segments with the BrdU-labelled cells were occasionally found within the pineal epithelium. These findings suggest that the proliferation and neurogenesis of the pineal photoreceptor cells might persist also in the adult rainbow trout, thus maintaining highly sensitive, photo-signal transduction mechanisms for melatonin synthesis.
A variety of tumours may arise in the pinealregion; accurate diagnosis is important in the selection of treatment and prognosis. A retrospective analysis of the MRI studies of 25 patients with pathologically proven pinealregion tumours was performed, focused on the relationship between the tumour and neighbouring structures. Compression of the tectal plate was classified as expansive or invasive, and compression of the corpus callosum as inferior, anterior or posterior. In 10 of the 14 patients (71 %) with germ cell tumours tectal compression was of the invasive type; 8 patients (57 %) had multiple tumours and in 13 (93 %) the tumour margins were irregular. Teratomas were readily diagnosed because of characteristic heterogeneous signal intensity. Pineal cell tumours were differentiated from germ cell tumours by their rounded shape, solid nature, sharp margins, and expansive type of tectal compression. Meningiomas were characterised by their falcotentorial attachments, posterior callosal compression, and a low-intensity rim on T2-weighted images. Gd-DTPA injection enabled clear demonstration of the site and extent of tumour spread and was useful in differentiating cystic and solid components. The appearances described, while not pathognomonic, are helpful in the differential diagnosis of pinealregion tumours, and valuable in planning appropriate treatment. (orig.). With 4 figs., 6 tabs.
Non-mammalian vertebrates have multiple extraocular photoreceptors, mainly localised in the pineal complex and the brain, to mediate irradiance detection. In this study, we report the full-length cDNA cloning of ruin lizard melanopsin and pinopsin. The high level of identity with opsins in both the transmembrane regions, where the chromophore binding site is located, and the intracellular loops, where the G-proteins interact, suggests that both melanopsin and pinopsin should be able to generate a stable photopigment, capable of triggering a transduction cascade mediated by G-proteins. Phylogenetic analysis showed that both opsins are located on the expected branches of the corresponding sequences of ortholog proteins. Subsequently, using RT-PCR and RPA analysis, we verified the expression of ruin lizard melanopsin and pinopsin in directly photosensitive organs, such as the lateral eye, brain, pineal gland and parietal eye. Melanopsin expression was detected in the lateral eye and all major regions of the brain. However, different from the situation in Xenopus and chicken, melanopsin is not expressed in the ruin lizard pineal. Pinopsin mRNA expression was only detected in the pineal complex. As a result of their phylogenetic position and ecology, reptiles provide the circadian field with some of the most interesting models for understanding the evolution of the vertebrate circadian timing system and its response to light. This characterization of melanopsin and pinopsin expression in the ruin lizard will be important for future studies aimed at understanding the molecular basis of circadian light detection in reptiles.
Magnetic resonance imaging is a routine diagnostic measure for a suspected intracerebral mass. Computed tomography is usually also indicated. Further diagnostic procedures as well as the interpretation of the findings vary depending on the tumor location. This contribution discusses the symptoms and diagnostics for supratentorial tumors separated in relation to their intra- or extracranial location. Supratentorial tumors include astrocytoma, differentiated by their circumscribed and diffuse growth, ganglioglioma, ependyoma, neurocytoma, primitive neuroectodermal tumors (PNET), oligodendroglioma, dysem-bryoplastic neuroepithelial tumors (DNET), meningoangiomatosis, pinealtumors, hamatoma, lymphoma, craniopharyngeoma and metastases. The supratentorial extracranial tumors include the choroid plexus, colloid cysts, meningeoma, infantile myofibromatosis and lipoma. The most common sub-forms, especially of astrocytoma, will also be presented. PMID:17541538
A 65-year-old male who had previously received curative treatment for a pinealtumor presented with an extremely rare case of primary central nervous system (CNS) primitive neuroectodermal tumor (PNET) of the spinal cord manifesting as progressive tetraparesis. Although the histology was not verified, highly radiosensitive tumor was suspected because of the benign clinical course for over 20 years after only radiation therapy. Magnetic resonance imaging demonstrated an intramedullary tumor extending from C5 to T1. He underwent partial resection and histological examination revealed blue tumor with undifferentiated small round cells. Immunohistochemically, c-kit was negative but CD99 was strongly and diffusely positive. Therefore, rearrangement of the Ewing sarcoma gene was examined to determine the presence of peripheral type of PNET. The results were negative and systemic workup revealed no other disease. These findings led to the diagnosis of primary intramedullary CNS PNET of the spinal cord, and suggested that the spinal cord tumor occurred independently of the prior pineal disease. The residual tumor was controlled by postoperative local radiation therapy.
We investigated the characteristic diagnostic imaging features of pineal cysts in 14 patients. Periodic MR images were obtained on all of them during the follow-up period of more than one year. Neurological deficits attributable to a pineal cyst were observed in only one patient, who had a convergence disturbance. the T{sub 1}-and T{sub 2}-weighted images were studied in all 14 cases, and to enhance contrast, Gd-DTPA was administered to all patients. The cysts had homogenous low intensity signals in T{sub 1}-weighted images and there were homogenous high intensity regions in T{sub 2}-weighted images. The margins were clear with little mass effect on the surrounding brain tissues. The results of Gd-DTPA enhancement of the cyst wall revealed the existence of three distinct patterns. They were: (1) A ring-like enhancement pattern seen in four cases, (2) an arcuate (partial) enhancement pattern observed in five patients, and (3) no enhancement, found in another five cases. The degree of enhancement was influenced by the relationship between thickness of the cyst wall and the spatial resolution of the MRI image. During the follow-up period no increase in the size of a given cyst was evident. These studies emphasize that follow-up MR imaging is necessary for determining changes in pineal cysts over time. Moreover, sagittal MR images are particularly useful for diagnosing pineal cysts and for understanding the relationship between the cyst and the surrounding tissues. (author).
Abstract in spanish Las malformaciones cavernosas de la región pineal son raras, con solamente 21 casos publicados hasta el momento en la literatura. A pesar de la dificultad de su diagnóstico debido a su extrema rareza, la presencia de esta lesión puede ser sospechada basándonos en sus características radiológicas. Presentamos el caso de una paciente de 57 años de edad, con un cuadro clínico de instauración aguda de desorientación, somnolencia y diplopia. La TC cerebral mostró un (more) a hemorragia aguda en la región pineal e hidrocefalia triventricular asociada y la RM cerebral fue sugestiva de que se tratase de una malformación cavernosa. La paciente fue operada con escisión total de la lesión y el estudio histológico confirmó el diagnóstico de angioma cavernoso. Concluimos que la cirugía para extracción total de la lesión es el tratamiento de elección cuando, basados en la imagen, sospechamos un angioma cavernoso de la región pineal. Abstract in english Cavernous malformations rarely occur in the pinealregion with only 21 reported to date. Although its diagnosis is not easy because of the extreme rareness of this condition, the presence of this lesion can be suspected based on its typical radiological findings. We report the case of a 57-year-old woman presented with desorientation, somnolence and diplopy. The CT-scan showed an acute hemorrhage in the pinealregion and triventricular hydrocephalus. An MRI suggested a ca (more) vernous malformation. The patient was operated with total en-bloc removal of the lesion. We conclude that surgical exploration and total resection is the treatment of choice when the diagnosis of cavernous angioma is suspected of the basis of neuroimaging.
Background Because the pineal gland produces melatonin, it is suggested to be involved in the regulation of sleep and circadian rhythm, though there is scant proof of this. Tumors of the pineal gland are rare and various in terms of histological and biological malignancy. We evaluated the occurrence of subjective sleep disturbances in nine patients who underwent a pinealectomy due to pineocytoma WHO?I without additional therapy. Methods Patients with intracranial low-grade lesions and patients without a craniotomy who underwent a microscopic lumbar discectomy were matched to our study group by gender, age, and date of surgery. We used standardized sleep questionnaires on sleepiness during the daytime, sleep disturbances, and general pathologic sleep patterns. Results Patients who underwent...
The role of gamma radiosurgery as an additional therapy after conventional treatments for pineal and related tumors was studied in 30 out of 33 cases with a mean follow-up of 23.3 months. Overall results showed that complete response (CR) was obtained in 8 cases (26.7%) and response rate was 73.3%. However, enlargement of the tumors was noted in 8 cases, of which 7 (23.3%) died of tumor progression (PG). Germinomas and pineocytomas showed higher response and control rates of 100%, and no tumor enlargement or death occurred after gamma knife treatment. In germinoma with STGC (syncytiotrophoblastic giant cell) which has been thought to have intermediate prognosis, two cases showed partial response (PR), but another died from progression of the disease. Malignant germ cell tumors and pineoblastomas showed unfavorable response and prognosis; the response and progression rates were 50%. However, complete response was obtained in 3 cases (25%) after gamma radiosurgery. Gamma knife was the initial treatment in three cases without pathological diagnosis in which one obtained CR and two showed partial response (PR). Stereotactic gamma radiosurgery is expected to be an effective and novel treatment for pineal and related tumors not only as an adjuvant, but also as an initial therapy. (author)
In addition to behavioral evidence for the detection of earth-strength magnetic fields (MF) by rodents, recent investigations have revealed that electrophysiological and biochemical responses to MF occur in the pineal organ and retina of rodents. In addition, ferrimagnetic deposits have been identified in the ethmoidal regions of the rodent skull. These findings point to a new sensory phenomenon, which interfaces with many fields of biology, including neuroscience, psychophysics, behavioral ecology, chronobiology and sensory physiology.
Of intracranial physiological calcification, common calcification of pinealregion, choroid plexus of lateral ventricles and of basal ganglia was examined based on the frequency of occurence of age and sex and type of CT scanners. Consecutive cases of 2877 (1450 males and 1427 females) underwent plain CT scanning were studied. Pathological calcification was excluded from this study. Three types of CT scanners (SCN-200, Somatom 2 and TCT-10 A) were used. As a whole, calcification was shown in 67.7 % in pinealregion, 57.6 % in choroid plexus of lateral ventricles and 7.5 % in basal ganglia. First, we reported in detail the calcification of pinealregion, in which calcification occurred most frequently. Calcification in pinealregion had a close relation with age by increasing with aging. The youngest patient was 8 years old. There was a striking increase in number of patients aged from 10 to 39 years. There was a gradual increase in those aged over 40 years. Of patients aged from 70 to 79 years, calcification was found in 81.5 %. The incidence was noted no changes in patients aged over 80 years. As for patients aged over 20 years, calcification was observed in 75.1 % (82.6 % males and 68.0 % females). In patients aged from 20 to 79 years, the calcification was significantly higher in male than female. Although there was a different incidence of calcification examined by three types of CT scanners, it was not significant. There was no significant difference between thickness of 8 mm section and 10 mm.
Trilateral retinoblastoma is the association of bilateral retinoblastomas and an intracranial primitive neuroectodermal tumour. Bilateral retinoblastomas with a pineal tumour are typical manifestations of this association. However, there may be variants, including unilateral retinoblastoma with intracranial tumour. The intracranial tumour can occur in the suprasellar or parasellar regions even before presentation of the retinal mass. We report a female infant with a suprasellar retinoblastoma and unilateral intraocular retinoblastoma. (orig.)
Pineal evolution is envisaged as a gradual transformation of pinealocytes (a gradual regression of pinealocyte sensory capacity within a particular cell line), the so-called sensory cell line of the pineal organ. In most non-mammals the pineal organ is a directly photosensory organ, while the pineal...
The circadian hormone melatonin is synthesized predominantly in the pineal gland by the actions of two pineal-specific enzymes: serotonin N-acetyltransferase (NAT) and hydroxyindole-O-methyltransferase (HIOMT). Pineal night-specific ATPase (PINA), another pineal- and night-specific protein we recent...
In 9 brain tumor patients treated with radiation, chemotherapy, and/or surgery, changes in cerebral blood flow (CBF) and metabolism of normal brain tissue were determined serially by positron emission tomography (PET). The subjects had glioblastomas (4 patients), and malignant oligodendroglioma, astrocytoma grade II, astrocytoma grade III, pontine glioma and pineal germinoma (each one patient), whose ages ranged from 11 to 62 years. One patient was treated with irradiation alone, one with combined irradiation and chemotherapy, and the other 7 patients with trimodal combined therapy including irradiation, chemotherapy and surgery. The patients received a total dose of 59 to 61 Gy, including 30 or 40 Gy to the whole brain. Chemotherapy consisted of intravenous administration of ACNU and oral administration of FT-207. CBF and cerebral metabolic rate of oxygen (CMRO{sub 2}) were measured by the {sup 15}O-steady state technique. Cerebral metabolic rate of glucose (CMRGlc) was measured by the {sup 18}F-labelled 2-fluoro-2-deoxy-D-glucose method. For the quantitative analysis of CBF, CMRO{sub 2}, and CMRGlc, elliptic regions of interests (ROIs), varying in size from 10 to 30 mm, were used as normal brain tissue. The second PET performed one month after therapy revealed a tendency for the increase of CBF, CMRO{sub 2}, and CMRGlc in surgical cases. Three months later, CBF, CMRO{sub 2}, and CMRGlc tended to decrease in most cases, except for two cases showing an increased CMRO{sub 2}. Regions exposed to higher doses showed a marked decrease for these parameters, suggesting a strong radiation dose-dependency. (N.K.).
A 28-year-old man presented with progressive mental deterioration. Thirteen years earlier he had undergone radiation therapy for a pineal germinoma. Neuroimaging showed a homogeneously enhanced mass lesion along the ventricular wall. The cerebrospinal fluid (CSF) level of human chorionic gonadotropin (HCG) was high. Endoscopic biopsy revealed that the tumor was a two-cell pattern germinoma. The diagnosis was germinoma with syncytiotrophoblastic giant cells (STGC). He first received three cycles of chemotherapy with carboplatin and etoposide and then two cycles with ifosfamide, cisplatin, and etoposide. Subsequently, the tumor size decreased markedly and the CSF level of HCG returned to normal. However, he died 22 months after the recurrence. Histological verification and measurement of tumor markers are necessary for the optimum treatment of germ cell tumors. Adequate initial chemotherapy and long-term follow up are essential for patients with germinoma with STGC.
Germ cell tumors (GCTs) may occur in both children and adults and include a broad array of histologic subtypes, such as teratoma, seminoma (known as dysgerminoma in the ovary and germinoma in the pineal gland), choriocarcinoma, yolk sac tumor, embryonal cell carcinoma, and mixed GCT. In adults, GCTs occur most commonly in the gonads. In children, sacrococcygeal tumors predominate. Teratomas are a common form of GCT. They are defined histologically as containing tissues derived from all 3 germ cell layers: ectoderm, mesoderm (most teratomas contain fat, an imaging hallmark, which is a mesodermal derivative), and endoderm. Teratomas are also classified as mature or immature, depending on the degree of differentiation of its components, and in adults, immature tumors are more likely to exhibi...
Melatonin, an indoleamine hormone synthesized in the pinealocytes, has been implicated as influencing the intake of alcohol in rats. It has been shown that this hormone is voltammetrically electroactive at the surface of pretreated carbon fiber microelectrodes in vitro and in vivo, in rat cerebral melatonergic regions such the pineal gland. The aim of this work consisted in the study of the influence of melatonin on spontaneously ethanol drinking or ethanol avoiding rats selected throughout a free choice two bottle test. It appeared that only the water preferring rats were affected by treatment with the hormone and that in vivo voltammetric related levels of melatonin were higher in the pineal gland of ethanol drinking rats versus water preferring rats. In addition, when treated with the m...
Abstract in spanish Los meningiomas del tercer ventrículo son raros. Representan, aproximadamente, el 0,15% de todos los meningiomas. La mayoría de los meningiomas del tercer ventrículo se localizan en la parte posterior, en la región pineal. Menos frecuentemente se originan en la parte anterior del tercer ventrículo. Presentamos los casos de dos pacientes con meningiomas grandes y gigantes, con origen en la parte anterior del tercer ventrículo. Abstract in english Third ventricle meningiomas are rare, representing approximately 0,15% of all meningiomas. The majority of third ventricular meningiomas are located posteriorly in the pinealregion. Less commonly, they arise in the anterior part of the third ventricle. We report the cases of two patients with large and giant meningiomas originating in the anterior part of the third ventricle.
Abstract in portuguese Aneurisma da veia de Galeno é patologia rara, representando menos de 1% das malformações vasculares intracranianas. Apresentamos o caso de um homem de 65 anos que teve episódio de crise convulsiva tônico-clônica generalizada. Exames de imagem evidenciaram grande processo expansivo calcificado na região pineal, confirmando o diagnóstico de aneurisma trombosado de veia de Galeno. Devido à trombose espontânea da malformação, foi excluída a possibilidade de tratamento endovascular bem como microcirúrgico, mantendo-se o acompanhamento clínico. Abstract in english Vein of Galen aneurysm is a rare pathology, representing less than 1% of intracranial vascular malformations. We report on a 65 years-old man who experienced a generalized tonic-clonic seizure. Brain imaging showed a large calcified expanding mass in the pinealregion, confirming the diagnosis of a vein of Galen aneurysm. Because of the spontaneous thrombosis of the malformation, there was no need for microsurgical or endovascular treatment and he is been regularly followed since that.
Serotonin N-acetyltransferase (arylalkylamine N-acetyltransferase, AA-NAT, HGMW-approved symbol AANAT;EC 2.3.1.87) is the penultimate enzyme in melatonin synthesis and controls the night/day rhythm in melatonin production in the vertebrate pineal gland. We have found that the human AA-NAT gene spans {approx}2.5 kb, contains four exons, and is located at chromosome 17q25. The open reading frame encodes a 23.2-kDa protein that is {approx}80% identical to sheep and rat AA-NAT. The AA-NAT transcript ({approx}1 kb) is highly abundant in the pineal gland and is expressed at lower levels in the retina and in the Y79 retinoblastoma cell line. AA-NAT mRNA is also detectable at low levels in several brain regions and the pituitary gland, but not in several peripheral tissues examined. Brain and pituitary AA-NAT could modulate serotonin-dependent aspects of human behavior and pituitary function. 31 refs., 5 figs.
Contents include the following: disodium cryomoglycate, a mast-cell stabilizer, alters postradiation regional cerebral blood flow in primates; intracellular recordings from pineal cells in tissue culture: membrane properties and response to norepinephrine; gamma radiation affects active electrolyte transport by rabbit ileum: basal Na and Cl transport; histamine H2 receptors mediate morphine-induced locomotor hyperactivity of the C57BL/6J mouse; Interleukin 1 is a radioprotector; histamine decreased calcium-mediated potassium current in guinea pig hippocampal ca1 pyramidal cells; cytochemical study of developing neurotransmitter properties of dissociated sympathetic neurons grown in co-culture with dissociated pineal cells: angiotensin II-induced taste aversion learning in cats and rats and the role of the area postrema; effects of area postrema lesions on taste aversions produced by treatment with WU-2721 in the rat; and DOD nuclear mishaps.
In diagnostic pathology thyroid transcription factor-1 (TTF-1) is used as a relatively specific and sensitive diagnostic marker of thyroid and lung adenocarcinomas and lung carcinoids but has also been demonstrated in minor proportions of carcinomas from other organs as well as nonepithelial neoplasms. Two antibody clones are widely used for TTF-1 demonstration, 8G7G3/1 and SPT24, the latter being the most sensitive. Few studies have addressed the occurrence of TTF-1 in central nervous system (CNS) tumors with highly divergent results, a major reason for which seems to be use of different clones. Based on multitissue blocks we analyzed the TTF-1 expression in a series of 155 CNS tumors comparing antibody clones 8G7G3/1 and SPT24 in optimized protocols on the Benchmark Ultra stainer. With clone SPT24 TTF-1 staining was observed in 13 cases (8%). Among astrodendroglial and oligodendroglial tumors, TTF-1 expression was found in 10 of 56 grades III to IV tumors (18%), as opposed to 0 of 47 grades I to II tumors (0%). The TTF-1 expression in positive tumors was generally weak to moderate and focal (mean histoscore 28, range: 2 to 120). TTF-1 positivity was inversely correlated to the expression of nestin. Among 52 other CNS tumors, TTF-1 expression was found in 1 of 3 central neurocytoma (the only CNS tumor with a moderate, diffuse staining), 1 of 18 ependymal tumors, and 1 of 5 choroid plexus tumors, whereas 4 pinealtumors, 11 meningiomas, 8 embryonal tumors, and 4 mixed neuronal-glial tumors all were negative. None of the 155 tumors stained with the 8G7G3/1 antibody clone. TTF-1 expression in primary brain tumors should be taken into consideration when interpreting brain tumors of uncertain origin.
Abstract in spanish Las neoplasias endocrinas múltiples constituyen síndromes con herencia autosómica dominante en los cuales hay afectación tumoral de 2 o más glándulas endocrinas, agrupadas según la afectación glandular en grupos: 1, 2A, 2B y las mixtas. Presentamos una paciente atendida en el INEN, del sexo femenino, de 44 años de edad, que a los 24 años fue operada de adenoma bronquial tipo carcinoide, 11 años más tarde fue intervenida quirúrgicamente por carcinoma medular d (more) el tiroides, y 7 años después comienza con aumento de volumen de las manos y los pies, por lo que ingresa en nuestro servicio donde se le diagnostica un adenoma hipofisario productor de GH, un tumor de la pineal, así como un tumor cromafín del riñón derecho. Dada la atipicidad del cuadro, y por no haber encontrado en la literatura revisada casos similares, consideramos oportuna su presentación. Abstract in english Multiple endocrine neoplasm are syndromes with autosomal dominant inheritance, where there is tumoral involvement of two or more endoce glands, grouped by glandular afection as: 1, 2A, 2B, and mixed. Case of a female patient, aged 44 seen in National Institute of Endocrinology (NIEN) and that when she aged 24 was operted on by a carcinoid bronchial adenoma, eleven year after she showed a increase in hands and feets volumen and is admissed in our service and is diagnosed a (more) s HG-producer hypophyseal adenoma, a tumor of pineal gland as well as a chromaffin tumor in right kidney. Due to atypical picture, and the lack of similar cases in reviewed literature, we considered appropriate its presentation.
Pineal lymphoid development was studied in two breeds of chickens from hatching until sexual maturity. No lymphocytes were found in the pineal prior to 9 days of age (da). Lymphocytes migrate through the endothelium of venules into the pineal stroma. Lymphoid tissue reached its maximal accumulation in 32-da pineal glands of both breeds. At this age, the New Hampshire (NH) breed had a larger proportion of lymphoid volume to total pineal volume (32%) than did pineal glands from White Leghorn (WL) chickens (18%).
We evaluated normal pineal glands on Gd-DTPA enhanced MR images on a 1.5 Tesla superconducting unit. On enhanced sagittal MR images with a 3-mm slice thickness, pineal glands were identified as solid or cystic structures. The solid and cystic pineal glands were divided into two subgroups according to the degree of enhancement. The solid pineal glands showed diffuse or subtle enhancement and cystic ones showed peripheral enhancement either completely or incompletely. Of the 50 patients, 19 (38%) had solid pineal glands and 31 (62%) had cystic ones. In male, 7 out of 12 (63%) showed solid pineal glands and in female, 27 out of 39 (70%) showed cystic ones. (author).
The pineal gland is a neuroendocrine organ of the brain. Its main task is to synthesize and secrete melatonin, a nocturnal hormone with diverse physiological functions. This review will focus on the central and pineal mechanisms in generation of mammalian pineal rhythmicity including melatonin production. In particular, this review covers the following topics: (1) local control of serotonin and melatonin rhythms; (2) neurotransmitters involved in central control of melatonin; (3) plasticity of the neural circuit controlling melatonin production; (4) role of clock genes in melatonin formation; (5) phase control of pineal rhythmicity; (6) impact of light at night on pineal rhythms; and (7) physiological function of the pineal rhythmicity. PMID:21782887
The survival, revascularization, reinnervation, and recovery of function of transplanted rat pineal glands were studied following grafting into four different locations in pinealectomized rats. Pineal grafts were well vascularized by fenestrated capillaries. Pinealocytes in the grafts maintained hig...
Serum melatonin concentration and its day-night difference in pinealectomized, stereotaxically grafted rats with pineal transplants was examined. The nighttime serum melatonin concentration increased significantly only in pinealectomized rats that received two pineal transplants. In neither pinealec...
Melatonin is a pineal secretory product that acts as a chemical messenger for the dark/light cycle and plays a central role in synchronization of circadian rhythms. Melatonin has been reported to exhibit a variety of therapeutic effects, including antiaging, anti-oxidative, anti-inflammation, and anticancer (such as induction of tumor suppressor genes and suppression of the metabolism of tumor cells, including breast cancer cells). In this study, we investigated the genome-wide transcriptional responses of MCF-7 human breast cancer cells exposed to melatonin by microarray gene expression profiling. We identified 1,946 and 983 genes that were 2-fold up- or down-regulated within 72 h of 1 nM and 100 nM melatonin treatment. Gene Ontology (GO) enrichment analysis was performed for identificati...
The age-related incidence of detectable pineal calcification in 725 patients (age range, newborn-20 yrs) suggests that there is a relationship between calcification and the hormonal role played by the pineal gland in the regulation of sexual development. Pineal calcification (demonstrated by computed tomography (CT) on 8-mm-thick sections) in patients less than 6 years old should be looked upon with suspicion, and follow-up CT should be considered to exclude the possible development of a pineal neoplasm.
The pineal gland plays an essential role in vertebrate chronobiology by converting time into a hormonal signal, melatonin, which is always elevated at night. Here we have analyzed the rodent pineal transcriptome using Affymetrix GeneChip® technology to obtain a more complete description of pineal...
The neuroendocrine functions of the pineal affect a wide variety of glandular and nervous system processes. Beside melatonin (MEL), the pineal gland secretes and expresses certain proteins essential for various physiological functions. It has been suggested that the pineal gland may also have an ant...
A comparative ultrastructural study was made of the pineal organ of two related species of the Syngnathidae, the pipefish, Syngnathus acus, and the seahorse, Hippocampus hudsonius. Both species have a relatively small pineal organ, which ultrastructurally shows several similarities with the pineal of other teleosts. In the pineal organ of Syngnathus acus, the photoreceptor cells have well-developed outer segments consisting of about 15 to 60 saccules. The pineal supporting cells are characterized by the presence of numerous myeloid bodies. In Hippocampus hudsonius the pineal outer segments are scarce and poorly developed; generally, they show not more than 20 saccules. The apical parts of the supporting cells contain dense-core vesicles with a diameter varying from 100 to 180 nm. Corresponding vesicles were not observed in the pineal organ of Syngnathus acus. Arguments are presented for the suggestion that the pineal organ of the Syngnathidae, in spite of its relatively small size, still has a functional significance. In Syngnathus acus, light reaching the pineal organ directly might have a regulating effect on pineal activity. In Hippocampus hudsonius, however, light acting directly on the pineal organ appears to have minor effect on pineal function. PMID:7397765
A 20-year-old man presented with a rare case of germinoma with a large component of epithelioid cell granuloma manifesting as oscillopsia. Magnetic resonance imaging demonstrated a mass in the pinealregion with homogeneous enhancement with gadolinium. Craniotomy was performed, ending in biopsy. The initial histological diagnosis was epithelioid cell granuloma, but systemic investigation detected no evidence of granulomatous disorder. A revised diagnosis of germinoma was based on positive immunohistochemical staining for placental alkaline phosphatase (PLAP) and c-kit. Histological diagnosis is sometimes incorrect if granulomatous reaction is dominant. Immunohistochemical staining for PLAP and c-kit should be performed if germinoma is clinically suspected.
Stereotactic radiosurgery using a gamma knife obtains good results for small intracranial disease, arteriovenous malformation (AVM) and acoustic neurinoma. In this study, accuracy of the radiation method of stereotactic radiosurgery using a LINAC was investigated and preliminary treatment results were also evaluated. The deviation of rotation center of the LINAC gantry was within 0.5 mm. However, the deviation of rotation center of the LINAC table was more than 0.5 mm. To apply the LINAC target positioner manipulator, the deviation of rotation center of the LINAC table was improved to within 0.5 mm. Between July 1992 and November 1994, 25 patients received stereotactic radiosurgery using a LINAC. All patients had a small intracranial lesion, AVM; 6, primary brain tumor; 9 (acoustic neurinoma; 4, meningioma; 2, astrocytoma; 2 and pinealtumor; 1) and metastatic brain tumor; 10. Two of 6 AVMs and one of 4 acoustic neurinomas decreased in size. Seven of 10 metastatic brain tumors either shrunk or disappeared. It is suggested that stereotactic radiosurgery is more effective than whole brain irradiation for metastatic brain tumor. In only one patient who had AVM, post irradiation brain edema appeared. Optimal dose to control tumors remains to be determined by accumulation of further clinical experiences. (author).
The phosphorylation of specific proteins in pineal homogenate was analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and autoradiography. Cyclic AMP had the capacity to stimulate in a dose-dependent manner the incorporation of /sup 32/P in protein bands of apparent molecular weights 59K, 56K, and 35K with a maximal effect at 1 microM. On the other hand, calcium alone did not induce a marked increase in /sup 32/P incorporation with the exception of a dose-dependent phosphorylation of a 46K protein with a peak effect at 0.2 mM calcium concentration. The addition of exogenous calmodulin enhanced /sup 32/P incorporation in proteins migrating in the 62K and 52K regions, an effect that was antagonized by the calmodulin inhibitor trifluoperazine. However, also under these conditions, the stimulation of pineal protein phosphorylation was rather weak compared to that observed in other brain areas. In an attempt to investigate the functional changes of these biochemical processes during environmental lighting and adrenergic stimulation, it was found that the administration of (-)-isoproterenol (5 mg/kg, s.c.), a beta-receptor agonist, induced a clear-cut enhancement of /sup 32/P incorporation into the cyclic AMP-sensitive 59K and 56K proteins only in animals exposed for 18 h to the light, whereas it was almost ineffective in those kept in the dark for the same period. This effect was antagonized by (-)-propranolol pretreatment (20 mg/kg), suggesting that the changes in cyclic AMP-dependent protein phosphorylation observed in supersensitive pineals may represent a beta-receptor mediated process.
The CNS is both source and target of melatonin. This methoxyindole formed in the pineal gland is also produced in other CNS regions and additionally enters the brain by uptake from the circulation as well as via the pineal recess. The mammalian circadian pacemaker, the suprachiasmatic nucleus (SCN), not only controls the pineal, but also receives a feedback information on darkness. Two G protein-coupled melatonin receptors, MT1 and MT2, are responsible for the transduction of many melatonergic actions. High receptor densities are especially found in the SCN, but their presence at lower expression levels in other areas is functionally important. Various metabolites and analogs are formed in the CNS, such as N-acetylserotonin, 5-methoxytryptamine, 5-methoxytryptophol, 5-methoxylated kynuramines, and even 6-sulfatoxymelatonin. The chronobiological effects of melatonin go beyond the resetting of a single circadian oscillator. They contribute to phase relationships between oscillatory subsets and are required for robust rhythm amplitudes. CNS effects of melatonin comprise sleep initiation, antiexcitatory, antiepileptic, antinociceptive, anxiolytic, proneurotrophic, antiinflammatory, antioxidant and other neuroprotective actions. The role as a sleep-promoting compound, which is limited by its short half-life in the circulation, has led to the development of controlled-release formulations and of various synthetic agonists, such as ramelteon, agomelatine, tasimelteon, TIK-301, UCM765 and UCM924. Their differences concerning receptor affinities, preferences for receptor subtypes, and pharmacokinetics are discussed, as well as additional antidepressive actions of agomelatine and TIK-301 based on properties as antagonists of the serotonergic 5-HT2C receptor. Indirect antidepressive effects by melatonergic drugs are largely explained by circadian readjustments. PMID:22640220
The results of radiation treatment of 63 patients with pinealtumors and ectopic pinealomas are analysed. The histopathological diagnosis has been verified in 17 cases, and they consist of 9 germinoma, 3 teratoma and 5 embryonal carcinoma. The overall 5 year survival rate was 79.5%. Survival rate was different according to histology and site of tumor involvement. Local control was achieved more frequently with doses of over 45 Gy in five to six weeks. Marginal relapse (4 cases) and spinal metastasis (7 cases) were occured with ports under 10 x 10cm/sup 2/, but not over 10 x 10 cm/sup 2/. Prophylactic spinal irradiation were undertaken in 7 patients, and there were no spinal metastases in these patients. Tumor response detected by CT scan at 10-20 Gy was well related to relapse pattern and histopathological classification. There were no in-field relapse in patients with tumors which responded well at 10-20 Gy and disappeared at more than 40 Gy. Teratomas were demonstrated as radioresistant tumors at 10-20 Gy. Therapuetic diagnosis by CT scan seems to be a reliable procedure to determine indication of tumorectomy. (author).
Abstract in spanish El tumor neuroectodérmico pigmentado es un tumor benigno de crecimiento rápido e intensamente pigmentado del maxilar inferior (y en ocasiones de otros sitios), que consiste en una masa infiltrativa de células dispuestas según un patrón alveolar. Aparece casi exclusivamente en lactantes. Se presenta como una tumoración protuberante en un maxilar o la mandíbula principalmente en tejidos blandos; encontrándose excepcionalmente en el tracto intestinal, pelvis, retrope (more) ritoneo y riñón. Clínicamente se manifiesta como una tumoración localizada, con presencia o no de zonas pigmentadas. Estas neoplasias son raras y afectan mayormente niños, que por lo general son menores de un año y que pueden ser congénitos. Su localización en cerca de un 70% es la mandíbula; facio-cervical, en 90%, también se reportaron en localizaciones como: fontanela anterior, hueso temporal y duramadre, epidídimo, huesos largos, mediastino. Éstos son considerados como formas periféricas, ya que existen formas centrales que pueden afectar cerebro, cerebelo, glándula pineal. La clínica de estos casos puede simular a muchas otras patologías, dificultando su diagnostico ya que es una masa que protruye y deforma que rara vez ulcera. Las radiografías muestran una masa radiolúcida con capacidad de destrucción focal y desplazamiento de los dientes, por lo que se puede confundir con un ameloblastoma es por esto que es necesario un manejo adecuado con los exámenes histológicos necesarios como se hizo en el presente caso. Abstract in english The Pigmented neuroectodermal tumor is a benign tumor of intensely pigmented and rapid growth of the lower jaw (and in occasions of other sites [places]), that consists of a mass of infiltrative cells arranged according to an alveolar boss. It (he, she) appears almost exclusively in nursing. He (she) appears as a protruding tumor in the jaw Maxillary one or principally in the soft (smooth) fabrics; being exceptionally in the intestinal tract, pelvis, retroperitoneum and k (more) idney. Clinical, it (he, she) demonstrates located as a tumor or not with presence of pigmented areas. These tumors are rare and mostly affect children, who are generally under one year and can be congenital. Its location in about 70 percent is the mandible, facio-cervical in 90 percent have also been reported in locations such as anterior fontanel, temporal bone and dura, epididymis, long bones, mediastinum. These are regarded as peripherally, as there are ways that can affect Central Brain, cerebellum, pineal gland. The clinic in these cases may mimic other pathologies, easily diagnosed as a protruding mass that deforms and rarely ulcerates. Radiographs showed a radiolucent mass capable of focal destruction and displacement of teeth, it can be confused with an ameloblastoma that is why it is necessary to an adequate histological examinations were made as necessary in this case.
Several epidemiological studies have shown that high levels of melatonin, an indolic hormone secreted mainly by the pineal gland, reduce the risks of developing cancer, thus suggesting that melatonin triggers the activation of tumor-suppressor pathways that lead to the prevention of malignant transformation. This paper illustrates that melatonin induces phosphorylation of p53 at Ser-15 inhibiting cell proliferation and preventing DNA damage accumulation of both normal and transformed cells. This activity requires p53 and promyelocytic leukemia (PML) expression and efficient phosphorylation of p53 at Ser-15 residue. Melatonin-induced p53 phosphorylation at Ser-15 residue does not require ataxia telangiectasia-mutated activity, whereas it is severely impaired upon chemical inhibition of p38 ...
This study was designed to seek the appropriate scanning parameters for T1 and T2 weighted images of rat head by use of a high (4.7 T) magnetic field strength magnetic resonance imaging unit. The optimum values of variables for T1 weighted images were considered to be a time of repetition of 1,000 msec, and for T2 weighted images, 8 echoes. When the sagittal images of a healthy rat head were scanned using these optimum values, the cerebrum, cerebellum, olfactory bulb, pituitary gland, pineal gland, spinal cord, tongue, nasopharynx, nasal conchae, vermis and cerebrospinal fluid were clearly observed in either T1 or T2 weighted images. Moreover, a primary brain tumor induced by ethylnitrosourea was depicted as a high signal intensity mass in T2 and contrast-enhanced T1 weighted images.
Purpose Central nervous system germinomas often extend or disseminate into the ventricular and subarachnoid space. We present a case of primary central nervous system germinoma consisting mainly of meningeal dissemination, which is extremely unusual. Case report A 16-year-old boy presented with pure germinoma, manifesting as anorexia and headache for 10 days. Radiological examinations revealed a large mass lesion in the posterior fossa and a small mass lesion on the pineal lobule with thickening of the tentorium cerebelli and falx. The patient underwent partial removal of the infratentorial tumor via open surgery. Intraoperative findings indicated extension of the dural and supracerebellar mass lesions into the epiarachnoid space. Three chemotherapy courses comprising ifosfamide, etoposide...
Purpose Central nervous system germinomas often extend or disseminate into the ventricular and subarachnoid space. We present a case of primary central nervous system germinoma consisting mainly of meningeal dissemination, which is extremely unusual. Case report A 16-year-old boy presented with pure germinoma, manifesting as anorexia and headache for 10?days. Radiological examinations revealed a large mass lesion in the posterior fossa and a small mass lesion on the pineal lobule with thickening of the tentorium cerebelli and falx. The patient underwent partial removal of the infratentorial tumor via open surgery. Intraoperative findings indicated extension of the dural and supracerebellar mass lesions into the epiarachnoid space. Three chemotherapy courses comprising ifosfamide, etoposide...
Purpose To better define outcome and prognostic factors in primary pinealtumors. Materials and methods Thirty-five consecutive patients from seven academic centers of the Rare Cancer Network diagnosed between 1988 and 2006 were included. Median age was 36?years. Surgical resection consisted of biopsy in 12 cases and resection in 21 (2 cases with unknown resection). All patients underwent radiotherapy and 12 patients received also chemotherapy. Results Histological subtypes were pineoblastoma (PNB) in 21 patients, pineocytoma (PC) in 8 patients and pineocytoma with intermediate differentiation in 6 patients. Six patients with PNB had evidence of spinal seeding. Fifteen patients relapsed (14 PNB and 1 PC) with PNB cases at higher risk (p?=?0.031). Median survival time was not reached. Media...
Pineal gland visible in plain skull radiography when calcified had been an important indicator for evaluation of any space, occupying lesion within cranium according to displacement of it from normal midline position. Since the pineal gland is more frequently demonstrated on CT scan than plain skull radiography, it seems helpful to define the incidence and localization of pineal gland. 324 patients, performed head CT scan are analyzed incidence and localization of calcified pineal gland. The results were as follows: 1. The overall incidence of pineal calcification was 51%. 2. The male and female ratio in pineal calcification was 56% to 43%. 3. 1) In the AP localization of pineal gland, the ratio of distance from anterior inner table of the skull to the pineal gland and that from pineal gland to the posterior inner table was 1.46 {+-} 0.20. 2) In the lateral localization of pineal gland, according to 'Lateral Percentage Shift' by Hahn and Rim (1976), the result was 0.98% shift in 80 normal cases, but 2.20% shift in 38 cases with S.O.L.
Objectives The purpose of this study was to evaluate cone beam CT (CBCT) scans for the presence of physiological and pathological intracranial calcifications. Methods CBCT scans from male and female patients that met our ascertainment criteria were evaluated retrospectively (n = 500) for the presence of either physiological or pathological intracranial calcifications. Results Out of the 500 patients evaluated, 176 had evidence of intracranial physiological calcification (35.2% prevalence), and none had evidence of pathological calcification. There was a 3:2 male-to-female ratio and no ethnic predilection; the ages of affected patients ranged from 13 years to 82 years with a mean age of 52 years. The majority of calcifications appeared in the pineal/habenular region (80%), with some also appearing in the choroid plexus region bilaterally (12%), and a smaller subset appearing in the petroclinoid ligament region bilaterally (8%). Conclusions Intracranial physiological calcifications can be a common finding on CBCT scans, whereas pathological intracranial calcifications are rare. PMID:22842632
A 44-year-old man presented with a rare subfrontal schwannoma with headache. He had undergone radiation therapy for a pineal lesion 30 years previously, but the histology was not verified. On admission, neurological examination revealed no focal deficits including hyposmia. Computed tomography demonstrated a mass measuring 5 × 3 cm in the right anterior cranial fossa. Magnetic resonance imaging revealed a heterogeneously enhanced mass with multiple cysts. The tumor, which was clearly separable from the surrounding normal brain, was totally resected through a right frontal craniotomy. There was no adhesion between the tumor and the olfactory groove or cribriform plate. The frontal base dura was suspected to be the tumor attachment. The patient was discharged without hyposmia. Histological examination revealed a typical pattern of schwannoma consisting of Antoni type A and type B. Immunohistochemical staining was positive for S-100 protein but negative for epithelial membrane antigen. Subfrontal schwannoma not associated with the olfactory groove or cribriform plate is extremely rare. The operative findings and absence of hyposmia suggest that the meningeal branch of the trigeminal nerve was the origin of the tumor. However, the possibility of radiation-induced reactive Schwann cells cannot be excluded.
Seventeen patients with pinealtumors and one ectopic (suprasellar) germinoma were treated with radiation therapy. Surgery was restricted to decompression in 16 patients, and only two patients had resection of the tumor. Thirteen of 18 patients are alive without evidence for disease with a ten-year surrvival rate of 88%. The tumor dose ranged from 4000 rads to 6000 rads. No age or dose dependence in survival was noted, but patients with whole brain irradiation or generous volume to include ventricular system had better survival. No case of spinal metastasis was noted. The possibility of increased incidence of meningeal seeding following surgical intervention is considered. From their data, the authors feel that radiation therapy with or without surgical decompression should be the primary treatment for pinealoma. Surgery can be used for diagnosis and/or treatment of patients who show delayed response to radiation. Recommendation is made for the use of whole brain irradiation to 4000 rads followed by a boost to the tumor area to 5000 rads.
1. In pineal glands of adult spontaneously hypertensive rats (Okamoto strain), dopamine levels increased 34%, adrenaline concentrations increased 152% and noradrenaline levels decreased by 26%, when compared with Wistar-Kyoto normotensive controls. 2. These results are consistent with the hypothesis of an increased uptake of peripheral adrenaline resulting in increased release of noradrenaline from pineal sympathetic nerves in hypertensive rats. 3. The activity of pineal N-acetyltransferase was increased fourfold in hypertensive rats, indicating increased stimulation of pineal beta-adrenoreceptors. 4. Methylation of pineal membrane phospholipids was also increased (100-320%) in hypertensive rats. 5. These results indicate a correlation in vivo between increased beta-adrenoreceptor stimulation and increased methylation of membrane phospholipids in the rat pineal gland, which could result in changes in membrane fluidity and affect the coupling of the beta-adrenoreceptors to the adenylate cyclase. PMID:6256115
Pineal lesions are rare. Tumours in this location comprise 0.4-1% of intracranial tumours. They grow mainly as solid-mass lesions, and cystic tumours are not common. On MRI, a cystic configuration is associated usually with non-neoplastic pineal lesions rather than with a tumour, but analysis does not allow cystic pineal tumours to be distinguished from glial cysts with certainty. We compared neuroradiological and pathological data from 13 cystic pineal lesions, analysing preoperative MRI. Formalin-fixed, paraffin-embedded surgical specimens were stained routinely and immunocytochemically, using the streptavidin-biotin-complex method. Histology revealed six pineocytomas, four glial cysts, an arachnoid cyst, a low-grade astrocytoma and a teratoma. Signal characteristics of pineocytomas were similar in many respects to those of glial pineal cysts. Histomorphological analysis allowed unambiguous discrimination between pineocytomas and glial pineal cysts. (orig.)
The pineal gland plays an essential role in vertebrate chronobiology by converting time into a hormonal signal, melatonin, which is always elevated at night. Here we have analyzed the rodent pineal transcriptome using Affymetrix GeneChip(R) technology to obtain a more complete description of pineal cell biology. The effort revealed that 604 genes (1,268 probe sets) with Entrez Gene identifiers are differentially expressed greater than 2-fold between midnight and mid-day (false discovery rate
In an attempt to clarify further the role of the hypothalamic paraventricular nuclei (PVN) in the control of pineal function, the effects of 2 min electrical stimulation of these nuclei were investigated in acutely blinded, adult, male Sprague-Dawley rats. Pineal serotonin-N-acetyltransferase (NAT) activity, melatonin content and catecholamine levels were measured by means of radio-enzymatic, radioimmunoassay and high-performance liquid-chromatography methods, respectively. All three pineal parameters underwent significant declines following brief PVN stimulation during the night time. These observations lend credence to the view that the neural pathways transmitting light information to the sympathetic innervation controlling pineal melatonin synthesis. 22 references, 1 figure.
Cone-rod homeobox (Crx) encodes Crx, a transcription factor expressed selectively in retinal photoreceptors and pinealocytes, the major cell type of the pineal gland. In this study, the influence of Crx on the mammalian pineal gland was studied by light and electron microscopy and by use of microarray and qRTPCR technology, thereby extending previous studies on selected genes (Furukawa et al. 1999). Deletion of Crx was not found to alter pineal morphology, but was found to broadly modulate the mouse pineal transcriptome, characterized by a > 2-fold down-regulation of 543 genes and a > 2-fold up-regulation of 745 genes (p < 0.05). Of these, one of the most highly up-regulated (18-fold) was Hoxc4, a member of the Hox gene family, members of which are known to control gene expression cascades. During a 24-h period, a set of 51 genes exhibited differential day/night expression in pineal glands of wild-type animals; only eight of these were also day/night expressed in the Crx-/- pineal gland. However, in the Crx-/- pineal gland 41 genes exhibited differential night/day expression that was not seen in wild-type animals. These findings indicate that Crx broadly modulates the pineal transcriptome and also influences differential night/day gene expression in this tissue. Some effects of Crx deletion on the pineal transcriptome might be mediated by Hoxc4 up-regulation.
Abstract in portuguese A melatonina é um hormônio produzido pela glândula pineal, cuja secreção está diretamente relacionada ao ciclo claro-escuro. É um poderoso antioxidante e tem papel fundamental na regulação do estado sono/vigília, do ritmo de vários processos fisiológicos, participando do controle do relógio biológico, inclusive nos seres humanos. Ressalta-se que há evidências da sua ação no sistema genital feminino, influenciando a função ovariana e a fertilidade. De f (more) ato, este hormônio interage com esteróides sexuais, como o estrogênio, modificando a sinalização celular e a resposta no tecido alvo. Estudos clínicos sugerem que o tratamento com a melatonina interviria com a evolução de neoplasia-dependente do estrogênio. O objetivo dessa revisão é analisar as principais ações da melatonina no sistema neuroendócrino, no ciclo sono-vigília, no sistema imunológico, no sistema cardiovascular, bem como no sistema reprodutor. Abstract in english Melatonin is secreted by the pineal gland and this is linked to the day/night cycle. It is an antioxidant and plays a fundamental role in the regulation of the jet-lag stage, in several physiological reactions and in control of the biologic rhythm. Human melatonin has an important influence on the female genital system. In fact, melatonin may influence production and action of steroids, modifying cellular signalization on the target tissue. There are many evidences that t (more) he melatonin therapy may be interfering with neoplasia development, mainly of the estrogen-dependent tumor. This paper aims to analyze the actions of melatonin on the neuroendocrine, immunological and cardiovascular systems, as well as on the reproductive function.
Young adult male domestic pigeons were exposed to artificial long photoperiod (LP, 200 watt; 20 hr light, L : 4 hr dark, D), short photoperiod (SP; 4 L : 20 D) and administration of exogenous testosterone propionate (TP) at a daily dose of 1 mg/100 g body weight for 60 consecutive days in primary breeding and regressive phases-I. Administration of TP in LP and SP during primary breeding phase decreased both the adrenal and pineal gland weight. In the TP-LP treatment during breeding phase, adreno-cortical cord width, nuclear diameter of sub-capsular zone (SCZ), central zone (CZ), and pinealocytes decreased significantly. Cholesterol, ascorbic acid level, and side-chain cleavage enzyme (SCC) within the CZ regions also decreased. Lipid granules increased in the SCZ but dec...
Background There is as yet little knowledge as to the arachnoid architecture within the velum interpositum. The aim of this study was to clarify the distribution of the arachnoid membrane within the velum interpositum and its relationship with the arachnoid envelope over the pinealregion. Methods In seven adult cadaver heads, histological sections of the third ventricle roof, stained with Masson?s trichrome stains, were studied under light microscopy. Results Within the velum interpositum, there are two arachnoid layers. The dorsal layer of arachnoid membrane envelops the internal cerebral veins and fixes them to the surrounding tela choroidea as well as the ventral arachnoid layer. The ventral layer of arachnoid membrane is a direct anterior extension of the arachnoid envelope over the p...
Background & AimsAnti-tumor immunity changes over the course of tumor progression; it is not clear how or when the developing tumor overcomes immune surveillance. Intraductal papillary mucinous neoplasm (IPMN) is an intraepithelial precursor lesion of pancreatic cancer that progresses from adenoma to carcinoma. We investigated when and how the human anti-tumor immune reaction changes during pancreatic tumor development. MethodsUsing immunohistochemical analysis of cells isolated from patients with IPMN, the numbers of tumor-infiltrating lymphocytes and dendritic cells and the maturation state of dendritic cells in the regional lymph nodes were investigated during tumor progression. Gene expression profiles were compared among epithelial neoplastic cells at each stage of tumor develo...
This study was undertaken to evaluate the variations in appearance of the normal pineal gland. The findings of 1000 consecutive MR imaging examinations obtained at 0.5 T were studied. The age of the patients ranged from 1 day to 83 years, and findings in children and adults were compared. In all age groups the pineal gland appeared mainly in three forms: (1) nodule-like, (2) crescent-like and (3) ring-like. Overall prevalences of these forms were 52 %, 26 % and 22 %, respectively. Apparent differences in frequencies were evident in children and adults with respect to the crescent-and ring-like types. Cystiform pineal lesions 5 mm or larger in one diameter (anteroposterior, sagittal or transverse) were taken to be true pineal cysts, when compared with the gland`s ring-like appearance (less than 5 mm). Pineal cysts had a prevalence of 0.6 % in children and 2.6 % in adults. No symptomatic pineal cyst with mass effect on the lamina tecti was detected in the series. Besides identifying the three anatomical types of the pineal gland as seen on MR imaging and addressing the potential significance of differences in their frequencies in children and adults, the author tries to explain the previous discrepancy between the MR imaging and autopsy series findings with respect to frequencies of the pineal cysts. (orig.)
Calcification of the pineal gland is shown to be closely related to defective sense of direction. In a tricentre prospective study of 750 patients lateral skull radiographs showed that 394 had calcified pineal glands. Sense of direction was assessed by subjective questioning and objective testing an...
The light and electron microscopic features of pigmented cells in the adult dog pineal gland have been described. The presence of pigmented cells was a constant characteristic of the dog pineal gland, though wide variations in the amount of pigment could be found among different animals. Conversely,...
We have used immunoblotting and biochemical techniques to analyze expression of Na+,K(+)-ATPase alpha and beta subunits in rat pineal glands. Western blot analysis of pineal microsomal membrane fractions with antisera specific for each of the three rat alpha and two rat beta subunits revealed simila...
Secretion of melatonin by the mammalian pineal gland is primarily regulated by the release of norepinephrine (NE) from sympathetic nerve terminals that originate from the superior cervical ganglia. Peptidergic nerves that originate in the perikarya located in the sensory trigeminal ganglia also innervate the pineal gland. Some of these peptidergic nerve fibers contain substance P. Previously, we have characterized neurokinin 1 type substance P receptors in the pineal gland. However, the function of this receptor in the pineal gland remains unclear. Here, we examined the modulatory effect of substance P on rat pineal NE transmission. We show that at the presynaptic level, substance P stimulates the KCl-induced [(3)H]NE release from the pineal nerve ending. However, we found that substance P did not affect the basal levels of either arylalkylamine-N-acetyltransferase (AANAT) activity or melatonin secretion in rat pineal organ cultures. However, in the presence of NE, substance P inhibited the NE-induced increase in AANAT activity and melatonin secretion. This is the first time that a function for substance P in the mammalian pineal gland has been demonstrated.
Studies of the adrenergic regulation of cyclic GMP in the pineal gland show that (-)-norepinephrine stimulates cyclic GMP primarily in pineal cells, rather than in nerve endings as previously thought. The response exhibits the interesting and unusual characteristic of homologous sensitization: It is...
Nocturnal melatonin pineal output is triggered by sympathetic outflow. Antidepressants that block norepinephrine neuronal uptake should increase pineal function. This can be monitored by measuring 6-sulfatoximelatonin (aMT6s), the main melatonin metabolite, in the urine. In this study, we compared t...
The parietal eye of the lizard responds to illumination by sending afferent impulses to the pineal gland during daylight, the photophase. The pineal gland has efferently conducting neurons which are especially sensitive to norepinephrine and whose feedback to the parietal eye enhances its photo resp...
This investigation is based upon the pineal organs of 92 specimens of 36 species of the family Pteropodidae (Mammalia, Chiroptera). The size of the megachiropteran pineal correlates well with body size (r = 0.864), confirming the former conclusions that generally larger bodied bats have larger pinea...
A protein kinase that is dependent on cAMP was found to be present in significant amounts in rat and bovine pineal glands. This enzyme system was isolated from bovine pineal glands and shown to consist of two proteins, a kinase and a cAMP-binding protein. The kinase primarily phosphorylates histones...
We describe CT and MR findings in a 23-month-old infant with a melanotic neuroectodermal tumour of the pineal gland. The tumour has been stereotactically biopsied and surgically resected. The pathological diagnosis was made on the resected piece. Embryology of the pineal gland and the histology of melanotic neuroectodermal tumour of infancy are discussed. (orig.)
The pineal gland, sharing morphological and biochemical similarities with the retina, plays a unique and central role in the photoneuroendocrine system. The unique development of the pineal gland is directed by a specific combination of the expressed genes, but little is known about the regulatory m...
The chicken pineal gland contains the autonomous circadian oscillator together with the photic-input pathway. We searched for chicken pineal genes that are induced by light in a time-of-day-dependent manner, and isolated chicken homolog of bZIP transcription factor E4bp4 (cE4bp4) showing high simila...
The pineal gland of birds contains one or more circadian oscillators that play a major role in overall temporal organization. We have developed a flow-through culture system for the isolated pineal by which we can measure the release of melatonin continuously from superfused glands over long periods...
The effcct of a single high-intensity light pulse with a duration of 1 ms on nighttime pineal activity of male Sprague-Dawley rats was investigated. 10 minutes after light exposure pineal N-actyltransferase activity and melatonin content were significantly reduced. These results show that the rat pi...
In the pineal gland and retina of chickens, serotonin N-acetyl-transferase (NAT) activity and melatonin content are modulated by different receptors, alpha-2 adrenergic receptors in pineal gland and D2-dopamine receptors in retina. The effect of two D2-dopamine receptor agonists, bromocriptine and quinpirole (LY 171555), on melatonin synthesis in these tissues was investigated. Systemic administrations of bromocriptine and quinpirole decreased nocturnal NAT activity and melatonin content of both pineal gland and retina. Bromocriptine was equipotent in the two tissues, whereas quinpirole was approximately 100-fold more potent in retina than in pineal gland. In pineal gland, the suppressive effects of bromocriptine and quinpirole on NAT activity were blocked by yohimbine, a selective alpha-2 adrenergic receptor antagonist, but not by spiperone, a D2-dopamine receptor antagonist. In contrast, bromocriptine- and quinpirole-induced decreases of the enzyme activity in retina were antagonized by spiperone, and not affected by yohimbine. The nocturnal increase of NAT activity of pineal glands in vitro was inhibited with an order of potency clonidine greater than bromocriptine greater than quinpirole. Additionally, bromocriptine and quinpirole displaced the specific binding of (3H)rauwolscine, an alpha-2 adrenergic receptor antagonist, to membranes from chicken pineal gland, with potencies comparable to those observed for inhibition of NAT activity in vitro. It is suggested that bromocriptine and quinpirole, in addition to their D2-dopaminergic activity, can stimulate alpha-2 adrenergic receptors in pineal gland of chicken.
Using on-line microdialysis, we have characterized in vivo dynamics of pineal 5-hydroxytryptamine (5-HT; serotonin) release. Daily pineal 5-HT output is triphasic: (i) 5-HT levels are constant and high during the day; (ii) early in the night, there is a novel sharp rise in 5-HT synthesis and release...
In comparison to adult individuals over the age of 50, pineal cysts do rarely occur in children and adolescents. Here we report on four young patients who had pineal cysts in combination with hypophyseal dwarfism. We studied an 8-year-old girl with chiasmal germinoma, an 8-year-old boy with epilepsy, a 17-year-old male with spontaneous hypophyseal dwarfism and a 11-year-old female with craniopharyngioma. We also investigated a 29-year-old man with pontine glioma and a 48-year-old women with prolactinoma. The comparison of neuroimaging the pineal cysts in children and adults revealed the characteristics of their location in the pineal gland and the presence of residual normal gland. The etiology of pineal cysts in combination with pituitary dwarfism is unclear. However, our cases would suggest that they may be related to endocrinological disorders of the hypothalamus and the pituitary gland. (author).
The effect of acute ethanol administration on pineal serotonin N-acetyltransferase (NAT) activity, norepinephrine and indoleamine content was examined in male rats. When ethanol was administered in two equal doses (2 g/kg body weight) over a 4 hour period during the light phase, the nocturnal rise in NAT activity was delayed by seven hours. The nocturnal pineal norepinephrine content was not altered by ethanol except for a delay in the reduction of NE with the onset of the following light phase. Although ethanol treatment led to a significant reduction in nocturnal levels of pineal serotonin content, there was no significant effect upon pineal content of 5-hydroxyindoleacetic acid (5-HIAA). The data indicate that ethanol delays the onset of the rise of nocturnal pineal NAT activity.
Adult AMES mice and male Sprague Dawley rats were exposed to an artificial magnetic field, generated by Helmholtz coils. 3.5 hours after the onset of darkness the coils were activated for one hour resulting in an inversion of the horizontal component of the earth's magnetic field. The coils were activated and deactivated at 5 min intervals during the 1 hour exposure period. In both mice and rats, the levels of serotonin in the pineal were markedly increased by the exposure. In rats, an increase of pineal 5-hydroxyindole acetic acid and a decrease of the activity of the pineal enzyme serotonin-N-acetyltransferase also was observed. However, pineal and serum melatonin levels were not altered. The results indicate that the metabolism of serotonin in the pineal is quickly affected by the exposure of animals to a magnetic field.
In mammals, the production of melatonin by the pineal gland is mainly controlled by the suprachiasmatic nuclei (SCN), the master clock of the circadian system. We have previously shown that agents involved in inflammatory responses, such as cytokines and corticosterone, modulate pineal melatonin synthesis. The nuclear transcription factor NFKB, detected by our group in the rat pineal gland, modulates this effect. Here, we evaluated a putative constitutive role for the pineal gland NFKB pathway. Male rats were kept under 12 h:12 h light-dark (LD) cycle or under constant darkness (DD) condition. Nuclear NFKB was quantified by electrophoretic mobility shift assay on pineal glands obtained from animals killed throughout the day at different times. Nuclear content of NFKB presented a daily rhyt...
The authors described a case of giant size tumor of the submental region in a 53 years old patient. The very large tumor was treated by total extirpation. Histological investigation had shown structure of lipoma. (author). 20 refs, 4 figs.
... majority of these tumors benign or malignant? Typical age of the patient? These are benign tumors. Rarely ... below this region in the clivus. The typical age of these patients is—it’s an age range, ...
Previously, we demonstrated that experimental peritonitis in chickens was attenuated by treatment with exogenous melatonin, while the developing inflammation decreased pineal AANAT activity. This suggested the existence of a bidirectional relationship between the activated immune system and pineal gland function. The aim of the present study was to identify the step(s) in the chicken pineal melatonin biosynthetic pathway that are affected by inflammation. Peritonitis was evoked by i.p. injection of thioglycollate solution, either 2h after the start, or 2h before the end of the light period, and the animals were sacrificed 4h later. The effect of inflammation on the expression of genes encoding enzymes participating in melatonin biosynthesis in the pineal gland, i.e. tryptophan hydroxylase 1 (Tph1), dopa decarboxylase (Ddc), arylalkylamine N-acetyltransferase (Aanat) and acetylserotonin O-methyltransferase (Asmt), was evaluated by qPCR. The pineal and serum melatonin concentration as well as the content of its precursors in the pineal gland were measured, along with the activity of the relevant biosynthetic enzymes. Developing peritonitis caused an increase in the pineal levels of the Tph1 mRNA during the night and the Asmt mRNA during the day, while nocturnal Aanat transcription was reduced. Both the pineal and serum melatonin level and the pineal content of N-acetylserotonin (NAS) were decreased during the night in birds with peritonitis. The amount and activity of pineal AANAT were significantly reduced, while the activity of HIOMT was increased under these experimental conditions. These results indicate that the observed decrease in MEL biosynthesis in chickens with developing inflammation is a result of transcriptional downregulation of the Aanat gene, followed by reduced synthesis and activity of the encoded enzyme. PMID:22935823
Computed tomography (CT) was performed on renal tumors (Wilms' tumor and renal cell carcinoma) and renal cysts in dogs and cats. CT images in renal tumors were well correlated with macroscopic findings, and contrast CT images were quite useful in differentiating tumoralregions from non-tumoral ones. On renal cysts, intravenous pyelography and ultrasonography were as effective as CT images in morphological diagnosis, but CT was considered to be superior for evaluating three-dimensional (3-D) relationships in complicated lesions. (author).
Yolk sac tumor (endodermal sinus tumor) is a one of the five highly malignant germ cell tumors and commonly affects gonads of young children. Its extra-gonadal occurrence is uncommon and is rarely seen in head and neck region. In this paper we describe a 2-year-old girl with yolk sac tumor (YST) in the post auricular region. She was treated with extensive surgical resection.
Abstract in portuguese São estudados três casos de germinomas cerebrais, sendo um tópico, da região pineal, e dois ectópicos, chamados germinomas supra-selares ou quiasmáticos. Estes últimos parecem ser mais agressivos que os seus congeneres tópicos, pois alem de se disseminarem pelas cisternas basais, costumam infiltrar as paredes do III ventrículo, fórnix, hipotálamo, nervos e quiasma ópticos. Caracteristicamente produzem um enorme aumento das proteínas liquóricas, desacompanhad (more) o de uma pleocitose proporcional. As proteínas liquóricas aumentadas sao globulinas cujas reações mostram-se fortemente positivas, possivelmente produzidas pelas celulas de aspecto linfocitario que constituem parte desta neoplasia. O aumento das proteinas liquoricas e tao acentuado que em presenca de uma crianca ou adolescente com sindrome de hipertensão intracraniana, hiperproteinoraquia sem pleocitose e sinais clínicos ou radiológicos sugestivos de localização na base do crânio a possibilidade de um germinoma quiasmático deve ser seriamente considerada, pois o quadro e muito sugestivo. Abstract in english Three cases of Cerebral Germinomas, one of them situated in the pinealregion (topical) and two ectopical of the so called suprasellar or chiasmal Germinomas are studied. These last ones may be more aggressive than the congeneral topical ones, since besides it's dissemination throughout the basal cisternas they usually infilstrate into de walls of the III Ventricle, Fornix, Hypothalamus, Chiasma and Optic nervs. A high level of proteins in the spinal fluid without proport (more) ional increase of the cells is characteristic. Globulins are the predominant fraction of the increased spinal fluid proteins, as indicated by the highly positive laboratory test. These globulins are possibly produced by the lymphocytes which are part of this neoplasm. The high level of protein in the spinal fluid without proportional increase of the cells, in the presence of intracranial syndrome in a child or adolescent, with anatomical signs of basal localization make the possibility of a Chiasmal Germinona highly probable.
The enhanced MR findings of hematopoietic regions in aplastic anemia were compared with those of spondylitis, metastatic vertebral tumors and hematologic neoplasms. The enhanced MR images showed hematopoietic regions to homogeneously enhance and occupy the margin of vertebral bodies, while spondylitis and metastatic tumors appeared as round, inhomogeneously enhancing lesions. MR images of leukemia and myelodysplastic syndrome showed homogeneous enhancement at the margins of vertebrae that was difficult to differentiate from hematopoietic regions. Enhanced MR images were useful in detecting the hematopoietic areas in marrow and differentiating them from spondylitis and metastatic tumors, although further experience is needed to distinguish between tumorous hyperplastic regions and benign hematopoietic regions in marrow. (author).
A lymphoma was found in a Japanese killifish (medaka), Oryzias latipes. The tumor mass was detected in the area adjacent to the left operculum. Lymphoid cells were observed in the dermis, gill, skeletal muscle, thyroid gland, kidney and thymic region. The thymus was considered the primary site because the tumor mass was located mainly at the thymic region, and tumor cells showed massive proliferation in the thymic region.
There are sparse or contradictory data on frequency and pathological significance of pineal calcifications in childhood. This is particularly so for children younger than 6 years of age. We therefore looked for pineal gland calcifications in 1044 consecutive a.p. and lateral skull films. Pineal calcification was diagnosed, if accepted by both authors, and if the calcified spot fitted into at least 2 of 4 localisation methods. 80 patients with pineal calcifications were detected using this method. In 40 of these patients CCT confirmed the calcification. The frequency of pineal calcification was 3% in the first 12 months of life rising gradually to 7.1% in children of 10 years of age. From 10 years onwards, there is a marked increase of frequency of calcifications of the pineal gland up to 33% in the group of children of 18 years of age. In contrast to some statements in literature, pineal calcifications seem to be physiological in a limited percentage even below the age of 6 years.
In non-mammalian vertebrates, the pineal gland functions as the central pacemaker that regulates the circadian rhythms of animal behavior and physiology. We generated a transgenic zebrafish line [Tg(Gnat2:gal4-VP16/UAS:nfsB-mCherry)] in which the E. coli nitroreductase is expressed in pineal photoreceptor cells. In developing embryos and young adults, the transgene is expressed in both retinal and pineal photoreceptor cells. During aging, the expression of the transgene in retinal photoreceptor cells gradually diminishes. By 8 months of age, the Gnat2 promoter-driven nitroreductase is no longer expressed in retinal photoreceptor cells, but its expression in pineal photoreceptor cells persists. This provides a tool for selective ablation of pineal photoreceptor cells, i.e., by treatments with metronidazole. In the absence of pineal photoreceptor cells, the behavioral visual sensitivity of the fish remains unchanged; however, the circadian rhythms of rod and cone sensitivity are diminished. Brief light exposures restore the circadian rhythms of behavioral visual sensitivity. Together, the data suggest that retinal photoreceptor cells respond to environmental cues and are capable of entraining the circadian rhythms of visual sensitivity; however, they are insufficient for maintaining the rhythms. Cellular signals from the pineal photoreceptor cells may be required for maintaining the circadian rhythms of visual sensitivity. PMID:22815753
In mammals, the production of melatonin by the pineal gland is mainly controlled by the suprachiasmatic nuclei (SCN), the master clock of the circadian system. We have previously shown that agents involved in inflammatory responses, such as cytokines and corticosterone, modulate pineal melatonin synthesis. The nuclear transcription factor NFKB, detected by our group in the rat pineal gland, modulates this effect. Here, we evaluated a putative constitutive role for the pineal gland NFKB pathway. Male rats were kept under 12 h:12 h light-dark (LD) cycle or under constant darkness (DD) condition. Nuclear NFKB was quantified by electrophoretic mobility shift assay on pineal glands obtained from animals killed throughout the day at different times. Nuclear content of NFKB presented a daily rhythm only in LD-entrained animals. During the light phase, the amount of NFKB increased continuously, and a sharp drop occurred when lights were turned off. Animals maintained in a constant light environment until ZT 18 showed diurnal levels of nuclear NFKB at ZT15 and ZT18. Propranolol (20 mg/kg, i.p., ZT 11) treatment, which inhibits nocturnal sympathetic input, impaired nocturnal decrease of NFKB only at ZT18. A similar effect was observed in free-running animals, which secreted less nocturnal melatonin. Because melatonin reduces constitutive NFKB activation in cultured pineal glands, we propose that this indolamine regulates this transcription factor pathway in the rat pineal gland, but not at the LD transition. The controversial results regarding the inhibition of pineal function by constant light or blocking sympathetic neurotransmission are discussed according to the hypothesis that the prompt effect of lights-off is not mediated by noradrenaline, which otherwise contributes to maintaining low levels of nuclear NFKB at night. In summary, we report here a novel transcription factor in the pineal gland, which exhibits a constitutive rhythm dependent on environmental photic information. PMID:20205557
The formation of dansyl derivatives of amino acids, 5-hydroxyindoleacetic acid and histamine, and their separation on polyamide plates provided a reliable and sensitive method for studying circadian changes in single pineal and pituitary glands of the rat. There appears to be no correlation between the circadian changes in concentrations of these substances in the pineal and pituitary glands. Chronically administered D-amphetamine altered the circadian rhythms of five amino acids in the pituitary, including the putative transmitters taurine, glycine, and glutamate; in the pineal gland only the rhythmical changes of lysine and 5-hydroxyindoleacetic acid were affected. PMID:1223321
Pineal hormone and thyroid functions, were studied simultaneously in rats after the induction of acute psychic stress as well as exogenous administration of melatonin, thyroxine and also after thyroidectomy. A gradual increase in /sup 131/I uptake, serum PBI and melatonin levels were observed in blood, reaching a maximum on the 8th day of psychic stress. Melatonin administration resulted in hypothyroidism whereas thyroxine increased the activity of the pineal gland. Thyroidectomy revealed a gradual decrease in melatonin content of the pineal gland whereas supplementation with thyroxine resulted in a melatonin content similar to that observed in the sham operated (control) group.
Sclerosing stromal tumor is a rare ovarian neoplasm. We describe the radiologic findings of sclerosing stromal tumor in two patients. In both patients, MR and CT images showed a large mass in the left adnexal region. On dynamic contrast-enhanced images, the tumors showed early peripheral enhancement with centripetal progression. (orig.) With 2 figs., 7 refs.
Lipoma is a common tumor of soft tissue. Its location on the oral mucosa is rare, representing 1% to 5% of benign oral tumors although it is the most mesenchymal tumor of the trunk and proximal por-tions of extremities. Lipoma of the oral cavity may occur in any region. The buccal mucosa, tongue, an...
Angiography of renal tumors confirms the suspected diagnosis and permits an assessment of regional and metastatic spread during the same procedure, thus providing more information as to operability. Furthermore, preoperative tumor embolisation can be done if applicable - a technique routinely done by us in cases of large tumors.
The human pineal gland produces melatonin in a circadian rhythm. The substance has different functions - as a hormone, as an antioxidant and as a neurotransmitter. The secretion of melatonin and its tumor inhibition function can be influenced by electric and magnetic fields. Investigations have been carried out with rodents which have a melatonin rhythm similar to humans; nevertheless, they show a high variability between the species. The present state of knowledge only allows limited use of melatonin as an indicator for the impact of electric and magnetic fields. (orig.) [German] In der Epiphyse des Menschen wird in circadianem Rhythmus Melatonin produziert und ausgeschuettet. Die Substanz hat unterschiedliche Funktionen - als Hormon, Antioxidans und Neurotransmitter. Seine Ausschuettung und seine tumorhemmende Funktion koennen durch elektrische und magnetische Felder beeinflusst werden. Anhand von Nagern, die einen dem Menschen aehnlichen Melatoninrhythmus haben, allerdings eine hohe Speziesvarianz aufweisen, wurden diese Funktionen untersucht. Nach dem jetzigen Kenntnisstand eignet sich Melatonin nur bedingt als Indikator fuer die Wirkungen elektrischer und magnetischer Felder. (orig.)
Studies have been conducted at Battelle, Pacific Northwest Laboratory, to examine extremely-low-frequency (ELF) electromagnetic fields for possible biological effects in animals. Three areas of investigation are reported here: (1) studies on the nervous system, including behavior and neuroendocrine function, (2) experiments on cancer development in animals, and (3) measurements of currents and electric fields induced in animal models by exposure to external magnetic fields. In behavioral experiments, rats have been shown to be responsive to ELF electric field exposure. Furthermore, experimental data indicate that short-term memory may be affected in albino rats exposed to combined ELF and static magnetic fields. Neuroendocrine studies have been conducted to demonstrate an apparent stress-related response in rats exposed to 60-Hz electric fields. Nighttime pineal melatonin levels have been shown to be significantly depressed in animals exposed to either electric or magnetic fields. A number of animal tumor models are currently under investigation to examine possible relationships between ELF exposure and carcinogenesis. Finally, theoretical and experimental measurements have been performed which form the basis for animals and human exposure comparisons.
Studies have been conducted at Battelle, Pacific Northwest Laboratory, to examine extremely-low-frequency (ELF) electromagnetic fields for possible biological effects in animals. Three areas of investigation are reported here: (1) studies on the nervous system, including behavior and neuroendocrine function, (2) experiments on cancer development in animals, and (3) measurements of currents and electric fields induced in animal models by exposure to external magnetic fields. In behavioral experiments, rats have been shown to be responsive to ELF electric field exposure. Furthermore, experimental data indicate that short-term memory may be affected in albino rats exposed to combined ELF and static magnetic fields. Neuroendocrine studies have been conducted to demonstrate an apparent stress-related response in rats exposed to 60-Hz electric fields. Nighttime pineal melatonin levels have been shown to be significantly depressed in animals exposed to either electric or magnetic fields. A number of animal tumor models are currently under investigation to examine possible relationships between ELF exposure and carcinogenesis. Finally, theoretical and experimental measurements have been performed which form the basis for animals and human exposure comparisons.
Abstract in spanish Antecedentes. Entre las complicaciones tardías de la radioterapia se encuentran la atrofia cerebral, la radionecrosis y el desarrollo de tumores radioinducidos. Se ha descrito recientemente la formación de cavernomas intracraneales en pacientes tratados con radioterapia cerebral. Objetivo. Presentar los casos de tres niños, dos con meduloblastomas y uno con un germinoma pineal, en los que se encontraron cavernomas cerebrales años después del tratamiento con radiotera (more) pia, a fin de contribuir al conocimiento de esta eventualidad en el medio neuroquirúrgico. Resultados. Los pacientes fueron dos niñas y un niño entre 2,5 y 7 años de edad (media 5,2 años). El intervalo medio entre la radioterapia y la aparición del cavernoma fue de 5,3 años (extremos 5 y 6 años). Las lesiones fueron encontradas en los estudios de neuroimagen que se realizan habitualmente a estos pacientes para seguimiento de sus tumores originarios. Durante el período de observación, ningún paciente presentó síntomas o signos relacionados con el cavernoma. No obstante, los tres niños requerirán un seguimiento clínico y de neuroimagen para vigilar la evolución clínica de estas lesiones descubiertas accidentalmente. Conclusiones. La presencia de cavernomas intracraneales puede detectarse años después del tratamiento con radioterapia. Al contrario de casos previos publicados en los que fue frecuente su presentación con hemorragia, los cavernomas también pueden ser detectados de manera casual en los estudios de seguimiento que se realizan habitualmente a niños con tumores cerebrales tratados previamente con radioterapia. En este caso, parece aconsejable mantener una actitud conservadora, reservando la cirugía para las lesiones que crecen o sangran. Abstract in english Background. Delayed complications of radiation therapy comprise cerebral atrophy, radionecrosis and induction of tumors. Recent reports indicate the possibility of the "de-novo" formation of intracranial cavernomas in patients submitted to radiation therapy to the brain. Objectives. To report three children, two with medulloblastomas and one with a pineal germinoma, treated with radiotherapy that developed intracerebral cavernous hemangiomas some years after treatment. Wi (more) th this work, we aim to draw attention to this occurrence in the neurosurgical community. Results. The patients were two girls and one boy with ages comprised between 2.5 and 7 years (mean 5.2 years). The average interval from irradiation to the appearance of cavernoma was of 5.3 years (range 5-6 years). The lesions were found during the routine neuroimaging studies performed for the follow-up of their primary neoplasms. No patient showed signs or symptoms related to the cavernomas. However, the three children will need both clinical and neuroimaging surveillance to monitor the evolution of these incidentally discovered lesions. Conclusions. Intracranial cavernomas can occur years after cerebral radiation therapy. In spite of previous reports that show a high incidence of bleeding lesions, cavernomas may be found incidentally during the neuroimaging surveillance studies that are performed to children with brain tumors previously treated with radiotherapy. In these cases, a conservative attitude seems to be advisable, reserving surgery only for those lesions that grow or bleed.
Abstract in spanish Las lectinas son proteínas que contienen áreas singulares para el reconocimiento de secuencias de azúcares en los glicoconjugados. La lecitina del tomate Lycopersicon esculentum (LEL) es capaz de reconocer específicamente los residuos de N-acetil-glucosamina (Gly-Nac) y poli-N-acetil-lactosamina. Utilizamos la técnica histoquímica para LEL conjugada a la biotina con el propósito de investigar en la glándula pineal de ratones adultos y durante el desarrollo, las es (more) tructuras morfológicas capaces de unirse a esta lecitina. Nuestros resultados experimentales mostraron un material de coloración por la LEL, solamente en la superficie de las células endoteliales de todos los vasos sanguíneos y en todas las regiones de la glándula. La excepción ocurrió en los ratones con un día pos-natal (PN1), donde solamente los vasos de la región más periférica de la glándula presentaban coloración marrón amarillenta por la LEL, pero ninguno presentaba esta coloración en la región más central de la glándula. La reacción apareció especialmente en el espacio interno de las pseudo-rosetas, demostrando así que este espacio está, seguramente, representado por un vaso Abstract in english Lectins are proteins with binding sites that recognize a specific sequence of sugar moieties in complex glycoconjugates. In the present study the tomato lectin Lycopersicon esculentum (LEL) (a selective microglial and endothelial marker) has been reported to recognize specific residues of N-acetylglucosamine (GlyNAc) and poly-N-acetyllactosamine. In the pineal gland the biotinylated LEL was used to investigate the appearance of these sugar residues in the structures of (more) the rats during their development and adult life. Our results showed that the binding of LEL occurred exclusively in the material adherents on surface of the endothelia of the vessels in the peripheral and central regions of the gland. An exception can be cited to rats in first postnatal day where the vessels in the central region did not display the LEL-reaction. In all animals studied and, from 3- postnatal day onwards the LEL-reactions could be observed within the central space of pseudo-rosettes also characterizing this space as a vessel
We report a unique case of mediastinal paravertebral chordoma without bone destruction in a 47-year-old Japanese woman. She was admitted to hospital after a tumor was incidentally detected on a chest radiograph. The tumor was located in the paravertebral region of the mediastinum and did not show any destruction of the thoracic vertebra radiologically. The tumor was clinically diagnosed as a benign neurogenic tumor and the tumor was easily removed surgically. Microscopically, the tumor mainly consisted of tumor cells with extensively vacuolated cytoplasm, arranged in cord- and nest-like fashion against a myxoid matrix background. Immunohistochemically, the tumor cells showed diffuse positivity for pancytokeratin (AE1/AE3) and vimentin. The tumor cell nuclei were positive for brachyury, whi...
Immature and unstable tumor vasculature provides an aberrant tumor microenvironment and leads to resistance of tumors to conventional therapy. Hence, normalization of tumor vessels has been reported to improve the effect of immuno-, chemo- and radiation therapy. However, the humoral factors, which can effectively induce maturation of tumor vasculature, have not been elucidated. In this study, we found that the novel peptide apelin and its receptor APJ can induce the morphological and functional maturation of blood vessels in tumors. This apelin-induced tumor vascular maturation enhances the efficacy of cancer dendritic cell-based immunotherapy and significantly suppresses tumor growth by promoting the infiltration of invariant natural killer T cells into the central region of the tumor and...
PurposeCurrent stereotactic ablative radiotherapy (SABR) protocols for lung tumors prescribe a uniform dose regimen irrespective of tumor size. We report the outcomes of a lung tumor volume-adapted SABR dosing strategy. Methods and MaterialsWe retrospectively reviewed the outcomes in 111 patients with a total of 138 primary or metastatic lung tumors treated by SABR, including local control, regional control, distant metastasis, overall survival, and treatment toxicity. We also performed subset analysis on 83 patients with 97 tumors treated with a volume-adapted dosing strategy in which small tumors (gross tumor volume <12 mL) received single-fraction regimens with biologically effective doses (BED) <100 Gy (total dose, 18-25 Gy) (Group 1), and larger tumors (gross tumor volume ?12 mL) r...
Intramedullary tumors are conventionally regarded as fusiform enlargement of the spinal cord shadow on myelography and computed tomography myelography. With exophytic growth, however, these tumors resemble intradural extramedullary tumors, since a cap defect of the metrizamide column and a shift of the spinal cord are seen on contrast studies. Seventeen cases of intramedullary tumors were evaluated, six of which involved exophytic tumor growth documented radiologically and at surgery. These tumors were predominantly located from the lower cervical to the upper thoracic region or in the conus medullaris. They were infrequently associated with a syrinx or cyst, and occupied shorter segments of the spinal axis than do tumors without exophytic growth. These tumors could be divided into two types. Type I tumors were accompanied by swelling of the spinal cord and, in some cases, a cap defect of the metrizamide column on the rostral side. Those of Type II had no cord swelling but cord deformity was present, and they were seldom associated with a syrinx or cyst. Cap defects were observed on both the rostral and caudal sides of the tumors. Thus, Type I tumors are mainly intramedullary, whereas Type II tumors are extramedullary. Since it is difficult to differentiate Type II tumors from intradural extramedullary tumors, one should keep in mind the possibility of exophytic growth of intramedullary tumors.
Chordoma arising from the notochordal remnants is a rare primary bone tumor in the cervicosacral region and is even more unusual in the thoracic region. The authors experienced a case of thoracic chordoma and reports its CT and MR findings.
Previously, we demonstrated that experimental peritonitis in chickens was attenuated by treatment with exogenous melatonin, while the developing inflammation decreased pineal AANAT activity. This suggested the existence of a bidirectional relationship between the activated immune system and pineal gland function. The aim of the present study was to identify the step(s) in the chicken pineal melatonin biosynthetic pathway that are affected by inflammation. Peritonitis was evoked by i.p. injection of thioglycollate solution, either 2h after the start, or 2h before the end of the light period, and the animals were sacrificed 4h later. The effect of inflammation on the expression of genes encoding enzymes participating in melatonin biosynthesis in the pineal gland, i.e. tryptophan hydroxylase ...
The effects of chronic 30-day electric field exposure on pineal serotonin N-acetyl transferase (EC 2.1.15) activity as well as melatonin and 5-methoxy tryptophol (5-MTOL) concentrations in rats, were assessed.
As a component of studies to search for effects of 60-Hz electric field exposure on mammalian endocrine function, concentrations of melatonin, 5-methoxytryptophol, and serotonin-N-acetyl transferase activity were measured in the pineal glands of rats exposed or sham-exposed at 65 kV/m for 30 days.In two replicate experiments there were statistically significant differences between exposed and control rats in that the normal nocturnal increase in pineal melatonin content was depressed in the exposed animals. Concentrations of 5-methoxytryptophol were increased in the pineal glands of the exposed groups when compared to sham-exposed controls. An alteration was also observed in serotonin-N-acetyl transferase activity, with lower levels measured in pineal glands from exposed animals.
Reports from recent epidemiological studies have suggested a possible association between extremely low frequently (ELF; including 50- or 60-Hz) electric- and magnetic-field exposure, and increased risk of certain cancers, depression, and miscarriage. ELF field-induced pineal gland dysfunction is a possible etiological factor in these effects. Work in our laboratory and elsewhere has shown that ELF electromagnetic-field exposure can alter the normal circadian rhythm of melatonin synthesis and release in the pineal gland. Consequences of reduced or inappropriately timed melatonin release on the endocrine, neuronal, and immune systems are discussed. Laboratory data linking ELF field exposure to changes in pineal circadian rhythms in both animal and humans are reviewed. The authors suggest that the pineal gland, in addition to being a convenient locus for measuring dyschronogenic effects of ELF field exposure, may play a central role in biological response to these fields via alterations in the melatonin signal.
Using rather simple and mild extraction and separation methods, three ovine pineal fractions (XM 300R - PP 7.2, PP 7.2' and PP 7.2S) were obtained, which contain peptidic/proteic substances and which show fluorescence characteristics of indoles. The ovine fractions were compared with the bovine pineal E5-fraction. The ovine fractions are chemically sensitive to normal laboratory light and stable in red light (..lambda.. > 600 nm). Immunologically, these fractions and the bovine E5 fraction are stable. From the results of radioimmunological experiments it was concluded that the bovine pineal E5 fraction as well as the ovine pineal fraction XM 300R - PP 7.2 and PP 7.2S may contain (a) peptide(s) ending by the same carboxy terminal tripeptide Pro-Arg-Gly(NH/sub 2/).
The perivascular space of the rat pineal gland is known to contain phagocytic cells that are immunoreactive for leukocyte antigens, and thus they appear to belong to the macrophage/microglial cell line. These cells also contain MHC class II proteins. We investigated this cell type in the pineal gland of mice. Actively phagocytosing cells with a prominent lysosomal system were found in the pericapillary spaces of the mouse pineal gland following intravenous injection of horseradish peroxidase. The cells also exhibited strong acid phosphatase activity. Perivascular cells were immunopositive for MHC class II protein and for CD68, a marker of monocytes/phagocytes. This study verifies that perivascular phagocytes with antigen-presenting properties are present in the mouse pineal gland.
We present a case of pineal teratoma in a symptomatically stable 6-year-old child in which MRI revealed intraventricular lipid accumulation in the absence of any primary tumour growth, metastatic disease or tumour degeneration. (orig.)
Since Classical Antiquity numerous authors have linked the origin of some mental disorders to physical and functional changes in the pineal gland because of its attributed role in humans as the connection between the material and the spiritual world. The pineal organ was seen as a valve-like structure that regulated the flow of animal spirits through the ventricular system, a hypothesis that took on more vigour during the Middle Ages and the Renaissance. The framework for this theory was ''the three cells of the brain'', in which the pineal gland was even called the ''appendix of thought''. The pineal gland could also be associated with the boom, during this period, of certain legends about the ''stone of folly''. But the most relevant psychopathological role of this organ arrived with Des...
SummaryLarval zebrafish lacking eyes and pineal organ show elevated activity levels and undirected light-seeking behaviour upon loss of illumination. This behaviour, termed dark photokinesis, is mediated by hypothalamic deep brain photoreceptors expressing melanopsin.
Cholangiocarcinoma (CCA) is a devastating biliary cancer. Melatonin is synthesized in the pineal gland and peripheral organs from serotonin by two enzymes, serotonin N-acetyltransferase (AANAT) and acetylserotonin O-methyltransferase (ASMT). Cholangiocytes secrete neuroendocrine factors, including s...
Exposure to extremely-low-frequency (ELF) electric or magnetic fields has been postulated as a potentially contributing factor in depression. Epidemiologic studies have yielded positive correlations between magnetic- and/or electric-field strengths in local environments and the incidence of depression-related suicide. Chronic exposure to ELF electric or magnetic fields can disrupt normal circadian rhythms in rat pineal serotonin-N-acetyltransferase activity as well as in serotonin and melatonin concentrations. Such disruptions in the circadian rhythmicity of pineal melatonin secretion have been associated with certain depressive disorders in human beings. In the rat, ELF fields may interfere with tonic aspects of neuronal input to the pineal gland, giving rise to what may be termed functional pinealectomy. If long-term exposure to ELF fields causes pineal dysfunction in human beings as it does in the rat, such dysfunction may contribute to the onset of depression or may exacerbate existing depressive disorders. 85 references.
Purpose: To implement a computer-aided detection system for kidney segmentation and kidney tumor detection on abdominal computed tomography (CT) scans. Material and Methods: Abdominal CT images were digitized with a film digitizer, and a gray-level threshold method was used to segment the kidney. Based on texture analysis performed on sample images of kidney tumors, a portion of the kidney tumor was selected as seed region for start point of the region-growing process. The average and standard deviations were used to detect the kidney tumor. Starting at the detected seed region, the region-growing method was used to segment the kidney tumor with intensity values used as an acceptance criterion for a homogeneous test. This test was performed to merge the neighboring region as kidney tumor boundary. These methods were applied on 156 transverse images of 12 cases of kidney tumors scanned using a G.E. Hispeed CT scanner and digitized with a Lumisys LS-40 film digitizer. Results: The computer-aided detection system resulted in a kidney tumor detection sensitivity of 85% and no false-positive findings. Conclusion: This computer-aided detection scheme was useful for kidney tumor detection and gave the characteristics of detected kidney tumors.
The study was aimed to determine influence of pineal stimulation by light restriction on the response of rat testes to single, locally administered exposure dose of 7.79x10-2 C/kg of X-rays. Different arrangements of light-dark cycles before and after irradiation were used. It was found that stimulation of the pineal by light deprivation before and after irradiation may be accelerated by displacing the animals after irradiation to normal conditions.
We present a case of pineal apoplexy in an anticoagulated and hypertensive 56-year-old Hispanic male. At presentation, the patient's international normalized ratio (INR) was 10.51 and his blood pressure was 200/130 mmHg. His presenting symptoms included acute onset of headache, chest pain, nausea, vomiting, vertigo, and visual disturbance. Neuroimaging demonstrated hemorrhage into a morphologically normal pineal gland. Under conservative management, the patient experienced gradual resolution of all symptoms excluding the disturbance of upward gaze.
Neurocristic tumors are rare growths with a predilection for the scalp region. These lesions have a highly variable appearance and an unpredictable course. Long-term surveillance is recommended due to their potential for recurrence and possible malignant transformation into melanoma. The following is a report on congenital neurocristic tumor of the scalp and neck region. Laryngoscope, 2012. PMID:23070857
Retina and anterior neural fold homeobox (Rax) gene encodes a transcription factor essential for vertebrate eye development. Recent microarray studies indicate that Rax is expressed in the adult rat pineal gland and retina. The present study reveals that Rax expression levels in the rat change significantly during retinal development with a peak occurring at embryonic day (E) 18, whereas Rax expression in the pineal is relatively delayed and not detectable until E20. In both tissues, Rax is expressed throughout postnatal development into adulthood. In the mature rat pineal gland, the abundance of Rax transcripts increases 2-fold during the light period with a peak occurring at dusk. These findings are consistent with the evidence that Rax is of functional importance in eye development and suggest a role of Rax in the developing pineal gland. In addition, it would appear possible that Rax contributes to phenotype maintenance in the mature retina and pineal gland and may facilitate 24-h changes in the pineal transcriptome.
Since Classical Antiquity numerous authors have linked the origin of some mental disorders to physical and functional changes in the pineal gland because of its attributed role in humans as the connection between the material and the spiritual world. The pineal organ was seen as a valve-like structure that regulated the flow of animal spirits through the ventricular system, a hypothesis that took on more vigour during the Middle Ages and the Renaissance. The framework for this theory was "the three cells of the brain", in which the pineal gland was even called the "appendix of thought". The pineal gland could also be associated with the boom, during this period, of certain legends about the "stone of folly". But the most relevant psychopathological role of this organ arrived with Descartes, who proposed that it was the seat of the human soul and controlled communications between the physical body and its surroundings, including emotions. After a period of decline during which it was considered as a mere vestigial remnant of evolution, the link between the pineal gland and psychiatric disorders was definitively highlighted in the 20th century, first with the use of glandular extracts in patients with mental deficiency, and finally with the discovery of melatonin in 1958. The physiological properties of melatonin reawakened interest in the relationship between the pineal gland and mental disorders, fundamentally the affective and sleep disorders, which culminated in the development of new pharmacological agents acting through melatonergic receptors (ramelteon and agomelatine). PMID:21715172
Although Indium-111-DTPA-IgG (In-111-DTPA-IgG) was originally developed as an imaging agent for inflammation/infection, it is known to accumulate in some malignant tumors. Whether such accumulation is related to an inflammatory response to the tumor or to some other mechanism remains to be determined. To address this issue, the accumulation of In-111-DTPA-IgG and Tc-99m-MIBI, which has been recently reported as a tumor-seeking agent, was compared in rabbit VX-2 cancer. In-111-DTPA-IgG and Tc-99m-MIBI were injected into the femoral region of six VX-2 tumor-bearing rabbits 11, 18, and 21 days after implantation of the tumor. On Tc-99m-MIBI scintigraphy, necrosis was visualized as a defect, whereas In-111-DTPA-IgG accumulated in necrotic regions. The In-111-DTPA-IgG or Tc-99m-MIBI tumor to muscle ratios increased as the tumors grew. In-111-DTPA-IgG demonstrated a higher tumor to muscle ratio than Tc-99m-MIBI. In addition, the accumulation of In-111-DTPA-IgG was much higher in necrotic regions than in the viable tumor. These results suggest that the higher tumor uptake of In-111-DTPA-IgG might be mainly accounted for by accumulation in the necrosis and inflammation, whereas Tc-99m-MIBI accumulates in viable tumor cells alone. (author)
MC-C fibrosarcoma and B16F0 melanoma tumors were implanted intradermally in the dorsal region of the foot of mice. Tumor progression was compared to standard implantation in the flank. Although foot tumors only reached 13% (MC-C) and 25% (B16F0) of the mean volume of flank tumors, a more malignant phenotype in terms of histology and survival rate was observed in this type of tumors. Moreover, lung metastases were only detected in hosts bearing foot tumors, in contrast to MC-C and B16F0 populations with tumors growing in the flank. In addition, cellular influx and local immune reaction were higher in the dorsal region of the foot. According to our results, the dermis of the flank allows excessive tumor growth due to its low reactivity. Thus, differences in innate and adaptive immune effectors between the evaluated tumor microenvironments would account for the differences in tumor malignancy. Due to its striking differences with the standard flank inoculation, the tumor implantation model herein introduced could be a valuable tool to study the metastatic potential of different cell lines and the microenvironment components affecting tumor growth. PMID:19197148
We have analyzed 12 microsatellite markers on chromosome 9p in 54 paired cutaneous malignant melanoma (CMM) tumors and normal tissues. Forty-six percent of the tumors, including two in situ CMMs showed loss of heterozygosity (LOH) at 9p. Only one tumor was homozygously deleted for 9p markers. The smallest deleted region was defined by five tumors and included markers D9S126 to D9S259. Loss of eight or more markers correlated significantly with worse prognosis (Pp16 in any of the CMM tumors. In four tumors, the LOH for 9p markers did not involve p16. The reported data suggest the existence of several tumor suppressor genes at 9p that are involved in the predisposition to and/or progression of CMM and exclude p16 from involvement in the early development of some melanoma tumors. 36 refs., 5 figs., 1 tab.
Objective is to identify epidemiologic and radiologic criteria allowing specific diagnoses of tumors and tumor-like lesions in the hip region and pelvis, and to optimize pre-operative staging. Patients with pelvic tumors are usually older, and their tumors are larger relative to patients with tumors in extremities. The majority of tumors in the pelvis are malignant (metastases, myeloma, chondrosarcoma, Ewing-, osteo-, and MFH/fibrosarcoma), while those in the proximal femur are in majority benign (fibrous dysplasia, solitary bone cyst, and osteoid osteoma). Soft tissue masses in the thigh in the elderly are typically sarcomas without tumor specific signs. Common tumor-like lesions occurring in the hip and pelvis that can mimic neoplasm are: infections (including tuberculosis), insufficienc...
Purpose: For lung cancer patients with poor pulmonary function because of emphysema or fibrosis, it is important to predict the amplitude of internal tumor motion to minimize the irradiation of the functioning lung tissue before undergoing stereotactic body radiotherapy. Methods and Materials: Two board-certified diagnostic radiologists independently assessed the degree of pulmonary emphysema and fibrosis on computed tomography scans in 71 patients with peripheral lung tumors before real-time tumor-tracking radiotherapy. The relationships between the computed tomography findings of the lung parenchyma and the motion of the fiducial marker near the lung tumor were investigated. Of the 71 patients, 30 had normal pulmonary function, and 29 had obstructive pulmonary dysfunction (forced expiratory volume in 1 s/forced vital capacity ratio of <70%), 6 patients had constrictive dysfunction (percentage of vital capacity <80%), and 16 had mixed dysfunction. Results: The upper region was associated with smaller tumor motion, as expected (p = .0004), and the presence of fibrosis (p = .088) and pleural tumor contact (p = .086) were weakly associated with tumor motion. The presence of fibrotic changes in the lung tissue was associated with smaller tumor motion in the upper region (p <.05) but not in the lower region. The findings of emphysema and pulmonary function tests were not associated with tumor motion. Conclusion: Tumors in the upper lung region with fibrotic changes have smaller motion than those in the upper region of the lungs without fibrotic changes. The tumor motion in the lower lung region was not significantly different between patients with and without lung fibrosis. Emphysema was not associated with the amplitude of tumor motion.
Spinal extradural angiolipomas are benign tumors mostly localized in the thoracic region. A 50-year-old woman and a 36-year-old man presented with rare lumbar spinal angiolipoma manifesting as low back pain but without neurological signs. Magnetic resonance imaging showed lumbar extradural tumors at the L4-5 and L1-2 levels, respectively. Each patient underwent complete surgical resection of the epidural tumors. Histological examination revealed characteristics of angiolipomas in both tumors. The symptoms of both patients improved postoperatively and no recurrence of the tumors was found 1 year after surgery.
We report oligo-array comparative genomic hybridization findings in a case of malignant phyllodes tumor of the breast. In addition to gains of 1q and 5p, and losses of 10p and 13q14q22, this tumor had also losses of two regions to which tumor suppressor genes are mapped: 1p36 (SDHB) and 17q11.2 (NF1). Both genes are associated with hereditary cancer syndromes, including gastrointestinal stromal tumors. Whether these two genes played a role in the development or progression of this phyllodes tumor of the breast with a sarcomatous stromal component warrants further investigation of similar cases.
Extrarenal occurrence of Wilms' tumor is exceptional and the diagnosis is almost always made after surgery. The exact mechanism whereby a Wilms' tumor occurs in extrarenal tissue is unknown. The tumor is most commonly located in the retroperitoneum or inguinal region. Localization in subcutaneous tissue is extremely rare. In this paper, the case of a 1-month-old female infant with an extrarenal Wilms' tumor located in the lumbosacral region is presented. Surgical excision is the treatment of choice, and the same general therapeutic rules should be followed as when the kidney is affected. PMID:22465824
Hemangiopericytoma, initially described by Stout and Murray in 1942 (1), is a rare vascular tumor arising from mesenchymal cells with pericytic differentiation. Hemangiopericytomas usually occur in the 5th decade of life and account for 3-5% of all soft tissue sarcomas and 1% of all vascular tumors (2). The tumor usually occurs in the limbs, pelvis, or head and neck region; 15-30% of all hemangiopericytomas occur in the head and neck (2,3). Here we present a case of hemangiopericytoma of the submandibular region with keratocystic odontogenic tumors in an adolescent patient. (J. Oral Sci. 50, 233-237, 2008)
ROI method used in Ga-68 EDTA PET dynamic study for quantitative determination of brain tumor BBB permeability assumes that the tumor is homogeneous in terms of Ga-68 EDTA kinetics, even though it is known to be highly heterogeneous. It is desirable to examine regions of different kinetics separately. In this study, we have developed an efficient and effective method to separate tissue regions of different Ga-68 EDTA kinetics. The method uses a two-compartment model to extract three principal component factors (vascular component, fast and slow components) from whole-tumor kinetics by model fitting, then each pixel kinetics in the tumor was expressed in terms of these factors by least-square regression to provide factor images. The whole tumor was separated into two regions - one with mainly fast kinetics and one with slow kinetics. The two regions have markedly different uptake and clearance rate. This method has combined the advantage of statistical factor analysis and modeling approach.
Abstract in spanish Objetivo: describir y analizar la embriología, anatomía, angioarquitectura y clínica de la malformación de la vena de Galeno. Método: revisión bibliográfica con actualización del tema. Resultados: la malformación de la vena de Galeno es una anormalidad congénita que representa el 30% de las lesiones vasculares en los pacientes pediátricos. Se caracteriza por la persistencia de una vena embrionaria: la vena prosencefálica media, asociada a shunts arteriales por (more) persistencia de una conexión fistulosa con arterias coroideas primitivas. La vena de Galeno se localiza en la región pineal, dentro de la cisterna cuadrigeminal. Se forma por la unión de las venas cerebrales internas y cursa posteriormente drenando hacia el seno recto. Su longitud varía de 3,1 a 25 mm. Las malformaciones de la vena de Galeno se clasifican en: 1) malformación aneurismática verdadera y 2) dilatación aneurismática. Basándose en la angioarquitectura el primer tipo se divide en 2 formas: mural y coroidea. La presentación clínica es variada y depende del tipo. El diagnóstico prenatal es posible con la ecografía y la resonancia magnética. El diagnóstico definitivo se logra con la angiografía digital. El éxito del tratamiento depende del reconocimiento de sus tipos y formas y, de un adecuado equipo de especialistas. Conclusión: el conocimiento de la embriología, anatomía y , tipos y formas de la malformación de la vena de Galeno, aseguran el éxito del diagnóstico y tratamiento. Abstract in english Objective: to describe and analyse the embryology, anatomy, angioarchitecture and clinical presentation of the vein of Galen malformation. Method: bibliographic review and up to date. Results: the vein of Galen malformation is a congenital anomaly that represents 30% of all the vascular lesions in the pediatric population. It is secondary to the persistence of an embrionary vein: the medial prosencephalic vein, associated with arterial shunts secondary to the persistence (more) of a fistulous connection with the coroideal primitive arteries. The vein of Galen is localized at the pinealregion, within the cuadrigeminal cistern. It is formed by the union of both internal cerebral veins and drains posteriorly into strait sinus. It has a length of 3.1 to 25 mm. They are classified in: 1) truth aneurismal malformation and 2) aneurismal dilatation. Based on its angioarchitecture the first type is divided into 2 forms: mural and coroidal. The clinical presentation is variable and depends on the type. Prenatal diagnosis is possible with ecography and magnetic resonance. Definitive diagnosis is performed with digital angiography. A successful treatment depends on the recognition of the different types and forms and on the presence of an appropriate team of specialists. Conclusion: the knowledge of the embryology, anatomy and, types and forms of the vein of Galen malformation assure the success of its diagnosis and treatment.
Objective: This study aims at evaluating the adequacy of digital subtraction angiography and magnetic resonance venography in imaging of the galenic venous system for surgical planning of approaches to the pinealregion. Anatomical dissections were carried out in 10 cadavers of several age groups and these were compared to imaging findings in 10 living subjects. Methods: The presence or absence of 10 predetermined veins or vein groupings belonging to the galenic venous system were prospectively analyzed in 10 cadaver dissections and imaging findings of 10 age matched human subjects. The studied vessels were the vein of galen, the internal cerebral veins, both basal vein of Rosenthals, internal occipital vein, occipitotemporal veins, precentral cerebellar veins, tectal veins, pineal veins, superior vermian veins (including superior cerebellar veins (SCVs)) and posterior pericallosal veins. Each of the subjects had both digital subtraction angiography and magnetic resonance venography studies performed. Diagnostic digital subtraction angiography was performed using the transfemoral route and the venous phase was used for the study. Magnetic resonance venography was performed in 1.5 T MRI equipment using the 2D-TOF sequence. All studies were reported to be normal. Results: There was wide variation in the anatomy of the galenic venous system. There were interpersonal, intrapersonal and age related variations. Both the digital subtraction angiography and the magnetic resonance venography were efficient at demonstrating large veins. However, smaller veins were less readily demonstrated in either study. The general sensitivities of the digital subtraction angiography and the magnetic resonance venography for the galenic venous system were 45.5% and 32.5%, respectively. Surgically important veins were missed in most studies. Conclusions: Anatomically, the galenic venous system is highly variable. This variability is caused by interpersonal, intrapersonal and age related differences and causes each individual galenic venous system to be unique. Therefore, modern neurosurgical procedures require anatomical information on individual differences. Current radiological methods of digital subtraction angiography and magnetic resonance venography fail short of providing the necessary information. New and more sophisticated MRI technology may fulfill this need.
The specific detection of tumors in vivo using a radiolabeled syngeneic monoclonal antibody made by fusion of P3U1 (BALB/c myeloma cells) and C57BL/6 spleen cells primed with syngeneic B16 melanoma cells was investigated by color imaging, autoradiography, and biodistribution. The radiolabeled antimelanoma antibody specifically accumulated only in the tumor lesions, whereas no radioactivity was observed in normal tissues or organs. The distribution patterns of the radioactive antibody in the tumor lesions depended on the sizes of the tumor. Almost the entire region of the small metastatic tumor in lymph nodes was labeled, whereas the radioactive antibody was irregularly localized mainly in the center of the medium-sized tumor. However, only the peripheral region of the large primary tumor was labeled. The highest uptake of radioactivity (tumor:blood ratio) was observed in the small lymph node metastatic tumor lesions rather than in the large primary tumor. Furthermore, high resolution color imaging of B16 melanoma was also obtained by using /sup 125/I-labeled monoclonal antibody. Tumor location was specifically visible without subtraction or enhancement methods 3-5 days after injection of the radiolabeled antibody.
Most mammals use changing annual day-length cycles to regulate pineal melatonin secretion and thereby drive many physiological rhythms including reproduction, metabolism, immune function, and pelage. Prolonged exposure to short winter day lengths results in refractoriness, a spontaneous reversion to long-day physiological status. Despite its critical role in the timing of seasonal rhythms, refractoriness remains poorly understood. The aim of this study was therefore to describe cellular and molecular mechanisms driving the seasonal secretion of a key hormone, prolactin, in refractory Syrian hamsters. We used recently developed single cell hybridization and reporter assays to show that this process is initiated by timed reactivation of endocrine signaling from the pars tuberalis (PT) region of the pituitary gland, a well-defined melatonin target site, causing renewed activation of prolactin gene expression. This timed signaling is independent of per1 clock gene expression in the suprachiasmatic nuclei and PT and of melatonin secretion, which continue to track day length. Within the PT, there is also a continued short day-like profile of ICER expression, suggesting that the change in hormone secretion is independent of cAMP signaling. Our data thus identify the PT as a key anatomical structure involved in endogenous seasonal timing mechanisms, which breaks from prevailing day length-induced gene expression. PMID:12724339
Abnormalities in the oxidative metabolism of glucose in human cerebral gliomas have been studied in seven patients using positron emission tomography. Measurements of regional cerebral blood flow and oxygen consumption were obtained using the oxygen-15 steady-state inhalation technique. Values of regional cerebral glucose consumption were obtained using fluorine 18-labeled 2-fluoro-2-deoxy-D-glucose and a simplification of the method of Sokoloff. Functional values were obtained for regions of tumor and brain tissue in the middle cerebral artery territory of the contralateral cortex. Values of regional glucose consumption were calculated for both regions using a value of the lumped constant quoted for normal brain tissue (0.42). Tumorregional cerebral blood flow was comparable to that in the contralateral cortex, whereas regional cerebral oxygen consumption was depressed. This depression resulted in low tumor values of the fractional oxygen extraction ratio (0.21 +/- 0.07), indicating that oxygen supply exceeded the metabolic demand. In contrast, tumorregional cerebral glucose consumption was not depressed and regional glucose extraction ratios were similar for tumor and brain tissue. The metabolic uncoupling between regional oxygen consumption and regional glucose consumption (CMRO2/CMRGlu . 0.24 +/- 0.07 ml of oxygen per milligram of glucose) is indicative of increased aerobic glycolysis.
Clinical observations of tumor response in a variety of sites to Cf-252 (Cf) neutron brachytherapy (NT) are described. Many tumors which are accessible and easily implanted are suitable for Cf-NT, but in advanced stages, must be integrated into a more comprehensive program of local, regional and systemic therapy. With local tumor clearance and control, there should be treatment for regional disease using conventional photon radiotherapy; adjuvant therapies for disseminated disease using systemic therapy is also needed. While potential for therapy exists for Cf-NT treatment of many tumors, additional clinical trials carried out in a variety of global settings are needed where different tumors are common and are available for studies. Tumors suitable for study include e.g. cervix, uterus, vagina, tonsil-oropharynx, anterior oral cavity, prostate, female urethra, nasopharynx, anus and rectum, malignant glioma, parotid, perhaps esophagus, bladder, non-oat cell lung, localized sarcoma and melanoma, etc.
Thermal parameters and tumor response were determined in 33 abdominal and pelvic deep-seated tumors which were treated with hyperthermia in combination with radiation therapy. Hyperthermia was applied regionally for a total of 3-14 sessions (mean; 6.4 sessions), using an 8 MHz radiofrequency (RF) capacitive heating device. An average tumor temperature (T{sub av}) of more than 42 deg C was achieved in 17 (52%) tumors, and intratumor tempertures above 42 deg C cold be maintained for more than 20 min (effective heat session) in 103 (52%) of the 198 heat sessions. Of the 33 tumors, 4 tumors exhibited complete regression (CR), 7 PRa (80-99% regression), 7 PRb (50-79% regression) and 15 NR (<50% regression). Tumor response (CR + PRa) was apparently dependent on the thermal parameters. Tumors with T{sub av} of more than 42 deg C or those receiving more than three effective heat sessions showed a significantly higher response rate than those heated less effectively. This trend was also noted in minimum tumor temperature. As to radiation dose, most of the responders received a total of 60-70 Gy irradiation. The two characteristic features in tumor response in effectively heated tumors, were slow tumor regression and appearance of an intratumor low density area on post-treatment computed tomography. (author). 20 refs; 3 figs.; 9 tabs.
The purpose of this study was to evaluate the usefulness of diffusion tensor imaging (DTI) in the grading of gliomas. DTI was performed in 24 patients with histologically confirmed brain gliomas. After placing the regions of interest (ROI) in the tumor center, tumor border, white matter adjacent to tumor, and normal-appearing white matter (NAWM) of the contralateral hemisphere, the FA values were measured. The size of the ROI was found to be 61 ml. In addition, the FA ratios were calculated for the ROIs in relation to the NAWM of the contralateral hemisphere. The mean FA ratios in patients with grade II gliomas were 0.348 for the tumor center, 0.564 for the tumor border, and 0.897 for the white matter adjacent to the tumor. For patients with grade III gliomas, the mean FA values were 0.247, 0.346, 0.782, respectively. Further, for patients with grade IV gliomas, the mean FA values were 0.204, 0.226, 0.336, respectively. The differences in the FA ratios between the grade II and III tumors were significant in the tumor center and tumor border ({rho} = 0.005, {rho} = 0.002, respectively). Moreover, the differences in the FA ratios between the grade III and IV tumors were significant in the tumor border and white matter adjacent to the tumor ({rho} = 0.004, {rho} = 0.004, respectively). DTI is a non-invasive imaging modality that may provide valuable information for the pre-operative grading of gliomas.
Immature and unstable tumor vasculature provides an aberrant tumor microenvironment and leads to resistance of tumors to conventional therapy. Hence, normalization of tumor vessels has been reported to improve the effect of immuno-, chemo- and radiation therapy. However, the humoral factors, which can effectively induce maturation of tumor vasculature, have not been elucidated. In this study, we found that the novel peptide apelin and its receptor APJ can induce the morphological and functional maturation of blood vessels in tumors. This apelin-induced tumor vascular maturation enhances the efficacy of cancer dendritic cell-based immunotherapy and significantly suppresses tumor growth by promoting the infiltration of invariant natural killer T cells into the central region of the tumor and thereby robustly inducing apoptosis of tumor cells. Additionally, we showed APJ expression to be enhanced in the tumor endothelium in comparison with normal-state endothelial cells. These findings provide a new target for tumor vascular-specific maturation, which is expected to improve the efficacy of conventional cancer therapies. PMID:22037214
Abstract Background: Anaplastic astrocytomas are progressive brain tumors with a tendency to infiltrate the surrounding tissue. Recurrence is very common, with recurrent tumors being extremely refractory to existing therapies. Case Presentation: A 33-year-old woman presented with a history of an unprovoked fall, followed by seizures. An MRI scan revealed a mass in the fronto-temporo-parietal region of the brain, suggesting a primary tumor. She underwent craniotomy and surgical debulking of the tumor. The histology of the tumor tissue revealed an anaplastic astrocytoma. Follow-up MRI scans indicated the presence of a residual, rapidly progressing tumor. A 6-week course of fractionated radiation and concurrent chemotherapy with Temodar (temozolomide capsules) did not stop tumor progression. ...
Using a mouse predisposed to neoplasia by a germ line mutation in Apc (Apc(Min)), we tested whether induced hyperplasia is sufficient to increase intestinal tumor multiplicity or size in the intestine. We found that hyperplasia in the jejunum correlated with a significant increase in tumor multiplicity. However, tumor multiplicity was unchanged in the hyperplastic colon. This result indicates that even an intestine predisposed to neoplasia can, in certain regions including the colon, accommodate net increased cell growth without developing more neoplasms. Where hyperplasia correlated with increased tumor multiplicity, it did not increase the size or net growth of established tumors. This result suggests that the event linking hyperplasia and neoplasia in the jejunum is tumor establishment. Two novel observations arose in our study: the multiple intestinal neoplasia (Min) mutation partially suppressed both mitosis and transforming growth factor alpha-induced hyperplasia throughout the intestine; and zinc treatment alone increased tumor multiplicity in the duodenum of Min mice. PMID:18310091
Using a mouse predisposed to neoplasia by a germ line mutation in Apc (ApcMin), we tested whether induced hyperplasia is sufficient to increase intestinal tumor multiplicity or size in the intestine. We found that hyperplasia in the jejunum correlated with a significant increase in tumor multiplicity. However, tumor multiplicity was unchanged in the hyperplastic colon. This result indicates that even an intestine predisposed to neoplasia can, in certain regions including the colon, accommodate net increased cell growth without developing more neoplasms. Where hyperplasia correlated with increased tumor multiplicity, it did not increase the size or net growth of established tumors. This result suggests that the event linking hyperplasia and neoplasia in the jejunum is tumor establishment. Two novel observations arose in our study: the multiple intestinal neoplasia (Min) mutation partially suppressed both mitosis and transforming growth factor alpha-induced hyperplasia throughout the intestine; and zinc treatment alone increased tumor multiplicity in the duodenum of Min mice.
MR images of parotid tumors, lingual and oropharyngeal carcinoma, nasopharyngeal carcinomas and skull base tumors were obtained, and the clinical significance of MRI for their treatment was evaluated. In all of these regions, MRI provided much information that could not be obtained by conventional CT, and contributed to treatment planning and the evaluation of treatment efficacy. MRI is now becomming an indispensable method for assessing head and neck tumors.
A 17-year-old female presented with a very rare case of primary Ewing's sarcoma of the skull involving the occipitotemporal region. Systemic examination found no evidence of metastasis. The tumor was surgically removed, and the patient underwent radiotherapy and chemotherapy. Fourteen months after surgery there has been no recurrence of the tumor. Cranial primary Ewing's tumor has a good prognosis after radical surgery and adjuvant therapy.
Soft tissue chondromas are the benign chondro-osseous tumors of soft tissue that usually occur in the extra-osseous and extra-synovial regions of the extremities. We present here a rare location for a soft tissue chondroma that originated from the dura mater in the lumbar spinal canal, and it mimicked a nerve sheath tumor. We present here the MRI findings and pathologic features of this tumor.
Objective This is a retrospective review of 22 surgically treated benign and malignant tumors of brachial plexus region to describe clinical presentation, the characteristics of brachial plexus tumor and clinical outcomes with a literature review. Methods Twenty-one patients with consecutive 22 surgeries for primary brachial plexus tumors were enrolled between February 2002 and November 2011 were included in this study. The medical records of all patients were reviewed. Results Eleven male and 10 female patients were enrolled. Mean age was 39 years. Three patients had brachial plexus tumor associated with neurofibromatosis (13.6%). Presenting signs and symptoms included parenthesis and numbness (54.5%), radiating pain (22.7%), direct tenderness and pain (27.2%), palpable mass (77.3%). Twelve patients presented preoperative sensory deficit (54.5%) and 9 patients presented preoperative motor deficit (40.9%). Twenty tumors (90.9%) were benign and 2 tumors (9.1%) were malignant. Benign tumors included 15 schwannomas (68.2%), 4 neurofibromas (18.2%) and 1 granular cell tumor (4.5%). There were 1 malignant peripheral nerve sheath tumor (MPNST) and 1 malignant granular cell tumor. Gross total resection was achieved in 16 patients (72.7%), including all schwannomas, 1 neurofibroma. Subtotal resection was performed in 6 tumors (27.3%), including 3 neurofibromatosis associated with brachial plexus neurofibromas, 1 MPNST and 2 granular cell tumor in one patient. Conclusion Resection of tumor is the choice of tumor in the most of benign and malignant brachial plexus tumors. Postoperative outcomes are related to grade of resection at surgery and pathological features of tumor. PMID:14713946
Objective: Computerized liver tumor segmentation on computed tomography (CT) images is a challenging problem. Level set methods have been proposed for CT liver and tumor segmentation. However, the common models using image gradient or region competition have inherent drawbacks, and are not very robust for liver tumor segmentation. Methods: We propose a new unified level set model to integrate image gradient, region competition and prior information for CT liver tumor segmentation. The probabilistic distribution of liver tumors is estimated by unsupervised fuzzy clustering, and is utilized to enhance the object indication function, define the directional balloon force and regulate region competition. This unified model has been evaluated on 25 two-dimensional (2D) CT scans and 4 three-dimen...
By using immunohistochemistry, a network of nerve fibers containing pituitary adenylate-cyclase activating polypeptide (PACAP) was demonstrated in the pineal gland of the golden hamster, a photoperiodic species often used in pineal and circadian rhythm research. The nerve fibers are present in the capsule from where they permeate into the pineal perivascular spaces and parenchyma. Immuno-electron microscopy showed the PACAPergic nerve terminals, with clear transmitter vesicles, to terminate in the interstitial spaces between the pinealocytes or in the perivascular spaces. Some of the PACAPergic nerve terminals made synapse-like contacts with the pinealocytes. The origin of the PACAP-containing nerve fibers innervating the pineal gland of the hamster was investigated by combined retrograde tracing with fluorogold and immunohistochemistry for PACAP. A 2% fluorogold solution was injected iontophoretically into the superficial pineal gland and the animals were allowed to survive for 1 wk. After perfusion fixation of the rats, the location of the tracer was investigated in the brain, the parasympathetic sphenopalatine, and otic ganglia, as well as in the sensory trigeminal ganglia. The tracer was found in perikarya of all the investigated ganglia. However, co-localization with PACAP was found only in the trigeminal ganglion. PMID:15683466
The thiol reagent cysteamine was administered to adult male rats with the aim of investigating its effect on different neural and pineal components. As expected, immunoreactive somatostatin decreased in the median eminence (ME) (p less than 0.05) and gastric antrum (p less than 0.05) after cysteamine; however, no significant change was observed in the pineal IRS content after drug treatment. A decrease in norepinephrine was observed in the ME (p less than 0.001), hypothalamus (p less than 0.001) and pineal gland (p less than 0.05), together with a rise in ME (p less than 0.005) and hypothalamic dopamine (p less than 0.005) content; these results are consistent with a dopamine-beta-hydroxylase inhibiting effect of cysteamine. No effect was observed on hypothalamic serotonin and 5-hydroxyindole-acetic acid content. Pineal N-acetyltransferase (NAT) activity was significantly higher (p less than 0.05) after cysteamine than after saline, but no statistically significant effect was observed on pineal melatonin content. The mechanism involved in the NAT rise is presumably not related to the known stimulatory effect of norepinephrine, which fell after cysteamine. It is suggested that cysteamine may act at an intracellular level, inhibiting NAT degradation, an effect demonstrated in vitro and thought to be related to a thiol:disulfide exchange mechanism.
Serotonin and two of its metabolites, melatonin and 5-methoxytryptophol, exhibit circadian rhythmicity in the pineal gland. We recently reported a marked reduction in the normal night-time increase in melatonin concentration in the pineal glands of rats exposed to 60-Hz electric fields. Concomitant with the apparent abolition of melatonin rhythmicity, serotonin-N-acetyl transferase (SNAT) activity was suppressed. We have now conducted studies to determine if abolition of the rhythm in melatonin production in electric-field-exposed rats arises solely from interference in SNAT activity, or if the availability of pineal serotonin is a factor that is affected by exposure. Pineal serotonin concentrations were compared in rats that were either exposed or sham exposed to 65 kV/m for 30 days. Sham-exposed animals exhibited normal diurnal rhythmicity for pineal concentrations of both melatonin and serotonin; melatonin levels increased markedly during the dark phase with a concurrent decrease in serotonin levels. In the exposed animals, however, normal serotonin rhythmicity was abolished; serotonin levels in these animals did not increase during the light period. The conclusion that electric field exposure results in a biochemical alteration in SNAT enzyme activity can be inferred from the loss of both serotonin and melatonin rhythmicity, as well as by direct measurement of SNAT activity itself. 35 references, 3 figures, 1 table.
Pituitary adenylate-cyclase activating polypeptide (PACAP) is a neuropeptide originally isolated from the hypothalamus and located in many neuronal systems in both the central and peripheral nervous system. PACAP is also found in nerve fibers innervating the pineal gland, where it stimulates the secretion of the pineal hormone, melatonin, by binding to specific PACAP-receptors located on the cell membrane of the pinealocyte. In this study we have investigated the origin of PACAP-containing nerve fibers innervating the rat pineal gland by combined retrograde tracing with Fluorogold and immunohistochemistry for PACAP. A solution of 2% Fluorogold was injected iontophoretically into the superficial pineal gland of Wistar rats, and the animals were allowed to survive for 1 week. After perfusion fixation of the rats, the location of the tracer was investigated in the brain and the sphenopalatine, otic, and trigeminal ganglia. The tracer was found in all the investigated ganglia. However, colocalization with PACAP was predominantly found in the trigeminal ganglion and only occasionally in the sphenopalatine and otic ganglia. Due to the stimulatory function of PACAP on pineal melatonin secretion, the PACAP-containing neurons of this ganglion could be considered a subset of the parasympathetic nervous system. The presence of neurons with a parasympathetic function in a ganglion that has been considered a purely sensory ganglion, is a new concept in neuroanatomy. PMID:12932850
We evaluated the feasibility of localized harmonic motion (LHM) imaging for tumor detection in vivo. LHM was induced using a single-element focused ultrasound (FUS) transducer (80 mm focal, 100 mm diameter, 1.54 MHz) and a separate transducer (5 kHz PRF, 5 MHz) was used to track motion by cross-correlating RF signals. A scan was performed with the transducers assembly and LHM was induced 5 times per location. Images were formed averaging the calculated LHM amplitudes. Ten New Zealand rabbits had VX2 tumors implanted on their thighs. Tumors were located using Magnetic resonance images and LHM images were obtained. Eight out of ten tumors were visualized on LHM images as a region with lower amplitude (5.7+/-1.3?m in tumors and 19.5+/-5.8?m in muscle). All tumors had an elongated shape running along the muscle fibers. It was possible to detect tumors larger than 4mm in width (short axis of the tumor). We performed a FUS ablation of one tumor and the ablated region was detected as well on LHM images as a reduced LHM amplitude region.
AbstractTo enrich our understanding of the mechanism of tumor lymphatic metastasis, we developed a model system for tracking metastatic tumor cells in the lymphatic system with cellular magnetic resonance imaging (MRI) in live mice to observe the interaction between tumor cells and the lymphatic system. Nude mice were inoculated subcutaneously with superparamagnetic iron oxide (SPIO)-labeled and unlabeled LOVO cells in the foot pad, groin, or axillary area. Serial 7 T MRI of the tumors and surrounding regions was performed in the following 2 weeks. After imaging, tumor tissues and regional lymph nodes were collected and subjected to immunohistologic analysis. T2/T2*-weighted MRIs showed the primary tumor growth and the draining lymphatic architecture, as well as the SPIO-labeled tumor cells metastasized into the regional lymph node at 8 days. MRIs also revealed information on sentinel lymph node mapping with high-resolution anatomic information. Histologic findings confirmed the in vivo MRI results and revealed lymphangiogenesis, angiogenesis, infiltration of macrophages, and expression of vascular endothelial growth factor C in tumor and draining lymph nodes as well. This technology provides a powerful tool for tracking SPIO-labeled cancer cells in the lymphatics by cellular MRI. There was a close relationship between tumor lymphatic metastasis and lymphangiogenesis. PMID:23084246
We developed a non-invasive measurement of tumor cell proliferation, which allows to assess regionaltumor growth potential and grade of malignancy. Background, tracer synthesis and preliminary results have been presented in the PSI Annual Report 1995, Annex II. (author) 1 fig.
99mTc complex of hexamethylpropylene amine oxime (99mTc-HMPAO), which has been used as a tracer for regional cerebral blood flow (rCBF), has been shown to localize in primary brain tumors with wide spectrum of its uptake. The causes of the wide spectrum of tumor uptake, however, has not been underst...
Adenoid cystic carcinoma (ACC) of the lacrimal gland is a rarely encountered orbital tumor. It invades intracranially more frequently than carcinomas of other glands in the head and neck. A 61-year-old man underwent right orbital exenteration for a tumor in the supraorbital region. He had lost all r...
An analysis of genomic changes in ovarian cancer has provided the most comprehensive and integrated view of cancer genes for any cancer type to date. Ovarian serous adenocarcinoma tumors from 500 patients were examined by The Cancer Genome Atlas (TCGA) Research Network. TCGA researchers completed whole-exome sequencing, which examines the protein-coding regions of the genome, on an unprecedented 316 tumors.
Wilms' tumor, a pediatric nephroblastoma, has been associated with genetic alterations of the 11p13 and 11p15 regions. The introduction of a der(11) chromosome into the G401 Wilms' tumor cell line has been shown previously to revert the tumorigenic phenotype. A subtractive cDNA/RNA hybridization per...
Loss of heterozygosity at 3p21 is common in various cancers including nasopharyngeal carcinoma (NPC). BLU is one of the candidate tumor suppressor genes (TSGs) in this region. Ectopic expression of BLU results in the inhibition of colony formation of cancer cells, suggesting that BLU is a tumor supp...
The murine retrovirus SL3-3 is a potent inducer of T-cell lymphomas when inoculated into susceptible newborn mice. Previously, DNAs from twenty SL3-3-induced tumors were screened by PCR for provirus integration sites. Two out of 20 tumors demonstrated clonal provirus insertion into a common region. ...
Presented is the case of an extra axial epidermoid tumor that ruptures the dura mater invading the right front parietal region. its behavior is described in the study by means of CT and MR. Discussed are the most appropriate MR images for the discrimination of this tumor. (Author) 18 refs.
Paragangliomas are rare tumors of neural crest origin. They are benign in the majority of cases and are characterized by a strong vascularisation.In the head and neck region they most commonly occur as carotid body tumors. Jugulotympanic and especially vagal paragangliomas are seen less frequently. ...
Merkel cell tumor (MCT) is extremely rare, being discovered so far about 400 cases in literature. It is classified among neuroendocrine tumors. We report a case of MCT in the subclavicular region in a 93 years old woman. We confirm the efficacy of radiotherapy associated with octreotide, which these tumours express specific receptors for. PMID:15803813
Metastatic melanoma patients treated with an autologous DNP-modified tumor cell vaccine develop inflammatory responses in metastatic tumors characterized by infiltration of CD8+ T cells. To further define this immune response, we analyzed T cell receptor beta-chain variable (TCRBV) region repertoire...
Magnetic resonance imaging (MRI) of 41 soft tissue tumors were reviewed to evaluate the characteristics of tumors and surrounding tissue changes in accordance with their pathology and clinical findings. All MRI studies were performed with a 0.15-T system. T1-weighted images were obtained by using spin-echo sequences with a repetition time (TR)=400 msec and echo time (TE)=30 msec. T2-weighted images were obtained with TR=2000 msec and TE=60, 100 msec. In 11 cases, repeated T1-weighted images were obtained following the intravenous injection of Gd-DTPA (contrast media for MRI). Signal intensities of tumors and surrounding muscles and their ratio were calculated. MRI demonstrated the soft tissue tumors regarding the shape, size and relationship between tumor and surrounding muscle and underlying bone. Most of the tumors except for lipoma had low to intermediate intensity on T1-weighted image and high intensity on T2-weighted image. Some specific findings were obtained for lipoma, vascular tumor and benign neurogenic tumor. Lipomas showed high intensity both on T1- and T2-weighted images, and it was diagnostic findings. Arteriovenous malformation showed tubular structures with flow void characteristically. Neurilemmoma and neurofibroma showed central low intensity area on T2-weighted images. Malignant tumors such as liposarcomas and rhabdomyosarcomas had irregular margins and inhomogeneous internal texture. Contrast enhancement was found in hypervascular region in the tumor. MRI was also useful in respect to documentation of tumor itself and extension to surrounding tissue with multiplane. (author).
Background Tumors of the minor papilla of the duodenum are extremely rare, and they are mostly neuroendocrine tumors, such as somatostatinomas and carcinoid tumors. However, true incidence of carcinoid tumors in minor papilla might be much higher, because patients with minor papillary tumors usually remain asymptomatic. We report a very unusual case of carcinoid tumor in a patient with complete pancreas divisum with a review of the literature. Case presentation A 56-year-old female patient was referred for evaluation of pancreatic duct dilatation noted on abdominal ultrasonography and computerized tomography. She complained of intermittent epigastric pain for 6 months. A MRCP and ERCP revealed complete pancreas divisum with dilatation of the main pancreatic duct. On duodenoscopy, a small, yellows, subepithelial nodule was visualized at the minor papilla; biopsy of this lesion revealed a carcinoid tumor. She underwent a pylorus-preserving pancreaticoduodenectomy. The histologic evaluation showed a single nodule, 1 cm in diameter, in the submucosa with duodenal and vascular invasion and metastasis to the regional lymph nodes. Conclusion Although the size of the carcinoid tumor was small and the tumor was hormonally inactive, the concomitant pancreas divisum led to an early diagnosis, the tumor had aggressive behavior. Carcinoid tumors of the minor papilla should be included in the differential diagnosis of recurrent abdominal pain or pancreatitis of unknown cause. PMID:12378513
Abstract in portuguese Estudou-se a influência do tratamento diário com filtrado aquoso de Agaricus blazei Murrill (ABM) (25mg/ml), via oral, por 17 e 57 dias, em camundongos inoculados com tumor sólido de Ehrlich (TSE) por meio da curva de crescimento tumoral, do peso relativo do tumor, da contagem de regiões organizadoras de nucléolos (AgNORs) e dos padrões histológicos das massas tumorais e linfonodos poplíteos. Os animais que ingeriram o extrato aquoso do ABM por 57 dias apresentara (more) m menor (P0,05) entre os animais tratados e não tratados. Abstract in english The influence of daily administration of Agaricus blazei Murrill (ABM) aqueous solution (25mg/ml) during 17 and 57 days in mice bearing solid Ehrlich tumor was studied. Tumoral growth, tumoral and spleenic relative weights, nucleoly organization regions AgNORs values and tumor and popliteal lymph nodes histopathology were daily evaluated. The animals that received ABM during 57 days showed lower values (P(more) orresponding to the inflammatory phase of tumoral growth. The relative weight of the tumor and AgNORs values were similar (P>0.05) between treated and non-treated animals. No difference in microscopic evaluation of the tumors in treated and non-treated animals was seen and metastasis in popliteal nodes of the tumor occurred in all the animals.
The accumulation of CD4(+) T regulatory cells (Treg) in tumor tissue is a widely described phenomenon in mouse models and in human cancer patients. Understanding the mechanisms by which Treg migrate and accumulate in tumors is important because they strongly influence the potential efficacy of many immunotherapies. In this study, we used immunoscope technology to analyze the T-cell receptor (TCR) repertoire of tumor-infiltrating T cells in non-TCR transgenic mice. Both tumor-infiltrating Tregs and T effector cells (Teff) displayed sequence profiles in the CDR3 region that were characteristic of biased repertoires seen during clonal cell expansions, implying that strong T-cell responses have occurred within the tumor tissue. By comparing the TCR sequences of tumor-infiltrating Tregs, we obtained evidence of the presence of so-called public TCR sequences that are common to many individuals yet were tumor-specific in nature. Such comparisons also suggested that the Treg-Teff conversion process is not an active process at the tumor site or tumor-draining lymph nodes. Our findings strongly suggest that Treg infiltration of tumor tissue is followed by marked proliferation of a few dominant T-cell clones in the tumor. PMID:22573714
AIM: To test the hypotheses that diffusion weighed (DW)- and transcatheter intraarterial perfusion (TRIP)-magnetic resonance imaging (MRI) can each be used to assess regional differences in tumor function in an animal pancreatic cancer model.
The authors describe a vacuum-assisted skin grafting method to optimize graft take in the retroauricular region. This method is demonstrated after skin tumor resection of the retroauricular and mastoid areas. PMID:23180192
OBJECTIVE: To validate the methodology of isolated hypoxic hepatic perfusion (IHHP) using balloon catheter techniques and to gain insight into the distribution of tumor necrosis factor-alpha (TNF), melphalan, and mitomycin C (MMC) through the regional and systemic blood...
Dermoid cysts are rare tumors in the head and neck, particularly in the parotid gland. We experienced dermoid cysts arised in the parotid glands, periorbital area and submental region. So we report these cases with the review of literatures.
... condition that is characterized by multiple, painful fatty lipomas (benign, fatty tumors) that occur chiefly in post- ... occur in people who are not obese The lipomas are located primarily on the trunk region and ...
... into nearby organs or tissues (such as the abdominal wall). N categories for GI carcinoid tumors/cancers NX: The cancer has spread to nearby (regional) lymph nodes cannot be assessed. N0: The cancer has not ...
Purpose Patients with neurofibromatosis 1 (NF1), NF2, and schwannomatosis are at risk for multiple nerve sheath tumors and premature mortality. Traditional magnetic resonance imaging (MRI) has limited ability to assess disease burden accurately. The aim of this study was to establish an international cohort of patients with quantified whole-body internal tumor burden and to correlate tumor burden with clinical features of disease. Methods We determined the number, volume, and distribution of internal nerve sheath tumors in patients using whole-body MRI (WBMRI) and three-dimensional computerized volumetry. We quantified the distribution of tumor volume across body regions and used unsupervised cluster analysis to group patients based on tumor distribution. We correlated the presence and volume of internal tumors with disease-related and demographic factors. Results WBMRI identified 1286 tumors in 145/247 patients (59%). Schwannomatosis patients had the highest prevalence of tumors (P?=?0.03), but NF1 patients had the highest median tumor volume (P?=?0.02). Tumor volume was unevenly distributed across body regions with overrepresentation of the head/neck and pelvis. Risk factors for internal nerve sheath tumors included decreasing numbers of café-au-lait macules in NF1 patients (P?=?0.003) and history of skeletal abnormalities in NF2 patients (P?=?0.09). Risk factors for higher tumor volume included female gender (P?=?0.05) and increasing subcutaneous neurofibromas (P?=?0.03) in NF1 patients, absence of cutaneous schwannomas in NF2 patients (P?=?0.06), and increasing age in schwannomatosis patients (p?=?0.10). Conclusion WBMRI provides a comprehensive phenotype of neurofibromatosis patients, identifies distinct anatomic subgroups, and provides the basis for investigating molecular biomarkers that correlate with unique disease manifestations.
BACKGROUND: Intratumor heterogeneity may foster tumor evolution and adaptation and hinder personalized-medicine strategies that depend on results from single tumor-biopsy samples.METHODSTo examine intratumor heterogeneity, we performed exome sequencing, chromosome aberration analysis, and ploidy profiling on multiple spatially separated samples obtained from primary renal carcinomas and associated metastatic sites. We characterized the consequences of intratumor heterogeneity using immunohistochemical analysis, mutation functional analysis, and profiling of messenger RNA expression.RESULTS: Phylogenetic reconstruction revealed branched evolutionary tumor growth, with 63 to 69% of all somatic mutations not detectable across every tumorregion. Intratumor heterogeneity was observed for a mutation within an autoinhibitory domain of the mammalian target of rapamycin (mTOR) kinase, correlating with S6 and 4EBP phosphorylation in vivo and constitutive activation of mTOR kinase activity in vitro. Mutational intratumor heterogeneity was seen for multiple tumor-suppressor genes converging on loss of function; SETD2, PTEN, and KDM5C underwent multiple distinct and spatially separated inactivating mutations within a single tumor, suggesting convergent phenotypic evolution. Gene-expression signatures of good and poor prognosis were detected in different regions of the same tumor. Allelic composition and ploidy profiling analysis revealed extensive intratumor heterogeneity, with 26 of 30 tumor samples from four tumors harboring divergent allelic-imbalance profiles and with ploidy heterogeneity in two of four tumors.CONCLUSIONS: Intratumor heterogeneity can lead to underestimation of the tumor genomics landscape portrayed from single tumor-biopsy samples and may present major challenges to personalized-medicine and biomarker development. Intratumor heterogeneity, associated with heterogeneous protein function, may foster tumor adaptation and therapeutic failure through Darwinian selection. (Funded by the Medical Research Council and others.)
Abstract Retina and anterior neural fold homeobox (Rax) gene encodes a transcription factor essential for vertebrate eye development. Recent microarray studies indicate that Rax is expressed in the adult rat pineal gland and retina. The present study reveals that Rax expression levels in the rat change significantly during retinal development with a peak occurring at embryonic day 18, whereas Rax expression in the pineal is relatively delayed and not detectable until embryonic day 20. In both tissues, Rax is expressed throughout postnatal development into adulthood. In the mature rat pineal gland, the abundance of Rax transcripts increases 2-fold during the light period with a peak occurring at dusk. These findings are consistent with the evidence that Rax is of functional importance in ey...
Arecoline is an alkaloid of betel nut of Areca catechu. Betel nut is chewed by millions of people in the world and it causes oral and hepatic cancers in human. It has therapeutic value for the treatment of Alzheimer and schizophrenia. Arecoline has immunosuppressive, mutagenic and genotoxic effects in laboratory animals. It also affects endocrine functions. The objective of this study was to investigate the effects of arecoline on pineal-testicular axis in rats. Since pineal activity is different between day and night, the current study is undertaken in both the photophase and scotophase. The findings were evaluated by ultrastructural and hormonal studies of pineal and testicular Leydig cells, with quantitations of fructose and sialic acid of sex accessories. Arecoline treatment (10 mg/kg ...
Summary Aims The functional effect of the pineal gland cyst is difficult to evaluate with visual field examination. The aim of this study is to investigate the usefulness of visual evoked potentials (VEP) in patients with pineal gland cyst due to the possible compression on the visual pathway. Subjects and methods Black-and-white pattern-reversal checkerboard VEP were recorded in 75 patients (50 females and 25 males, mean age 26.3???15.7 and 25.6???17.6 years, respectively) with pineal gland cyst detected on magnetic resonance of the brain (subject group) and 75 age and sex-matched control subjects (control group). Amplitudes and P100 latencies were collected and later grouped as: (1) normal finding; (2) prechiasmal; (3) prechiasmal and postchiasmal; and (4) postchiasmal dysfunction. Resul...
The role of the pineal complex in lamprey metamorphosis was investigated by examining the influence of pinealectomy and continuous light and darkness on the initiation of this event in anadromous sea lampreys, Petromyzon marinus L. Larval lampreys, which on the basis of a condition factor were considered likely to enter metamorphosis in July, were separated in May of 1979 and 1980 into the following groups: (1) intact controls, (2) sham-operated controls, (3) pinealectomized individuals, (4) those exposed to continuous light, and (5) those exposed to continuous light or dark. The importance of the pineal complex to metamorphosis was supported by morphological evidence that, in all presumably pinealectomized individuals that entered metamorphosis, the complex had apparently not been removed during the surgical procedure. The ways in which the pineal complex may be involved in lamprey metamorphosis are discussed.
Rats exposed to 60-Hz electric fields of either 10, 65, or 130 kV/m from conception to 23 days of age exhibited reduced peak nighttime pineal melatonin contents compared to unexposed controls. As a group, the exposed rats also exhibited a phase delay, estimated at approximately 1.4 hours, in the occurrence of the nocturnal melatonin peak. No clear dose-response relationship was noticed over the range of electric field strengths used as treatments in these experiments. These are the first studies concerned with the effects of electric field exposure on the pineal melatonin rhythm in immature rats. The findings are generally consistent with those obtained using adult rats, where electric field exposure has been shown to abolish the nighttime rhythm in pineal melatonin concentrations.
Indole metabolism was studied in the pineal organ of the goldfish by radioautography and high-performance liquid chromatography. The rate of uptake of tritiated serotonin was rapid in vitro with dense labeling over the photoreceptor cells. Tritiated tryptophan was taken up at a slower rate and the label was distributed evenly over the epithelium. Continual light caused a reduction in the concentration of serotonin (5-HT) and 5-hydroxyindoleacetic acid (5-HIAA) compared to groups exposed to constant darkness both in vivo and in explants, suggesting that these effects are not derived from photoreceptors outside the pineal organ. These data are consistent with the hypothesis that indole metabolism is functionally linked to phototransduction events in the pineal organ of lower vertebrates.
The norepinephrine-induced inhibition of avian pineal N-acetyltransferase activity appears to be mediated by alpha 2-adrenergic receptors. In this study, alpha 2-adrenergic receptors in the chicken pineal gland were directly identified by radioligand binding. Membrane preparations of pineal glands from chickens from 1 to 6 weeks of age were examined using (/sup 3/H)rauwolscine, a selective alpha 2-adrenergic receptor antagonist, to characterize the binding sites. The results indicate no ontological change in either the affinity (KD) or density of receptor binding sites (Bmax) during the time span examined. The binding was saturable and of high affinity with a mean KD of 0.27 +/- 0.01 nM and a mean Bmax of 242 +/- 12 fmol/mg protein. Further characterization of these binding sites indicated that the alpha 2-adrenergic receptor is of the alpha 2A subtype, since prazosin and ARC-239 bound with low affinities and oxymetazoline bound with high affinity.
Rats exposed to 60-Hz electric fields of either 10, 65, or 130 kV/m from conception to 23 days of age exhibited reduced peak nighttime pineal melatonin contents compared to unexposed controls. As a group, the exposed rats also exhibited a phase delay, estimated at approximately 1.4 hours, in the occurrence of the nocturnal melatonin peak. No clear dose-response relationship was noticed over the range of electric field strengths used as treatments in these experiments. These are the first studies concerned with the effects of electric field exposure on the pineal melatonin rhythm in immature rats and the findings are generally consistent with those obtained using adult rats, where electric field exposure has been shown to abolish the nighttime rhythm in pineal melatonin concentrations. 15 refs., 1 fig., 1 tab.
Abstract NeuroD1 encodes a basic helix-loop-helix transcription factor involved in the development of neural and endocrine structures, including the retina and pineal gland. To determine the effect of NeuroD1 knockout in these tissues, a Cre/loxP recombination strategy was used to target a NeuroD1 floxed gene and generate NeuroD1 conditional knockout (cKO) mice. Tissue specificity was conferred using Cre recombinase expressed under the control of the promoter of Crx, which is selectively expressed in the pineal gland and retina. At 2-months of age, NeuroD1 cKO retinas have a dramatic reduction in rod- and cone-driven electroretinograms and contain shortened and disorganized outer segments; by 4-months, NeuroD1 cKO retinas are devoid of photoreceptors. In contrast, the NeuroD1 cKO pineal gl...
White-footed mice were maintained in short or long photoperiods from birth to 60 days of age (10 h vs. 14 h of light per day). Testes weights and spermatogenesis were substantially reduced in short daylengths. Pinealectomy at 5-7 days of age eliminated the suppressive effect of photoperiod on the reproductive system. However, testicular development was not retarded in intact males kept from 25 to 60 days of age in short daylengths. Exposure to short daylengths prior to 25 days of age contributes to photoperiodic inhibition of testicular development. Removal of the pineal gland did not consistently affect gonadal maturation in long photoperiods. The pineal gland transduces the effects of short daylengths on reproductive development. Some effects of long daylengths on the neuroendocrine axis of white-footed mice may also be mediated by the pineal gland.
Previously, we have demonstrated that the timing of the nocturnal peak of activity of the pineal arylalkylamine-N-acetyltransferase - a key enzyme in the melatonin biosynthesis pathway - in 3-wk-old chickens kept from the day of hatch under controlled laboratory conditions (L:D 12:12) varies depending on the season of hatch (summer vs. winter). The present study was undertaken to answer the following questions: (1) are season-related differences seen in the level of transcription of genes encoding enzymes of the melatonin biosynthesis pathway? (2) Does the pineal content of the main precursor (serotonin) and the final product (melatonin) exhibit age- and season-related changes? (3) At which step in postembryonic development are these season-related variations in pineal gland function most ...
Abstract Melatonin biosynthesis from serotonin involves the sequential activation of the arylalkylamine N-acetyltransferase (AANAT) and hydroxyindole-O-methyltransferase (HIOMT). Photoperiod synchronizes a daily rhythm in pineal and retinal melatonin secretion through controlling AANAT activity. Teleost fish possess two Aanat, one expressed in the retina (AANAT1) and the other expressed in the pineal gland (AANAT2). We report here the full-length cloning of Aanat1, Aanat2, SmHiomt and Otx5 (orthodenticle homeobox homolog 5) in the turbot (Scophthalmus maximus, Sm), a flatfish belonging to an evolutionary recent group of Teleost. The temporal expression pattern of the genes investigated is consistent with the idea that OTX5 is needed for photoreceptor specification, and that the pineal glan...
Abstract Objectives. Pineal tumours continue to present considerable clinical dilemmas and challenges. We were, therefore, interested to review our cumulative experience with a view to formulating a potential treatment strategy. Methods. A retrospective analysis of all patients treated with Stereotactic radiosurgery (SRS) for pineal tumours in one centre between 1987 and 2009. Forty-four patients (66% male) were treated radiosurgically with a mean age(+- 1sd) of 33.6 (16.4) years. Eleven had biopsy-proven pineal parenchymal tumours (PPT), six astrocytomas, three ependymomas, two papillary epithelial tumours and two germ cell tumours. Twenty (45%) patients had no definitive histology despite attempted surgical biopsy in 11. Prior to radiosurgery, 17 had undergone craniotomy, 10 radiotherapy...
Circadian rhythms are regulated by an internal clock, which is itself synchronized to environmental cues such as light and temperature. It is widely assumed that the circadian system is adapted to local cues, which vary enormously across habitats, yet the comparative data necessary for testing this idea are lacking. We examined photic and thermal resetting of the circadian clock in five species of Anolis lizards whose microhabitats differ in the amounts of sun and shade. The primary circadian oscillator in Anolis is the pineal gland, which produces the hormone melatonin. A flow-through culture system was employed to measure rhythmic melatonin output from individually cultured pineal glands. All species showed temperature-compensated circadian rhythms of pineal melatonin. Light caused signi...
Melatonin, a hormone produced by the pineal gland, is important for regulating circadian rhythms in many animals. Light at night causes an acute suppression of melatonin in nearly all vertebrate species. A previous study found that light failed to suppress melatonin in the lizard Anolis carolinensis. This is a surprising result given that the Anolis pineal gland is intrinsically photosensitive, is a key pacemaker controlling locomotor activity, and can be directly entrained to a light-dark cycle. To find out if the lack of photic suppression is widespread in the Anolis genus, we investigated the acute effects of light on melatonin secretion in five different species of Anolis using flow-through tissue culture. We administered a two-hour pulse of bright light to isolated pineal glands durin...
We aimed to prospectively analyze correlations between clinical features and histological classification of multi-segment intramedullary spinal cord tumors (MSICTs), and the extent of microsurgical resection and functional outcomes. Fifty-six patients with MSICTs underwent microsurgery for tumor removal using a posterior approach. The tumor was exposed through a dorsal myelotomy. Pre-operative and post-operative nervous function was scored using the Improved Japanese Orthopaedic Association (IJOA) grading system. Correlation analyses were performed between functional outcome (IJOA score) and histological features, age, tumor location, and the longitudinal extent of spinal cord involvement. The most frequently involved levels were the medullo cervical and the cervicothoracic regions (51.8%,...
Exophytic ependymomas of the spinal cord are very rare outside the filum or conus region. We present a patient with a thoracic spinal cord intradural extramedullary and intramedullary, World Health Organization grade II ependymoma. Gross total resection of the extramedullary component with subtotal resection of the intramedullary tumor was achieved, since there was no clear distinction between cord and tumor. The patient received postoperative external beam radiotherapy for residual tumor, and at a 2-year follow-up he is ambulatory without evidence of tumor recurrence.
Abstract in portuguese O tumor glômico é uma neoplasia benigna de células glômicas. Na maioria dos casos se apresenta como uma pápula solitária dolorosa na região subungueal. Relatamos o caso raro de um paciente com dois tumores glômicos sincrônicos sob o leito ungueal do mesmo dedo. Abstract in english The glomus tumor is an uncommon benign neoplasm of glomus cells. In the majority of the cases it is presented as a solitary painful papule in the subungual region. We report a rare case of a patient with two individual synchronous glomus tumors under the nail bed of the same finger.
Endodermal sinus tumors are an uncommon malignancy in children and occur most often in the gonads and sacrococcygeal region. In these locations, thy are found as primary tumors;in teratoma they form part of the malignant cpmponent. We present CT and MR imaging findings in two cases of endodermal sinus tumor occurring after the resection of a mature benign cystic sacrococcygeal teratoma during the neonatal period. A wareness of the transformation of a benign cystic teratoma to a different type of malignant germ cell tumor may be helpful in the evaluation of sacrococcygeal masses.
An 18-year-old male presented with severe proptosis and blindness in the right eye. Neuroimaging revealed a large and hypervascular tumor in the right retrobulbar region and a large tumor in the left cavernous sinus. Angiography showed the right tumor was extensively vascular, fed by a hypertrophic ophthalmic artery, and the left tumor was moderately vascular, fed by a large middle meningeal artery. Following embolization of the feeder vessels, the right retrobulbar hemangiopericytoma and the left cavernous sinus schwannoma were uneventfully and successfully resected. Such combinations of different pathological lesions present unusual therapeutic challenges.
Nanoparticles that have been developed to effectively deliver therapeutic drugs and imaging agents to tumorregions could increase therapeutic efficacy while dramatically reducing potential side effects with the capability of diagnosing tumors. In this review article, we discuss the development and optimization processes of glycol chitosan-based polymeric nanoparticles to accomplish the tasks of therapeutic drugs and imaging agents for cancer treatment. To achieve effective tumor imaging and therapy, we optimized the physicochemical properties of nanoparticles and examined several key factors (i.e., molecular weight, stability in the blood, deformability, and rapid cellular uptake), which are important issues influencing the in vivo biodistribution and tumor targeting ability of nanopartic...
A 66-year-old man presented with clival chordoma associated with subarachnoid hemorrhage. Computed tomography showed subarachnoid hemorrhage in the right ambient cistern and a well-enhanced tumor in the petroclival region. Surgical exploration performed on the day of admission showed a clot in the tumor. The tumor was totally removed. Histological examination showed hemorrhage between the tumor and the dura. The diagnosis was clival chordoma. Subarachnoid hemorrhage in chordoma seems to occur by spreading of intratumoral hemorrhage into the subarachnoid space due to dural invasion.
Children with Beckwith-Wiedemann syndrome (BWS) have increased risk for development of embryonal tumors. We present the case of an infant with BWS who has hypomethylation of LIT1 gene in the 11p15.5 chromosomal region and at 6 months of age presented with simultaneous occurrence of neuroblastoma arising from the left adrenal gland and a right adrenocortical tumor. She underwent surgical resection of both tumors and remains tumor free 18 months after surgery. Pediatr Blood Cancer 2008;51:695-698. Copyright 2008 Wiley-Liss, Inc.
Abstract Adrenal composite pheochromocytoma is rare, most of which is functional, and extra-adrenal composite paraganglioma is extremely rare. We describe and compare the clinicopathological and immunohistochemical features of a retroperitoneal extra-adrenal composite paraganglioma and an adrenal composite pheochromocytoma. Both tumors were nonfunctioning and laboratory tests revealed no biochemical abnormalities. Both tumors were composed of typical paraganglioma/pheochromocytoma closely admixed with ganglioneuroma component. In addition to typical immunohistochemical phenotypes characteristic of each component, both tumors showed focal staining of somatostatin, and the adrenal tumor was also regionally positive for insulin and prolactin. Despite this aberrant immunohistochemical expressi...
Intradural spinal lipoma occurs in less than 1% of all spinal cord tumors. It has been described at every level of the spinal canal, although its most common location is the cervicothoracic and thoracic region. However, lipoma located in the high cervical region is very unusual. We described two cases, a teenager and an adult, with progressive neurologic deficit from such a lipomatous tumor, which were evaluated by CT scanning and MR imaging.
This study examined the effects on pineal function of magnetic field (MF) exposures (ac and dc components) similar to those produced by the TransRapid TR-07 and other electromagnetic maglev systems (EMS). Rats were entrained to a light-dark cycle and then exposed to a continuous, or to an inverted, intermittent (on = 45 s, off = 15 s, induced current = 267 G/s) simulated multifrequency ac and dc magnetic field (MF) at 1 or 7 times the TR-07 maglev vehicle MF intensity for 2 hr. Other groups of rats were exposed to only the ac or the dc-component of the maglev MF. For comparison, one group was exposed to an inverted, intermittent 60-Hz MF. Each group was compared to an unexposed group of rats for changes in pineal melatonin and serotonin-N-acetyltransferase (NAT). MF exposures at an intensity equivalent to that produced by the TR-07 vehicle had no effect on melatonin or NAT compared with sham-exposed animals under any of the conditions examined. However, 7X TR-07-level continuous 2-h MF exposures significantly depressed pineal NAT by 45%. Pineal melatonin was also depressed 33--43% by a continuous 7X TR-07 MF exposure and 28% by an intermittent 60-Hz 850-mG MF, but the results were not statically significant. This study demonstrates that intermittent, combined ac and dc MFs similar to those produced by the TR-07 EMS maglev vehicle alter the normal circadian rhythm of pineal indoleamine metabolism. The pineal regulatory enzyme NAT was more sensitive to MF exposure than melatonin and may be a more desirable measure of the biological effects of MF exposure.
This study examined the effects on pineal function of magnetic field (MF) exposures (ac and dc components) similar to those produced by the TransRapid TR-07 and other electromagnetic maglev systems (EMS). Rats were entrained to a light-dark cycle and then exposed to a continuous, or to an inverted, intermittent (on = 45 s, off = 15 s, induced current = 267 G/s) simulated multifrequency ac and dc magnetic field (MF) at 1 or 7 times the TR-07 maglev vehicle MF intensity for 2 hr. Other groups of rats were exposed to only the ac or the dc-component of the maglev MF. For comparison, one group was exposed to an inverted, intermittent 60-Hz MF. Each group was compared to an unexposed group of rats for changes in pineal melatonin and serotonin-N-acetyltransferase (NAT). MF exposures at an intensity equivalent to that produced by the TR-07 vehicle had no effect on melatonin or NAT compared with sham-exposed animals under any of the conditions examined. However, 7X TR-07-level continuous 2-h MF exposures significantly depressed pineal NAT by 45%. Pineal melatonin was also depressed 33--43% by a continuous 7X TR-07 MF exposure and 28% by an intermittent 60-Hz 850-mG MF, but the results were not statically significant. This study demonstrates that intermittent, combined ac and dc MFs similar to those produced by the TR-07 EMS maglev vehicle alter the normal circadian rhythm of pineal indoleamine metabolism. The pineal regulatory enzyme NAT was more sensitive to MF exposure than melatonin and may be a more desirable measure of the biological effects of MF exposure.
Previous studies have identified and characterized D1- and D2-dopamine receptors in bovine pineal glands. The data indicate that the density of D1-dopamine receptors (974 fmol/mg protein) far exceed that of D2-dopamine receptors (37 fmol/mg protein). The objective of this study was to identify the mRNAs for both D1- and D2-dopamine receptors and to elucidate the status of dopamine and its possible involvement in the pineal function, particularly on melatonin synthesis. The expression of these dopamine receptor subtypes were determined by using a reverse transcriptase-polymerase chain reaction technique with specific pairs of primers to amplify D1- and D2-dopamine receptor mRNAs. Amplification of RNAs from bovine striatum (positive control) and bovine pineal gland resulted in products of the predicted lengths of 231 bp for D1- and 333 bp for D2-dopamine receptors. The results indicate that both D1- and D2-dopamine receptor mRNAs are present in the bovine pineal gland. The role of dopamine receptors was investigated by studying the effects of selective D1- and D2-dopamine agonists and antagonists on the N-acetyltransferase (NAT) activity of cultured bovine pinealocytes. The data showed that SKF-38393, a selective D1-agonist, enhanced NAT activity, and increased melatonin level, and the stimulatory effect was blocked by SCH-23390, a D1-selective antagonist, whereas quinpirole, a selective D2-agonist, inhibited NAT basal activity and decreased the melatonin basal level. Furthermore the inhibitory effect was blocked by D2-selective antagonists, spiperone, haloperidol, and domperidone. The present results indicate that the pineal dopamine receptors have a distinct effect on pineal function. The precise mechanism whereby activation of dopamine receptors altered the NAT activity and melatonin level needs to be further delineated. PMID:12932200
Transient exposure of cultured cells to conditions of extreme hypoxia can induce DNA overreplication and the generation of cellular variants. This effect may be important for the development of tumor heterogeneity, since hypoxia may arise in solid tumors as a result of vascular insufficiency. We have investigated whether reoxygenation of cancer cells obtained from hypoxic regions of solid tumors is associated with DNA overreplication. Murine tumor cells were isolated from i.m. transplants as a function of their distance from the vasculature using a technique which involves in vivo staining of tumor tissues with the fluorochrome Hoechst 33342. Studies which determined the radiation sensitivity and cell cycle distribution of cells in the subpopulations indicated that cells were isolated from regions of the tumor which differed in oxygen levels. When KHT fibrosarcoma cells were isolated from hypoxic regions of tumors and introduced into culture (i.e., were reoxygenated), flow cytometric analysis revealed that they did not undergo any large scale DNA overreplication. These results indicate that hypoxic conditions which exist in transplanted tumors do not induce cells to undergo DNA overreplication to the same extent that is achieved after in vitro exposure of cells to hypoxia. We also found that at high concentrations (10 microM) the Hoechst dye itself induced DNA overreplication. These concentrations are frequently used to vitally stain cells for sorting according to DNA content, and this effect must be considered in the interpretation of such experiments.
We have previously described the diurnal variation in regional cerebral blood flow (rCBF) response to bright light in human subjects as demonstrated by the positron emission tomography (PET) activation method. In this abstract, we report the differences in rCBF (an indicator of differences in regional neuronal activity) between the evening and midday dim light baseline scans which served as the control states in the above bright light activation study. Five right-handed, healthy volunteers underwent both an evening (8pm) and a midday (12N) O-15 water PET scanning session. Each scanning session was preceded by one hour of dim light adaptation (50 lux) and consisted of six rCBF scans at three different light intensities in an AABBCC sequence (A=50 lux, B=2500 lux, C=7000lux). Significant differences in rCBF between the evening and midday 50 lux states were identified using the statistical parametric mapping method developed by Friston et al (p<.001). The evening scans demonstrated areas of greater relative blood flow in the pineal gland, the lateral temporal cortex bilaterally, the right lateral prefrontal cortex, the superior aspect of the anterior cingulate, and the left thalamus. The midday scans showed areas of greater relative blood flow in the visual cortex, the left lateral prefrontal cortex. the inferior aspect of the anterior cingulate, the left parietal cortex and the cerebellum. Our results demonstrate an extensive diurnal variation in baseline human rCBF. This indicates that time of day may be an important variable in conducting and interpreting functional brain imaging studies. Furthermore, these results suggest possible neuroanatomical substrates through which the circadian system may regulate the various physiologic and behavioral processes that manifest circadian rhythms.
Iodinated recombinant human nerve growth factor (125I-rhNGF) stimulated neurite formation in PC12 cell cultures with a half-maximal potency of 35-49 pg/ml, compared with 39-52 pg/ml for rhNGF. In quantitative ligand autoradiography, the in vitro equilibrium binding of 125I-rhNGF to brain sections showed a 10-fold regional variation in density and was saturable, reversible, and specifically displaced by up to 74% with rhNGF or murine NGF (muNGF). At equilibrium, 125I-rhNGF bound to these sites with high affinity and low capacity (Bmax less than or equal to 13.2 fmol/mg of protein). Calculation of 125I-rhNGF binding affinity by kinetic methods gave average Kd values of 24 and 31 pM. Computer-generated maps revealed binding in brain regions not identified previously with 125I-muNGF, including hippocampus; dentate gyrus; amygdala; paraventricular thalamus; frontal, parietal, occipital, and cingulate cortices; nucleus accumbens; olfactory tubercle; subiculum; pineal gland; and medial geniculate nucleus. NGF binding sites were distributed in a 2-fold increasing medial-lateral gradient in the caudate-putamen and a 2-fold lateral-medial gradient in the nucleus accumbens. 125I-rhNGF binding sites were also found in most areas labeled by 125I-muNGF, including the interpedunucular nucleus, cerebellum, forebrain cholinergic nuclei, caudoventral caudate-putamen, and trigeminal nerve nucleus. 125I-rhNGF binding sites were absent from areas replete with low-affinity NGF binding sites, including circumventricular organs, myelinated fiber bundles, and choroid plexus. The present analysis provides an anatomical differentiation of high-affinity 125I-rhNGF binding sites and greatly expands the number of brain structures that may respond to endogenous NGF or exogenously administered rhNGF.
Epithelioid hemangioendothelioma (EHE) is a rare and low-grade vascular tumor, which usually occurs in the soft tissue, liver, breast, lung and skeleton. Here we submit a case with EHE of the clival region. A 58-year-old woman was admitted with a medical history of 3 months headache and 1 month visual deterioration. MRI revealed a well-circumscribed mass of 4.0-cm--3.0-cm with bony invasion. The tumor was subtotally removed in a piecemeal fashion. Histologically, the tumor was composed of epithelioid cells with eosinophilic cytoplasm and intracytoplasmic vacuoles. Immunohistochemically, the tumor cells were positive for the markers CD31, CD34, factor VIII and vimentin. The pathological result was interpretated as EHE of the clival region. EHE is an uncommon vascular tumor, which is rarely ...
In this paper a macroscopic model of tumor cord growth is developed, relying on the mathematical theory of deformable porous media. Tumor is modeled as a saturated mixture of proliferating cells, extracellular fluid and extracellular matrix, that occupies a spatial region close to a blood vessel whence cells get the nutrient needed for their vital functions. Growth of tumor cells takes place within a healthy host tissue, which is in turn modeled as a saturated mixture of non-proliferating cells. Interactions between these two regions are accounted for as an essential mechanism for the growth of the tumor mass. By weakening the role of the extracellular matrix, which is regarded as a rigid non-remodeling scaffold, a system of two partial differential equations is derived, describing the evolution of the cell volume ratio coupled to the dynamics of the nutrient, whose higher and lower concentration levels determine proliferation or death of tumor cells, respectively. Numerical simulations of a reference two-dim...
A folate-receptor-targeting radiopharmaceutical, Ga(III)-deferoxamine-folate (Ga-DF-Folate), was radiolabeled with two positron-emitting isotopes of gallium, cyclotron-produced (66)Ga (9.5 hour half-life) and generator-produced (68)Ga (68 minute half-life). The [(66)Ga]Ga-DF-Folate was administered to athymic mice with folate-receptor-positive human KB cell tumor xenografts to demonstrate that microPET mouse tumor imaging is feasible with (66)Ga, despite the relatively high positron energy of this radionuclide. Using the athymic mouse KB tumor xenograft model, dual-isotope autoradiography was also performed following i.v. co-administration of [(18)F]-FDG, a marker of regional metabolic activity, and folate-receptor-targeted [(111)In]In-DTPA-Folate. The autoradiographic images of 1 mm tumor sections demonstrate the gross heterogeneity of the KB cell tumor xenograft, as well as subtle disparity in the regional accumulation of the two radiotracers. PMID:14499330
Patients with head and neck squamous cell carcinoma (SCC) are at risk of developing additional tumors in the head and neck. The detection of a late lymph node metastasis poses a problem to the clinician: it could be a delayed regional metastasis or a new metastasis from a yet unknown second primary tumor. Differentiation between metastasis and recurrence of primary tumors versus second primary tumor may be difficult because all lesions have the histologic appearance of SCC. Differentiation between these possibilities, however, carries important differences in therapeutic and prognostic consequences. In the following case report we present an unusually late regional lymph node metastasis in a patient who was treated 4 years earlier for an SCC in the inferior alveolar ridge. The purpose of the present study was to apply mitochondrial DNA D-loop analysis to assess the clonal relationship between oral tumor and node metastasis. PMID:22819335
An intradural tumor in the upper cervical region was found in a dog with quadriparesis and chronic respiratory acidosis. Surgical removal of the tumor in the atlas and intraoperative radiotherapy were attempted. The tumor was histologically diagnosed as a neural glioma. A preoperative acid-base disturbance was dramatically improved after surgery. The clinical changes appeared in this case suggest that compression of the spinal cord at this region may cause paralysis of the respiratory muscles and secondarily result in chronic respiratory acidosis following the respiratory insufficiency.
Multiple biopsies were obtained from eight patients with malignant tumors during a course of fractionated radiotherapy. An analysis of the total 2-nitroimidazole concentration and a histological examination of the biopsy sample was done on material which appeared macroscopically similar. The parts of the tumor biopsies showing necrosis were found to contain much lower concentrations of nitroimidazole when compared with those found in the samples with well-vascularized and apparently viable tumor. During the course of irradiation changes in misonidazole concentrations were not found when similar histological material was examined. The low values of misonidazole in necrotic regions in human tumors may partly account for the wide variation of misonidazole concentrations reported in the literature (percent tumor/plasma, mean 62.9 +- 34.4 STD). The clinical significance of the microscopic distribution of misonidazole in tumors in unknown but further work in this area may aid in predicting the usefulness of future radiosensitizers.
This paper presents a tumor detection algorithm from mammogram. The proposed system focuses on the solution of two problems. One is how to detect tumors as suspicious regions with a very weak contrast to their background and another is how to extract features which categorize tumors. The tumor detection method follows the scheme of (a) mammogram enhancement. (b) The segmentation of the tumor area. (c) The extraction of features from the segmented tumor area. (d) The use of SVM classifier. The enhancement can be defined as conversion of the image quality to a better and more understandable level. The mammogram enhancement procedure includes filtering, top hat operation, DWT. Then the contrast stretching is used to increase the contrast of the image. The segmentation of mammogram images has been playing an important role to improve the detection and diagnosis of breast cancer. The most common segmentation method used is thresholding. The features are extracted from the segmented breast area. Next stage include,...
Abstract Primary anaplastic large cell lymphoma (ALCL) of skeletal muscle is very rare. We report a case of ALCL arising from the left psoas muscle. A 14-year-old girl presented with a large left inguinal tumor. She complained of a 2-month history of left leg pain, which had been exacerbated upon leg extension, and she had become aware of a rapidly growing left inguinal tumor 3 weeks before admission. CT scan and MRI revealed a large tumor arising from the left major psoas muscle and protruding into the inguinal region. In view of the tumor's location and the patient's age, soft tissue tumors such as rhabdomyosarcoma and primitive neuroectodermal tumor were initially considered. However, histopathological examination yielded a diagnosis of anaplastic lymphoma kinase-positive ALCL. The seru...
We examined the frequency of incidentally found or unexpected tumors discovered at the time of magnetic resonance imaging (MRI) examinations in the temporomandibular joint (TMJ) region for patients with suspicion of TMJ arthrosis. Five MR images (T1-weighted transverse scout image and proton density and T2-weighted oblique sagittal images at the open and closed mouth) were acquired. In 2776 MRI examinations of TMJ arthrosis, two tumors were discovered. They consisted of an adenoid cystic carcinoma in the deep portion of the parotid gland, and a malignant tumor extending from the infratemporal fossa to the parapharyngeal space. The rate of incidentally founded or unexpected tumors in TMJ examinations was low (0.072%), but the two tumors found were malignant tumors, and therefore, scout image should be carefully examined, not only used for positing the slice.
The aim of the study was to further elucidate the immunohistochemical and genetic characteristics of cribriform adenocarcinoma of minor salivary glands (CAMSG). The study comprised five CAMSG from two males and three females, aged 21?72?years. Four tumors were localized at the base of tongue and one in the floor of mouth. At the time of diagnosis, four tumors had metastasised to regional lymph nodes. After tumor resection, two patients were treated by radiotherapy and one by chemoradiotherapy. During the follow-up (median 14?months), two patients developed lymph node metastasis. Microscopically, all tumors showed cribriform, papillary, follicular, and microcystic growth patterns. The tumor cells displayed vesicular nuclei with intranuclear grooves. Immunohistochemically, all tumors showed ...
The aim of the study was to further elucidate the immunohistochemical and genetic characteristics of cribriform adenocarcinoma of minor salivary glands (CAMSG). The study comprised five CAMSG from two males and three females, aged 21?72 years. Four tumors were localized at the base of tongue and one in the floor of mouth. At the time of diagnosis, four tumors had metastasised to regional lymph nodes. After tumor resection, two patients were treated by radiotherapy and one by chemoradiotherapy. During the follow-up (median 14 months), two patients developed lymph node metastasis. Microscopically, all tumors showed cribriform, papillary, follicular, and microcystic growth patterns. The tumor cells displayed vesicular nuclei with intranuclear grooves. Immunohistochemically, all tumors showed ...
The authors studied 80 hepatocellular carcinomas from three continents for p53 gene (TP53) mutations and hepatitis B virus (HBV) sequences. p53 mutations were frequent in tumors from Mozambique but not in tumors from South Africa, China, and Germany. Independent of geographic origin, most tumors were positive for HBV sequences. X gene coding sequences of HBV were detected in 78% of tumors, whereas viral sequences in the surface antigen- and core antigen-encoding regions were present in less than 35% of tumors. These observations indicate that hepatocellular carcinomas are genetically heterogeneous. Mozambican-types of hepatocellular carcinomas are characterized by a high incidence of p53 mutations related to aflatoxins. In other tumors, the rarity of p53 mutations combined with the frequent presence of viral X gene coding sequences suggests a possible interference of HBV with the wild-type p53 function.
Between 1971 and 1982 86 patients have been treated because of a malignant tumor of the parotid gland. 64 patients have been irradiated after complete or incomplete first resection. 12/64 relapsed locally. The loco-regionaltumor control rate five and ten years after postoperative radiotherapy is 72%, 85% after complete resection, and 22% after incomplete resection. Tumor size and nodal disease are of prognostic value. Disease-free survival in patients without lymph nodes is 53%, with lymph node metastases 31% after five years. Small tumors have a better local control rate compared to locally advanced tumors. No difference was found neither for the total dose nor the histology of the tumor. Distant metastases became apparent after median eleven months. (orig./MG).
Glioma tumor-suppressor candidate region gene 2 (GLTSCR2) is a recently identified nuclear protein that interacts with the tumor suppressor PTEN. GLTSCR2 regulates the stability of PTEN, and is therefore believed to have a tumor suppressive function. In a recent study, we demonstrated that GLTSCR2 often exhibits genetic alterations and down-regulation in glioblastoma specimens. However, GLTSCR2 expression levels in human tumors and its mechanism of tumor suppression remain largely unknown. We performed an immunohistochemical examination of GLTSCR2 expression in samples of seborrheic keratosis (SK, n=69), a common benign skin tumor, and normal skin (n=23), and assessed the relationship between GLTSCR2 expression and the patients clinicopathologic factors. Our results showed that GLTSCR2 exp...
Rats exposed for 3 weeks to uniform 60-Hz electric fields of 39 kV/m (effective field strength) failed to show normal pineal gland circadian rhythms in serotonin N-acetyl transferase activity and melatonin concentrations. The time required for recovery of the melatonin rhythm after cessation of field exposure was determined to be less than 3 days. The rapid recovery suggests that the overall metabolic competence of the pineal is not permanently compromised by electric-field exposure, and that the circadian rhythm effect may be neuronally mediated.
Abstract in portuguese OBJETIVO: Apresentar nova técnica para pinealectomia em ratos. MÉTODOS: 80 ratos adultos fêmeas (Rattus norvegicus albinus) foram pesados e em seguida anestesiados por via intraperitoneal com xilazina e cetamina. Em seguida os animais foram fixados em uma prancha de cortiça e feita uma incisão na pele e no tecido subcutâneo, na região superior da cabeça, evidenciando a junção dos ossos parietais e occipital. Na região do lambda, realizou-se uma perfuração cir (more) cular, na calota craniana, com o auxilio de uma broca (4 mm) acoplada a um micromotor. Nesse orifício, após a dissecação da dura-mater visibiliza-se a confluência dos seios venosos longitudinal e transverso. Com o auxilio de uma pinça curva esses seios são deslocados, ligados e identificada a glândula pineal, que pode ser removida em peça única. Em seguida, o fragmento ósseo é devolvido ao seu lugar e as camadas cirúrgicas suturadas. RESULTADOS: Esta nova técnica é fácil de ser feita, evita hemorragias e só remove a glândula pineal, sem prejuízos para o restante do encéfalo. Além disso, possibilita a realização de uma cirurgia sham, visto que a glândula pineal permanece sem alterações. CONCLUSÃO: Espera-se que a técnica proposta facilite estudos visando a uma melhor compreensão da complexidade e importância da glândula pineal sobre a reprodução e outros sistemas do organismo. Abstract in english PURPOSE: To report a new, direct visual approach for rat pinealectomy. METHODS: Eighty adult female rats (Rattus norvegicus albinus EPM-1 strain) were weighted and anesthetized intraperitoneally with 15 mg/kg xylazine and 30 mg/kg ketamine. The animal was fastened to a dissection table, an incision was made in the skin and the subcutaneous tissue, bringing the lambda into view. The skullcap was opened with a dental drill, bringing the cerebral hemispheres and the superior (more) sagittal sinus into view. The pineal gland, located under the venous sinus, was removed in a single piece using tweezers. Next, the bone fragment was returned to its place and the surgical layers were sutured. RESULTS: This new technique is easy to be done, avoids bleedings and removes only the pineal gland without damage to the remaining encephalon. In addition it makes possible the achievement of a sham surgery, allowing the pineal gland to remain intact. CONCLUSION: The proposed technique intends to facilitate studies aiming to better understanding the complexity and importance of the pineal gland on reproductive and other body systems.
The use of magnetic resonance (MR) as a diagnostic technique in central nervous system pathology has made possible the detection of structures that are hard to view with other diagnostic methods. In 21 patients in whom the existence of pineal cyst was detected by chance, we describe the study technique employed and present the MR characterization. In the absence of specific clinical symptoms and sings, the differential diagnosis of this pathology, with respect to other neoplastic formations located in the pineal gland, is based on its typical location behind the third ventricle, its size, which does not vary in the different serial studies, and its signal intensity. (author)
Abstract in english The pineal gland functions as a neuroendocrine transducer that coordinate the organism response to changing environmental stimuli such as light and temperature. The main and best known pineal neurohormone is melatonin that is synthesized and released in a circadian fashion with a peak during the night darkness hours. We have recently reported that melatonin exerts important immuno regulatory functions. Here we describe the astonishing property of exogenous melatonin which (more) is able to counteract completely the depressive effect of anxiety-restraint stress and/or of corticosterone on thymus weight, andibody production and antiviral responses. This effect seems to be mediated by antigen-activated T cells via an opiatergic mechanism.
Previously, we have demonstrated that the timing of the nocturnal peak of activity of the pineal arylalkylamine-N-acetyltransferase - a key enzyme in the melatonin biosynthesis pathway - in 3-wk-old chickens kept from the day of hatch under controlled laboratory conditions (L:D 12:12) varies depending on the season of hatch (summer vs. winter). The present study was undertaken to answer the following questions: (1) are season-related differences seen in the level of transcription of genes encoding enzymes of the melatonin biosynthesis pathway? (2) Does the pineal content of the main precursor (serotonin) and the final product (melatonin) exhibit age- and season-related changes? (3) At which step in postembryonic development are these season-related variations in pineal gland function most pronounced? Male Hy-line chickens hatched in the summer or winter, from eggs laid by hens held on L:D 16:8, were kept from the day of hatch under L:D 12:12 conditions. At the age of 2, 9, or 16 d, chickens were sacrificed every 2 h over a 24-h period and their pineal glands, isolated under dim red light, were processed for the measurement of (i) the level of Aanat and Asmt (acetylserotonin O-methyltransferase) mRNAs encoding the two last enzymes involved in melatonin biosynthesis, (ii) the activity of these enzymes, and (iii) the pineal content of serotonin and melatonin. Circadian rhythmicity of all the measured parameters was evaluated by the cosinor method. The levels of Aanat mRNA, AANAT enzymatic activity, and the pineal melatonin content changed during postembryonic development in a manner that was dependent on the season of hatch. Furthermore, the diurnal profile of Asmt mRNA was elevated during the light phase. In "winter" birds, the pattern and amplitude of the diurnal rhythm of accumulation of this transcript did not change with age, while in "summer" birds it increased in an age-related way. In contrast, the enzymatic activity of hydroxyindole-O-methyltransferase (HIOMT; encoded by the Asmt gene) did not change rhythmically, although it increased with age in a season-related way. In "winter" chickens, the pineal serotonin content was low, regardless of age, and did not change rhythmically, whereas in "summer" individuals the serotonin rhythm was already well established by day 2, with the amplitude increasing with age. These results confirm the existence of a "seasonal memory" operating within the chicken pineal gland, although the mechanism(s) underlying this phenomenon have yet to be characterized. PMID:23003334
SummaryMost vertebrates process visual information using elaborately structured photosensory tissues, including the eyes and pineal. However, there is strong evidence that other tissues can detect and respond to photic stimuli [1-3]. Many reports suggest that photosensitive elements exist within the brain itself and influence physiology and behavior; however, a long-standing puzzle has been the identity of the neurons and photoreceptor molecules involved [4, 5]. We tested whether light cues influence behavior in zebrafish larvae through deep brain photosensors. We found that larvae lacking eyes and pineal perform a simple light-seeking behavior triggered by loss of illumination ("dark photokinesis"). Neuroanatomical considerations prompted us to test orthopedia (otpa)-deficient fish, which...
Aims: In our previous work, we reported that the insulin potentiating effect on melatonin synthesis is regulated by a post-transcriptional mechanism. However, the major proteins of the insulin signaling pathway (ISP) and the possible pathway component recruited on the potentiating effect of insulin had not been characterized. A second question raised was whether windows of sensitivity to insulin exist in the pineal gland due to insulin rhythmic secretion pattern. Main methods: Melatonin content from norepinephrine(NE)-synchronized pineal gland cultures was quantified by high performance liquid chromatography with electrochemical detection and arylalkylamine-N-acetyltransferase (AANAT) activity was assayed by radiometry. Immunoblotting and immunoprecipitation techniques were performed to es...
The system to be developed in the present study will enable us to extract the tumorregion automatically from three-dimensional ultrasonic images of the breast, and differentiate benign from malignant tumors by using the characteristics of their surface form. In application of such a system, the accuracy of diagnosis greatly depends on its ability to extract tumor automatically. We developed an algorithm for determination of the tumorregion using fuzzy reasoning, that is, we classified each voxel of three-dimensional images as “tumor,” “normal tissue” and “boundary,” and, using relaxation techniques to resolve regional contradictions, made final decisions as to the tumorregion. It must be noted that, according to this algorithm, a three-dimensional the space differentiation filtering automatically generates a membership function for the fuzzy reasoning. Previous attempts of extracting tumor used a single LoG filter as the space differentiation filter. We recently developed a method which can cope with diverse ultrasound images more flexibly. With this new method, multiple DoG filters with varying characteristics are prepared in addition to the LoG filter, and the optimum one is selected from multiple extraction results. The introduction of this method improved the accuracy of extraction.
The recently emerged concept of "vessel normalization" implies that judicious blockade of vascular endothelial growth factor (VEGF) signaling may transiently "normalize" the tumor vasculature, making it more suitable for tumor disposition of subsequently administered drugs. In this study, therefore, the effect of pretreatment with SU5416, a selective VEGF receptor-2 inhibitor, on tumor disposition and in vivo antitumor activity of polyethylene glycol (PEG)-modified liposomal paclitaxel (PL-PTX) was evaluated in Colon-26 solid tumor-bearing mice. To improve the solubility and in vivo disposition characteristics of SU5416, the inhibitor was formulated in PEGylated O/W emulsion (PE-SU5416). Pretreatment with PE-SU5416 significantly enhanced the in vivo antitumor effect of PL-PTX, although PE-SU5416 administration alone did not show any antitumor effect. Immunostaining for endothelial cells and pericytes demonstrated that the pretreatment with PE-SU5416 enhanced the pericyte coverage of the tumor vasculature. In addition, tumors treated with PE-SU5416 contained significantly smaller hypoxic regions compared with the nontreated control group, demonstrating that structural normalization of the tumor vasculature resulted in an improvement in tumor vessel functions, including oxygen supply. Furthermore, the pretreatment with PE-SU5416 increased the distribution of PEG liposomes and included PTX in the core region of the tumor, as well as conversely decreasing the ratio of their peripheral distribution. These results suggest that the structural and functional normalization of the tumor vasculature by the pretreatment with PE-SU5416 enabled liposomes to reach the deeper regions within tumor tissues, leading to more potent antitumor activity of PL-PTX. PMID:23134499
Purpose: In a retrospective study we examined the predilection sites, the CT and MR morphology and the contrast behaviour of intracranial pilocytic astrocytoma (PA) in a large number of patients. Material and methods: The study consists of 47 patients (18 male, 29 female, mean age 10.1 years) with histologically proven PA. Results: The chief predilection site turned out to be the hypothalamic region (15/47=32%). The other regions involved were (in descending order): Brain hemispheres 8/47=17%; cerebellar vermis 7/47=15%, cerebellar hemispheres; thalamic nuclei and pontomedullar region 4/47=8.5% each; pineal gland 2/47=4%; pons, lamina tecti and optic fascicle 1/47=2% each. The PA presented 24/47=51% cysts; 7/47=15% calcifications; 2/47=4% necrosis and 1/47=2% perifocal oedema. In three cases (3/47=6%) CT and MRI showed no contrast enhancement. Conclusion: PA appear in almost all brain regions but there is a clear preference of the hypothalamic region. PA of the hypothalamic region are a special subgroup. They are often associated with neurofibromatosis 1, tend to infiltrate surrounding structures, and to dissiminate into the intracranial and spinal subarachnoid space. (orig.) [Deutsch] Ziel: Retrospectiv sollen an einem groesseren Patientenklientel Praedilektionsorte, CT- und MR-Morphologie sowie das Kontrastmittelverhalten intrakranieller pilozytischer Astrozytome untersucht werden. Material und Methode: Die Studie stuetzt sich auf die CT- und MR-Befunde von 47 Patienten (18 m, 27 w) mit einem mittleren Alter von 10,1 Jahren, bei denen jeweils ein pilozytisches Astrozytom histologisch gesichert war. Ergebnisse: Als eindeutiger Praedilektionsort erwies sich die Hypothalamusregion (15/47=32%). Die Grosshirnhemisphaeren waren 8mal (8/47=17%), der Kleinhirnwurm 7mal (7/47=15%), die Kleinhirnhemisphaeren, das Thalamuskerngebiet und die pontomedullaere Region je 4mal (4/47=8,5%), die Glandula pinealis zweimal (2/47=4%), der Pons, die Lamina tecti und der Fasciculus opticus je einmal (1/47=2%) betroffen. 24mal (24/47=51%) wurden Zysten, 7mal (7/47=15%) Verkalkungen, 2mal (2/47=4%) Nekrosen und einmal mit Perifokaloedem (1/47=2%) diagnostiziert. Nur dreimal waren die pilozytischen Astrozyome kontrastmittelnegativ (3/47=6%). Schlussfolgerung: Pilozytische Astrozytome kommen in nahezu allen Hirnregionen vor, wobei die Hypothalamusregion eindeutig bevorzugt ist. Die hier gelegenen pilozytischen Astrozytome stellen eine Sondergruppe dar. Sie sind haeufig mit der Neurofibromatose 1 (NF 1) vergesellschaftet, neigen zur infiltrativen Ausbreitung in die Umgebung und zur Dissemination in den intrakraniellen und spinalen Subarachnoidalraum. (orig.)
We report on 554 bone tumors and tumor-like lesions of the foot, which have been diagnosed within the period from 1945-1985 in the Department of Diagnostic Radiology, in the Surgical and Orthopedic Department and in the Division of Pathology of Bone Tumors of the University of Freiburg. Criteria of WHO classification for bone tumors according to Schajowicz were used. Morphological aspects, clinical symptoms and pettern of distribution differ widely from lesions of other skeletal regions. Bone tumors of the foot are much more frequently associated with pain caused by the special anatomy of the foot. Malignant lesions are very rare in the foot. We found only 42 malignant tumors corresponding to 1.4% of all malignant bone tumors. On contrary 13% of all benign bone tumors are localized in the foot. However, 90% of them are osteochondromas and chondromas. Other benign lesions are rare, especially tumors arising from connective tissue of bone. In several cases correct diagnosis was only possible by histologic examination whereas modern digital imaging did not substantially add to conventional plain film and tomographic examination. Preoperative CT scans were very useful for exact planning of surgical procedures especially in benign tumors.
Since the first pioneering work in the area of tumors of the spine, medical professionals have sought to determine the proper role of spine surgery in the management of spinal tumors. Experience has proven that spine surgery is effective in the treatment of spinal cord compression for decreasing pain and improving quality of life with low rates of surgical complications. We use several staging systems to assess the patient's prognosis, to determine the best type of tumoral resection in preoperative surgical planning, and to provide guidance as to the best therapeutic option for the patient. In the surgical treatment of spine tumors, one of two opposing strategies must be chosen: (1) palliative surgery with cord decompression and spine stabilization or (2) curative surgery with en bloc radical resection of the tumor and stabilization. In this article, we describe indications and surgical techniques related to cervical spinal tumors: fixation and laminectomy of the upper and lower cervical spines, corporectomy, and partial and total vertebrectomy. For tumors of the cervicothoracic region, the most frequent level of spine metastasis and thoracic spine tumors, we describe the fixation and laminectomy technique, en bloc tumor resection, and partial and total vertebrectomy. The last part of the article addresses outcomes following spinal surgery, including outcomes related to en bloc Pancoast Tobias tumor resection, malignant dumbbell schwanomas, and metastasis. PMID:19064057
We describe a case of pleomorphic adenoma associated with the formation of a large oval cyst in the right parotid gland in a 54-year-old Japanese man. The proliferative activity of the tumor cells was evaluated by counting the number of argyrophilic nucleolar organizer regions (AgNORs). The tumor, measuring 17×12×12 mm, was a clearly demarcated mass with an almost cystic appearance. It contained whitish cheese-like material. Histologically, the cyst cavity was filled with keratin and was lined by keratinizing squamous tumor cells. Flattened tumor cells were found in the hyalinized stroma. Adjacent islands of squamous metaplastic tumor cells and glandular tumor cells were present. The mean number of AgNORs per nucleus of tumor cells in the glandular portion, mildly keratinizing lining, highly keratinizing basal lining, highly keratinizing superficial lining, and flattened portion was 2.2±0.9, 1.7±1.1, 1.6±1.2, 1.2±0.9, and 1.3±0.8, respectively. Our results suggest that in some pleomorphic adenomas, small squamous metaplastic tumor islands might aggregate and lead to the formation of a large cyst in which the keratinizing tumor cells of the lining have higher proliferative activity than the flattened tumor cells in the hyalinized stroma.
Neuroendocrine tumors develop in various organs in patients with multiple endocrine neoplasia type 1 (MEN1). Among those, tumors developed in upper gastrointestinal tract, thymus and bronchus have historically been called “carcinoid tumor”. Occurrence of “carcinoid tumor” in other region is very rare and molecular pathogenesis of such tumors is unknown. We have experienced a patient with MEN1 who have developed an “ectopic” retroperitoneal neuroendocrine tumor. Genetic analysis of the MEN1 gene in tumor cells revealed a somatic mutation in exon 9 as well as a germline mutation in exon 10. Allele-specific amplification followed by sequence analysis revealed these two mutations exist on the different allele, indicating both alleles are functionally inactivated. Immunohistochemical staining with an anti-menin antibody revealed that wild-type menin is not expressed in tumor cells. Expression of p27Kip1 protein is not observed in tumor cells, either. These results confirmed the inactivation of the MEN1 gene as a genetic cause of an ectopically developed neuroendocrine tumor in a patient with MEN1.
Neuroendocrine tumors develop in various organs in patients with multiple endocrine neoplasia type 1 (MEN1). Among those, tumors developed in upper gastrointestinal tract, thymus and bronchus have historically been called “carcinoid tumor”. Occurrence of “carcinoid tumor” in other region is very rare and molecular pathogenesis of such tumors is unknown. We have experienced a patient with MEN1 who have developed an “ectopic” retroperitoneal neuroendocrine tumor. Genetic analysis of the MEN1 gene in tumor cells revealed a somatic mutation in exon 9 as well as a germline mutation in exon 10. Allele-specific amplification followed by sequence analysis revealed these two mutations exist on the different allele, indicating both alleles are functionally inactivated. Immunohistochemical staining with an anti-menin antibody revealed that wild-type menin is not expressed in tumor cells. Expression of p27Kip1 protein is not observed in tumor cells, either. These results confirmed the inactivation of the MEN1 gene as a genetic cause of an ectopically developed neuroendocrine tumor in a patient with MEN1.
A 24-year-old woman underwent craniotomy for falx meningioma (5 cm in diameter) on October 24, 1995. The deepest part of the tumor was located in the anterior horn of the lateral ventricle, which was not resected. The histology was clear cell meningioma (CCM), aggressive in nature. The MIB-1 labeling index was high (11%). She underwent gamma knife (GK) radiosurgery for the residual tumor with an irradiation dose of 16 Gy at the tumor periphery on May 24, 1996. The postradiosurgical course was uneventful. The residual intraventricular tumor gradually decreased in size, but the peripheral portion gradually grew into the diencephalic region. The patient remained in good condition for 5 years until September 2001, when she exhibited memory disturbance and lethargy. Magnetic resonance imaging demonstrated a large tumor (4.5 cm in diameter) in the diencephalon, compressing the optic nerves and fornix. The calculated tumor doubling time was 120 days. A second craniotomy was performed on October 9, 2001. The tumor was totally resected through the anterior transcallosal approach. The histology and the MIB-1 labeling index of the tissue from the second operation did not differ markedly from those of the first operation. Neither tumor recurrence nor metastasis has been observed to date. GK radiosurgery contributed to control of the residual intraventricular tumor, but the peripheral portion of the tumor, which received a relatively low radiation dose (16 Gy), grew rapidly. This suggests that a marginal dose of 16 Gy may not be sufficient for control of CCM.
Recent studies indicate a possible role of nitric oxide (NO) in regulating leukocyte-endothelial cell interactions, which plays a key role in the tumor immunity. The purpose of the present study is aimed to observe the tumor hemodynamics intravitally and to clarify the effect of NO on tumor microcirculation by means of a real-time confocal laser-scanning microscope using NO-reactive indicators. Visualization of localization of NO and the leukocyte behavior was made in the mesenteric microvessels of an experimental tumor model rat. Production of NO was clearly visualized along the endothelium of the tumor-free rats, but scarcely found in the newly formed tumor microvessels. A higher level of NO production was observed in a solid tumorregion, where a more marked decrease in the leukocyte-endothelial cell interactions was observed. Local administration of a NO synthase (NOS) inhibitor increased leukocyte adhesion. This indicates that tumor-derived NOS creates the tumor specific microenvironment of the immature angiogenic tumor vessels, thereby modulating leukocyte behavior.
Abstract in spanish El tumor de células gigantes de partes blandas de bajo potencial de maligno, es una neoplasia poco frecuente, clasifica dentro de las lesiones fibrohistiocíticas. Histológicamente es un tumor con hallazgos idénticos al tumor de células gigantes del hueso. Presentamos un caso correspondiente a esta neoplasia. Se trató de paciente de 26 años con una lesión tumoral 20 cm x15 cm x15 cm, en ambas regiones lumbares y región sacra. El estudio histológico reveló una ne (more) oplasia con abundantes células gigantes, células fusiformes, hemosiderina y hueso metaplásico. Los estudios inmunohistoquímicos demostraron fuerte positividad de CD68 para las células osteoclásticas. La evolución del paciente fue favorable, sin evidencia de recidivas. Es imprescindible realizar el diagnóstico diferencial de este tumor con otras neoplasias con abundantes células gigantes, como el tumor de células gigantes de la vaina tendinosa y el fibrohistiocitoma maligno rico en células gigantes, el cual es un sarcoma de alto grado Abstract in english The giant cell tumor of soft tissues of low potential malignancy is a very rare tumor. It?s classified in fibrohistiocytic neoplasm and has features identical to giant cell tumor of bone. We present a clinical case for this less frequent malignancy. Patient 26 years old man with a tumor of 20 cm x 15 cm x 15 cm, in both lumbar and the sacral regions. Histological examination revealed a neoplasm with abundant giant cells, spindle cells, hemosiderin and metaplastic bone. T (more) he immunohistochemistry studies practice showed strong positivity of CD68 for the osteoclastic cells. The patient outcome was favorable, without evidence of recurrence. It is essential to make the differential diagnosis of this kind of tumor with other neoplasm with abundant giant cells, such as the giant cell tumor of the tendon sheath and malignant giant cell, also malignant fibrous hystiocitoma, which is rich in giant cells and high grade sarcoma
Tumor hypoxia is an important prognostic indicator for cancer therapy outcome. EF5 [2-(2-nitro-1[ H]-imidazol-1-yl)- N-(2,2,3,3,3-pentafluoropropyl)-acetamide] has been employed to measure tumor hypoxia in animals and humans using immunohistochemical methods. EF5 is a lipophilic molecule designed to have a very uniform biodistribution, a feature of obvious benefit for use in PET imaging. The present study represents the first demonstration of noninvasive PET imaging of rat tumors using fluorine-18 labeled EF5. Because of the small tumor size, partial volume effects may result in underestimation of concentration of the compound. Therefore, validation of the PET data was performed by gamma counting of the imaged tissue. The tumor models studied were the Morris 7777 (Q7) hepatoma (n=5) and the 9L glioma (n=2) grown subcutaneously in rats. Our previous studies have demonstrated that early passage 9L tumors are not severely hypoxic and that Q7 tumors are characterized by heterogeneous regions of tumor hypoxia (i.e., Q7 tumors are usually more hypoxic than early passage 9L tumors). The seven rats were imaged in the HEAD Penn-PET scanner at various time points after administration of 50-100 micro Ci (18)F-EF5 in 30 mg/kg carrier nonradioactive EF5. The carrier was used to ensure drug biodistribution comparable to prior studies using immunohistochemical methods. (18)F-EF5 was excreted primarily via the urinary system. Images obtained 10 min following drug administration demonstrated that the EF5 distributed evenly to all organ systems, including brain. Later images showed increased uptake in most Q7 tumors compared with muscle. Liver uptake remained relatively constant over the same time periods. Tumor to muscle ratios ranged from 0.82 to 1.73 (based on PET images at 120 min post injection) and 1.47 to 2.95 (based on gamma counts at approximately 180 min post injection). Tumors were easily visible by 60 min post injection when the final tumor to muscle ratios (based on gamma counts) were greater than 2. Neither of the 9L tumors nor the smallest Q7 tumor met this criterion, and these tumors were not seen on the PET images. These preliminary results suggest that (18)F-EF5 is a promising agent for noninvasive assessment of tumor hypoxia. Plans are underway to initiate a research project to determine the safety and preliminary evidence for the efficacy of this preparation in patients with brain tumors. PMID:12552344
We present, for the first time an in vivo implementation of dynamic light scattering (DLS) adapted to optical coherence tomography (OCT). Human bladder carcinoma tumors were grown in dorsal skin-fold window chambers fitted to male nude mice and imaged at a rate of 200 Hz using OCT. Maps of speckle decorrelation times (DT) were generated for regions of skin from individual mice as well as for regions containing tumor tissue before and after treatment with chemotherapy. Variations in DT were found between individual mice exhibiting different skin anatomy (primarily due to deterioration from the window chamber implantation). A significant difference in DT was also observed between tumorregions and surrounding normal tissue. Finally, maps of DT generated for tumor tissue treated with chemotherapy indicated a drop in DT at 24 and 48 hours after treatment. These preliminary results suggest the feasibility of using DLSOCT to measure intracellular motion as an endogenous contrast mechanism in vivo.
Background: Conventional magnetic resonance (MR) imaging has a number of limitations in the diagnosis of the most common intracranial brain tumors, including tumor specification and the detection of tumoral infiltration in regions of peritumoral edema. Purpose: To prospectively assess if diffusion-weighted MR imaging (DWI) could be used to differentiate between different types of brain tumors and to distinguish between peritumoral infiltration in high-grade gliomas, lymphomas, and pure vasogenic edema in metastases and meningiomas. Material and Methods: MR imaging and DWI was performed on 93 patients with newly diagnosed brain tumors: 59 patients had histologically verified high-grade gliomas (37 glioblastomas multiforme, 22 anaplastic astrocytomas), 23 patients had metastatic brain tumors, five patients had primary cerebral lymphomas, and six patients had meningiomas. Apparent diffusion coefficient (ADC) values of tumor (enhancing regions or the solid portion of tumor) and peritumoral edema, and ADC ratios (ADC of tumor or peritumoral edema to ADC of contralateral white matter, ADC of tumor to ADC of peritumoral edema) were compared with the histologic diagnosis. ADC values and ratios of high-grade gliomas, primary cerebral lymphomas, metastases, and meningiomas were compared by using ANOVA and multiple comparisons. Optimal thresholds of ADC values and ADC ratios for distinguishing high-grade gliomas from metastases were determined by receiver operating characteristic (ROC) curve analysis. Results: Statistically significant differences were found for minimum and mean of ADC tumor and ADC tumor ratio values between metastases and high-grade gliomas when including only one factor at a time. Including a combination of in total four parameters (mean ADC tumor, and minimum, maximum and mean ADC tumor ratio) resulted in sensitivity, specificity, positive (PPV), and negative predictive values (NPV) of 72.9, 82.6, 91.5, and 54.3% respectively. In the ROC curve analysis, the area under the curve of the combined four parameters was the largest (0.84), indicating a good test. Conclusion: Our results suggest that ADC values and ADC ratios (minimum and mean of ADC tumor and ADC tumor ratio) may be helpful in the differentiation of metastases from high-grade gliomas. It cannot distinguish high-grade gliomas from lymphomas, and lymphomas from metastases. ADC values and ADC ratios in peritumoral edema cannot be used to differentiate edema with infiltration of tumor cells from vasogenic edema when measurements for high-grade gliomas, lymphomas, metastases, and meningiomas were compared
We evaluated the results of Gamma Knife radiosurgery for petroclival meningioma in 50 patients (11 males and 39 females). The mean of the patients' age was 55.5 (range: 15 to 79) years old. Stereotactic radiosurgery was performed as a primary treatment in 29 patients. Twenty-one patients had undergone one to five prior resections. Tumors were located at the clivus in 2 patients. In the other 48 cases, tumors were located around the petrous apex or spread over the petro-clival region. Seventeen of the 48 tumors extended into the cavernous sinus. The mean tumor volume was 14.9 (range: 0.7 to 75) ml. The mean maximum dose was 27.2 (range: 18 to 35.7) Gy and the mean tumor margin dose was 13.6 (range: 8.1 to 25) Gy. In a median follow-up period of 36 (range: 6 to 112) months, 20 tumors (40%) decreased in size and 27 tumors (54%) remained unchanged. Only 3 tumors (6%) had radiographic evidence of progression in the treated part of the tumor. Surgical resection was performed in 3 patients after radiosurgery. In 1 patient, a second radiosurgery and then surgical resection was done. A second radiosurgery was also performed in 4 other patients. In 2 of these 4 patients, the second radiosurgery was done for tumor relapse outside the treatment field. The overall tumor control rate was 94%. Cranial nerve deficits without the evidence of tumor growth developed in only 3 patients (6%). Stereotactic radiosurgery was safe and effective in the management of patients with petroclival meningiomas, despite of the proximity of the tumors to critica neural and vascular structures. (author)
Abstract in portuguese INTRODUÇÃO: O carcinoma basocelular é o tumor mais comum entre os tumores das pálpebras. Nesta região, a reconstrução é complexa e recomenda-se que haja perda mínima de tecido saudável. OBJETIVO: Para definir a relação entre margem livre de tumor na excisão e taxa de recidiva do carcinoma basocelular das pálpebras. MÉTODOS: Este estudo prospectivo incluiu 111 pacientes operados para remoção de carcinoma basocelular das pálpebras no período de 2001 a 200 (more) 3, com acompanhamento subsequente de 5 anos. Os pacientes foram avaliados de acordo com a idade, localização do tumor, taxa de recidiva, e margem livre de tumor na excisão. RESULTADOS: Não se encontrou associação significativa entre a excisão incompleta do tumor e casos de recidiva, exceto em pacientes com idade inferior a 56 anos, pacientes do sexo feminino e em tumores do canto medial. CONCLUSÃO: Um risco maior de recidiva de carcinoma basocelular das pálpebras com excisão incompleta foi confirmado estatisticamente apenas em pacientes mais jovens, em mulheres, e nos tumores do canto interno. Abstract in english INTRODUCTION: Basal cell carcinoma is the most common tumor of the eyelid. In this region, reconstruction is complex and damage to healthy tissue should be minimal. Objective: To define the relationship between margin clearance at excision and the recurrence rate of basal cell carcinoma of the eyelid. METHODS: This prospective study was conducted with 111 patients submitted to surgery for basal cell carcinoma of the eyelid between 2001 and 2003 and followed up for a perio (more) d of five years. The patients were evaluated according to age, tumor site, recurrence rate and margin clearance at excision. RESULTS: No significant association was found between incomplete tumor excision and recurrence except in patients under 56 years of age, female patients and in the case of tumors of the medial canthus. CONCLUSION: A risk of recurrence in incompletely excised basal cell carcinomas of the eyelid was only confirmed in younger patients, females and for tumors of the medial canthus.
Distant metastasis of primary neoplasms is the main factor that limits the success of antineoplastic therapy. It can be regarded as an early or late event in the neoplastic process, and varies considerably with tumor type. The metastatic potential of a given tumor greatly influences prognosis. Tumor metastasis is not a single neoplastic event, rather, it involves several major steps: invasion of cells from the primary tumor into tissue, and penetration of blood and lymph vessels; release of tumor cell emboli into the circulation; arrest of the emboli in capillary beds of distant organs; invasion of the wall of the arresting vessel, infiltration into adjacent tissue, and multiplication; and growth of vascularized stroma into the new tumor as proliferating tumor cells invade the distant organ. Lodgement and invasion are complex events that are not fully defined. Arrest and lodgement appears to require a thromboembolic event in which the metastatic embolis (1 cell) contacts vascular endothelium and adheres to the wall with thrombis formation following aggregation of platelets and fibrin to the tumor cell(s). Invasion may involve: formation of collagenases by tumor cells; mechanical disruption; chemotactic factors. Metastatic patterns depend on the route of metastasis, tumor type, and target organ (favored soil). In general, carcinomas metastasize via lymphatics and sarcomas via hematogenous routes. Others, melanoma, mast cell tumors, etc., show mixed patterns. This knowledge is important when one is attempting to prognostically stage a tumor, especially when thoracic radiographs are negative. The question of enlarged regional lymph nodes will be discussed in lecture relative to specific tumor types. 4 refs., 1 tab.
Approximately 45% of sporadic well-differentiated pancreatic neuroendocrine tumors harbor mutations in either ATRX (alpha thalassemia/mental retardation X-linked) or DAXX (death domain-associated protein). These novel tumor suppressor genes encode nuclear proteins that interact with one another and function in chromatin remodeling at telomeric and peri-centromeric regions. Mutations in these genes are associated with loss of their protein expression and correlate with the alternative lengthening of telomeres phenotype. Patients with multiple endocrine neoplasia-1 (MEN-1) syndrome, genetically defined by a germ line mutation in the MEN1 gene, are predisposed to developing pancreatic neuroendocrine tumors and thus represent a unique model for studying the timing of ATRX and DAXX inactivation in pancreatic neuroendocrine tumor development. We characterized ATRX and DAXX protein expression by immunohistochemistry and telomere status by telomere-specific fluorescence in situ hybridization in 109 well-differentiated pancreatic neuroendocrine lesions from 28 MEN-1 syndrome patients. The study consisted of 47 neuroendocrine microadenomas (<0.5?cm), 50 pancreatic neuroendocrine tumors (?0.5?cm), and 12 pancreatic neuroendocrine tumor lymph node metastases. Expression of ATRX and DAXX was intact in all 47 microadenomas, and none showed the alternative lengthening of telomeres phenotype. ATRX and/or DAXX expression was lost in 3 of 50 (6%) pancreatic neuroendocrine tumors. In all three of these, tumor size was ?3?cm, and loss of ATRX and/or DAXX expression correlated with the alternative lengthening of telomeres phenotype. Concurrent lymph node metastases were present for two of the three tumors, and each metastasis displayed the same changes as the primary tumor. These findings establish the existence of ATRX and DAXX defects and the alternative lengthening of telomeres phenotype in pancreatic neuroendocrine tumors in the context of MEN-1 syndrome. The observation that ATRX and DAXX defects and the alternative lengthening of telomeres phenotype occurred only in pancreatic neuroendocrine tumors measuring ?3?cm and their lymph node metastases suggests that these changes are late events in pancreatic neuroendocrine tumor development. PMID:22575867
The development of more selective delivery systems for cancer diagnosis and chemotherapy is one of the most important goals of current anticancer research. The purpose of this study is to evaluate various self-assembled nanoparticles as candidates to shuttle radionuclide and/or drugs into tumors and to investigate the mechanisms underlying the tumor targeting with self-assembled nanoparticles. By combining different hydrophobic moieties and hydrophilic polymer backbones, various self-assembled nanoparticles were prepared, and their in vivo distributions in tumor-bearing mice were studied by radionuclide imaging. One type of nanoparticles (fluorescein isothiocyanate-conjugated glycol chitosan (FGC) nanoparticles) exhibited highly selective tumoral localization. Scintigraphic images obtained 1 day after the intravenous injection of FGC nanoparticles clearly delineated the tumor against adjacent tissues. The mechanisms underlying the tumor targeting with self-assembled nanoparticles were investigated in terms of the physicochemical properties of nanoparticles and tumor microenvironments. FGC nanoparticles were preferentially localized in perivascular regions, implying their extravasation to tumors through the hyperpermeable tumor vasculature. The magnitude and pattern of tumoral distribution of self-assembled nanoparticles were influenced by several key factors--(i) in vivo colloidal stability: nanoparticles should maintain their intact nanostructures in vivo for a long period of time, (ii) particle size, (iii) intracellular uptake of nanoparticle: fast cellular uptake greatly facilitates the tumor targeting, (iv) tumor angiogenesis: pathological angiogenesis permits access of nanoparticles to tumors. We believe that this work can provide insight for the engineering of nanoparticles and be extended to cancer therapy and diagnosis, so as to deliver multiple therapeutic agents and imaging probes at high local concentrations. PMID:17126900
Neurofibromatosis is generally classified into types I and II: the latter may be life-threatening when the acoustic nerve tumor becomes enlarged. The author reports on a patient with bilateral acoustic nerve tumors, as well as large tumors at the neck and sacral regions, who developed facial nerve paralysis following surgery in which a gamma knife was used. The patient, a 30-year-old woman with no family history of neurofibromatosis, had a prominent neurofibroma at the pharyngeal region surgically removed when she was about 23. The procedure left her with dysfunctions of the vocal cords and lingual movements. At the age of 30 (March 2001), a tumor originating at S1 of the sacral nerve plexus was removed, which caused her leg movements to be restricted. Later, an acoustic nerve tumor was found to have enlarged; and in July 2001, the left acoustic nerve tumor was extirpated by using a gamma knife. Starting in early 2002, her left facial movements appeared to be compromised but during the follow-up observation period, she regained the movements. Patients with neurofibromatosis are often plagued by the development of multiple tumors and surgical sequelae. One is reminded that it is necessary to plan treatment with sufficient consideration given to quality of life (QOL) (including the problem of an acoustic nerve tumor that may develop in future) as well as individual patients wishes. (author)
Since the conception of the pentavalent technetium polynuclear complex of dimercaptosuccinic acid, Tc(V)-DMS, a great number of papers published on its clinical applicability forced us to question ''how tumor tissue appropriates the Tc(V)-DMS.'' Preliminary in vitro studies with Ehrlich ascites tumor cells (EATC) indicated the pH-sensitive character of this tumor agent. From this finding and the well-established notion that malignant tumors are more acidic than normal tissue, the in vivo correlation of Tc(V)-DMS accumulation in tumor tissue with its tissue acidification was considered of interest. The systemic lowering of tumor tissue pH by the stimulation of aerobic glycolysis has been well reported. In the present paper, the response of Tc(V)-DMS tumor accumulation to acidification induced by the glucose administration was explored in EATC-bearing mice. Measurement of tumor tissue pH was carried out by direct microelectrode technique and by histochemical umbelliferone technique in tumor tissue excised from EATC bearing mice. The regional acidity distribution is correlated with the regional radioactivity distribution registered by autoradiography. Evidence related to the pH sensitiveness of Tc(V)-DMS in response to glycolytic acidification was gathered; the pH measurement and the in vivo biodistribution of the double-tracer macroautoradiography with C-14 deoxyglucose (C-14-DG) demonstrated that the regional tissue distribution of Tc(V)-DMS was superimposed to that of C-14-DG. The glucose interventional modality offers the premier foundation for the interpretation of Tc(V)-DMS accumulation in diagnostic studies of malignant tumors.
To study the inactivation of a possible tumor suppressor gene at chromosome 9p associated with the development and progression of cutaneous malignant melanoma (CMM), we have analyzed 12 microsatellite markers in 54 paired tumors and normal tissues. Forty-six percent of the tumors (corresponding to 52% of patients) showed loss of heterozygosity (LOH) for at least one marker. The smallest deleted region included markers D9S126, D9S265 and D9S259, spanning 5 centiMorgans of chromosome 9p21. Forty-two percent of the metastasic tumors and 50% of the primary tumors, including two in situ CMM, showed 9p21 deletions. Tumors with the worst prognoses showed larger deletions at 9p, ({chi}{sup 2} = 4.16, p < 0.04), and three cases showed two non-contiguous regions deleted, one telomeric to IFNA and the other centromeric. The presence of large and non-contiguous deletions, in the cases with the worst prognoses, suggests the existence of more than one tumor suppressor gene at 9p involved in the predisposition to, and progression of, malignant melanoma, outside the region of the recently identified p16 gene (MTS1), which has been found deleted in about 60% of melanoma cell lines.
The results of gamma knife radiosurgery for malignant skull base tumors were analyzed using repeated magnetic resonance imagings and neurological examinations. Nineteen malignant skull base tumors were treated and followed up for 22.3 months (5-40 months) using MR imagings. The mean age was 54.4 years old (ranging from 16-85). Ten were male and 9 were female. Prior to the radiosurgery, removal of the tumors in 17 cases, conventional radiation therapy in 7, and chemotherapy in 4 etc. were performed. The pathological diagnoses were chordoma in 6 patients, metastatic tumors in 5, epipharyngeal carcinoma in 2, adenoid cystic carcinoma in 2, and others in 4. The locations of tumors were clivus in 8, parasellar region in 5, epipharynx in 2, paranasal sinus in 2, C-P angle in 1, and intraorbital region in 1 (14 intracranial and 5 extracranial). The mean diameter of the tumor was 33.5 mm. The mean maximum dose was 26.8 Gy and the mean marginal dose was 12.9 Gy during treatment. Repeated MR imagings revealed decrease of tumor size in 12 cases, showing no change in 1, and increase of tumor size in 5 (unknown in 1). Follow-up neurological examinations showed improvement in 3 patients, no change in 9, and deterioration in 7. There were 11 deaths during a mean follow-up period of 17.8 months (5-32 months) and another 8 cases are alive for a mean follow-up of 30.5 months (20-40 months) after the radiosurgery. Although the tumor size was large at the time of treatment, the results of gamma knife radiosurgery were promising. Considering the quality of life of patients with malignant skull base tumors, it is emphasized that gamma knife treatment is the method of choice compared with radical removal of the tumors. (author).
The response of a rhabdomyosarcoma tumor in an inbred strain of rat has been measured after irradiation by charged-particle beams of helium and neon ions. Tumor volume regression and regrowth and tumor cure were measured and compared with results from 220-kVp x irradiation. RBEs for 20-day radiation-induced growth delay (RBE/sub 20/), for 50-day radiation-induced growth delay (RBE/sub 50/), and for 50% tumor cure probability (RBE/sub TCD50/180/) were measured in the plateau (high energy and spread-out Bragg-peak (low energy) ionization regions of both charged-particle beams. In the neon-ion peak region, RBE/sub 20/, RBE/sub 50/, and RBE/sub TCD50/180/ values (with standard deviations) of 2.9 -+ 0.7, 2.6 -+ 0.5, and 3.1 -+ 0.6, respectively, were obtained. These high values reflect the effect of a high-LET contribution in the beam and possibly the presence of a significant hypoxic fraction in this tumor. In the neon plateau region, RBE/sub 20/ and RBE/sub 50/ values of 1.7 -+ 0.4 and 1.8 -+ 0.3 were obtained. These values are significantly lower than those in the peak region and indicate a marked difference in beam quality between the peak and plateau regions of the beam. This characteristic may make the neon beam a candidate for possible use in the radiotherapy of human tumors. For the helium-ion Bragg-peak position, RBE/sub 20/, RBE/sub 50/, and RBE/sub TCD50/180/ values of 1.5 -+ 0.3, 1.4 -+ 0.3, and 1.4 -+ 0.2, respectively, were obtained. These values indicate that there is a significant increase in biological effectiveness in the helium-ion spread-out peak region. For the helium-ion plateau region, RBE/sub 20/ and RBE/sub 50/ values of 1.0 -+ 0.2 and 1.1 -+ 0.2 indicate that this region can be considered a region of low-LET radiation.
In recent literature, there have been case reports of an extremely rare entity characterized by hybrid peripheral nerve tumors consisting of elements of neurofibroma, schwannoma, and/or perineurioma. The authors present a unique case of a patient with multiple painful hybrid tumors with negative genetic testing for neurofibromatosis Type 1 and no clinical evidence of neurofibromatosis Type 2 or schwannomatosis. A 28-year-old woman presented with tentatively diagnosed schwannomatosis. She had painful bilateral retromastoid scalp tumors as well as multiple other painful tumors in the distribution of the saphenous, femoral, and sciatic nerves. Her family history was significant for a paternal grandfather with a solitary schwannoma. The patient underwent multiple surgical procedures for tumor resection, including tumors in the regions of the retromastoid scalp, bilateral sciatic nerves, left femoral nerve, and left axilla. These tumors were examined and evaluated histologically. Within the tumors, components of both neurofibromas and schwannomas were found, even though these 2 peripheral nerve sheath tumors have been long considered to be distinct entities. This case report suggests a distinct syndrome that has not previously been appreciated. PMID:22978539
Peripheral nerve sheath tumors of the head and neck - a review. Peripheral nerve sheath tumors are derived from neural crest and rare classified as neuroectodermal in origin. They can be divided into neurofibroma, schwannoma and neurogenic sarcoma. Neurofifromas are benign well circumscribed, nonencapsulated tumors which involve all elements of normal peripheral nerves. Schwannomas are beginning encapsulated tumors composed fundamentally by Schwann cells. Neurogenic sarcomas are malignant tumors which can be de novo or arise from preexisting neurofibroma or schwannoma. Peripheral nerve sheath tumors can arise from any nerve that contain myelin sheath, but are more frequent in extremities and trunk, being rare on cervical region. neurogenic tumors of head and neck can arise from cranial nerves, especially vagus nerve, brachial plexus and other small nervous plexus. Computed tomography and magnetic resonance imaging are the methods of choice in the evaluation of those tumors and can demonstrate lesions with several patterns. Areas of cystic degeneration are frequent in schwannomas, while neurofibromas are usually homogeneous. About 1/3 of those tumors are hyper vascularized and those who arise nervous spinal; roots can have an aspect of dumbbell which contain cervical and intravertebral components. (author) 51 refs., 5 figs.
Tumor angiogenesis is the process by which new blood vessels are formed from the existing vessels in a tumor to promote tumor growth. Tumor angiogenesis has important implications in the diagnosis and treatment of various solid tumors. Flat panel detector based cone beam CT opens up a new way for detection of tumors, and tumor angiogenesis associated with functional CBCT has the potential to provide more information than traditional functional CT due to more overall coverage during the same scanning period and the reconstruction being isotropic resulting in a more accurate 3D volume intensity measurement. A functional study was conducted by using CBCT to determine the degree of the enhancement within the tumor after injecting the contrast agent intravenously. For typical doses of contrast material, the amount of enhancement is proportional to the concentration of this material within the region of interest. A series of images obtained at one location over time allows generation of time-attenuation data from which a number of semi-quantitative parameters, such as enhancement rate, can be determined. An in vivo mice study with and without mammo tumor was conducted on our prototype CBCT system, and half scan scheme is used to determine the time-intensity curve within the VOI of the mouse. The CBCT has an x-ray tube, a gantry with slip ring technology, and a 40×30 cm Varian Paxscan 4030CB real time FPD.
/sup 67/Ga-citrate uptake ratios were measured in 21 primary lung cancers, of which volume-doubling times (DT) were simultaneously determined from sequential films taken at a month interval or so prior to treatment. This analysis was to determine whether /sup 67/Ga-citrate uptake ratio was a useful technique to assess growth rate of tumor. Uptake ratio was expressed as ratio of net cpm of the tumor to that of corresponding region in the opposite lung field, and corrected by the tumor volume and by the attenuation factor related with tumor depth. Study has demonstrated the presence of the significant negative correlation (p < 0.001) between tumor uptake ratios with /sup 67/Ga and DTs, this is, net uptake ratio was increased with a decrease in DT. The different types of lung cancers were ranked with regard to their increasing uptake ratios: adenocarcinoma, squamous cell carcinoma and anaplastic carcinoma, while DTs were decreasing inversely. It was also observed that, in squamous cell carcinoma, increase in tumor volume caused decrease of /sup 67/Ga tumor uptake ratio. Measurement of /sup 67/Ga-citrate tumor uptake ratio is considered to contribute to the estimation of the rate of tumor growth.
We have analyzed 12 microsatellite markers on chromosome 9p in 54 paired cutaneous malignant melanoma (CMM) tumors and normal tissues. Forty-six percent of the tumors, including two in situ CMMs showed loss of heterozygosity (LOH) at 9p. Only one tumor was homozygously deleted for 9p markers. The smallest deleted region was defined by five tumors and included markers D9S126 to D9S259. Loss of eight or more markers correlated significantly with worse prognosis (P<.002). Among the primary tumors, 87.5% of those with large deletions have a high risk of metastasis, as compared with only 18% of those without deletions or with loss of fewer than 8 markers (P<.001). It was not possible to demonstrate homozygous deletions of p16 in any of the CMM tumors. In four tumors, the LOH for 9p markers did not involve p16. The reported data suggest the existence of several tumor suppressor genes at 9p that are involved in the predisposition to and/or progression of CMM and exclude p16 from involvement in the early development of some melanoma tumors. 36 refs., 5 figs., 1 tab.
The distinction of multifocal versus multicentric gliomas can conceivably have important therapeutic implications. We present a 27-year-old man with two radiologically distinct non-enhancing infiltrative masses in the anterior frontal lobe and the posterior temporoparietal region. No intervening disease was evident on MRI modalities; the lesions were stable over a period of many months. He underwent two separate resections a few months apart. Given the question of whether his tumors represented two de novo primary multicentric tumors or one multifocal tumor, single nucleotide polymorphism (SNP) array karyotyping and in situ hybridization studies were performed on both tumors. The two tumor profiles looked remarkably similar, histologically and genetically: both were anaplastic astrocytomas with a common 33Mb gain/ amplification of 8q23.3-q24.3, including MYC amplification, suggesting a monoclonal origin. The temporoparietal neoplasm showed several additional genetic alterations. This case illustrates that even with today's advanced neuroimaging modalities, extensive radiologically invisible tumor may be present between seemingly separate sites of glioma involvement. Thus modern global genomic studies of such tumors may help distinguish whether multiple tumors represent one extensive neoplasm with microscopically invasive disease or multiple genetically distinct tumors. PMID:22720694
Ultrasonography performed at 21 weeks of gestation and magnetic resonance imaging at 23 weeks identified a huge tumor in the occipital region. Premature rupture of the membrane occurred at 28 weeks of gestation, so this baby boy was delivered by emergency cesarean section. Anemia and low blood pressure due to hemorrhage from the surface of the tumor required massive blood transfusion and hemostasis. The tumor was conservatively managed. He manifested symptoms of high output heart failure and persistent infection, necrotizing enterocolitis, and septicemia, and died 51 days after birth. Autopsy examination found the black tumor, weighing 885 g, with a clear boundary with the brain parenchyma. Histological examination showed the tumor was contiguous with the thickened dura mater. The tumor consisted of small, spindle-shaped, round, and polygonal cells without characteristic organized pattern, and positive for S-100 protein and neuron-specific enolase, and negative for HMB-45 and glial fibrillary acidic protein. Ultrastructural study revealed melanin granules within the tumor cells. The diagnosis was meningeal melanocytoma. His skin and spinal cord were unremarkable. Complete tumor resection is considered the best treatment option, followed by incomplete resection with postoperative radiotherapy, but we could not deliver aggressive treatment in our patient because of hemorrhage from the tumor surface and his poor general condition.
In this report, we describe a case of recurrent desmoid tumor that was characterized by a novel APC gene mutation and osteopontin (OPN) expression. A 20-year-old female patient with adenomatous polyposis underwent a right colectomy at 13 years of age. Five years later, she developed an abdominal desmoid tumor that was resected. After 2 more years, a recurrent desmoid tumor was found in the same region. This tumor grew rapidly and quickly became massive. The doubling time was estimated to be 122 days, based on the computed tomography findings. When we analyzed the APC gene in the recurrent desmoid tumor, we found a novel frame-shift mutation at codon 1564. This frame-shift mutation changed TTA to TAG, which is a stop codon. Northern blot analysis and immunohistochemical analysis for OPN, a GRGDS (glycine-arginine-glycine-aspartic acid-serine)- containing adhesive molecule, revealed abundant amounts of OPN mRNA and protein expression in this desmoid tumor. We postulated that the truncated APC protein and OPN expression might be involved in the invasive nature of this recurrent desmoid tumor. A primary cell culture derived from the desmoid tumor was assessed for chemosensitivity to 5-fluorouracil, cisplatin, doxorubicin, colchicine, docetaxel, and anti-OPN antibody. Docetaxel was found to have the strongest inhibitory effect on cell growth. As a result, docetaxel was administered to this patient (60 mg/m2/month) for 3 cycles. Over the next 2 years, no detectable recurrences occurred. Thus, docetaxel was clinically effective for the treatment of a recurrent desmoid tumor.
Purpose: To evaluate the respiratory motion of primary esophageal cancers and pathologic celiac-region lymph nodes using time-resolved four-dimensional computed tomography (4D CT). Methods and Materials: Respiration-synchronized 4D CT scans were obtained to quantify the motion of primary tumors located in the proximal, mid-, or distal thoracic esophagus, as well as any involved celiac-region lymph nodes. Respiratory motion was measured in the superior-inferior (SI), anterior-posterior (AP), and left-right (LR) directions and was analyzed for correlation with anatomic location. Recommended margin expansions were determined for both primary and nodal targets. Results: Thirty patients underwent 4D CT scans at Massachusetts General Hospital for planned curative treatment of esophageal cancer. Measurements of respiratory tumor motion were obtained for 1 proximal, 4 mid-, and 25 distal esophageal tumors, as well as 12 involved celiac-region lymph nodes. The mean (SD) peak-to-peak displacements of all primary tumors in the SI, AP, and LR dimensions were 0.80 (0.45) cm, 0.28 (0.20) cm, and 0.22 (0.23) cm, respectively. Distal tumors were found to have significantly greater SI and AP motion than proximal or mid-esophageal tumors. The mean (SD) SI, AP, and LR peak-to-peak displacements of the celiac-region lymph nodes were 0.92 (0.56) cm, 0.46 (0.27) cm, and 0.19 (0.26) cm, respectively. Conclusions: Margins of 1.5 cm SI, 0.75 cm AP, and 0.75 cm LR would account for respiratory tumor motion of >95% of esophageal primary tumors in the dataset. All celiac-region lymph nodes would be adequately covered with SI, AP, and LR margins of 2.25 cm, 1.0 cm, and 0.75 cm, respectively.
Extraskeletal Ewing's sarcoma is rarely found in the head and neck regions. We report an unusual case of extraskeletal Ewing's Sarcoma of the parapharynx region in a 49-year-old man who presented with blindness. MRI examination showed marked enhancement of tumor thrombosis involving the superior sag...
A 67-year-old man with generalized fatigue and weight loss developed hyponatremia. Endocrinologic examination demonstrated panhypopituitarism. Magnetic resonance imaging showed a pituitary mass extending slightly to the suprasellar region. Transsphenoidal resection of the tumor was performed. Histological examination found exclusively granulomatous tissue with cholesterol clefts, and no epithelial component. This cholesterol granuloma may be classified as xanthogranuloma of the sellar region.
The 9p21 region of human chromosome 9 is a hot spot for chromosomal aberrations in both cultured cell lines and primary tumors. This region contains a gene, P16 (also called MTS1, CDKN2 and p16INK4), that encodes a presumptive negative cell cycle regulator called p16. P16 is deleted or mutated at hi...
A cDNA clone for human p53 cellular tumor antigen has been isolated and characterized. This clone contains the complete 3'-untranslated region and most of the open reading frame for the protein. Nucleotide sequence analysis revealed that p53 mRNA contains an Alu repeat in the 3'-untranslated region....
The pineal-related organs of lower vertebrates have the ability to discriminate different wavelengths of light. This wavelength discrimination is achieved through antagonistic light responses to UV or blue and visible light. Previously, we demonstrated that parapinopsin underlies the UV reception in the lamprey pineal organ and identified parapinopsin genes in teleosts and frogs of which the pineal-related organs were reported to discriminate light. In this study, we report the first identification of parapinopsin in the reptile lineage and show its expression in the parietal eye of the green iguana. Spectroscopic analysis revealed that iguana parapinopsin is a UV-sensitive pigment, similar to lamprey parapinopsin. Interestingly, immunohistochemical analyses using antibodies specific to parapinopsin and parietopsin, a parietal eye green-sensitive pigment, revealed that parapinopsin and parietopsin are colocalized in the outer segments of the parietal eye photoreceptor cells in iguanas. These results strongly suggest that parapinopsin underlies the wavelength discrimination involving UV reception in the iguana parietal eye. The current findings support the idea that parapinopsin is a common photopigment underlying the UV-sensitivity in wavelength discrimination of the pineal-related organs found from lampreys to reptiles. PMID:22720013
OBJECTIVE: To determine whether doses of the pineal hormone melatonin alleviate jet lag. DESIGN: Double blind, placebo controlled crossover trial. SETTING: Long haul return flights from Auckland, New Zealand, to London and back. SUBJECTS: Twenty volunteers with experience of transcontinental flights...
RATIONALE: Animal studies suggest that the pineal hormone melatonin influences basal stress hormone levels and dampens hormone reactivity to stress. OBJECTIVES: We investigated whether melatonin also has a suppressive effect on stress-induced catecholamine and cortisol release in humans. As stress ...
Pineal glands display a day-night rhythm in the synthesis and secretion of melatonin. Dispersed chick pinealocytes retain their ability to respond to light in vitro for at least a week. Pinealocytes incubated overnight with /sup 3/H-retinol in the dark incorporate radioactivity predominantly into retinyl esters. To identify the chick pineal photopigment, SDS-PAGE was performed on radiolabelled preparations of pinealocytes and (intraocularly injected) rat retina. When intact cells or membrane preparations of cultured cells were incubated with NaCNBH/sub 3/, in the dark, a single radioactive peak with an apparent molecular weight of 32,000 daltons was observed. Rat retina preparations revealed a major peak at approximately 40,000 daltons. Protease inhibitors were present in the workup, and radioactivity corresponding to the smaller peak from pineal was not observed in retina. There was no radioactive peak when NaCNBH/sub 3/ was omitted. When samples were boiled in SDS the radioactivity shifted to the origin. These data suggest a protein in pinealocyte membranes which binds retinoid via a Schiff's base. Exposure to light of deoxycholate solubilized pineal membranes reduced the radioactivity associated with the protein. These findings raise the possibility that this protein is the pinealocyte's photopigment. Photopigments smaller than those observed in mammals have been reported in invertebrates.
The role of the pineal gland is to translate the rhythmic cycles of night and day encoded by the retina into hormonal signals that are transmitted to the rest of the neuronal system in the form of serotonin and melatonin synthesis and release. Here we describe that the production of both melatonin a...
Vasopressin (VP)-converting aminopeptidase (VP-AP) activity and VP contents were measured in single rat pineal glands during the summer of two successive years. The peptidase activity decreased significantly in August. The lowest activity (±SEM) of 0.18±0.02 pmol·hour?1 was recorded on August 14, co...
Abstract in portuguese Foi observado haver uma relação entre o estímulo sonoro intenso e alterações morfológicas na glândula (g.l) pineal de ratas adultas. Estes animais foram estimulados por uma campainha elétrica, com nível de intensidade sonora em torno de 110 db, por 1, 2, 4 e 7 dias e como também por mais 10 estímulos sucessivos no sétimo dia. Foram observadas alterações celulares, tais como: núcleos picnóticos, vacuolizações e perda do aspecto lobular da distribuição dos pinealócitos, sendo que estas alterações se agravam com o aumento do número de estimulações. Abstract in english The authors studied the effect of noise (110 dB), delivered by an eletric bell, upon parenchima cells of pineal gland of albino female rats. Several experimental groups were previously formed and stimulated during, 1, 2, 4 and 7 days. In addition another group was formed and stimulated during 7 days plus 10 additional stimulations of about 3 minutes each after the routine stimulations in the seventh day. The authors observed that a single stimulation of about 3 minutes wa (more) s sufficient to determine alterations in the parenchima cells of the pineal of experimental animals; the changes were characterized by picnolisis in some groups, whereas in others groups picnolisis and interstitials vacuolizations were evidently increased directly with stimulation. The results suggest that the sound stimulation has a destructible effect upon the parenchima cells of the pineal gland of the female albino rats.
Albino rats were subjected to pinealectomy, superior cervical ganglionectomy, or the appropriate sham preparation and were placed in lighting conditions so that light onset was advanced by 10 hr. After 6 days of this regimen, all animals exhibited a complete shift in their outer segment disc shedding rhythm, indicating that the pineal gland is not a factor in mediating such a shift.
The pineal hormone melatonin is involved in physiological transduction of temporal information from the light dark cycle to circadian and seasonal behavioural rhythms, as well as possessing neuroprotective properties. Melatonin and its receptors MT1 and MT2, which belong to the family of G protein-c...
A 22-year-old female developed intracranial and spinal subarachnoid metastases 9 years after radiation therapy for a pineal germinoma. Computed tomographic scans showed no evidence of local recurrence. Cerebrospinal axis irradiation achieved total remission. Delayed subarachnoid dissemination may be caused by germinoma cells remaining dormant in the subarachnoid space, outside the radiation field. (author).
A bovine pineal acid extract displays a vasotocin-like bioactivity in several bioassays, and is recognized by antibodies against the Pro-Arg-Gly-amide ending common to vasopressin and vasotocin. By using molecular sieve filtration and reversed-phase HPLC, a vasopressin- and oxytocin-like peptide was...
To identify the characteristics of the oscillator located in the pineal organ, we examined the effects of temperature and light on melatonin secretion rhythm using pineal organs in cultures. At 20°C, the melatonin rhythm was obvious: low secretion during the daytime and high during the nighttime. When the temperature was lowered from 20 to 10°C, the melatonin rhythm disappeared. When the temperature was returned from 10 to 20°C, the rhythm quickly reappeared. The plasma melatonin level was measured in living lampreys kept at 7°C to establish the melatonin profile at low temperature in vivo: secretion was not significantly different between daytime and nighttime. Under continuous light conditions, the melatonin elevation normally seen during the subjective night became obscure after 72 h. When the LD cycle was shifted by 6 h (phase-advanced or phase-delayed), the melatonin rhythm shifted to remain in the same phase relation to the LD cycle. This re-synchronization took several LD cycles. The results indicate that, in cultures, the melatonin secretion rhythm in the pineal organ of the lamprey is both light- and temperature-sensitive, and that in vivo, the melatonin rhythm is not the critical factor maintaining the locomotor activity rhythm of the lamprey. The role of the pineal organ and melatonin in the circadian organization of the lamprey is discussed.
Dark-cycle, night administration of the pineal hormone melatonin in drinking water to aging mice (15 months of age) prolongs survival of BALB/c females from 23.8 to 28.1 months and preserves aspects of their youthful state. Similar results were seen in New Zealand Black females beginning at 5 months...
A series of 34 patients with tumours of the third ventricle were operated on by a transcallosal route. Basal extrinsic lesions compressing or invading the ventricle as well as tumours located in the pineal area were excluded from this review. Tumours were approached by a transforaminal entry in 16 c...
The innervation of the rat pineal gland from the sphenopalatine, otic, superior cervical and trigeminal ganglia was investigated in animals by use of in vivo retrograde tracings. A solution of 2% Fluorogold was iontophoretically injected into the superficial pineal gland in a series of Wistar rats. After a survival time of 4-10 days, the animals were fixed by perfusion and the brains, sphenopalatine, otic, superior cervical and trigeminal ganglia were investigated with a fluorescence microscope. Many retrogradely labelled perikarya were found in the superior cervical ganglia, but a smaller number of neurones were also labelled in the sphenopalatine, otic and trigeminal ganglia. Injections of the tracer into the subarachnoidal space were used as the control for unspecific uptake and transport of the tracer. The input to the pineal gland from the parasympathetic sphenopalatine and otic ganglia might be involved in the regulation of the annual rhythms of the pineal gland. The projections from the sensory trigeminal ganglion could be involved in the control of the blood flow of the gland. PMID:10420437
1. The effects of caffeine and 3-isobutyl-l-methylxanthine (IBMX) on voltage-activated K+ currents were examined by use of patch clamp recording techniques in dissociated chick autonomic ganglion neurones, chick pineal cells and rat anterior pituitary cells. 2. In chick ciliary ganglion neurones, ca...
Melatonin, a hormone produced by the pineal gland, is important for regulating circadian rhythms in many animals. Light at night causes an acute suppression of melatonin in nearly all vertebrate species. A previous study found that light failed to suppress melatonin in the lizard Anolis carolinensis. This is a surprising result given that the Anolis pineal gland is intrinsically photosensitive, is a key pacemaker controlling locomotor activity, and can be directly entrained to a light-dark cycle. To find out if the lack of photic suppression is widespread in the Anolis genus, we investigated the acute effects of light on melatonin secretion in five different species of Anolis using flow-through tissue culture. We administered a two-hour pulse of bright light to isolated pineal glands during the night. The results show photic suppression of melatonin in all five Anolis species, but the suppression is weak relative to that seen in other vertebrates. Moreover, Anolis species differ in the magnitude of the effect. These findings are discussed in the context of vertebrate pineal evolution and the ecology of Anolis lizards. Given their extensive phylogenetic and ecological divergence, Anolis lizards provide a promising system for investigating the ecology and evolution of circadian organization. PMID:21757022
Circadian rhythms are regulated by an internal clock, which is itself synchronized to environmental cues such as light and temperature. It is widely assumed that the circadian system is adapted to local cues, which vary enormously across habitats, yet the comparative data necessary for testing this idea are lacking. We examined photic and thermal resetting of the circadian clock in five species of Anolis lizards whose microhabitats differ in the amounts of sun and shade. The primary circadian oscillator in Anolis is the pineal gland, which produces the hormone melatonin. A flow-through culture system was employed to measure rhythmic melatonin output from individually cultured pineal glands. All species showed temperature-compensated circadian rhythms of pineal melatonin. Light caused significant phase delays of the melatonin rhythm, and this effect varied among species. Controlling for phylogenetic differences, the results indicate that the pineal glands of shade-dwelling species are more sensitive to photic resetting than species living in more brightly illuminated habitats. The differences were not due to variation in free-running period, but may be due to variation in oscillator phase and/or robustness. Surprisingly, thermal resetting was not statistically significant. Overall, the results suggest that the Anolis circadian system is adapted to photic habitat. PMID:22350678
The pineal organ of the lizard Anolis carolinensis can be maintained for up to 10 days in superfused organ culture. During this time it synthesizes and releases melatonin into the medium flowing slowly over it. Collection of timed aliquots of medium and subsequent analysis for melatonin by radioimmu...
The retinoic acid-related orphan receptor ? (ROR?) exhibits a highly restricted neuronal-specific expression pattern in brain, retina and pineal gland. So far, neither a natural ROR? target gene nor a functional ligand have been identified, and the physiological role of the receptor is not well unde...
The role played by postsynaptic alpha-adrenergic receptors in the stimulation of pineal N-acetyltransferase (EC 2.3.1.5) and [3H]melatonin production was investigated in the rat. In vivo studies indicated that phenylephrine, an alpha-adrenergic agonist, potentiated and prolonged the effects of isopr...
Serotonin N-acetyltransferase is the enzyme responsible for the diurnal rhythm of melatonin production in the pineal gland of animals and humans. Inhibitors of this enzyme active in cell culture have not been reported previously. The compound N-bromoacetyltryptamine was shown to be a potent inhibito...
The circadian rhythm of pineal melatonin requires the nocturnal increment of serotonin N-acetyltransferase (arylalkylamine N-acetyltransferase [AANAT]) protein. To date, only limited information is available in the critical issue of how AANAT protein expression is up-regulated exclusively at night r...
Melatonin production in the chick pineal gland is high at night and low during the day. This rhythm reflects circadian changes in the activity of serotonin N-acetyltransferase (arylalkylamine N-acetyltransferase, AA-NAT; EC 2.3.1.87), the penultimate enzyme in melatonin synthesis. In contrast to the...
If variations of pineal or plasmatic rate of melatonin have been underlined with the rodent, with the man it does not appear that the electromagnetic fields exposure involve a significant change at the melatonin level or its principal metabolite. (N.C.)
A 57-year-old man was referred to our hospital because of a lump of his lateral neck region. Aspiration and intraoperative biopsies were performed to confirm the pathological diagnosis. The tumor showed a neoplastic epithelium arranged in a ductal or follicular pattern with papillary proliferation, and tumor cells were immunohistochemically positive for thyroglobulin. The pathological diagnosis was papillary thyroid carcinoma metastasis to a lymph node in the lateral neck region. Metastases were also observed in other lymph nodes in the submandibular region, and multiple metastatic foci were later found in the lungs and brain. Heavy ion radiotherapy was performed to extend the patient's life.
Cutaneous squamous cell carcinoma of the head and neck most often spreads via direct extension or through lymphatics to regional lymph nodes. This is a unique case of a cutaneous squamous cell carcinoma of the nasal dorsum with direct vascular invasion of the facial vein. This was initially incorrectly identified as a regional level Ib lymph node metastases, and the intervening venous structures were neither extirpated during an initial surgery nor recognized during subsequent radiation therapy. The patient then presented with a sizable recurrence in the right suborbital subcutaneous tissue region extending into the neck and internal jugular vein. During further resection, direct tumor invasion into the facial vein was pathologically confirmed. This unusual involvement is presented as the first documented report of regional spread via tumor thrombosis within the facial vein as demonstrated in the facial vein with a tumor thrombus, as demonstrated by computed tomography and microscopic findings. PMID:19144305
We studied the effect of a single dose of X-radiation given to the regional lymph nodes on allograft rejection. Our model was an A-strain tumor, transplanted to C57B1/6, DBA/2, and C57B1/6 x CBA hosts. Irradiation (1,000 rad) of the regional lymph nodes inhibited graft rejection, as judged by increased tumor growth, slower rejection, and, in the case of DBA/2 mice, by fewer regressions; irradiation of the contralateral lymph nodes did not have this effect. The mechanism of immunosuppression appeared to be B-cell independent, since immunosuppression could be induced by regional X-radiation as readily in B-cell deficient mice as in normal mice. The suppression was critically time-dependent, viz, irradiation before, or 6 or more days after, tumor graft was without significant effect. Treatment of the allogeneic host with cyclophosphamide several days before grafting, so as to reduce T-suppressor cells, attenuated the immunosuppression of regional X-radiation.
Abstract in portuguese Para estudar as mutações nos exos 4 a 8 do gene p53, foram utilizados 15 tumores mamários, mamas normais das mesmas cadelas e seis mamas de cadelas normais. O DNA extraído das amostras de tecido foi sequenciado e analisado para a presença de mutações. Em 71,8% das amostras obtidas foram observadas mutações, sendo as "missense" as mais frequentes. Os exons mais comprometidos foram 5, 7 e 8 com 23,4, 31,6 e 23,4% de mutações, respectivamente. O estudo conclui que (more) tumores mamários caninos têm relação com mutações no gene p53 e que as mutações ocorrem com maior frequência nas regiões da proteína que estão ligadas ao DNA no núcleo celular. Isto pode alterar a funcionalidade da proteína e propiciar o crescimento do tumor. As mamas adjacentes aos tumores, apesar da aparência macroscópica normal, apresentaram mutações, que podem representar recidivas se a mama não for retirada juntamente com o tumor. Abstract in english Fifteen female canines with mammary tumors and 6 normal females were used to study mutations in exons 4 to 8 of the p53 gene. DNA samples from the tumors, respective adjacent normal mammary tissue and mammary glands from healthy animals were sequenced and analyzed for the presence of mutations. Mutations were found in 71.8% of the samples and the most frequent were missense mutations. The most attacked exons in the mammary tumor were 5, 7 and 8, with 23.4, 31.6 and 23.4% (more) mutations, respectively. Canine mammary tumors are related to mutations in gene p53 and mutations mostly occur in the region of the protein that is linked to the DNA in the cell nucleus, which can change the functionality of the cell and propitiate tumor growth. Despite being macroscopically normal, the mammary tissue adjacent to the tumors has mutations that can lead to recurrence if not removed together with the tumor.
A putative tumor suppressor gene on the short arm of human chromosome 9 has been identified recently and named as multiple tumor suppressor 1 (MTS1). MTS1 is identical to the previously identified cyclin-dependent kinase-4 inhibitor gene p16, a cell cycle regulatory protein. Frequent homozygous deletions of MTS1 gene has been documented recently in cell lines derived from different types of tumors including breast tumors, suggesting that MTS1 is a tumor suppressor gene that is probably involved in a variety of human tumors. To determine the frequency of MTS1 mutations in primary breast tumors, we screened 39 primary breast tumors (16 lobular carcinoma and 23 ductal carcinoma) and 5 established breast tumor cell lines by utilizing single stranded conformational polymorphism (SSCP) analysis. SSCP analysis was carried out for all 3 exons of the MTS1 gene utilizing primers in the flanking intronic sequences. Two of the five breast cancer tumor cell lines analyzed exhibited deletion of the entire MTS1 gene. However, only one of the thirty-nine primary breast tumors revealed a potential SSCP variation in exon 2 of the MTS1 gene which is currently characterized by sequencing. SSCP analysis also revealed two intragenic polymorphisms, one in exon 2 and one in the 3{prime} untranslated region, that could be used to assay allelic loss directly at the MTS1 locus. These results suggest that the mutation of the MTS1 gene may not be a critical genetic change in the formation of primary breast cancer, and the deletions observed in breast tumor cell lines may be due to product of cell growth in vitro.
We have previously reported that the hypoxic cytotoxin tirapazamine causes central vascular dysfunction in HCT-116 xenografts. Here we further extend this finding to SiHa xenografts and SCCVII murine tumors. Within 1?day after treatment with tirapazamine both tumor types develop areas of non-perfused tissue in central regions of tumors. To explore the mechanism by which the hypoxic cytotoxin tirapazamine causes vascular dysfunction we altered the blood oxygen content with carbogen (95% O2 and 5% CO2) breathing in tumor bearing mice. Carbogen treatment was able to decrease the number of tumors responding to tirapazamine but was not able to eradicate the vascular dysfunction completely. In complementary in vitro studies, immunohistochemical staining of tirapazamine-treated endothelial cells ...
The physical and radiobiogical basis as well as the rationale for neutron brachytherapy, using Cf-252, in human cancer therapy is reviewed. Cf-252 brachytherapy represents an economical and effective form of neutron radiotherapy that is readily and safely applied clinically. It can be used anywhere in the world without unusual personnel, equipment or facilities, or prohibitive expenses or maintenance costs. Used on bulky head and neck, thoracic, abdominal, pelvic, brain and appendage cancers, it overcomes hypoxic radioresistance and produces remarkable rates of tumor clearance. It is easily combined with photon radiotherapy and in proper schedules and doses, it can control advanced but still localized regional cancers to produce tumor cure. It will clear the local manifestations of recurrent or metastatic tumors or advanced stages of primary tumors and therefore in conjunction with other adjuvant therapies offers much more effective tumor control and palliation than present conventional therapy. 208 refs.
Parapharyngeal space (PPS) tumors are rare and benign in 80% of cases. Since surgeons first resected this anatomical region, the surgical approach to PPS bulks has been a hot topic due to their shape and the important structures involved. We present a series of patients treated with a transcervical or transcervical-transparotid approach to benign PPS tumors without mandibulotomy. Between May 2003 and March 2009, 18 patients (11 male and 7 female) with benign PPS tumors underwent a surgical resection, avoiding mandibulotomy. Average age of the patients was 49 years (range 3???76), average tumor size was 5.5 ?? 4 ?? 3 cm and histological examination of the resected tumors showed: seven pleomorphic adenomas of the deep parotid lobe, four schwannomas, two mycobacteriosis, two paraganglio...
Abstract in english A six years old girl consulted due to mammary development. On physical examination, clitoris enlargement and a tumor localized in the abdominal-pelvic region were observed. Hormonal study disclosed elevated testosterone and estradiol levels. On exploratory laparotomy, a right ovarian tumor was observed and a right salpingo-oophorectomy was performed. The contemporary biopsy informed a disgerminoma, leading to a surgical staging of the tumor. The definitive pathological di (more) agnosis was a juvenile granular cell tumor, limited to the ovary. In the postoperative period, estradiol and testosterone levels returned to normal values and the pseudopuberty reverted. The patient did not receive adjuvant treatment and after three years of follow up, there is no evidence of tumor recidivism (Rev Méd Chile 2003; 131: 71-6)
A 16-year-old boy presented with an unusual case of a supratentorial, extraaxial small round blue cell tumor of the central nervous system, which was most likely a primitive neuroectodermal tumor (PNET). Preoperative computed tomography and magnetic resonance imaging showed a large multistage hematoma in the left central region. Intraoperatively, a small, superficial tumorous lesion was found between the sagittal sinus and a large cortical vein hidden by the hematoma. The histological diagnosis was PNET. This tumor is one of the most aggressive intracerebral tumors, not only in children, so treatment strategies must be early, profound, and interdisciplinary. This case represents an important example of atypical extraaxial appearance of this lesion, which should be considered in the differential diagnosis of cortical or subcortical hemorrhage, since complete resection of this lesion is critical for the successful treatment and outcome.
Uterine leiomyomas, or fibroids, are benign tumors that affect millions of women worldwide and that can cause considerable morbidity. To study the genetic basis of this tumor type, we examined 18 uterine leiomyomas derived from 17 different patients by exome sequencing and identified tumor-specific mutations in the mediator complex subunit 12 (MED12) gene in 10. Through analysis of 207 additional tumors, we determined that MED12 is altered in 70% (159 of 225) of tumors from a total of 80 patients. The Mediator complex is a 26-subunit transcriptional regulator that bridges DNA regulatory sequences to the RNA polymerase II initiation complex. All mutations resided in exon 2, suggesting that aberrant function of this region of MED12 contributes to tumorigenesis. PMID:21868628
Head and neck paragangliomas that are exclusively or predominantly dopamine-secreting are rare. Surgery and/or radiotherapy are modalities for locoregional tumoral control. Little is known about the efficacy of radiotherapy for biochemical control in such tumors. We report a 62-year-old Chinese man with bilateral carotid body tumors which were exclusively dopamine secreting. The left-sided tumor invaded the skull base and encased the left carotid artery. Surgery was not performed due to high risk of morbidity and mortality. The patient received external beam radiotherapy to bilateral neck regions. Progressive decline and eventual normalization of urinary dopamine excretion was seen together with a slight reduction in tumor size. This is the first report demonstrating the efficacy of radiotherapy for both biochemical and locoregional control of functioning carotid body paragangliomas.
The majority of patients with tumors generally are sensitive and very useful of radiotherapy. Major cases in pediatric cancer are leukemia, brain tumor, neuroblastoma, malignant lymphoma, Wilms tumor, retinoblastoma, rhabdomyo-sarcoma, osteosarcoma, testicular tumors, etc. Others are hemangioma including Kasabach-Merritt Syndrome. Radiation therapy is indicated in all cases of malignant tumor in children. Recently the treatment results improve with the help of well organized chemotherapy. Cancer in children is almost a speciality on its own. Since the total number of patients in any region is not large, treatment is best concentrated at special oncology centers. Long-term results in the majority of cases are disappointing, and the nursing problems are formidable. Surgery, Radiation and Chemotherapy are all valuable, especially in combination - multidisciplinary therapy and multidisciplinary team.
We report here in on a case of malignant fibrous histiocytoma (MFH) of the left postauricular region. A 17-year-old male was referred to our hospital with swelling of the left neck. CT scan and MRI showed a 2 cm mass lesion in the deep neck, and PET showed abnormal accumulation in the cervical lymph nodes and distant organs. Based on these findings, the tumor was considered as benign and was resected under general anesthesia. A histological examination showed that the tumor consisted of growing spindle cells with large irregular nuclei. Immunohistochemical staining with vimentin and ?-SMA, showed that the tumor cells were positive. Finally the tumor was diagnosed as an MFH. Since the tumor was considered to be residual, we performed radical neck dissection as salvage surgery. To date, no local recurrence nor distant metastasis has been observed.
A 53-year-old male presented with a case of prolactin-producing pituitary adenoma with abundant spherical amyloid depositions masquerading as extensive calcification and manifesting as visual disturbance. Computed tomography revealed a large high density mass suggesting calcified tumor in the intra- and supra-sellar regions. Magnetic resonance imaging revealed a heterogeneously enhanced large pituitary tumor reaching lateral ventricle. Blood prolactin level was elevated to 5971 ng/ml. Cabergoline treatment for 3 months provided considerable shrinkage of the tumor but failed to improve the visual symptoms. Transcranial surgery revealed that the tumor was fibrous and included abundant grayish translucent spherical granules with diameter of 0.5-1.5 mm. Immunohistochemically, the tumor was strongly positive for prolactin. Congo red stain and polarized light showed that these spherical bodies were amyloid depositions. No calcification was noted.
Drug targeting to tumors with limited toxicity and enhanced efficacy of drug is one of the important goals for cancer treatment pharmaceutics. Monocytes/macrophages are able to migrate to tumor sites across the blood barriers by acting as Trojan horses carrying drug cargoes. Taking this advantage, we have intended to develop an efficient administration system using a biologically active carrier of mouse peritoneal macrophage bearing liposomal doxorubicin (macrophage-LP-Dox). We expect that this system could improve the cancer therapeutic efficacy through deeper penetration into tumor even hypoxic region behind tumor blood vessel. We first confirmed that macrophages containing iron oxides could migrate and infiltrate into tumors effectively by MR imaging. Next, we showed that doxorubicin (D...
Protoporphyrin IX (PPIX) fluorescence-guided brain tumor resection using 5-aminolevulinic acid labeling is one of the most valuable tools available to determine the extent of glioma infiltration, but requires repeated spectroscopic evaluation of the tissue. The present method informs the surgeon of residual tumor in real time using spectrum analysis of PPIX fluorescence and an audible alert system. The target region was illuminated with a laser with a peak wavelength of 405 ± 1 nm in addition to the usual microscope halogen lamp during tumor resection. Analysis of the spectrum detected the PPIX peak using a difference in relative intensity exceeding 500 at 636 nm and 632 nm, when an audible alert was transmitted to the surgeon. Using this method, infiltration of glioma was detected and confirmed histologically in three of six glioblastomas. The surgeon can detect tumor infiltration far more objectively and with less effort using this system during tumor resection.
Radiolabeled antibodies for cancer therapy are being investigated in clinical trials in more than 30 centers. {sup 131}Iodine-labeled antibody (Ab) therapy of solid tumors has produced few responses when given alone. When given in conjunction with chemotherapy and external beam therapy in hepatoma patients objective responses have occurred. Because of the short range of {sup 131}I, {sup 90}Y and {sup 186}Re are being studied and objective responses have occurred in patients without the addition of other therapies. {sup 131}I-labeled Ab therapy of lymphoma, a radioresponsive tumor, has produced a much higher objective response rate than in other solid tumors. Regional RIT has not been shown to offer a definite advantage over the intravenous route. Tumor doses have generally been less than 2000 cGy per treatment with some tumors receiving higher doses. The bone marrow is the dose-limiting organ for RIT and marrow cryopreservation with subsequent reinfusion may prove useful. (Author).
Abstract in english Neuroendocrine tumors are uncommon, including VIPoma that produces vasoactive intestinal polypeptide. We report a 45-year-old female presenting with a history of diarrhea lasting three months. An abdominal CAT scan showed a solid tumor in the body of the pancreas. A fine needle aspiration biopsy of the tumor was compatible with a neuroendocrine tumor. The patient was subjected to a partial pancreatectomy, excising a 4 cm diameter tumor. The pathological study was compatib (more) le with a neuroendocrine carcinoma. There was no regional lymph node involvement. During the postoperative period the results of serum vasoactive intestinal polypeptide were received. These were 815.9 pg/ml before surgery and normalized after the operation.
The microenvironment of a tumor is a highly complex milieu, primarily characterized by immunosuppression, abnormal angiogenesis, and hypoxic regions. These features promote tumor progression and metastasis, resulting in poor prognosis and greater resistance to existing cancer therapies. Galectin-1 is a ?-galactoside binding protein that is abundantly secreted by almost all types of malignant tumor cells. The expression of galectin-1 is regulated by hypoxia-inducible factor-1 (HIF-1) and it plays vital pro-tumorigenic roles within the tumor microenvironment. In particular, galectin-1 suppresses T cell-mediated cytotoxic immune responses and promotes tumor angiogenesis. However, since galectin-1 displays many different activities by binding to a number of diverse N- or O-glycan modified targ...
Small cell lung carcinoma (SCLC) is extremely aggressive and frequently metastasizes widely in its early stage. Because tumor hypoxia is related to aggressive tumor behavior and the hypoxic adaptation of SCLC is poorly documented, we stained SCLC tumors arranged in a tissue microarray for hypoxia-inducible factor (HIF)-1? and HIF-2? proteins. We found an overall lack of HIF-2? protein expression, which was confirmed in large tumor sections. HIF-1? protein was strongly expressed in most tumors, frequently adjacent to necrotic regions. In concordance, cultured SCLC but not non–small cell lung carcinoma cells showed no or extremely low levels of HIF-2? mRNA and no HIF-2? protein at hypoxia. HIF-1? was stabilized after 4 hours at hypoxia,...
A 66-year-old man presented with complaints of numbness for the past 5 years and progressive motor weakness of the right leg for the previous 2 months. Magnetic resonance imaging revealed large intra- and extracranial tumors in the frontoparietal region. Physical examination suggested the extracranial lesion was a subcutaneous lipoma, which had been partially resected 60 years before, connected to the intracranial lesion via a defect of the skull. Gross total removal of the tumors was performed. Histological examination showed the intracranial lesion was epidermoid tumor, and connected to the extracranial lipoma by a lipoma bridge. The symptoms improved remarkably following surgery. This case of intracranial epidermoid tumor associated with intra-extracranial lipoma indicates that implantation of skin tissue in childhood carries the risk of epidermoid tumor even after several decades. Neuroimaging screening is recommended to detect the development of any intracranial components.
Chondroid lipoma is a rare variant of lipoma that pathologically can mimic liposarcoma or possibly other sarcomas. Variants of lipoma, including chondroid lipoma, may demonstrate radiological evidence of fat within the tumor, but often display heterogeneous features on imaging studies, making a clinical diagnosis difficult. A large collective experience with the imaging characteristics of chondroid lipoma is lacking due to the rarity of this tumor. We present a case of chondroid lipoma of the upper thigh in a 37-year-old woman who had regions of metaplastic bone formation within the tumor. Radiologically, the tumor presented as a large soft tissue mass with calcification and ossification. Although metaplastic bone formation in conventional lipoma is well described, it has been rarely reported to occur in chondroid lipoma and has not been pathologically documented or illustrated. The imaging findings and histopathology of this unusual tumor are presented, along with a review of the literature. (orig.)
Summary Aim: The aim of this study was to evaluate survival rates and treatment response in stage I-IV gastric cancer in relation to tumor stage (TNM), histology, Lauren's classification and tumor localization. Patients and Methods: Clinical and histopathological data of 160 patients with stage I-IV gastric cancer were analyzed in this retrospective, single-center study. Results: Most patients (73.1%) showed an advanced or metastatic tumor stage (III/IV). The median 3-year overall survival (OS) was 20 +- 16.8 months and correlated significantly with tumor stage (I: OS 30.6 +- 15 months vs. IV: 10.4 +- 9.3 months; p < 0.0001). Stage III/IV tumors were significantly more often poorly differentiated (G3; p = 0.011) and located in the corpus region. Signet ring cell (SRC) cancers were found in...
A CASE REPORT: A 20-year-old man with juvenile hepatocellular carcinoma (HCC) without HBV, nor HCV infections. A complaint of pain in the right abdomen, wherein a bulky hepatic tumor occupying a large area of the right lobe as well as tumors that were 20 mm and 10 mm in size in liver regions S2 and S3, respectively, were observed via an abdominal CT scan. A biopsy resulted in a diagnosis of well-differentiated hepatocarcinoma. The main voluminous tumor mass in the right lobe was resected, but the tumor still remained in the lateral segment after the surgery. On day 21 after the surgery, we initiated a therapy for the remaining tumor. He is still alive 36 months after surgery. PMID:22202418
To achieve in vivo observation of drug effect on tumors implanted in living mice, we have developed a novel method of non-invasive and time-resolved observations by using phase-contrast X-ray computed tomography (CT). For observations, we used a large-area imaging system fitted with a two-crystal X-ray interferometer and a newly developed sample manipulator. A series of images of tumors with or without antitumor drug (paclitaxel) dosage once a day for four days was successfully obtained. Image analysis clearly showed that a low-density region corresponded to necrosis near the center of both tumors spreading gradually. In addition, the density distribution of necrosis in the dosed tumor was lower than that of necrosis in the tumor without dosage. These results indicate that this imaging method has practical applications for non-invasive and time-resolved observations of drug effects on living mice.
A 60-year-old woman was admitted to Nagasaki Prefectural Shimabara Hospital, with a painful tumor in her umbilical region. The tumor was about 1×1 cm in size. Histological examination of biopsied specimens revealed it to be a metastatic adenocarcinoma. Abdominal computed tomography and ultrasonography revealed a cystic tumor of about 23 mm in diameter in the pancreatic body. In addition, serum levels of cancer antigen 19-9 were elevated. With a tentative diagnosis of pancreatic tumor, she underwent surgery. When we opened her peritoneal cavity, there was no evidence of intra-abdominal disseminations, liver metastases or ascites. At that time, distal pancreatectomy accompanied by splenectomy was the procedure of choice. Histological examination revealed a moderately differentiated adenocarcinoma in the pancreatic body along with fatty replacement of the pancreatic tail. The umbilical tumor was a metastatic adenocarcinoma, which is referred to as a Sister Mary Joseph's nodule.
Adrenal composite pheochromocytoma is rare, most of which is functional, and extra-adrenal composite paraganglioma is extremely rare. We describe and compare the clinicopathological and immunohistochemical features of a retroperitoneal extra-adrenal composite paraganglioma and an adrenal composite pheochromocytoma. Both tumors were nonfunctioning and laboratory tests revealed no biochemical abnormalities. Both tumors were composed of typical paraganglioma/pheochromocytoma closely admixed with ganglioneuroma component. In addition to typical immunohistochemical phenotypes characteristic of each component, both tumors showed focal staining of somatostatin, and the adrenal tumor was also regionally positive for insulin and prolactin. Despite this aberrant immunohistochemical expression, relevant clinical symptoms or laboratory abnormalities were absent. These tumors serve to exemplify the extremely rare occurrences of clinically silent, nonfunctioning composite pheochromocytoma or paraganglioma with aberrant expression of hormones. PMID:20829582
Poly (lactide-co-glycolide) (PLGA) coupled with methoxy poly (ethylene glycol) (mPEG) or chlorin e6 (Ce6) was synthesized using the Steglich esterification method. PLGA-linked mPEG (PLGA-mPEG), PLGA-linked Ce6 (PLGA-Ce6), and Fe3O4 were utilized to constitute multifunctional PLGA nanoparticles (~160nm) via the multi-emulsion W1/O/W2 (water-in-oil-in-water) method. The photo-sensitizing properties of Ce6 molecules anchored to PLGA nanoparticles enabled in vivo luminescence imaging and photodynamic therapy for the tumor site. The encapsulation of Fe3O4 allowed high contrast magnetic resonance (MR) imaging of the tumor in vivo. Overall, PLGA nanoparticles resulted in a significant tumor volume regression for the light-illuminated KB tumor in vivo and enhanced the contrast at the tumorregion,...
Intracranial clear cell meningioma (CCM) is very rare and often has an aggressive clinical course. The predilection site of intracranial CCM in children was cerebellopontine angle where represents challenging tumor resection because of the vicinity of brainstem, vertebral artery, and lower cranial nerve. Therefore, special consideration is required for this tumor. We report two cases with intracranial CCM in a family and reviewed the literature concerning pediatric intracranial CCM. Case 1 is a 4-year-old boy with a tumor at the right posterior fossa. Case 2 is an 8-year-old boy with a left basilar regiontumor. Gross total resection and subtotal resection was achieved in case 1 and case 2, respectively. Case 1 had no tumor recurrence at 12 months after the operation. Case 2 received cyber...
Breast cancer is a heterogeneous disease with known expression-defined tumor subtypes. DNA copy number studies have suggested that tumors within gene expression subtypes share similar DNA Copy number aberrations (CNA) and that CNA can be used to further sub-divide expression classes. To gain further insights into the etiologies of the intrinsic subtypes, we classified tumors according to gene expression subtype and next identified subtype-associated CNA using a novel method called SWITCHdna, using a training set of 180 tumors and a validation set of 359 tumors. Fisher?s exact tests, Chi-square approximations, and Wilcoxon rank-sum tests were performed to evaluate differences in CNA by subtype. To assess the functional significance of loss of a specific chromosomal region, individual genes ...
We investigated the anti-tumor effects of a dry powder preparation of the antlered form of Ganoderma lucidum (G. lucidum AF, rokkaku-reishi in Japanese), a variant type of G. lucidum, not only in allogeneic Sarcoma 180-bearing ddY mice, but also in syngeneic MM 46-bearing C3H/He mice. G. lucidum AF inhibited tumor growth and elongated the life span when orally administered to mice by free-feeding of a 2.5% G. lucidum AF-containing diet. It also showed anti-tumor activity in spite of post-feeding after tumor inoculation. G. lucidum AF significantly countered the depression of splenic CD8+ cells and protected the decrease in interferon-gamma (IFN-?) production in regional lymph nodes of MM 46-bearing mice, indicating that the anti-tumor activity of G. lucidum AF might be caused by its immunostimulating action. These results suggest that the ingestion of G. lucidum AF can be useful for the prevention and curing of cancer.
The usefulness of {sup 67}Ga-citrate and {sup 99m}Tc-MDP scintigraphy were investigated using 81 patients with head and neck malignant tumor. The detection rate for primary and metastatic lesions was defined as the true-positive rate (TPr). In salivary gland tumor, TPr of {sup 67}Ga citrate scintigraphy were higher than squamous cell carcinoma. In squamous cell carcinoma, TPr of {sup 67}Ga citrate scintigraphy correlated with the tumor size of primary lesions. In squamous cell carcinoma, TPr of the tongue and floor of the mouth were lower than any other site. In the metastatic lesions of adenoid cystic carcinoma, significant difference of TPr of {sup 67}Ga citrate scintigraphy appeared among the cases. {sup 99m}Tc-MDP scintigraphy provided very useful information for evaluating the presence of tumor invasion to bone in the primary region and bone metastatic region. (author)
Atypical Spitz tumors can hardly be differentiated from spitzoid melanoma. CGH might help in the differential diagnosis. An 8 year old child with an atypical Spitz tumor (with a CGH pattern compatible with melanoma) of 8.0 mm Breslow thickness and micrometastases in two lymph node regions was seen at our department. The management and prognosis of atypical Spitz tumors is controversial, and aggressive procedural steps similar to melanoma are usually not recommended. Even performing sentinel lymph node biopsy has been questioned. After extensive interdisciplinary consultations, we did not recommend resection of both lymph node regions and chose instead to follow-up with regular whole-body MRI and adjuvant treatment with pegylated interferon. Treatment decisions for atypical Spitz tumors are a major medical and ethical challenge due to the limited available data. PMID:21489908
The loss of heterozygosity (LOH) has been reported in numerous neoplasms in both human and animals, and has often been observed in chromosomal regions, which contain tumor-suppressor genes. We previously found frequent LOH on chromosomes 4, 12 and 19 in radiation-induced lymphomas from (BALB/cHeA x STS/A)F1 hybrid mice by allelotype analysis at polymorphic microsatellite loci. In this study, to elucidate the nature of allelic losses, we refined the loss regions on chromosomes 4, 12 and 19 of the tumors from the F1 mice and then analyzed them cytogenetically. The results represent evidence of a wide range of allelic losses owing to mitotic recombination on chromosomes 4 and 19 in the tumors, possibly reflecting functional losses of putative tumor-suppressor genes. It is suggested that the generation of these large homozygous chromosomal segments probably containing the affected genes is one of the genetic alterations responsible for tumorigenesis.
Loss of heterozygosity data from familial tumors suggested that BRCA1, a gene that confers susceptibility to ovarian and early-onset breast cancer, encodes a tumor suppressor. The BRCA1 region is also subject to allelic loss in sporadic breast and ovarian cancers, an indication that BRCA1 mutations may occur somatically in these tumors. The BRCA1 coding region was examined for mutations in primary breast and ovarian tumors that show allele loss at the BRCA1 locus. Mutations were detected in 3 of 32 breast and 1 of 12 ovarian carcinomas; all four mutations were germline alterations and occurred in early-onset cancers. These results suggest that mutation of BRCA1 may not be critical in the development of the majority of breast and ovarian cancers that arise in the absence of a mutant germline allele.
AbstractBackground Partial nephrectomy (NSS) for unilateral nephroblastoma may be beneficial, although in case of regional lymph node (LN) involvement, radiotherapy counteracts the functional benefit of NSS. The aim is to verify whether decrease of tumor volume under preoperative chemotherapy implies clearance of regional LN. Procedure SIOP 9301 (1993-2001) collected 1,450 localized nephroblastoma patients of whom 1,360 (93%) had sufficiently available data and were retrospectively reviewed. Results Histologic subtypes were classically distributed. Patients were divided in those with tumor positive LN (76, 5.5%) and those with tumor negative LN (1,284, 94.5%) at surgery. In the LN(+) group, the tumor volume changed from a median of 554 (318-772) to 192 (63-458)-ml-=-67% (27-88%) during pre...
Abstract in portuguese A hipófise, a sela túrcica e a região peri-selar podem ser acometidas por uma série de lesões, incluindo tumores benignos e malignos, bem como uma ampla variedade de doenças não neoplásicas. Os aspectos clínicos e radiológicos podem auxiliar no diagnóstico diferencial destas lesões. Porém, em muitos casos, somente a análise histopatológica pode estabelecer o diagnóstico definitivo. Neste artigo, revisamos principais tumores não hipofisários da região selar e peri-selar, ressaltando seus aspectos endócrinos mais relevantes. Abstract in english The pituitary gland, sella turcica and the parasellar region can be involved by a wide variety of lesions, including benign and malignant neoplasms as well as a wide variety of non neoplastic tumor-like lesions. Clinical and radiological aspects could help in the differential diagnosis of these lesions. Nevertheless, in many cases only the histopathological analysis could establish the definitive diagnosis. In this paper, we review the nonpituitary tumors of the sellar region emphasizing the associated hormonal disturbances.
