M Salvati

..The aim of the study was to evaluate the treatment of the extracranial metastases from glioblastoma multiforme in the elderly, discussing their uncommon occurrence and their pathogenesis...

..05) and that the association of postoperative radiotherapy and re-operation in the event of recurrent metastatic lesions is advisable even though statistical significance was not reached (p?>?0.05)...

..Paragangliomas affecting the filum terminale are extremely rare, benign tumors. The literature yielded thirty-two cases of paraganglioma in this site...

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..The characterization of molecular markers thus becomes particularly important for the stratification of patients raising the possibility to individualize treatment...

..The presence of an oligodendroglial component in GBM appears to be an important prognostic factor to which better prognosis can be related. LOH 1p and 19q was significantly associated with GBM with oligodendroglial component...

..However, it is not yet clear whether immunosuppressive drugs function as a direct transforming factor...

..Multicenter studies, taking into account molecular biological findings, are necessary to define a common therapeutic strategy for astroblastomas...

..The use of radiotherapy should be carefully evaluated for relatively benign or congenital lesions which generally affect young patients with a long life expectancy...

..For glioblastomas mean survival time was 10.4 months, accounting for 1-3% of all the glioblastomas treated. A thorough revision of the pertinent literature revealed some clinical-biological peculiarities...

..Stereotactic biopsy represents a safe and satisfactory method for achieving sure diagnosis...

..Most of these tumors are sarcomas, meningiomas or gliomas and only occasionally schwannomas. We report 5 cases of postirradiation acoustic nerve schwannoma observed in our Department...

..Finally, it seems that surgical indications for multiple brain metastases from sarcoma have increased during the last ten years...

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..However, considering the rarity of brain metastasis from prostate carcinoma, standard brain MRI follow-up in men with prostatic cancer does not seem to be necessary yet...

..To add a further contribution to the literature supporting the relationship between previous head trauma and development of glioma...

..In addition, patients treated with postoperative radiotherapy seem to show a trend toward increased survival...

..In one of these patients metastasis was detected prior to diagnosis of primitive cancer. In a review of the literature only seven cases of solitary brain metastasis preceding the diagnosis of uterine cancer have been documented...

..The onset of this tumor during childhood is particularly unusual...

..004 and P = 0.005, respectively). The results of the present study suggest that MGMT methylation status might be an important prognostic factor associated with better OS and PFS in elderly patients with GBM treated with RT and TMZ...

..The potential advantages of combined chemoradiation schedules in patients with recurrent GBM need to be explored in future studies...

..Astroblastoma is a rare glial tumour about which little is known...

..In patients with multiple tumors, each tumor must be treated as an individual entity. The mere presence of multiple tumors does not justify their removal...

..We believe that it is important to achieve an early diagnosis of brain tumour in such patients with a clinical and neuroradiological follow up, so that they can be treated promptly...

..We conducted a prospective trial in 43 consecutive elderly patients with GBM treated with hypofractionated radiotherapy (RT) followed by adjuvant temozolomide...

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..We consider the pathogenetic hypotheses and problems of diagnosis, especially differential from other multifocal diseases of the central nervous system...

..The median survival was 16.3 months, ranging from 13 to 22 months. According to our experience, elderly patients should undergo the same treatment of younger patients, provided they are in good health conditions...

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..CONCLUSIONS: The postoperative radiotherapy in gliomas of the conus medullaris where total resection is not possible seems provide a beneficial effect on preventing tumour regrowth...

..In patients undergoing decompressive craniectomy, the bone flap is temporarily preserved either in the subcutaneous tissue of the patient or frozen. However, there are some drawbacks related to these methods...

..The fact that 88 cases have been reported in recent years suggests that a thorough biological, clinical studies be carried out on this association...

..Prognosis is influenced by preoperative clinical status and by the disease responsible for the formation of CSH...

..We discuss the clinical data and the differences of these rare tumors from those of spontaneous counterpart and radiation-induced meningiomas of the adult population...

..However, it is important to fully investigate brain lesions in patients with breast cancer so that potentially curable meningiomas are not considered as metastases...

..CONCLUSION: The authors conclude that total removal of fibroma should be extended to normal bone and in cases in which total removal is not possible the residue should be checked for regrowth by serial MRI...

..The prognosis after multimodality therapy (surgery, radiotherapy, chemotherapy) remains poor. From the literature, only four cases of paediatric patients with long-term survival have been reported...

..The basal transtemporal approach is particularly indicated to remove tumours of the temporal horn and trigone and it seems to reduce the risk of speech disturbances and alterations of posture...

..We also suggest that HBV and its X protein (HBX) might play an important role in such aggressive behavior of the neoplasia...

..It is still the first treatment for GH- and ACTH-secreting adenomas, whereas in patients with prolactinomas, surgery should be reserved for cases of resistance or intolerance to dopamine agonists...

..This case represents a radiologically visible supratentorial extra-pial subarachnoidal cavernous angioma. This case provides confirmation of one of the supposed causes of subarachnoid hemorrahage ''sine materia''...

..In the 9 patients who did not receive whole brain radiotherapy, the mean survival was 15 months and there was an higher frequency of brain relapse...

..Promising molecular biology studies are under way to evaluate the role of oncosuppresor gene expression in hepatocarcinogenesis and in the way the disease spreads...

..The possible adjuvant role of antineoplastic drugs is also discussed, and the literature on this topic is reviewed...

..However, survival of patients appears to be modified by the type of treatment performed...

..The possibility of an increase in cerebral blood flow following removal of CSH, makes slow, gradual decompression mandatory in all patients submitted to cranial trapanation...

..To evaluate efficacy of short-course radiotherapy in elderly and/or poor performance status patients with high grade glioma...

..Introduction of these approaches is relatively recent but promises a further refinement of their indications and surgical technique aimed at mimmismg postoperative morbidity...

..The systemic disease was still clinically silent. CONCLUSION: Our case involved only brain stem metastasis, probably implicating Batson's direct route of the paravertebral venous pathway...

..Although it is difficult to distinguish preoperatively the paraganglioma from other tumours of the cauda equina, like neurinoma or ependymoma, this neuroendocrine tumour should be included in differential diagnosis...

..Although the latter lengthens survival and reduces the incidence of metastases, it is not as efficacious as in primary sarcomas...

..However, atypical appearance of demyelinating lesions simulating a brain tumor is a possible well-known phenomenon...

..The authors describe the clinical and pathological remarks, together with treatment modalities, removal extent and overall survival, of 11 patients in whom brain metastases were detected more than 10 years from the primary tumor...

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..The unique feature of this case was the magnetic resonance image showing increased signal intensity in the paraspinal musculature consistent with a contusion, which probably formed after SMT. The pertinent literature is also reviewed...

..On the contrary, these should be scrupulously evaluated when deciding whether to employ this method for therapeutic purposes for relatively benign or congenital lesions (which generally affect young patients with a long life expectancy)...

..The purpose of this study was to describe our experience with such lesions in elderly patients and to establish their prognosis factors...

..The etiopathogenetic mechanisms and clinical features of our patients and those of the literature are discussed...

..Our experience confirms that surgery should be the treatment of choice for these lesions, in view of both their tendency to bleed and their straightforward surgical removal...

..4 cm in the right thyroid lobe. As far as we know, this patient is the third case of meningioma associated with parathyroid adenoma and papillary thyroid carcinoma described in the literature...

..Although the described case is unique, knowledge of the potential for this uncommon behavior in cutaneous SCC may be useful, especially because of its increasing incidence...

..Despite prognosis of gliosarcomas remains poor, a multidisciplinary approach (surgery, radiotherapy and chemotherapy) seems to be associated with slight more prolonged survival times...

..Multimodal treatment by surgery, radiation and chemotherapy is the best choice of treatment and leads to a median survival of about 20 months...

..Two of our patients have been studied by MRI, but we do not find predictive radiological finding of this particular association...

..Nevertheless, a concomitant use of temozolomide during radiotherapy does not seem to improve survival, although it does not increase toxicity...

..This is mandatory in patients with large metastases (diameter >3 cm)...

..These resulted in complete recovery. CONCLUSIONS: We support the efficacy and safety of this natural dural substitute treated with Tutoplast method...

..Surgical outcome combines low mortality with a high probability of functional recovery, especially when paraparesis is not severe and of relatively recent onset...

..The "atypical" neurocytoma seems to be a distinct entity, with a less favourable prognosis and a higher tendency to recur...

..It is important that every new case of meningeal SFT be reported to throw light on this particular tumor and to affirm its status as a clinicopathological entity...

..None of the patients had recurrence. CONCLUSIONS: Our results indicate that surgical dural repair in selected cases is related to low morbidity and mortality preserving from delayed risks such as recurrence and infections...

..We reserve surgical resection of necrotic tissue for patients whose clinical status worsens despite ventriculostomy, those for whom worsening is accompanied by signs of brainstem compression, and those with tight posterior fossae...

..The knowledge that this kind of tumor, particularly in young patients, may regress is important in the decision of the best therapeutic approach...

..The other cases described in the literature were also critically reviewed...

..We conclude that TSS is safe and well tolerated even in elderly patients, with a low incidence of minor complications. The indications for post-operative radiotherapy in patients with incomplete tumor resection should be better defined...

..All patients showed spinal stability. CONCLUSIONS: Multilevel oblique corpectomy was found to be a safe technique that guarantees good results in terms of both regression of clinical symptoms and long-term spinal stability...

..We describe a group of six families, in each of which more than one member had glioma, and discuss the probable mechanisms of oncogenesis in familial tumors in light of the pertinent literature...

..This consideration, in our opinion, is important, because more effort should be made to understand the pathogenesis of glioblastoma multiforme and to improve the therapeutic approaches...

..Surgical treatment with postoperative radiant therapy is necessary. These patients show improved quality of life, above all in relation to the maintenance of functional autonomy during the survival period...

..We wish to describe the position of the superior medullary velum (SMV) in midline posterior fossa tumours as a sign in helping to distinguish between midline medulloblastoma and midline astrocytoma...

..In selected cases, prompt surgical evacuation of the hematoma results in an excellent outcome. Outcomes seem to be directly related to the patient's preoperative neurologic status and the presence of associated intracranial lesions...