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[PMID]: 29216385
[Au] Autor:Peyre M; Gauchotte G; Giry M; Froehlich S; Pallud J; Graillon T; Bielle F; Cazals-Hatem D; Varlet P; Figarella-Branger D; Loiseau H; Kalamarides M
[Ad] Address:Department of Neurosurgery, Groupe Hospitalier Pitié-Salpêtrière, France.
[Ti] Title:De novo and secondary anaplastic meningiomas: a study of clinical and histomolecular prognostic factors.
[So] Source:Neuro Oncol;, 2017 Dec 05.
[Is] ISSN:1523-5866
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Background: Following recent studies underlining the differences between de novo and secondary anaplastic meningiomas and the prognostic value of TERT promoter mutation, we decided to conduct a multicenter retrospective study to address these questions and determine specific prognostic factors in each of these two anaplastic meningioma subgroups. Methods: Among the 68 meningioma cases initially selected, only 57 were confirmed as anaplastic meningiomas after centralized pathological review. TERT promoter mutation analysis was performed in all cases. Results: Median overall survival was 2.6 years and 5-year survival rate was 10%. This study confirmed the better prognosis of de novo anaplastic meningiomas (28 tumors) compared to secondary anaplastic meningiomas (29 tumors) (p=0.02). In the "de novo" group, meningiomas diagnosed on histological anaplasia alone had a better prognosis than patients with a high number of mitoses with or without anaplasia (p=0.01). In the "secondary" group, tumors demonstrate very heterogeneous clinical courses leading to malignant transformation and time to first relapse as a low grade tumor was a strong predictor of overall survival (p=0.0007). TERT promoter mutation in anaplastic meningiomas was rare (14%) and did not influence overall survival, but was associated with a shorter recurrence-free survival in the secondary anaplastic meningioma subgroup (p=0.02). The absence of TERT promoter methylation, although rare (3/33 cases), may be associated with prolonged overall survival (p=0.02). Conclusion: This study highlights the different prognoses of de novo and secondary anaplastic meningiomas with specific prognostic factors in each subgroup. The analysis of TERT mutation and methylation could provide additional prognostic insights.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:Publisher
[do] DOI:10.1093/neuonc/nox231

  2 / 1357 MEDLINE  
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[PMID]: 29489901
[Au] Autor:Michaud K; de Tayrac M; D'Astous M; Paquet C; Gould PV; Saikali S
[Ad] Address:Department of Neurosurgery, Centre Hospitalier Universitaire de Québec, Québec, Canada.
[Ti] Title:Impact of 9p deletion and p16, Cyclin D1, and Myc hyperexpression on the outcome of anaplastic oligodendrogliomas.
[So] Source:PLoS One;13(2):e0193213, 2018.
[Is] ISSN:1932-6203
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVE: To study the presence of 9p deletion and p16, cyclin D1 and Myc expression and their respective diagnostic and prognostic interest in oligodendrogliomas. METHODS: We analyzed a retrospective series of 40 consecutive anaplastic oligodendrogliomas (OIII) from a single institution and compared them to a control series of 10 low grade oligodendrogliomas (OII). Automated FISH analysis of chromosome 9p status and immunohistochemistry for p16, cyclin D1 and Myc was performed for all cases and correlated with clinical and histological data, event free survival (EFS) and overall survival (OS). RESULTS: Chromosome 9p deletion was observed in 55% of OIII (22/40) but not in OII. Deletion was highly correlated to EFS (median = 29 versus 53 months, p<0.0001) and OS (median = 48 versus 83 months, p<0.0001) in both the total cohort and the OIII population. In 9p non-deleted oligodendrogliomas, p16 hyperexpression correlated with a shorter OS (p = 0.02 in OII and p = 0.0001 in OIII) whereas lack of p16 expression was correlated to a shorter EFS and OS in 9p deleted OIII (p = 0.001 and p = 0.0002 respectively). Expression of Cyclin D1 was significantly higher in OIII (median expression 45% versus 14% for OII, p = 0.0006) and was correlated with MIB-1 expression (p<0.0001), vascular proliferation (p = 0.002), tumor necrosis (p = 0.04) and a shorter EFS in the total cohort (p = 0.05). Hyperexpression of Myc was correlated to grade (median expression 27% in OII versus 35% in OIII, p = 0.03), and to a shorter EFS in 9p non-deleted OIII (p = 0.01). CONCLUSION: Chromosome 9p deletion identifies a subset of OIII with significantly worse prognosis. The combination of 9p status and p16 expression level identifies two distinct OIII populations with divergent prognosis. Hyperexpression of Bcl1 and Myc appears highly linked to anaplasia but the prognostic value is unclear and should be investigated further.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180228
[Lr] Last revision date:180228
[St] Status:In-Data-Review
[do] DOI:10.1371/journal.pone.0193213

  3 / 1357 MEDLINE  
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[PMID]: 29229328
[Au] Autor:Tsang DS; Burghen E; Klimo P; Boop FA; Ellison DW; Merchant TE
[Ad] Address:Department of Radiation Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee.
[Ti] Title:Outcomes After Reirradiation for Recurrent Pediatric Intracranial Ependymoma.
[So] Source:Int J Radiat Oncol Biol Phys;100(2):507-515, 2018 Feb 01.
[Is] ISSN:1879-355X
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:PURPOSE: To determine the long-term outcomes and the optimal dose and volume for reirradiation of recurrent pediatric ependymoma. METHODS AND MATERIALS: Patients with recurrent ependymoma treated with a second course of fractionated radiation therapy (RT2) were reviewed retrospectively. Eligible patients had localized, intracranial ependymoma at initial diagnosis that was treated with focal radiation (RT1) without craniospinal irradiation (CSI) and were aged ≤21 years at the time of RT2. The median doses of RT1, focal RT2, and CSI-RT2 were 59.4, 54, and 39.6 Gy, respectively. The primary endpoint, overall survival (OS), was measured from the first day of RT2. RESULTS: We included 101 patients in the study. The median interval between RT1 and RT2 was 26.8 months (interquartile range, 18.0-43.1). The median durations of OS and freedom from progression (FFP) were 75.1 and 27.3 months, respectively. Male sex and anaplastic histology at recurrence were associated with decreased OS and FFP on multivariate analysis. Distant-only failure treated with CSI-RT2 was independently associated with improved OS compared with individuals with local failure treated with focal RT2 (hazard ratio 0.37; 95% confidence interval 0.16-0.87). Among individuals experiencing any distant failure after RT1, gain of chromosome 1q was adversely associated with poorer OS (hazard ratio 3.5; 95% confidence interval 1.1-10.6). No distant-only failures were observed in individuals with RT1 local failure who received CSI-RT2 (n=10). The 10-year cumulative incidence of grade ≥3 radiation necrosis after RT2 was 7.9%. CONCLUSIONS: Reirradiation for relapsed pediatric ependymoma was well tolerated by most patients and resulted in long-term survival in a subset of patients. The best results were observed in patients who experienced distant-only failure after RT1 and were treated with CSI as part of RT2, without anaplasia at recurrence. The option of reirradiation should be discussed with patients who develop recurrent ependymoma.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180222
[Lr] Last revision date:180222
[St] Status:In-Data-Review

  4 / 1357 MEDLINE  
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[PMID]: 29211618
[Au] Autor:Fernandez CV; Mullen EA; Chi YY; Ehrlich PF; Perlman EJ; Kalapurakal JA; Khanna G; Paulino AC; Hamilton TE; Gow KW; Tochner Z; Hoffer FA; Withycombe JS; Shamberger RC; Kim Y; Geller JI; Anderson JR; Grundy PE; Dome JS
[Ad] Address:Conrad V. Fernandez, IWK Health Centre, Dalhousie University, Halifax, Nova Scotia; Paul E. Grundy, University of Alberta, Edmonton, Alberta, Canada; Elizabeth A. Mullen, Dana-Farber/Boston Children's Cancer and Blood Disorders Centre, Boston; Thomas E. Hamilton and Robert C. Shamberger, Boston Chil
[Ti] Title:Outcome and Prognostic Factors in Stage III Favorable-Histology Wilms Tumor: A Report From the Children's Oncology Group Study AREN0532.
[So] Source:J Clin Oncol;36(3):254-261, 2018 Jan 20.
[Is] ISSN:1527-7755
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Background The National Wilms Tumor Study (NWTS) approach to treating stage III favorable-histology Wilms tumor (FHWT) is Regimen DD4A (vincristine, dactinomycin, and doxorubicin) and radiation therapy. Further risk stratification is required to improve outcomes and reduce late effects. We evaluated clinical and biologic variables for patients with stage III FHWT without combined loss of heterozygosity (LOH) at chromosomes 1p and 16q treated in the Children's Oncology Group protocol AREN0532. Methods From October 2006 to August 2013, 588 prospectively treated, centrally reviewed patients with stage III FHWT were treated with Regimen DD4A and radiation therapy. Tumor LOH at 1p and 16q was determined by microsatellite analysis. Ineligible patients (n = 5) and those with combined LOH 1p/16q (n = 40) were excluded. Results A total of 535 patients with stage III disease were studied. Median follow-up was 5.2 years (range, 0.2 to 9.5). Four-year event-free survival (EFS) and overall survival estimates were 88% (95% CI, 85% to 91%) and 97% (95% CI, 95% to 99%), respectively. A total of 58 of 66 relapses occurred in the first 2 years, predominantly pulmonary (n = 36). Eighteen patients died, 14 secondary to disease. A better EFS was associated with negative lymph node status ( P < .01) and absence of LOH 1p or 16q ( P < .01), but not with gross residual disease or peritoneal implants. In contrast, the 4-year EFS was only 74% in patients with combined positive lymph node status and LOH 1p or 16q. A total of 123 patients (23%) had delayed nephrectomy. Submitted delayed nephrectomy histology showed anaplasia (n = 8; excluded from survival analysis); low risk/completely necrotic (n = 7; zero relapses), intermediate risk (n = 63; six relapses), and high-risk/blastemal type (n=7; five relapses). Conclusion Most patients with stage III FHWT had good EFS/overall survival with DD4A and radiation therapy. Combined lymph node and LOH status was highly predictive of EFS and should be considered as a potential prognostic marker for future trials.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180220
[Lr] Last revision date:180220
[St] Status:In-Data-Review
[do] DOI:10.1200/JCO.2017.73.7999

  5 / 1357 MEDLINE  
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[PMID]: 29419959
[Au] Autor:Rodríguez Iglesias P; Serrano Durbá A; Rodríguez Caraballo L; Balaguer Guill J; Povo Martín I; Domínguez Hinarejos C; Boronat Tormo F
[Ad] Address:Sección de Urología Infantil. Servicio de Urología. Hospital Universitari i Politècnic la Fe. Valencia.
[Ti] Title:Nefroblastoma. Experiencia a largo plazo en el abordaje multidisciplinario. [Nephroblastoma. Long-term experience in the multidisciplinary approach].
[So] Source:Cir Pediatr;31(1):46-51, 2018 Feb 01.
[Is] ISSN:0214-1221
[Cp] Country of publication:Spain
[La] Language:spa
[Ab] Abstract:OBJECTIVES: Main objective: to perform a descriptive study of patients with nephroblastoma, diagnostic tests, medical and surgical treatment. Secondary objective: to evaluate the rate of relapse and 5-year survival and risk factors for relapse and death. MATERIALS AND METHODS: Retrospective study of patients with nephroblastoma treated according to the protocol of the SIOP-2001. Demographic variables, comorbidities and associated syndromes were collected. Other data were tumor location, size, extent and stage. The relapse rate and the development of other secondary tumors as well as the long-term survival were also studied. RESULTS: We collected 33 patients with nephroblastoma. A biopsy was performed in 7 patients (21.2%). The Kaplan-Meir curve for event-free survival (tumor recurrence) was 84% with a 95% CI = [0.73-0.98] and the Kaplan-Meier overall survival curve was 0.93 95% CI [0.85-1]. Recurrence occurred in all patients before the first year. CONCLUSIONS: Nephroblastoma is a tumor with a favorable prognosis. The unfavorable histology as well as advanced stages are factors of a poor prognosis. The follow-up must be exhaustive during the first year after the diagnosis.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180208
[Lr] Last revision date:180208
[St] Status:In-Data-Review

  6 / 1357 MEDLINE  
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[PMID]: 29378601
[Au] Autor:Percicote AP; Mardegan GL; Gugelmim ES; Ioshii SO; Kuczynski AP; Nagashima S; de Noronha L
[Ad] Address:Federal University of Paraná, Curitiba, Brazil. appercicote@gmail.com.
[Ti] Title:Tissue expression of retinoic acid receptor alpha and CRABP2 in metastatic nephroblastomas.
[So] Source:Diagn Pathol;13(1):9, 2018 Jan 22.
[Is] ISSN:1746-1596
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Nephroblastoma or Wilms tumor is the most frequent kidney cancer in children and accounts for 98% of kidney tumors in this age group. Despite favorable prognosis, a subgroup of these patients progresses to recurrence and death. The retinoic acid (RA) pathway plays a role in the chemoprevention and treatment of tumors due to its effects on cell differentiation and its antiproliferative, anti-oxidant, and pro-apoptotic activities. Reports describe abnormal cellular retinoic acid-binding protein 2 (CRABP2) expression in neoplasms and its correlation with prognostic factors and clinical and pathological characteristics. The aim of this study was to evaluate the immunohistochemical expression of retinoic acid receptor alpha (RARA) and CRABP2 in paraffin-embedded samples of nephroblastomas via semiquantitative and quantitative analyses and to correlate this expression with prognostic factors. METHODS: Seventy-seven cases of nephroblastomas were selected from pediatric oncology services. The respective medical records and surgical specimens were reviewed. Three representative tumor samples and one non-tumor renal tissue sample were selected for the preparation of tissue microarrays (TMA). The Allred scoring system was used for semiquantitative immunohistochemical analyses, whereas a morphometric analysis of the stained area was employed for quantitative evaluation. The nonparametric Mann-Whitney test was used for comparisons between two groups, while the nonparametric Kruskal-Wallis test was used to compare three or more groups. RESULTS: Immunopositivity for RARA and CRABP2 was observed in both the nucleus and cytoplasm. All histological components of the nephroblastoma (blastema, epithelium, and stroma) were positive for both markers. RARA, based on semiquantitative analyses, and CRABP2, bases on quantitative analyses, exhibited increased immunohistochemical expression in patients with metastasis, with p values of 0.0247 and 0.0128, respectively. These findings were similar to the results of the quantitative analysis of RARA expression, showing greater immunopositivity in tumor samples of patients subjected to pre-surgical chemotherapy. No significant correlation was found with the other variables studied, such as disease stage, anaplasia, risk group, histological type, nodal involvement, and clinical evolution. CONCLUSIONS: Semiquantitative and quantitative analyses of the markers RARA and CRABP2 indicate their potential as biomarkers for tumor progression and their participation in nephroblastoma tumorigenesis.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180130
[Lr] Last revision date:180130
[St] Status:In-Process
[do] DOI:10.1186/s13000-018-0686-z

  7 / 1357 MEDLINE  
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[PMID]: 29278963
[Au] Autor:Bharani V; Sharma P; Bal A; Prakash G
[Ad] Address:1 Postgraduate Institute of Medical Education and Research, Chandigarh, India.
[Ti] Title:A Plasma Cell Myeloma With Post-Therapy Anaplastic Morphology, Osteomyelosclerosis, and Strong Pan-Cytokeratin (AE1/AE3) Expression: A Potential Diagnostic Pitfall.
[So] Source:Int J Surg Pathol;:1066896917750472, 2017 Dec 01.
[Is] ISSN:1940-2465
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Reactive and neoplastic plasma cells can display considerable morphological anaplasia as well as variable immunoreactivity for epithelial markers including epithelial membrane antigen, pan-cytokeratin (panCK) and high-molecular-weight cytokeratin, potentially creating diagnostic dilemmas. We describe the case of a 51-year-old male, previously treated for IgGλ plasma cell myeloma, whose bone marrow biopsy showed focal replacement by sheets of pleomorphic malignant cells and grade 3 myelofibrosis, raising the morphological possibility of a carcinomatous infiltration. First-line immunohistochemistry revealed strong panCK as well as CD138 positivity. However, subsequent MUM-1 and CD38 stains were also positive, clinching the diagnosis of relapsed plasma cell myeloma with anaplastic morphology and aberrant strong cytokeratin expression. The case warns of the perils of using limited immunohistochemical panels in poorly differentiated metastatic neoplasms and the importance of providing a complete clinical background to the reporting pathologist.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 171227
[Lr] Last revision date:171227
[St] Status:Publisher
[do] DOI:10.1177/1066896917750472

  8 / 1357 MEDLINE  
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[PMID]: 29153366
[Au] Autor:Yadav N; Rao S; Saini J; Prasad C; Mahadevan A; Sadashiva N
[Ad] Address:Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Bangalore-560029, India. Electronic address: nishthayadav@yahoo.com.
[Ti] Title:Papillary glioneuronal tumors: A radiopathologic correlation.
[So] Source:Eur J Radiol;97:44-52, 2017 Dec.
[Is] ISSN:1872-7727
[Cp] Country of publication:Ireland
[La] Language:eng
[Ab] Abstract:OBJECTIVE: Papillary glioneuronal tumors (PGNT) are a rare and recently recognized tumor entity. The neuroimaging findings were reviewed to determine if any specific findings emerge to assist a preoperative diagnosis of PGNT. MATERIALS AND METHODS: Seven histologically confirmed cases of PGNT were evaluated from 2004 to 2014. Clinical, neuroimaging and histological findings were reviewed and tabulated. RESULTS: Headache and seizures were observed in 4 patients (57.1%) each. The majority (n=5, 71.4%) of lesions were periventricular and located in temporal lobe with 57.1% cases being solid cystic (n=4), and 42.9% being purely solid (n=3). Calcification and hemorrhage were noted in 3 cases (42.9%) and 5 cases (71.4%) respectively. The most frequent imaging feature was the presence of septations in the cystic component that enhanced on contrast which correlated with long pseudopapillary projections into the cyst cavity on histopathology. The solid inner component demonstrated heterogeneous enhancement. One case with tumor recurrence demonstrated hemorrhage with superficial siderosis, patchy diffusion restriction, raised choline and focal areas of raised perfusion which correlated on histopathology with increased cellularity and anaplasia. CONCLUSION: Presence of cystic mass in periventricular location with septations and a solid inner component should raise a suspicion of PGNT on neuroimaging.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1711
[Cu] Class update date: 171120
[Lr] Last revision date:171120
[St] Status:In-Process

  9 / 1357 MEDLINE  
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[PMID]: 29135517
[Au] Autor:Bishop JA; Westra WH
[Ad] Address:*Department of Pathology, The Johns Hopkins University, Baltimore, MD †Department of Pathology, UT Southwestern Medical Center, Dallas, TX.
[Ti] Title:MYB Translocation Status in Salivary Gland Epithelial-Myoepithelial Carcinoma: Evaluation of Classic, Variant, and Hybrid Forms.
[So] Source:Am J Surg Pathol;, 2017 Nov 09.
[Is] ISSN:1532-0979
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Epithelial-myoepithelial carcinoma (EMC) is a malignant salivary gland neoplasm comprised of a biphasic arrangement of inner luminal ductal cells and outer myoepithelial cells. Adenoid cystic carcinoma (AdCC) is also a biphasic tumor comprised of ductal and myoepithelial cells, but these components tend to be arranged in a more cribriform pattern. The occurrence of "hybrid carcinomas" that show mixed patterns of EMC and AdCC raises questions about the relationship of these morphologically overlapping but clinically distinct tumors. AdCCs frequently harbor MYB-NFIB gene fusions. Mapping of EMCs (including hybrid forms with an AdCC component) for this fusion could help clarify the true nature of EMC as a distinct entity or simply as some variant form of AdCC. Twenty-nine cases of EMC were evaluated including 15 classic low-grade EMCs, 7 intermediate-grade EMCs, 2 EMCs with myoepithelial anaplasia, 1 EMC with high-grade transformation, and 4 hybrid EMCs with an AdCC component. Break apart fluorescence in situ hybridization for MYB was performed, as was MYB immunohistochemistry. For the hybrid carcinomas and those with high-grade transformation, the divergent tumor components were separately analyzed. A MYB translocation was identified in 5 of 28 (18%) tumors including 3 of 4 (75%) hybrid carcinomas and 2 of 7 (29%) intermediate-grade EMCs. For the positive hybrid carcinomas, the fusion was detected in both the EMC and AdCC components. The MYB fusion was not detected in any of the classic EMCs (0/15) or in any of the EMCs with myoepithelial anaplasia (0/2) or high-grade transformation (0/1). The fluorescence in situ hybridization assay was unsuccessful in 1 case. MYB immunostaining was seen in 5 of 5 fusion-positive cases, and also 9 of 23 fusion-negative tumors. Classic low-grade EMCs are genetically distinct from AdCCs in that they do not harbor MYB fusions. The presence of a MYB fusion in EMCs showing hybrid features of AdCC or exhibiting highly infiltrative growth points to a subset of these tumors that may well be true AdCCs masquerading as EMCs.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1711
[Cu] Class update date: 171114
[Lr] Last revision date:171114
[St] Status:Publisher
[do] DOI:10.1097/PAS.0000000000000990

  10 / 1357 MEDLINE  
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[PMID]: 29129767
[Au] Autor:Al-Tamimi YZ; Palin MS; Patankar T; MacMullen-Price J; O'Hara DJ; Loughrey C; Chakrabarty A; Ismail A; Roberts P; Duffau H; Goodden JR; Chumas PD
[Ad] Address:Department of Neurosurgery, Leeds Teaching Hospital NHS Trust, Great George Street, Leeds, UK LS1 3EX; Department of Neurosurgery, Sheffield Teaching Hospitals NHS Foundation Trust, Glossop Road, Sheffield, UK S10 2JF.
[Ti] Title:Low-grade glioma with foci of early transformation does not necessarily require adjuvant therapy following radical surgical resection.
[So] Source:World Neurosurg;, 2017 Nov 09.
[Is] ISSN:1878-8769
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Low-grade glioma (LGG) is a slow-growing tumour often found in young adults with minimal or no symptoms. As opposed to true 'low-grade' lesions like dysembryoplastic neuroepithelial tumours (DNETs), they are associated with continuous growth and inevitable malignant transformation. METHOD: Case series of patients who have had en-bloc resection of low-grade glioma with foci of anaplasia found within embedded within the tumour specimen and not at margins. Patients offered and agreed to a conservative approach avoiding adjuvant therapy. RESULTS: In the current case series, we describe a small subset of LGG that have demonstrated foci of high-grade glioma but have exhibited behaviour and growth tendencies similar to LGG following radical surgical resection. All patients have to-date not exhibited recurrent disease requiring adjuvant therapy. CONCLUSION: This case series supports the use of early aggressive surgical treatment of grade II gliomas that are in fact pre-malignant. It acts as proof of concept that following radical resection, the presence of small foci of transformation embedded within grade II tumour may be treated with close radiological surveillance rather than immediate adjuvant therapy.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1711
[Cu] Class update date: 171113
[Lr] Last revision date:171113
[St] Status:Publisher


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