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Id: lil-681739
Autor: ÁLVAREZ, ANDRÉS M; LAMARRE, REYNALD.
Título: Estado del arte tumores de cresta neural, neurblastoma fisiopatología, diagnóóstico y tratamiento / State of art: neuural crest tumors, neuroblastoma (nb) pathophsiology, diagnoosis and treatment / Estado de arte: ttumores de cresta neural, neuroblastoma fisiopatologia, diagnóstico e tratamento
Fonte: Rev. MED;20(2):38-49, jul.-dic. 2012. ilus.
Idioma: es.
Resumo: El neuroblastoma es el tumor sólido extracraneal más frecuente en la infancia, con incidencia de 650 casos al año en los Estados Unidos de America y 100 casos por año en Italia y España. Se trata de un tumor que evoluciona de forma variable, desde la regresión espontánea hasta un comportamiento muy maligno, sobre todo en niños en edades mayores y con la existencia de enfermedad diseminada. Los signos y síntomas de presentación del neuroblastoma reflejan la localización del tumor y debido a las múltiples presentaciones clínicas, puede confundirse con gran variedad de patologías. Su tratamiento incluye la cirugía, la quimioterapia, la radioterapia y la terapia inmunológica. El papel de cada uno se determina anticipando el comportamiento clínico del tumor en cada caso, considerando la edad, el estadio y determinados parámetros biológicos. En los últimos 10 años, la estratificación por grupos de riesgo de los pacientes con neuroblastoma, basada en el análisis de un panel amplio de variables clínicas y biológicas, entre las que destacan la edad, el estadio y la amplificación del N-MYC, ha permitido un diagnóstico temprano y nuevas pautas para una mejoría importante en su tratamiento. El tratamiento del neuroblastoma se diseña hoy en día según grupos de riesgo, que se definen por parámetros clínicos y biológicos cada vez más sofisticados. El mejor conocimiento de la biología del neuroblastoma ha permitido distinguir entre aquellos tumores que pueden curarse con un tratamiento mínimo y los que requieren de un tratamiento multidisciplinario y complejo para tener posibilidades de curación. Es fundamental realizar al diagnóstico temprano con indicaciones de estadio y desarrollo de una terapia oportuna.

Neuroblastoma (NB) is the most common extracranial solid cancer in childhood and the most common cancer in infancy, with an annual incidence of about 650 cases per year in the US, and 100 cases per year in Italy and Spain. Roughly 50 percent of neuroblastoma cases occur in children younger than two years of age. It is a neuroendocrine tumor, arising from neural crest cells of the sympathetic nervous system (SNS). It most frequently originates in one of the adrenal glands, but can also develop in nerve tissues located in the neck, chest, abdomen, and pelvis. It is a highly variable tumor that can spontaneously regress or have highly malignant behavior, especially in older children with disseminated disease. Signs and symptoms of neuroblastoma reflect the presentation of tumor location and because of the multiple clinical presentations, can be confused with a variety of pathologies. Treatment modalities include surgery, chemotherapy, radiotherapy and immunotherapy. The role of each method is determined in advance of the clinical behavior of the tumor on a case specific basis, consideration of the age, stage and biological parameters. Over the past decade, stratification of patients with risk factors for neuroblastoma based on the analysis of a large panel of clinical and biological variables, among which are age, stage and N-MYC amplification, has allowed for early diagnosis and the generation of new guidelines for major advancements in treatment. Today, treatment of neuroblastoma has become increasingly sophisticated and is influenced by risk factors as well as clinical and biological parameters. A better understanding of the biology of neuroblastoma has allowed for the differentiation between tumors that can be cured with minimal treatment and those requiring a multidisciplinary and complex approach in order to have a chance of cure. Early diagnosis with staging is essential in the development of an appropriate therapy.

O neuroblastoma é o tumor sólido extra-craneal mais frequente na infância, com incidência de 650 casos por ano nos Estados Unidos da América e 100 casos por ano na Itália e Espanha. Trata-se de um tumor que evolui de forma variável, desde a regressão espontânea até um comportamento muito maligno, sobretudo em crianças com idades maiores e com a existência de doença disseminada. Os sinais e sintomas de apresentação do neuroblastoma refletem a localização do tumor e devido as múltiplas apresentações clínicas, pode ser confundido com uma grande variedade de patologias. Seu tratamento inclui a cirurgia, a quimioterapia, a radioterapia e a terapia imunológica. O papel de cada um é determinado antecipando o comportamento clínico do tumor em cada caso, considerando a idade, o estádio e determinados parâmetros biológicos. Nos últimos 10 anos, a estratificação por grupos de risco dos pacientes com neuroblastoma, baseada na análise de um painel amplo de variáveis clínicas e biológicas, entre as que destacam a idade, o estádio, e a amplificação do N-MYC, permitem um diagnostico precoce e novas pautas para uma melhoria importante no seu tratamento. O tratamento do neuroblastoma é feito hoje em dia de acordo com grupos de risco, que são definidos por parâmetros clínicos e biológicos cada vez mais sofisticados. O melhor conhecimento da biologia do neuroblastoma permitiu distinguir entre os tumores que podem ser curados com um tratamento mínimo e os que requerem um tratamento multidisciplinar e complexo para ter possibilidades de cura. É fundamental realizar o diagnóstico precoce com indicações de estádio e desenvolvimento de uma terapia oportuna.
Descritores: Neuroblastoma
-Neoplasias Encefálicas
Genes myc
Crista Neural
Limites: Humanos
Tipo de Publ: Artigo Clássico
Responsável: CO87.1 - Biblioteca Médica


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Texto completo SciELO Cuba
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Id: biblio-1127054
Autor: Sierra Benítez, Enrique Marcos; Álvarez Armas, Abel; León Pérez, Mairianny Quianella; Díaz Fiallo, Patricia; Castro Moreno, Ana María.
Título: Carcinoma escamoso epicraneal metastásico con invasión parenquimatosa cerebral, a propósito de un caso / Metastatic epicranial squamous carcinoma with parenchymal brain invasion, apropos of a case
Fonte: Rev. medica electron;42(3):1937-1947, mayo.-jun. 2020. graf.
Idioma: es.
Resumo: RESUMEN A nivel mundial se estiman que cada año se diagnostican aproximadamente 650 000 nuevos casos de cáncer escamoso de cabeza y cuello. Ocasionan 300 000 muertes y dos tercios de estos casos se originan en países en vías de desarrollo. Se presentó un caso de un paciente atendido en consulta a causa de crecimiento acelerado de la región frontotemporoparietal derecha, acompañado de sintomatología neurológica correspondiente a una afección funcional de los lóbulos parietal y temporal derecho. Se le realizó exámenes imagenológicos y biopsia por punción de la lesión, lo que arrojó un carcinoma escamoso como variedad histológica de la tumoración (AU).

ABSTRACT It is thought that around 650 000 new cases of head and neck squamous tumors are diagnosed in the world every year. They cause 300 000 deaths and two thirds of these cases are originated in developing countries. We presented the case of a patient who assisted the consultation due to the fast growth of the right frontotemporal parietal region, accompanied with neurological symptomatology corresponding to a functional disorder of the right parietal and temporal lobes. Imaging studies and a biopsy by lesion puncture were performed. It showed a squamous carcinoma as histological variant of the tumor (AU).
Descritores: Neoplasias Encefálicas
Carcinoma de Células Escamosas/diagnóstico
Espectroscopia de Ressonância Magnética
-Tabagismo/diagnóstico
Tabagismo/epidemiologia
Carcinoma de Células Escamosas/patologia
Carcinoma de Células Escamosas/radioterapia
Carcinoma de Células Escamosas/diagnóstico por imagem
Amnésia Anterógrada
Escala de Resultado de Glasgow
Hipertensão/diagnóstico
Oncologia
Neurocirurgia
Limites: Humanos
Masculino
Idoso
Tipo de Publ: Relatos de Casos
Responsável: CU424.1 - Centro Provincial de Información de Ciencias Médicas


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Texto completo SciELO Brasil
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Id: biblio-1249314
Autor: Wang, Yi; Zhou, Chuan; Luo, Huan; Cao, Jing; Ma, Chao; Cheng, Lulu; Yang, Yang.
Título: Prognostic implications of immune-related eight-gene signature in pediatric brain tumors
Fonte: Braz. j. med. biol. res = Rev. bras. pesqui. méd. biol;54(7):e10612, 2021. tab, graf.
Idioma: en.
Projeto: China Scholarship Council.
Resumo: Genomic studies have provided insights into molecular subgroups and oncogenic drivers of pediatric brain tumors (PBT) that may lead to novel therapeutic strategies. Participants of the cohort Pediatric Brain Tumor Atlas: CBTTC (CBTTC cohort), were randomly divided into training and validation cohorts. In the training cohort, Kaplan-Meier analysis and univariate Cox regression model were applied to preliminary screening of prognostic genes. The LASSO Cox regression model was implemented to build a multi-gene signature, which was then validated in the validation and CBTTC cohorts through Kaplan-Meier, Cox, and receiver operating characteristic curve (ROC) analyses. Also, gene set enrichment analysis (GSEA) and immune infiltrating analyses were conducted to understand function annotation and the role of the signature in the tumor microenvironment. An eight-gene signature was built, which was examined by Kaplan-Meier analysis, revealing that a significant overall survival difference was seen, either in the training or validation cohorts. The eight-gene signature was further proven to be independent of other clinic-pathologic parameters via the Cox regression analyses. Moreover, ROC analysis demonstrated that this signature owned a better predictive power of PBT prognosis. Furthermore, GSEA and immune infiltrating analyses showed that the signature had close interactions with immune-related pathways and was closely related to CD8 T cells and monocytes in the tumor environment. Identifying the eight-gene signature (CBX7, JADE2, IGF2BP3, OR2W6P, PRAME, TICRR, KIF4A, and PIMREG) could accurately identify patients' prognosis and the signature had close interactions with the immunodominant tumor environment, which may provide insight into personalized prognosis prediction and new therapies for PBT patients.
Descritores: Neoplasias Encefálicas/genética
Perfilação da Expressão Gênica
-Prognóstico
Regulação Neoplásica da Expressão Gênica
Proteínas de Ciclo Celular
Estimativa de Kaplan-Meier
Microambiente Tumoral
Complexo Repressor Polycomb 1
Limites: Humanos
Criança
Tipo de Publ: Ensaio Clínico Controlado Aleatório
Responsável: BR1.1 - BIREME


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Id: biblio-1249317
Autor: Xia, Lingyang; Jin, Peng; Tian, Wei; Liang, Shuang; Tan, Liye; Li, Binxin.
Título: Up-regulation of MARVEL domain-containing protein 1 (MARVELD1) accelerated the malignant phenotype of glioma cancer cells via mediating JAK/STAT signaling pathway
Fonte: Braz. j. med. biol. res = Rev. bras. pesqui. méd. biol;54(7):e10236, 2021. graf.
Idioma: en.
Resumo: This work aimed to research the function of MARVEL domain-containing protein 1 (MARVELD1) in glioma as well as its functioning mode. Bioinformatics analysis was utilized to assess the MARVELD1 expression in glioma tissues and its relationship with grade and prognosis, based on The Cancer Genome Atlas (TCGA), Genotype-Tissue Expression (GTEx), and Chinese Glioma Genome Atlas (CGGA) databases. Cell Counting Kit-8 (CCK-8), colony formation, and Transwell assays were carried out to determine the impact of MARVELD1 on malignant biological behavior of glioma, such as proliferation, invasion, and migration. qRT-PCR was carried out to test the mRNA level of MARVELD1. Western blot assay was performed to measure the protein expression of MARVELD1 and JAK/STAT pathway-related proteins. MARVELD1 was expressed at high levels in glioma tissues and cell lines. Kaplan-Meier survival analysis revealed that the higher MARVELD1 expression, the shorter the survival time of patients with glioma. Also, the MARVELD1 expression in WHO IV was significantly enhanced compared to that in WHO II and WHO III. Furthermore, the functional analysis of MARVELD1 in vitro revealed that knockdown of MARVELD1 in U251 cells restrained cell proliferation, migration, and invasion, while up-regulation of MARVELD1 in U87 cells presented opposite outcomes. Finally, we found that JAK/STAT signaling pathway mediated the function of MARVELD1 in glioma. MARVELD1 contributed to promoting the malignant progression of glioma, which is the key driver of activation of JAK/STAT signaling pathway in gliomas.
Descritores: Neoplasias Encefálicas
Glioma
-Fenótipo
Transdução de Sinais
Regulação Neoplásica da Expressão Gênica
Regulação para Cima
Movimento Celular
Linhagem Celular Tumoral
Proliferação de Células
Proteínas com Domínio MARVEL
Proteínas de Membrana
Camundongos Nus
Proteínas Associadas aos Microtúbulos
Limites: Humanos
Animais
Ratos
Responsável: BR1.1 - BIREME


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Texto completo SciELO Chile
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Id: biblio-1014439
Autor: Cabezón A, Rodrigo; Poblete V, María José; Ribalta L, Gloria.
Título: Lipoma intraóseo en la región esfenoclival: reporte de un caso y revisión de la literatura / Intraosseous lipoma in the sphenoclival region: case report and review of the literature
Fonte: Rev. otorrinolaringol. cir. cabeza cuello;79(2):207-212, jun. 2019. tab, graf.
Idioma: es.
Resumo: RESUMEN El lipoma intraóseo es un tumor mesenquimatoso poco frecuente que se presenta principalmente en el esqueleto apendicular. La localización dentro del cráneo, es aún más rara, y hasta la fecha solo se han descrito 6 casos en la literatura de lipomas intraóseos que comprometen la región esfenoclival. Por lo general, no presenta ningún síntoma y es un hallazgo incidental en el estudio de imágenes. Presentamos el caso de un paciente de 22 años de edad que consulta por obstrucción nasal y rinorrea mucosa de tres semanas de evolución. La tomografía computarizada y resonancia nuclear magnética evidenciaron una lesión en la región esfenoclival con características sugerentes de lipoma intraóseo. No se realiza estudio histopatológico. Con respecto al manejo, se decide hacer seguimiento radiológico. Se realizó una segunda resonancia magnética 4 meses después, sin cambios significativos.

ABSTRACT Intraosseous lipoma are a rare mesenchymal tumor that occurs primarily in the appendicular skeleton. Skull presentation is a rare finding, and only 6 cases have been described in literature so far of lipomas that compromise the sphenoclival region. In general, they are asymptomatic and occur as incidental findings in imaging studies. We present the case of a 22-year-old patient who consulted for nasal obstruction and mucous rhinorrhea of three weeks of evolution. Computed tomography and magnetic resonance imaging showed a lesion in the sphenoclival region suggestive of intraosseous lipoma. Histopathological study was not performed. Regarding management, radiological follow-up was decided. A second MRI was taken 4 months later, with no significant changes.
Descritores: Neoplasias Encefálicas/diagnóstico por imagem
Base do Crânio/patologia
Lipoma/patologia
-Neoplasias Encefálicas/cirurgia
Espectroscopia de Ressonância Magnética/métodos
Tomografia Computadorizada por Raios X/métodos
Diagnóstico Diferencial
Lipoma/diagnóstico por imagem
Limites: Humanos
Masculino
Adulto
Adulto Jovem
Tipo de Publ: Relatos de Casos
Revisão
Responsável: CL30.1 - Biblioteca


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Id: biblio-1045610
Autor: Sanka, S; Krishnamurthy, K; Vargas, A; Yale, C.
Título: Nasal lipoma with associated abnormalities of the corpus callosum
Fonte: West Indian med. j;62(2):154-154, Feb. 2013. ilus.
Idioma: en.
Descritores: Neoplasias Encefálicas/diagnóstico
Neoplasias Nasais/diagnóstico
Agenesia do Corpo Caloso/diagnóstico
Lipoma/diagnóstico
-Neoplasias Encefálicas/complicações
Recém-Nascido Prematuro
Imageamento por Ressonância Magnética
Neoplasias Nasais/complicações
Agenesia do Corpo Caloso/complicações
Lipoma/complicações
Neoplasias Primárias Múltiplas/complicações
Neoplasias Primárias Múltiplas/diagnóstico
Limites: Humanos
Recém-Nascido
Tipo de Publ: Relatos de Casos
Responsável: BR1.1 - BIREME


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Id: biblio-962742
Autor: Hoz, Samer Saad; Alkhaleeli, Ahmed Aman; Aktham, Awfa.
Título: Prolonged survival after surgical resection of cerebral metastasis from melanoma with multisystemic metastasis already present: a case report and literature review
Fonte: Säo Paulo med. j;136(4):372-375, July-Aug. 2018. tab, graf.
Idioma: en.
Resumo: ABSTRACT CONTEXT: Malignant melanoma is the third most common cause of cerebral metastases after breast and lung cancer. Despite advances in therapeutic options, the prognosis for patients with cerebral metastases from melanoma remains poor, with a median survival time of six months after diagnosis. CASE REPORT: A 65-year-old woman was diagnosed with a malignant melanoma on the third toe of her left foot.The tumorous spot was excised surgically. However, the melanoma reappeared after one year and skin biopsy confirmed recurrence of malignant melanoma. Investigations showed metastasis to the left pelvic region, left lobe of the liver and right lobe of the lung.The patient then received chemotherapy. Subsequently, the patient was brought to the emergency department with an altered level of consciousness (Glasgow coma scale: 9) and hemiplegia on the right side of her body. Computed tomography scans of the brain revealed hemorrhagic lesions in the parieto-occipital lobes of the brain. Urgent surgical evacuation was done to remove the lesion, following which the patient showed improvement in her score on the Glasgow coma scale and a concomitant decrease in weakness. She was discharged from hospital with full consciousness.The patient died of acute renal failure 14 months after the brain surgery and approximately 4 years after the initial presentation of the case. CONCLUSION: This case outcome is rare and shows the effectiveness of surgery to treat cerebral metastasis from malignant melanoma in a situation with multisystem metastasis already present.
Descritores: Neoplasias Cutâneas/patologia
Neoplasias Encefálicas/cirurgia
Dedos do Pé/patologia
Doenças do Pé/patologia
Melanoma/cirurgia
-Prognóstico
Neoplasias Cutâneas/mortalidade
Fatores de Tempo
Neoplasias Encefálicas/mortalidade
Neoplasias Encefálicas/secundário
Tomografia Computadorizada por Raios X
Análise de Sobrevida
Evolução Fatal
Melanoma/mortalidade
Melanoma/patologia
Limites: Humanos
Feminino
Idoso
Tipo de Publ: Relatos de Casos
Revisão
Responsável: BR1.1 - BIREME


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Aguiar, Guilherme Brasileiro de
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Id: biblio-979372
Autor: Paiva, Aline Lariessy Campos; Aguiar, Guilherme Brasileiro de; Lovato, Renan Maximilian; Zanetti, Arthus Vilar Deolindo; Panagopoulos, Alexandros Theodoros; Veiga, José Carlos Esteves.
Título: Cryptococcoma mimicking a brain tumor in an immunocompetent patient: case report of an extremely rare presentation
Fonte: Säo Paulo med. j;136(5):492-496, Sept.-Oct. 2018. tab, graf.
Idioma: en.
Resumo: ABSTRACT CONTEXT: Central nervous system (CNS) infectious diseases have high prevalence in developing countries and their proper diagnosis and treatment are very important for public health planning. Cryptococcus neoformans is a fungus that may cause several CNS manifestations, especially in immunocompromised patients. Cryptococcal meningitis is the most common type of involvement. Mass-effect lesions are uncommon: they are described as cryptococcomas and their prevalence is even lower among immunocompetent patients. The aim here was to report an extremely rare case of cryptococcoma causing a mass effect and mimicking a brain tumor in an immunocompetent patient. The literature on CNS cryptococcal infections was reviewed with emphasis on cryptococcomas. Clinical, surgical and radiological data on a female patient with this rare presentation of cryptococcoma mimicking a brain tumor are described. Case Report: A 54-year-old female patient presented to the emergency department with a rapid-onset progressive history of confusion and completely dependency for basic activities. Neuroimaging showed a left occipital lesion and neurosurgical treatment was proposed. From histopathological evaluation, a diagnosis of cryptococcoma was established. She received clinical support with antifungals, but despite optimal clinical treatment, her condition evolved to death. CONCLUSIONS: Cryptococcal infections have several forms of presentation and, in immunocompetent patients, their manifestation may be even more different. Cryptococcoma is an extremely rare presentation in which proper surgical and clinical treatment should be instituted as quickly as possible, but even so, there is a high mortality rate.
Descritores: Infecções Fúngicas do Sistema Nervoso Central/diagnóstico por imagem
Criptococose/diagnóstico por imagem
Cryptococcus neoformans/isolamento & purificação
Imunocompetência
-Neoplasias Encefálicas/patologia
Neoplasias Encefálicas/diagnóstico por imagem
Imageamento por Ressonância Magnética
Tomografia Computadorizada por Raios X
Hospedeiro Imunocomprometido
Evolução Fatal
Infecções Fúngicas do Sistema Nervoso Central/patologia
Criptococose/patologia
Doenças Raras/patologia
Doenças Raras/diagnóstico por imagem
Diagnóstico Diferencial
Limites: Humanos
Feminino
Pessoa de Meia-Idade
Tipo de Publ: Relatos de Casos
Responsável: BR1.1 - BIREME


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Texto completo SciELO Chile
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Id: biblio-902616
Autor: Jiménez, Daniel; Matamala, José Manuel; Chiti, Alessandra; Vergara, Carmen; Tissera, Claudia; Melo, Rómulo; Cartier, Luis.
Título: Expresión de O6-metilguanina-ADN-metiltransferasa (MGMT) en pacientes chilenos con glioblastoma multiforme / O6-methylguanine-DNA-methyltransferase (MGMT) expression in patients with glioblastoma multiforme
Fonte: Rev. méd. Chile;146(1):7-14, ene. 2018. tab, graf.
Idioma: es.
Resumo: Background: Patients with Glioblastoma multiforme (GBM) have a five years survival of less than 5%, but the response to chemotherapy with alkylating agents can vary depending on the methylation status of O6-methylguanine-DNA-methyltransferase (MGMT). Genetic testing has limitations for routine use, while immunohistochemistry (IHC) offers a fast and affordable technique but with heterogeneous results in the literature. Aim: To evaluate MGMT expression by IHC in tumor tissue of Chilean patients with GBM. Material and Methods: Tumor samples of 29 patients with a pathological diagnosis of GBM were studied. We performed IHC staining and manual analysis of positive and negative cells for MGMT expression. A cut-off of at least 10% of cells expressing MGMT was used. Demographic and clinical features of patients were obtained from clinical records. Results: The median number of cells counted per case was 692 (interquartile range [IQR] 492-928). Fifteen cases (52%) were positive for MGMT expression. Median overall survival was 5.3 months (IQR 3.4-12-8). The effect of MGMT expression on the therapeutic response was not studied since only 3 patients received chemotherapy. Conclusions: Our results are similar to international reports, but we were not able to determine the association between MGMT expression and therapeutic response.
Descritores: Neoplasias Encefálicas/enzimologia
Biomarcadores Tumorais/metabolismo
Glioblastoma/enzimologia
O(6)-Metilguanina-DNA Metiltransferase/metabolismo
-Prognóstico
Neoplasias Encefálicas/genética
Imuno-Histoquímica
Biomarcadores Tumorais
Regulação Neoplásica da Expressão Gênica
Chile
Taxa de Sobrevida
Estudos Retrospectivos
Glioblastoma/genética
O(6)-Metilguanina-DNA Metiltransferase/genética
Limites: Humanos
Masculino
Feminino
Adulto
Pessoa de Meia-Idade
Idoso
Responsável: CL1.1 - Biblioteca Central


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Id: biblio-1283496
Autor: Bulakbasi, Nail.
Título: Evaluación preoperatoria de los tumores cerebrales malignos mediante resonancia magnética con espectroscopia y difusión ponderada / Preoperative evaluation of solitary malignant brain tumors with MR spectroscopy and diffusion weighted imaging
Fonte: Salud(i)ciencia (Impresa) = Salud(i)ciencia (En linea);14(5):290-293, ago. 2006. ilus..
Idioma: es.
Resumo: One hundred eleven patients with solitary malignant brain tumors (55 low-, 31 high-grade gliomas, and 25 metastases) were prospectively evaluated. Gliomas classified as low- and highgrade by NAA/Cho, Cho/Cr, Lac/Cr and NADCT (p < 0.001). Higher degree of malignancy was associated with Cho/Cr (r = 0.648, p < 0.001), Lac/Cr (r = 0.583, p < 0.001), NAA/Cho (r = -0.657, p < 0.001) and NADCT (r = -0.473, p < 0.001). While NADCT , Lip/Cr (p < 0.001), NAA/Cho, Lac/Cr, NADCP and Cho/Cr (p < 0.05) could differentiate metastases from low-grade gliomas; NAA/Cho, Cho/Cr, Lip/Cr (p < 0.001), NAA/Cr, Lac/Cr and NADCP (p < 0.05) could differentiate them from high-grade gliomas. Except Lip/Cr ratio (p < 0.05), no parameter was useful to differentiate high grade gliomas from each other. Low-grade non-astrocytic gliomas had significantly higher Cho/Cr ratios than low-grade astrocytomas (p < 0.05). Furthermore pilocytic astrocytomas had significantly higher NAA/Cho and lesser NADCP than diffuse astrocytomas and low-grade non-astrocytic gliomas. Diffuse astrocytomas had also higher Lip/Cr than pilocytic astrocytomas, low-grade non-astrocytic gliomas and anaplastic astrocytomas. In the differentiation of tumor subgroups, highest Pearson correlation was found in Lip/Cr (r = 0.685, p < 0.001), NAA/Cho (r = -0.567, p < 0.001), NADCP (r = 0.522, p < 0.001), Lac/Cr (r = 0.437, p < 0.001) and Cho/Cr (r = 0.395, p < 0.001). MR spectroscopy and diffusion weighted images can support additional information to MR imaging in the differentiation and grading of malignant brain tumors

Se evaluaron en forma prospectiva 111 pacientes con tumores cerebrales malignos y solitarios (55 gliomas de bajo grado, 31 de alto grado, y 25 metástasis). Los gliomas fueron clasificados como de bajo y alto grado según NAA/Cho, Cho/Cr, Lac/Cr y CDANT (p < 0.001). Un grado mayor de malignidad se asoció con Cho/Cr (r = 0.648; p < 0.001); Lac/Cr (r = 0.583; p < 0.001); NAA/Cho (r = -0.657; p < 0.001); y CDANT (r = -0.473; p < 0.001). Mientras que CDANT , Lip/Cr (p < 0.001), NAA/Cho, Lac/Cr, CDANP y Cho/Cr (p < 0.05) pudieron diferenciar las metástasis de los gliomas de bajo grado; NAA/Cho, Cho/Cr, Lip/Cr (p < 0.001), NAA/Cr, Lac/Cr y CDANP (p < 0.05) pudieron diferenciarlas de los gliomas de alto grado. Excepto por la relación Lip/Cr (p < 0.05), ningún parámetro resultó de utilidad para diferenciar los gliomas de alto grado entre sí. Los gliomas no astrocíticos de bajo grado tuvieron relaciones Cho/Cr significativamente más elevadas que los astrocitomas de bajo grado (p < 0.05). Además, los astrocitomas pilocíticos tuvieron relaciones NAA/Cho significativamente más elevadas pero menores CDANP que los astrocitomas difusos y los gliomas no astrocíticos de bajo grado. Los astrocitomas difusos también presentaron relaciones Lip/Cr más elevadas que los de tipo pilocítico, los gliomas no astrocíticos de bajo grado y los anaplásicos. En la diferenciación de los subgrupos tumorales, la correlación de Pearson más elevada se halló en la relación Lip/Cr (r = 0.685; p < 0.001), NAA/Cho (r = -0.567; p < 0.001), CDANP (r = 0.522; p < 0.001), Lac/Cr (r = 0.437; p < 0.001) y Cho/Cr (r = 0.395; p < 0.001). La espectroscopia por resonancia magnética y las imágenes de difusión ponderada pueden aportar información adicional a las imágenes obtenidas mediante resonancia magnética para la diferenciación y estadificación de los tumores cerebrales malignos
Descritores: Neoplasias Encefálicas
Espectroscopia de Ressonância Magnética
Neoplasias Cerebelares
Diagnóstico Diferencial
Liberação de Cirurgia
Limites: Humanos
Masculino
Feminino
Responsável: AR392.1 - Biblioteca



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