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[PMID]:28463397
[Au] Autor:Murray MJ; Bailey S; Heinemann K; Mann J; Göbel UK; Saran F; Hale JP; Calaminus G; Nicholson JC
[Ad] Endereço:Department of Paediatric Haematology and Oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, CB2 0QQ, United Kingdom.
[Ti] Título:Treatment and outcomes of UK and German patients with relapsed intracranial germ cell tumors following uniform first-line therapy.
[So] Source:Int J Cancer;141(3):621-635, 2017 08 01.
[Is] ISSN:1097-0215
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:We aimed to retrospectively assess treatments/outcomes, including the value of high-dose-chemotherapy and autologous-stem-cell-rescue (HDC + AuSCR) and re-irradiation, in a large, European patient-cohort with relapsed intracranial germ-cell-tumors (GCTs) receiving uniform first-line therapy, including radiotherapy as standard-of-care. Fifty-eight UK/German patients (48 male/10 female) with relapsed intracranial-GCTs [13 germinoma/45 non-germinomatous GCT (NGGCT)] treated 1996-2010 as per the SIOP-CNS-GCT-96 protocol were evaluated. For germinoma, six patients relapsed with germinoma and five with NGGCT (one palliative, one teratoma patient excluded). Five-year overall-survival (OS) for the whole-group (n = 11) was 55%. Four of six germinoma relapses and two of five relapsing with NGGCT were salvaged; patients were salvaged with either standard-dose-chemotherapy (SDC) and re-irradiation or HDC + AuSCR with/without re-irradiation. Of 45 relapsed NGGCT patients, 13 were excluded (three non-protocol adherence, five teratoma, five palliation). Five-year OS for the remaining 32 relapsed malignant NGGCT patients treated with curative intent was 9% (95%CI: 2-26%). By treatment received, 5-year OS for the 10 patients receiving SDC and 22 patients treated with intention for HDC + AuSCR was 0% (0-0%) and 14% (3-36%), respectively. The three relapsed NGGCT survivors had raised HCG markers alone; two received additional irradiation. Patients with relapsed germinoma had better 5-year OS than those with relapsed NGGCT (55 vs. 9%; p = 0.007). Patients with relapsed germinoma were salvaged both with SDC and re-irradiation or HDC + AuSCR with/without re-irradiation; both represent valid treatment options. Outcomes for malignant relapse following initial diagnosis of NGGCT were exceptionally poor; the few survivors received thiotepa-based HDC + AuSCR, which is a treatment option at first malignant relapse for such patients, with further surgery/irradiation where feasible.
[Mh] Termos MeSH primário: Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Neoplasias Encefálicas/terapia
Germinoma/terapia
Recidiva Local de Neoplasia/terapia
Neoplasias Embrionárias de Células Germinativas/terapia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Neoplasias Encefálicas/patologia
Criança
Pré-Escolar
Terapia Combinada
Feminino
Seguimentos
Alemanha
Germinoma/patologia
Seres Humanos
Lactente
Masculino
Recidiva Local de Neoplasia/patologia
Estadiamento de Neoplasias
Neoplasias Embrionárias de Células Germinativas/patologia
Prognóstico
Estudos Retrospectivos
Taxa de Sobrevida
Reino Unido
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:180208
[Lr] Data última revisão:
180208
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE
[do] DOI:10.1002/ijc.30755


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[PMID]:28693060
[Au] Autor:Wei Q; Zang L; Li YJ; Gu WJ; Jin N; Guo QH; Du J; Ba JM; Lyu ZH; Lu JM; Dou JT; Mu YM; Yang GQ
[Ad] Endereço:Department of Endocrinology, Chinese PLA General Hospital, Beijing 100853, China.
[Ti] Título:[An analysis of four cases of misdiagnosed primary lymphocytic hypophysitis].
[So] Source:Zhonghua Nei Ke Za Zhi;56(7):512-515, 2017 Jul 01.
[Is] ISSN:0578-1426
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:To improve the differential diagnosis of sellar region mass, 4 cases with sellar mass and misdiagnosed as lymphocytic hypophysitis (LYH) were reviewed retrospectively.The 4 patients (2 male and 2 female) aged 20-60 years old were all presented with symptoms of headache, polydipsia and polyuria.Biochemical studies confirmed the diagnoses of central diabetes insipidus and hypopituitarism.Head MRI scans showed LYH like image for all the cases, and, thus, high dose methylprednisolone pulse therapy (HDMPT) was applied to the patients.Their symptoms deteriorated and the sellar mass enlarged after a short period of partial improvement.Operations were performed in all the patients.Histology study showed craniopharyngioma with abscess, primary abscess, secondary hypophysitis caused by Wegener's granulomatosis, and germinoma with secondary hypophysitis, respectively.In conclusion, surgery or biopsy is necessary for those who presented with sellar region mass and was suspected to be with LYH, but with poor response or even worse after HDMPT.
[Mh] Termos MeSH primário: Diabetes Insípido/complicações
Germinoma/complicações
Hipofisite/complicações
Hipopituitarismo/etiologia
Imagem por Ressonância Magnética
Doenças da Hipófise/etiologia
[Mh] Termos MeSH secundário: Abscesso
Adulto
Biópsia
Feminino
Germinoma/patologia
Cefaleia
Seres Humanos
Hipofisite/diagnóstico
Hipopituitarismo/diagnóstico por imagem
Hipopituitarismo/patologia
Masculino
Meia-Idade
Doenças da Hipófise/diagnóstico por imagem
Doenças da Hipófise/patologia
Estudos Retrospectivos
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170904
[Lr] Data última revisão:
170904
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170711
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.0578-1426.2017.07.008


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[PMID]:28614211
[Au] Autor:Gru AA; Williams ES; Cao D
[Ad] Endereço:*Departments of Pathology, University of Virginia, Charlottesville, VA †Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO.
[Ti] Título:Mixed Gonadal Germ Cell Tumor Composed of a Spermatocytic Tumor-Like Component and Germinoma Arising in Gonadoblastoma in a Phenotypic Woman With a 46, XX Peripheral Karyotype: Report of the First Case.
[So] Source:Am J Surg Pathol;41(9):1290-1297, 2017 Sep.
[Is] ISSN:1532-0979
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:We report a unique case of gonadal mixed germ cell tumor (GCT) composed of a predominantly spermatocytic tumor (ST)-like component and a minor component of germinoma arising in gonadoblastoma in a phenotypic woman with a 46, XX peripheral karotype. The patient was a 24-year-old woman (gravida 2, para 1) found to have a 7 cm pelvic mass during routine obstetric ultrasound examination at 20 weeks gestational age. She underwent a left salpingo-gonadectomy at gestational age 23 and 2/7 weeks. She recovered well and delivered a healthy baby at full term. The resected gonadal tumor measured 7.5 cm and microscopically was composed of 3 morphologically distinct components: gonadoblastoma (1%), germinoma (1%) and a ST-like component (98%). The ST-like component was composed of 3 populations of tumor cells: small cells, intermediate and large sized cells, similar to testicular ST. Scattered binucleated and multinucleated cells were present. Immunohistochemically the ST-like component was positive for pan-GCT markers SALL4 and LIN28 but with weaker staining than the germinoma. It was negative for OCT4 and TCL1. Only rare tumor cells were positive for SOX17. In contrast, the germinoma cells were diffusely and strongly positive for SALL4, LIN28, OCT4, SOX17, and TCL1. CD117 was positive in both the germinoma and ST-like component but with fewer tumor cells positive in the latter. Flurorescence in situ hybridization study demonstrated isochromosome 12p in the germinoma component but not in the gonadoblastoma and ST-like component. This patient did not receive further chemoradiation therapy after the surgery. She has been free of disease for 10 years and 1 month since her surgery. To our knowledge, this is the first case report of a ST-like GCT in a phenotypic female.
[Mh] Termos MeSH primário: Germinoma/patologia
Gonadoblastoma/patologia
Neoplasias Embrionárias de Células Germinativas/patologia
Neoplasias Primárias Múltiplas/genética
Neoplasias Ovarianas/patologia
Complicações Neoplásicas na Gravidez/patologia
[Mh] Termos MeSH secundário: Cromossomos Humanos X
Feminino
Germinoma/genética
Gonadoblastoma/genética
Seres Humanos
Cariotipagem
Neoplasias Embrionárias de Células Germinativas/genética
Neoplasias Ovarianas/genética
Fenótipo
Gravidez
Complicações Neoplásicas na Gravidez/genética
Adulto Jovem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170914
[Lr] Data última revisão:
170914
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170615
[St] Status:MEDLINE
[do] DOI:10.1097/PAS.0000000000000888


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[PMID]:28551652
[Au] Autor:Scherz A; Feller K; Berezowska S; Genitsch V; Zweifel M
[Ad] Endereço:Department of Medical Oncology, University Hospital Bern, Bern, Switzerland.
[Ti] Título:Successful Treatment of Pituitary Germinoma with Etoposide, Cisplatin, Vincristine, Methotrexate and Bleomycin Chemotherapy Without Radiotherapy.
[So] Source:Anticancer Res;37(6):3111-3115, 2017 06.
[Is] ISSN:1791-7530
[Cp] País de publicação:Greece
[La] Idioma:eng
[Ab] Resumo:We report on the case of a 25-year-old man with pituitary germinoma. The patient had noticed polydipsia, reduced sexual function, and loss of body hair. Laboratory investigations confirmed panhypopituitarism including diabetes insipidus. Magnetic resonance imaging of the brain showed a 14×8.4 mm enhancing lesion of the pituitary stalk and histopathology of the neurosurgical biopsy confirmed pituitary germinoma. The patient was treated with 3 cycles of chemotherapy, consisting of 150 mg/m etoposide and 75 mg/m cisplatin, with the administration of intrathecal 12.5 mg methotrexate, on day one, alternating every 10 to 11 days with 1 mg/m vincristine, 1,000 mg/m methotrexate on day 1 and 30 mg/m bleomycin on day 2. MRI scans showed lasting complete remission more than a year after completion of chemotherapy. Intracranial germinomas are exquisitely sensitive to radiation. However, due to concerns of side-effects (radiation-associated tumour, relapse outside the radiation field, mental and pituitary hormonal dysfunction), and after discussing both approaches carefully with the patient, the decision was made to treat his pituitary germinoma with chemotherapy alone. Further studies should address the question as to whether a modulated approach, using radiotherapy only as a salvage in patients with relapse, might result in a better overall outcome, given the potentially harmful long-term side-effects of radiotherapy to the brain.
[Mh] Termos MeSH primário: Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Bleomicina/administração & dosagem
Cisplatino/administração & dosagem
Etoposídeo/administração & dosagem
Germinoma/tratamento farmacológico
Metotrexato/administração & dosagem
Neoplasias Hipofisárias/tratamento farmacológico
Vincristina/administração & dosagem
[Mh] Termos MeSH secundário: Adulto
Biomarcadores Tumorais/análise
Biópsia
Esquema de Medicação
Germinoma/química
Germinoma/diagnóstico por imagem
Germinoma/patologia
Seres Humanos
Imuno-Histoquímica
Imagem por Ressonância Magnética
Masculino
Neoplasias Hipofisárias/química
Neoplasias Hipofisárias/diagnóstico por imagem
Neoplasias Hipofisárias/patologia
Indução de Remissão
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers, Tumor); 11056-06-7 (Bleomycin); 5J49Q6B70F (Vincristine); 6PLQ3CP4P3 (Etoposide); Q20Q21Q62J (Cisplatin); YL5FZ2Y5U1 (Methotrexate)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170821
[Lr] Data última revisão:
170821
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170529
[St] Status:MEDLINE


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[PMID]:28436607
[Au] Autor:Frappaz D; Pedone C; Thiesse P; Szathmari A; Conter CF; Mottolese C; Carrie C
[Ad] Endereço:Department of Oncology, Institut d'Hématologie et d'Oncologie Pédiatrique, Lyon, France.
[Ti] Título:Visual complaints in intracranial germinomas.
[So] Source:Pediatr Blood Cancer;64(10), 2017 Oct.
[Is] ISSN:1545-5017
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Patients with brain tumors often report having visual complaints. This may be due to increased intracranial pressure, compression/invasion of the optic pathway or diplopia. We assessed the incidence and the etiology of visual symptoms in patients with intracranial germinoma tumors (ICGTs). METHODS AND MATERIALS: We performed a blinded retrospective review of the clinical charts and the initial magnetic resonance imaging (MRI) of 28 patients with ICGT. Thirteen tumors were pineal, five suprasellar, seven bifocal, and further three involved either the optic nerve, the corpus callosum, or the brainstem. RESULTS: Twelve patients reported visual disturbances, seven of whom mainly experienced a decrease in vision. Two of those were initially managed as "retrobulbar neuritis" when endocrinologic symptoms prompted assessment by MRI. Involvement of the optic pathway was underestimated, and both relapsed. Field deficits were definitive sequelae, whereas visual acuity was sometimes regressive in the absence of optic atrophy. CONCLUSIONS: Compression or invasion of the optic pathway by germinomas is not a rare occurrence, and this possibility should not be overlooked when thickening or contrast enhancement is detected. Radiotherapy fields should be extended accordingly.
[Mh] Termos MeSH primário: Neoplasias Encefálicas
Diplopia
Germinoma
Imagem por Ressonância Magnética
Síndromes de Compressão Nervosa
Doenças do Nervo Óptico
[Mh] Termos MeSH secundário: Adolescente
Adulto
Neoplasias Encefálicas/diagnóstico por imagem
Neoplasias Encefálicas/epidemiologia
Neoplasias Encefálicas/fisiopatologia
Criança
Diplopia/diagnóstico por imagem
Diplopia/epidemiologia
Diplopia/fisiopatologia
Feminino
Germinoma/diagnóstico por imagem
Germinoma/epidemiologia
Germinoma/fisiopatologia
Seres Humanos
Pressão Intracraniana
Masculino
Síndromes de Compressão Nervosa/diagnóstico por imagem
Síndromes de Compressão Nervosa/epidemiologia
Síndromes de Compressão Nervosa/fisiopatologia
Nervo Óptico/diagnóstico por imagem
Nervo Óptico/fisiopatologia
Doenças do Nervo Óptico/diagnóstico por imagem
Doenças do Nervo Óptico/epidemiologia
Doenças do Nervo Óptico/fisiopatologia
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170425
[St] Status:MEDLINE
[do] DOI:10.1002/pbc.26543


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[PMID]:28228150
[Au] Autor:Takizawa D; Mizumoto M; Yamamoto T; Oshiro Y; Fukushima H; Fukushima T; Terunuma T; Okumura T; Tsuboi K; Sakurai H
[Ad] Endereço:Department of Radiation Oncology, University of Tsukuba, Tsukuba, Ibaraki, Japan. dtakizawa@pmrc.tsukuba.ac.jp.
[Ti] Título:A comparative study of dose distribution of PBT, 3D-CRT and IMRT for pediatric brain tumors.
[So] Source:Radiat Oncol;12(1):40, 2017 Feb 22.
[Is] ISSN:1748-717X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: It was reported that proton beam therapy (PBT) reduced the normal brain dose compared with X-ray therapy for pediatric brain tumors. We considered whether there was not the condition that PBT was more disadvantageous than intensity modulated photon radiotherapy (IMRT) and 3D conventional radiotherapy (3D-CRT) for treatment of pediatric brain tumors about the dose reduction for the normal brain when the tumor location or tumor size were different. METHODS: The subjects were 12 patients treated with PBT at our institute, including 6 cases of ependymoma treated by local irradiation and 6 cases of germinoma treated by irradiation of all four cerebral ventricles. IMRT and 3D-CRT treatment plans were made for these 12 cases, with optimization using the same planning conditions as those for PBT. Model cases were also compared using sphere targets with different diameters or locations in the brain, and the normal brain doses with PBT, IMRT and 3D-CRT were compared using the same planning conditions. RESULTS: PBT significantly reduced the average dose to normal brain tissue compared to 3D-CRT and IMRT in all cases. There was no difference between 3D-CRT and IMRT. The average normal brain doses for PBT, 3D-CRT, and IMRT were 5.1-34.8% (median 14.9%), 11.0-48.5% (23.8%), and 11.5-53.1% (23.5%), respectively, in ependymoma cases; and 42.3-61.2% (48.9%), 54.5-74.0% (62.8%), and 56.3-72.1% (61.2%), respectively, in germinoma cases. In the model cases, PBT significantly reduced the average normal brain dose for larger tumors and for tumors located at the periphery of the brain. CONCLUSION: PBT reduces the average dose to normal brain tissue, compared with 3D-CRT and IMRT. The effect is higher for a tumor that is larger or located laterally.
[Mh] Termos MeSH primário: Neoplasias Encefálicas/radioterapia
Ependimoma/radioterapia
Germinoma/radioterapia
Terapia com Prótons/métodos
[Mh] Termos MeSH secundário: Adolescente
Criança
Pré-Escolar
Feminino
Seres Humanos
Masculino
Dosagem Radioterapêutica
Planejamento da Radioterapia Assistida por Computador
Radioterapia Conformacional/métodos
Radioterapia de Intensidade Modulada/métodos
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170613
[Lr] Data última revisão:
170613
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170224
[St] Status:MEDLINE
[do] DOI:10.1186/s13014-017-0775-2


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[PMID]:28189312
[Au] Autor:Nagasawa DT; Lagman C; Sun M; Yew A; Chung LK; Lee SJ; Bui TT; Ooi YC; Robison RA; Zada G; Yang I
[Ad] Endereço:Department of Neurosurgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States.
[Ti] Título:Pineal germ cell tumors: Two cases with review of histopathologies and biomarkers.
[So] Source:J Clin Neurosci;38:23-31, 2017 Apr.
[Is] ISSN:1532-2653
[Cp] País de publicação:Scotland
[La] Idioma:eng
[Ab] Resumo:Pineal germ cell tumors (GCTs) are primarily seen in pediatric and Asian populations. These tumors are divided into germinomatous and non-germinomatous GCTs (NGGCTs). GCTs are thought to arise by misplacement of totipotent stem cells en route to gonads during embryogenesis. Intracranial GCTs display an affinity to develop along the pineal-suprasellar axis and have variable manifestations dependent upon the location of the tumor. Management and outcomes are driven by histopathologies. In this study, we highlight two cases of pineal GCTs and present a review of the literature with an emphasis on histopathologies and biomarkers.
[Mh] Termos MeSH primário: Biomarcadores Tumorais
Neoplasias Encefálicas/patologia
Germinoma/patologia
Glândula Pineal/patologia
[Mh] Termos MeSH secundário: Adulto
Seres Humanos
Masculino
Adulto Jovem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Biomarkers, Tumor)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170510
[Lr] Data última revisão:
170510
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170213
[St] Status:MEDLINE


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[PMID]:28078450
[Au] Autor:Fukushima S; Yamashita S; Kobayashi H; Takami H; Fukuoka K; Nakamura T; Yamasaki K; Matsushita Y; Nakamura H; Totoki Y; Kato M; Suzuki T; Mishima K; Yanagisawa T; Mukasa A; Saito N; Kanamori M; Kumabe T; Tominaga T; Nagane M; Iuchi T; Yoshimoto K; Mizoguchi M; Tamura K; Sakai K; Sugiyama K; Nakada M; Yokogami K; Takeshima H; Kanemura Y; Matsuda M; Matsumura A; Kurozumi K; Ueki K; Nonaka M; Asai A; Kawahara N; Hirose Y; Takayama T; Nakazato Y; Narita Y; Shibata T; Matsutani M; Ushijima T; Nishikawa R; Ichimura K; Intracranial Germ Cell Tumor Genome Analysis Consortium (The iGCTConsortium)
[Ad] Endereço:Division of Brain Tumor Translational Research, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
[Ti] Título:Genome-wide methylation profiles in primary intracranial germ cell tumors indicate a primordial germ cell origin for germinomas.
[So] Source:Acta Neuropathol;133(3):445-462, 2017 Mar.
[Is] ISSN:1432-0533
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:Intracranial germ cell tumors (iGCTs) are the second most common brain tumors among children under 14 in Japan. The World Health Organization classification recognizes several subtypes of iGCTs, which are conventionally subclassified into pure germinoma or non-germinomatous GCTs. Recent exhaustive genomic studies showed that mutations of the genes involved in the MAPK and/or PI3K pathways are common in iGCTs; however, the mechanisms of how different subtypes develop, often as a mixed-GCT, are unknown. To elucidate the pathogenesis of iGCTs, we investigated 61 GCTs of various subtypes by genome-wide DNA methylation profiling. We showed that pure germinomas are characterized by global low DNA methylation, a unique epigenetic feature making them distinct from all other iGCTs subtypes. The patterns of methylation strongly resemble that of primordial germ cells (PGC) at the migration phase, possibly indicating the cell of origin for these tumors. Unlike PGC, however, hypomethylation extends to long interspersed nuclear element retrotransposons. Histologically and epigenetically distinct microdissected components of mixed-GCTs shared identical somatic mutations in the MAPK or PI3K pathways, indicating that they developed from a common ancestral cell.
[Mh] Termos MeSH primário: Neoplasias Encefálicas/genética
Germinoma/genética
Transdução de Sinais/genética
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Criança
Pré-Escolar
Instabilidade Cromossômica/genética
Metilação de DNA
Análise Mutacional de DNA
Feminino
Células Germinativas
Seres Humanos
Lactente
Japão
Elementos Nucleotídeos Longos e Dispersos/genética
Masculino
Meia-Idade
Quinases de Proteína Quinase Ativadas por Mitógeno/genética
Mutação
Fosfatidilinositol 3-Quinases/genética
RNA Mensageiro/metabolismo
Estatísticas não Paramétricas
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (RNA, Messenger); EC 2.7.1.- (Phosphatidylinositol 3-Kinases); EC 2.7.12.2 (Mitogen-Activated Protein Kinase Kinases)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170920
[Lr] Data última revisão:
170920
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170113
[St] Status:MEDLINE
[do] DOI:10.1007/s00401-017-1673-2


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[PMID]:28034815
[Au] Autor:Kinoshita Y; Yamasaki F; Tominaga A; Usui S; Arita K; Sakoguchi T; Sugiyama K; Kurisu K
[Ad] Endereço:Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan. Electronic address: y-kinoshita@hiroshima-u.ac.jp.
[Ti] Título:Transsphenoidal Posterior Pituitary Lobe Biopsy in Patients with Neurohypophysial Lesions.
[So] Source:World Neurosurg;99:543-547, 2017 Mar.
[Is] ISSN:1878-8769
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: The differential diagnosis of neurohypophysial lesions is difficult, and surgical biopsies are indispensable in the histologic diagnosis of some patients. Although pituitary stalk biopsies are uniformly performed, there is a considerable risk that they will result in impaired hormonal secretion. We attempt to clarify the usefulness and safety of posterior pituitary lobe biopsy by transsphenoidal surgery (TSS). METHODS: The cases of 11 consecutive patients who underwent posterior pituitary lobe biopsies by TSS were retrospectively studied. Patients with cystic sellar lesions were excluded. We examined the clinical findings, endocrinologic data, magnetic resonance imaging findings, and histologic diagnoses of the patients. The locations of neurohypophysial lesions and the histologic diagnoses by posterior pituitary lobe biopsies were examined. RESULTS: The major preoperative clinical symptoms were diabetes insipidus (DI) (90.9%), followed by anterior pituitary lobe dysfunction (hypopituitarism) (54.5%). In all the patients, the lesions occupied the pituitary stalk and the posterior pituitary lobe, and the bright spot, which would indicate a normal posterior pituitary gland, disappeared on T1-weighted imaging. The posterior pituitary lobe specimens could be histologically diagnosed in all these cases. DI persisted in 10 patients with preoperative DI after the biopsy, whereas the 1 patient without preoperative DI did not suffer from DI after the biopsy. CONCLUSIONS: A posterior pituitary lobe biopsy by TSS may be an alternative to pituitary stalk biopsy in patients with neurohypophysial lesions.
[Mh] Termos MeSH primário: Biópsia/métodos
Craniofaringioma/patologia
Germinoma/patologia
Histiocitose de Células de Langerhans/patologia
Neuroendoscopia/métodos
Doenças da Hipófise/patologia
Neuro-Hipófise/patologia
Neoplasias Hipofisárias/patologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Criança
Pré-Escolar
Craniofaringioma/complicações
Craniofaringioma/diagnóstico por imagem
Diabetes Insípido/etiologia
Feminino
Germinoma/complicações
Germinoma/diagnóstico por imagem
Histiocitose de Células de Langerhans/complicações
Histiocitose de Células de Langerhans/diagnóstico por imagem
Seres Humanos
Hipopituitarismo/etiologia
Imagem por Ressonância Magnética
Masculino
Doenças da Hipófise/complicações
Doenças da Hipófise/diagnóstico por imagem
Neoplasias Hipofisárias/complicações
Neoplasias Hipofisárias/diagnóstico por imagem
Estudos Retrospectivos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170918
[Lr] Data última revisão:
170918
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161231
[St] Status:MEDLINE


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[PMID]:28007604
[Au] Autor:Luo Z; Qian Z; Yang K; Liu H; Zhang W; Zeng Y
[Ad] Endereço:Department of Neurosurgery, NanJing Brain Hospital affiliated with NanJing Medical University, NanJing, China.
[Ti] Título:Primary Germinoma Originating from the Insular Lobe: A Case Report and Review of the Literature.
[So] Source:World Neurosurg;98:871.e1-871.e7, 2017 Feb.
[Is] ISSN:1878-8769
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Primary intracranial germinomas occurring in the cerebral hemisphere are extremely rare, with only a few reported cases in the literature. We describe an unusual case of a primary germinoma that developed in the insular lobe, with little involvement in the basal frontal lobe. CASE DESCRIPTION: A 19-year-old man presented with headache and vomiting. Magnetic resonance imaging showed a solitary, ring-like enhanced lesion in the left hemisphere, and a preliminary diagnosis of glioma was made. Surgery was performed, and the diagnosis of germinoma was made based on the histopathologic results. CONCLUSIONS: The causes of ectopic germinomas of the midline structures of the brain are still unclear, but the theory of misplacement may partially clarify this phenomenon. Reflecting a lack of definitive management guidelines for atypical germinoma, the present patient was treated with focal radiotherapy around the lesion after surgery and achieved remission by 34 months postoperatively.
[Mh] Termos MeSH primário: Neoplasias Encefálicas/cirurgia
Germinoma/cirurgia
[Mh] Termos MeSH secundário: Adolescente
Neoplasias Encefálicas/radioterapia
Córtex Cerebral
Criança
Craniotomia/métodos
Feminino
Germinoma/radioterapia
Seres Humanos
Imagem por Ressonância Magnética
Masculino
Adulto Jovem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170918
[Lr] Data última revisão:
170918
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161224
[St] Status:MEDLINE



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