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Journal of Neurosurgery Aug 2010Pineocytoma is a rare tumor, and the current literature on these tumors is primarily composed of case reports and small case series. Thus, recommendations on appropriate... (Review)
Review
OBJECT
Pineocytoma is a rare tumor, and the current literature on these tumors is primarily composed of case reports and small case series. Thus, recommendations on appropriate treatment of these tumors are highly varied. Therefore, the authors performed a systematic review of the literature on tumor control after surgery for pineocytoma to determine the relative benefits of aggressive resection and postoperative adjuvant radiotherapy.
METHODS
A comprehensive search of the published English-language literature was performed to identify studies citing outcome data of patients undergoing surgery for pineocytoma. Determination of rates of progression-free survival (PFS) was performed using Kaplan-Meier analysis.
RESULTS
Sixty-four articles met the criteria of the established search protocol, which combined for a total of 166 patients. Twenty-one percent of these patients had undergone a biopsy procedure, 38% had undergone subtotal resection (STR), 42% had undergone gross-total resection, and 28% were treated with radiation therapy. The 1- and 5-year PFS rates for the resection group versus the biopsy group were 97 and 90% (1 year), and 89 and 75% (5 years), respectively (p < 0.05, log-rank test). The 1- and 5-year PFS rates for the GTR group versus the group undergoing STR combined with radiation therapy were 100 and 94% (1 year), and 100 and 84% (5 years), respectively (p < 0.05, log-rank test). There was no significant difference in PFS for STR only compared with STR in addition to radiation therapy.
CONCLUSIONS
Gross-total resection is the ideal treatment for pineocytoma and might represent a cure for these lesions. When gross-total resection is not possible, adjuvant radiation therapy after STR is of questionable benefit for these patients.
Topics: Brain Neoplasms; Combined Modality Therapy; Humans; Kaplan-Meier Estimate; Pineal Gland; Pinealoma; Radiotherapy, Adjuvant
PubMed: 20136388
DOI: 10.3171/2009.12.JNS091683 -
Journal of Pineal Research Nov 2005Most observational studies show an association between melatonin and cancer in humans. We conducted a systematic review of randomized controlled trials (RCTs) of... (Meta-Analysis)
Meta-Analysis Review
Most observational studies show an association between melatonin and cancer in humans. We conducted a systematic review of randomized controlled trials (RCTs) of melatonin in solid tumor cancer patients and its effect on survival at 1 yr. With the aid of an information specialist, we searched 10 electronic databases from inception to October 2004. We included trials using melatonin as either sole treatment or as adjunct treatment. Prespecified criteria guided our assessment of trial quality. We conducted a meta-analysis using a random effects model. We included 10 RCTs published between 1992 and 2003 and included 643 patients. All trials included solid tumor cancers. All trials were conducted at the same hospital network, and were unblinded. Melatonin reduced the risk of death at 1 yr (relative risk: 0.66, 95% confidence interval: 0.59-0.73, I2=0%, heterogeneity P
Topics: Humans; Melatonin; Neoplasms; Randomized Controlled Trials as Topic; Risk Assessment
PubMed: 16207291
DOI: 10.1111/j.1600-079X.2005.00258.x -
Journal of Clinical Neuroscience :... Mar 2019The incidence of primary intracranial pure choriocarcinoma (PIPC) is extremely rare. Only several case and case series have been previously reported; therefore, there is...
The incidence of primary intracranial pure choriocarcinoma (PIPC) is extremely rare. Only several case and case series have been previously reported; therefore, there is still lack of knowledge about the prognosis and its standard treatment. We performed a collective study of all reported cases of PIPC to identify the predictive factors related with OS. A comprehensive search was performed on Pubmed's electronic database using the terms "primary intracranial choriocarcinoma" and "malignant germ cell tumor". Data about gender, various location, the presence of intratumoral hemorrhage, metastasis and treatment modalities were extracted from the published articles and we analyzed the overall survival based on this predictive factors. 51 cases were eligible and met the inclusion criteria. The majority of the patients were in the child population (44.7%) age between 6 and 12 years old. 77.1% of the patient were male and 22.9% were female. Tumor located other than suprasellar and pineal area showed better prognosis. Median OS of PIPC was 22 months. Patient underwent gross total resection had better outcomes compared with those who only had partial or subtotal resection. Adjuvant therapy (especially chemotherapy) significantly improved OS (p = 0.000, log-rank test). PIPC is chemosensitive and metastasis is the predictive factor for poor prognosis.
Topics: Child; Choriocarcinoma; Female; Humans; Male; Neoplasms, Germ Cell and Embryonal; Survival Analysis
PubMed: 30442453
DOI: 10.1016/j.jocn.2018.10.136 -
Anti-cancer Agents in Medicinal... 2018This systematic review aims to elucidate the role of melatonin (N-acetyl-5-metoxy-tryptamine) (MLT) in the prevention and treatment of cancer. MLT is a pineal gland...
This systematic review aims to elucidate the role of melatonin (N-acetyl-5-metoxy-tryptamine) (MLT) in the prevention and treatment of cancer. MLT is a pineal gland secretory product, an evolutionarily highly conserved molecule; it is also an antioxidant and an impressive protector of mitochondrial bioenergetic activity. MLT is characterized by an ample range of activities, modulating the physiology and molecular biology of the cell. Its physiological functions relate principally to the interaction of G Protein-Coupled MT1 and MT2 trans-membrane receptors (GPCRs), a family of guanidine triphosphate binding proteins. MLT has been demonstrated to suppress the growth of various tumours both, in vivo and in vitro. In this review, we analyze in depth, the antioxidant activity of melatonin, aiming to illustrate the cancer treatment potential of the molecule, by limiting or reversing the changes occurring during cancer development and growth.
Topics: Animals; Antineoplastic Agents; Antioxidants; Humans; Melatonin; Neoplasms; Oxidative Stress; Receptors, Melatonin
PubMed: 29173185
DOI: 10.2174/1871520617666171121120223 -
Clinical Neuroradiology Mar 2015Atypical teratoid/rhabdoid tumor (AT/RT) occurs in children less than 3 years old, and has a very poor prognosis. AT/RT seldom occurs in adult. We have experienced four... (Review)
Review
PURPOSE
Atypical teratoid/rhabdoid tumor (AT/RT) occurs in children less than 3 years old, and has a very poor prognosis. AT/RT seldom occurs in adult. We have experienced four cases of AT/RT at our institute. The purpose of this study is to evaluate the radiological image findings of adult-onset AT/RT and to conduct a systematic review.
METHODS
Image findings of four AT/RTs in our institute were retrospectively evaluated by an experienced neuroradiologist. If the images were unavailable, image findings were evaluated from the former image interpretation report. We assembled papers of adult-onset AT/RT (n = 38) and evaluated the image findings.
RESULTS
AT/RT occurs in a variety of sites (spinal region, pineal region, suprasellar region, jugular foramen, and so on). High density on computed tomography (CT) was seen in 10 of 11 cases; mixed intensity in T2-weighted image was seen in 13 of 18 cases; and high intensity on diffusion-weighted image (DWI) was seen in 3 of 3 cases. Contrast enhancement was observed in all cases in which images were available.
CONCLUSIONS
We have experienced four adult-onset AT/RT cases at our institute and have evaluated image findings through systematic review. The image findings of high density on CT, high intensity on DWI, with low apparent diffusion coefficient, and a heterogenous component should lead to an inclusion of AT/RT in the differential diagnosis of a tumor; these findings may be able to suggest AT/RT; however, they cannot make the diagnosis.
Topics: Adult; Diagnosis, Differential; Female; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Rhabdoid Tumor; Teratoma; Tomography, X-Ray Computed; Young Adult
PubMed: 24477665
DOI: 10.1007/s00062-013-0282-2 -
Neurosurgical Review Mar 2019We conducted a systematic review of 72 studies to characterize trilateral retinoblastomas. Kaplan-Meier analysis was used to estimate survival, and statistical...
We conducted a systematic review of 72 studies to characterize trilateral retinoblastomas. Kaplan-Meier analysis was used to estimate survival, and statistical significance was assessed by using a log-rank test. We analyzed 211 cases of trilateral retinoblastomas. The average age of onset of retinoblastoma was 0.79 ± 1.38 years, and the average latency period between the onset of retinoblastomas and trilateral retinoblastomas was 1.49 ± 1.76 years. The brain tumors were found before the retinoblastoma diagnosis in 6 cases (3.1%), concurrently in 61 cases (32.1%), and after the retinoblastoma diagnosis in 123 cases (64.7%). Pineal tumors were found in 155 cases (73.4%) and sellar tumors in 46 cases (21.8%). The overall median survival was 10.3 months (95% CI, 8.5-13) and the 5-year survival rate was 15.7%. Central nervous system symptoms were variable and associated with shorter survival in univariate and multivariate analyses. The survival time in patients who received high-dose chemotherapy with stem cell transplant was significantly longer (p = 0.0067) than that of with or without conventional chemotherapy. Twelve long-term survivors were reported, and of these, six patients were treated with high-dose chemotherapy with stem cell transplant and six patients were treated with conventional chemotherapy. It is important that survivors continue to undergo regular medical surveillance in order to detect trilateral retinoblastoma at a potentially curative stage. Trilateral retinoblastoma patients with an irradiation history had shorter survival than those without irradiation history for retinoblastoma. High-dose chemotherapy should be considered as a potential treatment option for trilateral retinoblastomas.
Topics: Child, Preschool; Female; Humans; Infant; Infant, Newborn; Kaplan-Meier Estimate; Male; Retinal Neoplasms; Retinoblastoma
PubMed: 28815312
DOI: 10.1007/s10143-017-0890-4 -
Clinical Neurology and Neurosurgery Mar 2020Papillary tumor of the pineal region (PTPR) is a rare neuroepithelial brain tumor, characterized by a high risk of local recurrence (greater than 70 % at 6 years). The...
Papillary tumor of the pineal region (PTPR) is a rare neuroepithelial brain tumor, characterized by a high risk of local recurrence (greater than 70 % at 6 years). The aim of our study was to review the available literature on radiotherapy for PTPR in order to evaluate timings, schedules, outcomes and toxicities of this treatment modality. In our review, 72.4 % (84) of the patients diagnosed with PTPR received radiation therapy. There is heterogeneity in the dose prescription, ranging from 45 Gy (25 × 1.8 Gy) to 60 Gy (30 × 2 Gy) for 3D Conformal Radiation Therapy and from 12 Gy to 36 Gy for Stereotactic Radiosurgery. Being considered as a grade II or III tumor, PTPR should receive higher total radiation dose in the adjuvant setting. Our analysis showed a very limited treatment-related toxicity with an expected 10-y OS of 72.5 %. At 5-years from the diagnosis, about 60 % of the patients experienced a local recurrence, whereas at 10 years the rate is higher than 80 %. In the literature, conflicting data about radiotherapy for PTPR are reported, in particular regarding disease progression. Although radiotherapy represents a fundamental treatment in the management of PTPR, prospective studies are required to better define its impact on overall survival and progression-free survival.
Topics: Brain Neoplasms; Humans; Neoplasm Grading; Neoplasm Recurrence, Local; Neurosurgical Procedures; Pineal Gland; Pinealoma; Progression-Free Survival; Radiosurgery; Radiotherapy, Adjuvant; Radiotherapy, Conformal; Salvage Therapy; Survival Rate; Treatment Outcome
PubMed: 31896492
DOI: 10.1016/j.clineuro.2019.105646 -
American Journal of Reproductive... Jul 2018Melatonin is a neurohormone synthesized from the aromatic amino acid tryptophan mainly by the pineal gland of mammals. Melatonin acts as a broad-spectrum antioxidant,...
Melatonin is a neurohormone synthesized from the aromatic amino acid tryptophan mainly by the pineal gland of mammals. Melatonin acts as a broad-spectrum antioxidant, powerful free radical scavenger, anti-inflammatory agent, anticarcinogenic factor, sleep inducer and regulator of the circadian rhythm, and potential immunoregulator. Melatonin and reproductive system are interrelated under both physiological and pathological conditions. Oxidative stress, inflammation, and immune dysregulation are associated with the pathogenesis of the female reproductive system which causes endometriosis (EMS), recurrent spontaneous abortion (RSA), and polycystic ovary syndrome (PCOS). Accumulating studies have indicated that melatonin plays pleiotropic and essential roles in these obstetrical and gynecological disorders and would be a candidate therapeutic drug to regulate inflammation and immune function and protect special cells or organs. Here, we systematically review the pleiotropic roles of melatonin in EMS, RSA, and PCOS to explore its pathological implications and treatment potential.
Topics: Abortion, Habitual; Abortion, Spontaneous; Animals; Endometriosis; Female; Humans; Melatonin; Polycystic Ovary Syndrome
PubMed: 29493042
DOI: 10.1111/aji.12839 -
Acta Neurologica Belgica Jun 2020The intra- and periventricular location tumor (IPVT) of a brain remains a hard challenge for the neurosurgeon because of the deep location and eloquent anatomic...
The intra- and periventricular location tumor (IPVT) of a brain remains a hard challenge for the neurosurgeon because of the deep location and eloquent anatomic associations. Due to this high risk of iatrogenic injury, many surgeons elect to perform biopsies of such lesions to establish a diagnosis. On the one hand, stereotaxic needle biopsy (SNB) is a minimally invasive procedure but with a significant risk of complications and a high risk of lack of tissue for molecular analyses for this region [Fukushima in Neurosurgery 2:110-113 (1978)]; on the other hand, the use of endoscopic intraventricular biopsy (EIB) allows for diagnosis with minimal surgical intervention [Iwamoto et al. in Ann Neurol 64(suppl. 6):628-634 (2008)]. IPVTs and related CSF pathway obstructions can be safely and effectively treated with endoscopic techniques. It is not possible to compare EIB with diagnoses made by any other method or with the established treatment. We aim to analyze the accuracy of EIB results by comparing them with results of biopsies performed later, in other methods and thereby evaluating the treatment evolution considering our personal experience. The difficulties and complications encountered are presented and compared with those reported in the literature to obtain the best review possible for this topic. A systematic review of literature was done using MEDLINE, the NIH Library, PubMed, and Google Scholar yielded 1.951 cases for EIB and 1912 for SNB, according to standard systemic review techniques. Review was conducted on 50 studies describing surgical procedures for lesions intra- and para-ventricular. The primary outcome measure was a diagnostic success. We also consider 20 patients with IPVT treated in our department. Clinical characteristics and surgical outcome were evaluated and a systematic review of the literature was performed. Overall, all our biopsies were diagnostic, with a positive histologic sample in 100% of our patients. 8 patients underwent a concurrent endoscopic third ventriculostomy. 4 patients underwent a concurrent ventriculostomy combined with septostomy. For 1 patient was necessary the only septostomy combined with biopsy. Every case has obtained a histological diagnosis. The percentage of complications was very low with only 1 case of post-operative infection and 1 case of hemorrhage. It was impossible to create a specific comparison from literature data of IPVTs between a stereotactic and endoscopic procedure, it presents only the collection of pineal gland tumor [Kelly in Neurosurgery 25(02):185-194 (1989); Quick-Weller in World Neurosurgery 96:124-128 (2016)] or unknown location of the lesion in major review [Marenco-Hillembrand et al. in Front Oncol 8:558 (2018)]. The present study aims to report our experience with the surgical management of IPVTs. The EIB sample yields an accurate histologic diagnosis tumor, with a positive histologic sample in 87, 95% of patients. The choice of the appropriate procedure should consider not only the preference and the experience of the neurosurgeon but also the several other variables as the location. While some periventricular lesions are better approached by endoscopic techniques, others are more suited for stereotactic-guided approaches. The ability to perform an EIB and relieve tumor-associated hydrocephalus by neuroendoscopy is considered to be a benefit of this procedure since this is less invasive than other treatments.
Topics: Adult; Aged; Biopsy; Brain Neoplasms; Cerebral Ventricle Neoplasms; Female; Humans; Male; Middle Aged; Neuroendoscopy; Ventriculostomy
PubMed: 32107717
DOI: 10.1007/s13760-020-01299-1 -
Dento Maxillo Facial Radiology Oct 2019Cone beam CT's use (CBCT) in dentistry is increasing. Incidental findings (IFs: discoveries unrelated to the original purpose of the scan), are frequently found as a...
OBJECTIVES
Cone beam CT's use (CBCT) in dentistry is increasing. Incidental findings (IFs: discoveries unrelated to the original purpose of the scan), are frequently found as a result of a large field of view. The aim of the systematic review is to analyze present literature on IFs using CBCT.
METHODS AND MATERIALS
The authors searched online databases of studies and assessed the prevalence of IFs among patients undergoing head and neck CBCT scans. STROBE criteria was used to evaluate the quality of the studies.
RESULTS
The original search retrieved 509 abstracts of which only 10 articles met the inclusion criteria. The sample size varied between 90 and 1000 participants. The frequency of IFs of the selected articles were 24.6-94.3%. The most common non-threatening IFs were found in the airway, such as mucous retention cyst (55.1%) and sinusitis (41.7%). Other non-threatening IFs were soft tissue calcifications such as calcified stylohyloid ligament (26.7%), calcified pineal gland (19.2%), and tonsillolith (14.3%). Threatening IFs were rare findings (1.4%). Three articles reported incidental carotid artery calcifications with a prevalence of 5.7-11.6%. Pathological findings were not common between the articles, but still relevant (2.6%). The studies had a risk of bias varying from moderate to low.
CONCLUSIONS
There is a high frequency of IFs, yet not all of them require immediate medical attention. The low prevalence of threatening IFs emphasizes that CBCT should not be considered a substitution for conventional radiographs, but when used, the scans should be evaluated by a maxillofacial radiologist.
Topics: Cone-Beam Computed Tomography; Head; Humans; Incidental Findings; Neck; Reproducibility of Results
PubMed: 31216179
DOI: 10.1259/dmfr.20180396