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Clinical Neuroradiology Sep 2013Hemangioblastoma (HBL) within the central nervous system is a benign vascular neoplasm that usually occurs in the cerebellum. Supratentorial occurrence of HBL is an... (Review)
Review
Hemangioblastoma (HBL) within the central nervous system is a benign vascular neoplasm that usually occurs in the cerebellum. Supratentorial occurrence of HBL is an extremely rare event. Till date, approximately 129 cases of supratentorial HBL have been reported in the literature. Here, we present three new cases of supratentorial hemangioblatomas, one of which was found to have the lesions in a unique location of the choroidal fissure. The clinical, histopathological, and neuroradiological characteristics, as well as management of this rare disease are discussed with a review of the pertinent literature.
Topics: Adult; Diagnosis, Differential; Female; Hemangioblastoma; Humans; Magnetic Resonance Angiography; Male; Middle Aged; Supratentorial Neoplasms; Tomography, X-Ray Computed
PubMed: 23207666
DOI: 10.1007/s00062-012-0183-9 -
Seminars in Roentgenology Jul 1990There is a multitude of variables that must be taken into account when interpreting an imaging study and deriving a differential diagnosis. These include the clinical as...
There is a multitude of variables that must be taken into account when interpreting an imaging study and deriving a differential diagnosis. These include the clinical as well as the imaging findings. An intelligent analysis of the imaging findings, whether CT or MR, and whether enhanced or not, will, in most cases, narrow the differential diagnosis. The imaging information, when taken along with the clinical information, should provide guidelines as to the next step, diagnostic or therapeutic. Ultimately, there is no substitute for histologic characterization when the diagnosis remains unresolved and there is a need to institute treatment.
Topics: Child; Child, Preschool; Diagnosis, Differential; Humans; Infant; Infant, Newborn; Magnetic Resonance Imaging; Supratentorial Neoplasms; Tomography, X-Ray Computed
PubMed: 2385807
DOI: 10.1016/0037-198x(90)90053-7 -
Neurologic Clinics Nov 1995Supratentorial low-grade gliomas comprise a group of primary central nervous system neoplasms with characteristics of neuroglial cells (i.e., astrocytes and... (Review)
Review
Supratentorial low-grade gliomas comprise a group of primary central nervous system neoplasms with characteristics of neuroglial cells (i.e., astrocytes and oligodendrocytes) and relatively low anaplastic potential, although through time they tend to behave more aggressively. Immediate surgical intervention and subsequent radiation therapy are advocated by some workers; at present, however, it remains unclear whether early intervention prolongs survival or changes the natural history of the disease, especially in those patients who present with a seizure and a normal interictal examination.
Topics: Adult; Brain; Combined Modality Therapy; Glioma; Humans; Neoplasm Staging; Radiotherapy, Adjuvant; Supratentorial Neoplasms; Survival Rate
PubMed: 8584000
DOI: No ID Found -
Current Opinion in Anaesthesiology Oct 2016The article reviews the recent evidence on the anesthetic management of patients undergoing craniotomy for supratentorial tumor resection. (Review)
Review
PURPOSE OF REVIEW
The article reviews the recent evidence on the anesthetic management of patients undergoing craniotomy for supratentorial tumor resection.
RECENT FINDINGS
A rapid recovery of neurological function after craniotomy for supratentorial tumor allows for the prompt diagnosis of intracranial complications and possibly an early hospital discharge. Intraoperative esmolol infusion was shown to reduce the anesthetic requirements, and may facilitate a more rapid recovery of neurological function. Outpatient craniotomy for supratentorial tumor resection has been associated with several clinical and economic benefits, but has not gained widespread use because of skepticism and medical-legal concerns. Awake craniotomy is associated with advantageous outcomes compared with surgery under general anesthesia, and is regarded as the standard of care for tumors that reside in or in close proximity to the eloquent brain. Recent studies have demonstrated that intraoperative electroacupuncture, dexmedetomidine, pregabalin, and lidocaine may facilitate postcraniotomy pain management. The use of volatile anesthetic agents in cancer surgery is associated with a worse survival compared with intravenous anesthetics, possibly by hindering immunologic defenses against cancer cells.
SUMMARY
Recent evidence has yielded valuable information regarding anesthetic management of patients undergoing supratentorial tumor craniotomy. Despite a plethora of studies that compare short-term outcomes using different anesthetic and analgesic regimens, randomized controlled trials that examine the long-term outcomes (i.e., neurocognitive function, quality of life, tumor recurrence, and survival) that are of particular interest to patients are needed.
Topics: Analgesics; Anesthesia; Anesthetics, Inhalation; Cognition; Craniotomy; Electroacupuncture; Humans; Neoplasm Recurrence, Local; Pain Management; Pain, Postoperative; Perioperative Care; Quality of Life; Supratentorial Neoplasms; Treatment Outcome
PubMed: 27285727
DOI: 10.1097/ACO.0000000000000365 -
The Lancet. Neurology Jul 2003Because of its unpredictable clinical course, treatment strategies for low-grade (grade II) astrocytoma vary from "wait and see" to gross tumour resection followed by... (Review)
Review
Because of its unpredictable clinical course, treatment strategies for low-grade (grade II) astrocytoma vary from "wait and see" to gross tumour resection followed by immediate radiotherapy. Clinical studies on grade II astrocytoma show that 5-year-survival ranges from 27% to 85% of patients with very few consistent prognostic variables besides the patient's age and the presence of neurological deficit. There is no universally recognised choice of therapy for patients with astrocytoma grade II, partly because of the shortcomings of histological classification systems. Routine microscopy tends to underestimate malignancy grading of astrocytomas and in most cases cannot distinguish between indolent and progressive subtypes. Recent studies suggest that proliferation and genetic markers can be used to identify subgroups of astrocytoma grade II with a rapid progressive clinical course. Therefore these markers should be included in ongoing and future clinical studies of patients with astrocytoma grade II.
Topics: Adult; Age Factors; Astrocytoma; Cell Transformation, Neoplastic; Disease Progression; Humans; Middle Aged; Mutation; Prognosis; Supratentorial Neoplasms; Treatment Outcome
PubMed: 12849117
DOI: 10.1016/s1474-4422(03)00434-4 -
World Neurosurgery May 2018Pediatric cerebral ganglioneuroblastoma is an exceedingly rare tumor. (Review)
Review
BACKGROUND
Pediatric cerebral ganglioneuroblastoma is an exceedingly rare tumor.
CASE DESCRIPTION
We describe the case of a 4-year-old boy with sudden mental status decline who was found to have a large intracranial lesion with intraventricular extension.
CONCLUSION
Management of the case and pathologic findings are discussed, along with a review of the literature on this rare entity.
Topics: Brain Neoplasms; Child, Preschool; Fatal Outcome; Ganglioneuroblastoma; Humans; Male; Supratentorial Neoplasms
PubMed: 29496580
DOI: 10.1016/j.wneu.2018.02.115 -
Annals of the Academy of Medicine,... May 1996The supratentorial low-grade gliomas are a heterogeneous group of central nervous system tumours. Knowledge of their biology, primarily based on histologic subtype and... (Review)
Review
The supratentorial low-grade gliomas are a heterogeneous group of central nervous system tumours. Knowledge of their biology, primarily based on histologic subtype and patient age, is helpful in determining prognosis and guiding therapeutic recommendations. The pilocytic tumours usually occur in younger patients and carry a favourable prognosis. Recurrence following gross total excision is rare, and approximately 80% of patients undergoing subtotal removal with or without postoperative radiation therapy (RT) will survive 10 years or longer. In contrast, non-pilocytic, supratentorial low-grade tumours (including the diffuse fibrillary, protoplasmic and gemistocytic subtypes), as well as mixed oligoastrocytomas and oligodendrogliomas are infrequently cured, even with gross total excision. Survival benefit with postoperative RT has been suggested by several retrospective studies. When RT is prescribed, localized treatment fields are suggested for total doses of 4500 to 6500 cGy. Ongoing prospective, randomized studies hopefully will clarify the role of RT in these neoplasms, as well as the optimal dose.
Topics: Age Factors; Astrocytoma; Biology; Glioma; Humans; Neoplasm Recurrence, Local; Oligodendroglioma; Prognosis; Prospective Studies; Radiotherapy Dosage; Randomized Controlled Trials as Topic; Retrospective Studies; Supratentorial Neoplasms; Survival Rate
PubMed: 8876906
DOI: No ID Found -
Pediatric Neurosurgery Feb 2001The clinical and pathological characteristics of supratentorial ependymomas (STE) in children are not well identified in the literature, because most series deal with...
The clinical and pathological characteristics of supratentorial ependymomas (STE) in children are not well identified in the literature, because most series deal with ependymomas regardless of their location or the age of the patient. As a result, the pathological description of the disorder is still debated. We therefore reviewed our cases of children operated for STE and compared them with cases of infratentorial ependymomas (ITE) to provide a better characterization of STE and suggest guidelines for treatment. From 1985 to 1999, we operated 18 children for STE, almost half of which developed with no connection to the ventricular system. Intraoperative bleeding and infiltration of the basal ganglia prevented total removal in 4 cases and were the main causes of operative mortality and morbidity. The 5-year overall survival and recurrence-free survival rates were 54 and 37%, respectively, and were highly affected by the extent of resection, but not by histological grade. Because of the high recurrence rate, we recommend systematic postoperative irradiation limited to the tumor site for all high-grade tumors in older children, and reoperation after subtotal removal and for recurrences.
Topics: Adolescent; Brain; Chemotherapy, Adjuvant; Child; Child, Preschool; Combined Modality Therapy; Ependymoma; Female; Follow-Up Studies; Humans; Infant; Magnetic Resonance Imaging; Male; Postoperative Complications; Radiography; Radiotherapy, Adjuvant; Reoperation; Stereotaxic Techniques; Supratentorial Neoplasms
PubMed: 11287807
DOI: 10.1159/000055999 -
Child's Nervous System : ChNS :... Oct 1999Pineal region supratentorial primitive neuroectodermal tumors (SPNETs; pineoblastomas) and nonpineal SPNETs are rare tumors that historically have carried a very poor... (Review)
Review
Pineal region supratentorial primitive neuroectodermal tumors (SPNETs; pineoblastomas) and nonpineal SPNETs are rare tumors that historically have carried a very poor prognosis. With multimodality therapy, including maximal surgical resection, craniospinal radiation therapy and chemotherapy, the survival for patients with pineal PNETs has significantly improved. Chemotherapy alone, at least in conventional doses, appears to be insufficient treatment for younger children with pineoblastomas, in whom there is almost universal rapid tumor progression and death. Survival of patients with nonpineal SPNETs remains in the order of 30-35% despite multimodality therapy. Unlike those with pineal SPNETs, a significant percentage of infants with nonpineal SPNETs who undergo gross total surgical resection followed by chemotherapy will be long-term survivors. This article gives an overview of the natural history, prognostic factors and treatment of both pineal and nonpineal SPNETs.
Topics: Child, Preschool; Combined Modality Therapy; Humans; Infant; Neuroectodermal Tumors, Primitive; Pineal Gland; Prognosis; Supratentorial Neoplasms
PubMed: 10550590
DOI: 10.1007/s003810050547 -
Neurosurgical Focus Feb 2003The purpose of this review is to highlight some of the pertinent concepts and controversies surrounding the diagnosis and treatment of pediatric supratentorial... (Review)
Review
The purpose of this review is to highlight some of the pertinent concepts and controversies surrounding the diagnosis and treatment of pediatric supratentorial high-grade gliomas. Unlike the adult counterparts, pediatric high-grade gliomas are likely derived from distinct cytogenetic and molecular alterations. Surgery has been shown to play a role in extending patient survival. Some success is associated with the provision of chemotherapy. Radiotherapy remains an important adjunct in children older than age 3 years. The challenges involved in improving the poor prognosis of children in whom these very aggressive tumors have been diagnosed will be discussed, as well as some of the novel approaches being investigated to improve patient survival and quality of life.
Topics: Adolescent; Biomarkers, Tumor; Chemotherapy, Adjuvant; Child; Child, Preschool; Chromosome Aberrations; Clinical Trials as Topic; Combined Modality Therapy; Craniotomy; Female; Forecasting; Glioma; Hematopoietic Stem Cell Transplantation; Humans; Infant; Infant, Newborn; Male; Neoplasm Invasiveness; Neoplasm Recurrence, Local; Neoplastic Syndromes, Hereditary; Prognosis; Radiotherapy, Adjuvant; Risk Factors; Supratentorial Neoplasms; Treatment Outcome
PubMed: 15727422
DOI: 10.3171/foc.2003.14.2.2