The second patient, an eight yr previous female, underwent a complete surgical resection of the left paraventricular mass also diagnosed like a papillary glioneuronal tumor. She presented emergently three months following diagnosis with emesis and weakness. A CT scan uncovered a hematoma that was surgically eliminated. Biopsies have been taken from inside the resection cavity and were optimistic pop over here for recurrent tumor. Six weeks right after sur gery, the patient is getting observed closely with surveillance imaging. These two cases show that papillary glioneuronal tumors can behave extra aggressively than described within the literature. We hypothesize that the higher MIB index could be far more predictive in the extra aggressive lesions. These tumors should be observed rather closely with surveillance imaging postoperatively. Our practical experience using the very first patient also demonstrates that in progressive disorder, radiation therapy could be a valuable different treatment method.
PE eleven. OSMOTIC BLOOD BRAIN BARRIER DISRUPTION CHEMOTHERAPY FOR DIFFUSE PONTINE GLIOMAS W. A. Hall,one N. D. Doolittle,2 L. Muldoon,two D. Fortin,four E. A. Neuwelt2, 3, one Department of Neurosurgery, University of Minnesota Health care School, Minneapolis, MN, 2Departments of Neurology and 3Neurosurgery, Oregon Wellbeing Science University, Portland, OR, 4Department of Neurosurgery and Neuro Oncology, Nanchangmycin Sherbrooke University, Sherbrooke, Quebec, Canada The prognosis for patients with diffuse pontine gliomas remains poor. New therapies are necessary for this disorder. From 1984 to 1998, 8 sufferers, median age eleven many years, with DPG have been treated with month to month osmotic blood brain barrier disruption chemotherapy working with intra arterial carboplatin or methotrexate and intravenous cytoxan and etoposide. Sufferers presented for any median duration of 6 weeks with elevated intracranial strain, prolonged tract indicators, diplopia, ataxia, and nau sea/vomiting.
DPG was demonstrated on MRI scan in seven sufferers and on CT scan in 1 patient. Two sufferers underwent tumor biopsy, a single had an astro cytoma as well as the other had an anaplastic astrocytoma. The median quantity of chemotherapy cycles that had been administered by BBBD was ten. One patient who started out on carboplatin was converted to methotrexate, and five started out within the methotrexate protocol had been converted to carboplatin. MRI demonstrated partial responses in 2 individuals, steady disorder in 5 sufferers, and sickness progression in one patient. The median time to tumor progres sion was 15 months. The median survival through the time of diagnosis was 27 months. The median survival time from your very first BBBD or intra arterial remedy was sixteen. five months. A single patient was lost to fol reduced up, date of death unknown. While the sample dimension is little, the time for you to disease progression and survival instances are longer than those previously reported in other DPG series.