PURPOSE: Treatment strategy of malignant congenital brain tumor is controversial. We report a congenital embryonal tumor case with various pathological components. METHODS: A normally delivered male infant had an enlarged head circumference at 1 month after birth. The abnormality of the right side of the head was also noted during the routine 4-month health check. The head circumference was 45.1 cm (+2.25, SD); neurological status, however, was normal, with a pediatric GCS of 9 and body weight of 6,370 g (-0.85, SD). Magnetic resonance imaging (MRI) revealed right brain tumor whose size was 99 × 91 × 86 mm. The tumor was enhanced homogeneously with central necrosis, and the margin of the tumor was well circumscribed. RESULTS: We performed a subtotal removal of the tumor. The pathological diagnosis was meningioma (MIB-1 index was 2 %). The residual tumor gradually shrank, and we performed monthly MRI follow-up. The tumor abruptly recurred 7 months after the operation. The level of patient consciousness deteriorated, and emergency removal surgery was performed. The histological examination showed various types of embryonal components without meningioma-like parts. The pathological diagnosis was an embryonal tumor. The MIB-1 index was 48 %. One month after the second operation, dissemination of the tumor occurred at the right temporal lobe, cerebellum, and in subcutaneous tissue. Chemotherapy (vincristine, cisplatin, cyclophosphamide, and etoposide) was initiated following radiation therapy (3 Gy/day, 8×). Adjuvant therapies were effective, and no tumor recurrence was detected during 34 months follow-up. CONCLUSION: Treatment strategies for malignant indefinite diagnosed tumor need to be discussed.
PURPOSE: Treatment strategy of malignant congenital brain tumor is controversial. We report a congenital embryonal tumor case with various pathological components. METHODS: A normally delivered male infant had an enlarged head circumference at 1 month after birth. The abnormality of the right side of the head was also noted during the routine 4-month health check. The head circumference was 45.1 cm (+2.25, SD); neurological status, however, was normal, with a pediatric GCS of 9 and body weight of 6,370 g (-0.85, SD). Magnetic resonance imaging (MRI) revealed right brain tumor whose size was 99 × 91 × 86 mm. The tumor was enhanced homogeneously with central necrosis, and the margin of the tumor was well circumscribed. RESULTS: We performed a subtotal removal of the tumor. The pathological diagnosis was meningioma (MIB-1 index was 2 %). The residual tumor gradually shrank, and we performed monthly MRI follow-up. The tumor abruptly recurred 7 months after the operation. The level of patient consciousness deteriorated, and emergency removal surgery was performed. The histological examination showed various types of embryonal components without meningioma-like parts. The pathological diagnosis was an embryonal tumor. The MIB-1 index was 48 %. One month after the second operation, dissemination of the tumor occurred at the right temporal lobe, cerebellum, and in subcutaneous tissue. Chemotherapy (vincristine, cisplatin, cyclophosphamide, and etoposide) was initiated following radiation therapy (3 Gy/day, 8×). Adjuvant therapies were effective, and no tumor recurrence was detected during 34 months follow-up. CONCLUSION: Treatment strategies for malignant indefinite diagnosed tumor need to be discussed.
Authors: R D Kortmann; J Kühl; B Timmermann; U Mittler; C Urban; V Budach; E Richter; N Willich; M Flentje; F Berthold; I Slavc; J Wolff; C Meisner; O Wiestler; N Sörensen; M Warmuth-Metz; M Bamberg Journal: Int J Radiat Oncol Biol Phys Date: 2000-01-15 Impact factor: 7.038
Authors: J Russell Geyer; Richard Sposto; Mark Jennings; James M Boyett; Richard A Axtell; David Breiger; Emmett Broxson; Bernadine Donahue; Jonathan L Finlay; Joel W Goldwein; Linda A Heier; Dennis Johnson; Claire Mazewski; Douglas C Miller; Roger Packer; Diane Puccetti; Jerilynn Radcliffe; May Lin Tao; Tania Shiminski-Maher Journal: J Clin Oncol Date: 2005-10-20 Impact factor: 44.544
Authors: Murali Chintagumpala; Tim Hassall; Shawna Palmer; David Ashley; Dana Wallace; Kimberly Kasow; Thomas E Merchant; Matthew J Krasin; Robert Dauser; Frederick Boop; Robert Krance; Shiao Woo; Robyn Cheuk; Ching Lau; Richard Gilbertson; Amar Gajjar Journal: Neuro Oncol Date: 2008-09-16 Impact factor: 12.300
Authors: P K Duffner; M E Horowitz; J P Krischer; H S Friedman; P C Burger; M E Cohen; R A Sanford; R K Mulhern; H E James; C R Freeman Journal: N Engl J Med Date: 1993-06-17 Impact factor: 91.245
Authors: David N Louis; Hiroko Ohgaki; Otmar D Wiestler; Webster K Cavenee; Peter C Burger; Anne Jouvet; Bernd W Scheithauer; Paul Kleihues Journal: Acta Neuropathol Date: 2007-07-06 Impact factor: 17.088