RESUMO
The authors present 2 cases of a rare association of intracranial tumors of different cell types: neurinoma with epidermoid cyst, and neurinoma with cholesterol granuloma. The presenting symptoms resulted from neurinomas arising from the V and VIII cranial nerves, respectively. The diagnoses were achieved using Magnetic Resonance Images (MRI). The association of these rare lesions is discussed using recent literature pertaining to the coexistence of multiple brain tumors.
Assuntos
Neoplasias Encefálicas/complicações , Colesterol , Cisto Epidérmico/complicações , Granuloma de Corpo Estranho/etiologia , Neurilemoma/complicações , Neuroma Acústico/complicações , Adulto , Neoplasias Encefálicas/diagnóstico , Cisto Epidérmico/diagnóstico , Feminino , Granuloma de Corpo Estranho/diagnóstico , Humanos , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Neurilemoma/diagnóstico , Neuroma Acústico/diagnósticoRESUMO
A retrospective uni-multivariate statistical analysis was performed on 32 prognostic factors to investigate their importance in predicting survival in a series of 76 adult patients with low-grade supratentorial astrocytomas treated over a 13-year period. The end point used for this study was the length of survival. The median survival time was 40 months. Overall actuarial survival at 2, 5, and 10 years was 69%, 38%, and 22%, respectively. Radical resection of the neoformation, a higher preoperative Karnofsky performance status (KPS) score, and an age younger than 50 years are strongly correlated with survival; postoperative radiotherapy appears to be associated with increased survival only in patients under 50 years of age.
Assuntos
Astrocitoma/diagnóstico , Astrocitoma/cirurgia , Neoplasias Supratentoriais/diagnóstico , Neoplasias Supratentoriais/cirurgia , Análise Atuarial , Adulto , Análise de Variância , Astrocitoma/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Radioterapia Adjuvante , Estudos Retrospectivos , Neoplasias Supratentoriais/patologia , Neoplasias Supratentoriais/radioterapia , Análise de Sobrevida , Resultado do TratamentoRESUMO
The immunohistochemical expression of p53 protein (p53) was examined in 52 patients out of a series of 66 patients with low-grade astrocytomas with long-term follow-up. All patients were also evaluated for several clinical and histological features, among which only preoperative Karnofsky score and the extent of surgery were statistically significant parameters to predict outcome on multivariate analysis. p53 accumulation was seen in 46.1% of patients, with a wide range of percentage of positive cells. Median survival for p53-positive and p53-negative patients was 41 and 37 months respectively. The survival curves of p53-positive and -negative patients were not statistically different. However, the curves showed a trend towards a more aggressive course in p53-positive patients beginning 3-4 years after surgery. Five years after diagnosis the survival estimate with the Kaplan-Meier method was 21.2% for patients with p53-positive tumours and 45.9% for patients with p53-negative tumours. This trend is not due to different distribution of major clinical prognostic factors (age, incomplete resection or Karnofsky status). The trend could be related to the time needed by the p53-positive clone to outgrow the rest of the p53-negative neoplastic cell population. This hypothesis is further supported by the fact that the five recurrences which were surgically removed (one anaplastic astrocytoma and four glioblastomas) derived from p53-positive tumours and were themselves intensely p53 positive.