Anaplastic thyroid cancer: Clinical outcomes with conformal radiotherapy.

BACKGROUND: The aim of this study was to review institutional outcomes for anaplastic thyroid cancer treated with conformal 3-dimensional radiotherapy (3DRT) or intensity-modulated radiotherapy (IMRT). METHODS: In all, 53 consecutive patients were analyzed. Thirty-one (58%) patients were irradiated with curative intent. Median radiation dose was 55 Gray (Gy; range, 4-70 Gy). Thirteen (25%) patients received IMRT to a median 60 Gy (range, 39.9-69.0 Gy). Thirty-nine (74%) patients received chemotherapy with radiation. RESULTS: The Kaplan-Meier estimate of overall survival (OS) at 1 year for definitively irradiated patients was 29%. Patients without distant metastases receiving >or=50 Gy had superior survival outcomes; 5 such patients had no evidence of disease at last follow-up. Use of IMRT versus 3DRT did not influence toxicity. CONCLUSIONS: Outcomes for anaplastic thyroid cancer treated with 3DRT or IMRT remain equivalent to historical results. Healthy patients with localized disease who tolerate full dose irradiation can potentially enjoy prolonged survival. Biologically targeted radiosensitization merits prioritized investigation.

Anaplastic sarcoma of the kidney.

Wilms tumor can appear with a wide spectrum of morphologic features and can sometimes cover or delay the recognition of other clinicopathologic entities of the kidney. We present a case of a new tumor entity of the kidney, namely the anaplastic sarcoma of the kidney, a tumor of high malignancy.

Anaplastic ganglioglioma arising from a Lhermitte-Duclos-like lesion. Case report.

The authors report the case of a 7-year-old boy with a history of developmental delay who presented with aggressive behavior. A magnetic resonance (MR) image showed a mass lesion originating from the cerebellar vermis with an atypical folial pattern and contrast enhancement. Histologically, the subtotally resected specimen consisted mostly of neuropil with nodular foci of ganglion cells. Lhermitte-Duclos disease (LDD) was diagnosed in the patient. A retrospective review of the tissue sections showed a nidus of associated astrocytic proliferation, suggesting a diagnosis of ganglioglioma. Five years later, the patient experienced an altered mental state and a facial droop. An MR image revealed a cerebellar mass with cystic areas and an enhancing nodule. The resected tissue specimen consisted primarily of a mixed proliferation of glial and ganglion cells consistent with a ganglioglioma. Two years later, a third craniectomy was performed in the patient for worsening headache and ataxia. Histologically, the tumor showed progressive anaplasia and was most accurately classified as an anaplastic ganglioglioma. Immunohistochemically, most of the tumor cells were immunoreactive for anti-phospho-mammalian target of rapamycin (mTOR) and phospho-S6 ribosomal protein antibodies. In contrast, the subpopulation of neoplastic ganglion cells in the tissue, particularly from the first surgery, did not express phosphatase and tensin homolog deleted from chromosome 10 (PTEN). This immunohistochemical pattern suggests that the large dysplastic ganglion cells (the gangliocytomatous component) forming the greater part of the lesion were associated with activation of the phosphatidylinositol 3-kinase-PTEN/Akt/mTOR signaling pathway, a feature previously reported in LDD. This case represents the first report of an anaplastic ganglioglioma arising in an LDD-like lesion.

[Methods of statistical analysis in differential diagnostics of the degree of brain glioma anaplasia during preoperative stage].

The authors proposed a possible preoperative diagnostics of the degree of supratentorial brain gliom anaplasia using statistical analysis methods. It relies on a complex examination of 934 patients with I-IV degree anaplasias, which had been treated in the Institute of Neurosurgery from 1990 to 2004. The use of statistical analysis methods for differential diagnostics of the degree of brain gliom anaplasia may optimize a diagnostic algorithm, increase reliability of obtained data and in some cases avoid carrying out irrational operative intrusions. Clinically important signs for the use of statistical analysis methods directed to preoperative diagnostics of brain gliom anaplasia have been defined

[The level of embryonic antigens in the blood serum and cerebrospinal fluid of neuro-oncological patients]. / Soderzhanie émbrional'nykh antigenov v syvorotke krovi i likvore neiroonkologicheskikh bol'nykh.

The levels of embryonic antigens (cancer embryonic antigen, alpha-fetoprotein, beta-chorionic gonadotropin were measured in the serum, spinal fluid, the cystic fluid of tumor 83 of neuro-oncological patients. It was found that the blood concentrations of cancer embryonic antigen and alpha-fetoprotein were not generally related to the degree of malignancy and the blood level of beta-chorionic gonadotropin decreased with the higher degree of tumor anaplasia. The high content of beta-chorionic gonadotropin in the spinal fluid suggests its origin from a brain tumor. The fatal postoperative outcome was noted in patients having high preoperative serum levels of alpha-fetoprotein and cancer embryonic antigen with simultaneous much higher concentrations of alpha-fetoprotein in the serum than those in the spinal fluid.

Impact of stereotactic interstitial radiation on brain capillary physiology.

rCBF, capillary permeability and vascular volume have been measured during the time course of interstitial stereotactic radiosurgery in normal and tumour-bearing dog brain. For rCBF measurement the stable Xenon-CT-technique with a modified Kety-Schmidt equation has been used, and for measurement of blood-to-brain transport of meglumine iothalamate the two-compartment CT-method as developed by Groothuis, which also reflects vascular volume. Anaplastic gliomas had been induced by intracerebral injection of avian sarcoma virus. Radiation sources have been 192-iridium and 198-gold. Both of the isotopes caused spherical blood-brain-barrier lesions with a more than 10-fold blood-to-brain transport increase. These effects occurred earlier and more pronounced with 192-iridium, but much longer lasting with 198-gold. Interstitial radiosurgery of the tumours led to a further increase of capillary permeability. Blood flow was significantly lowered not only within radionecrosis but also in the adjacent brain areas.

Anaplastic temporal lobe ganglioglioma. Case report.

Clinical, histological and histochemical features of anaplastic temporal ganglioglioma in a 30-year-old woman are described. Short clinical course (preoperative 2 years, postoperative 6 months), anaplastic features of glial astrocytic component with scarce GFAP and negative vimentin immunostaining indicate aggressive character of the tumor. Ganglionic component is confirmed by the strong Con A affinity and discrete FN and NSE immunostaining.