The 2nd patient, an eight year previous female, underwent a complete surgical resection of the left paraventricular mass also diagnosed being a papillary glioneuronal tumor. She presented emergently 3 months right after diagnosis with emesis and weakness. A CT scan uncovered a hematoma that was surgically removed. Biopsies have been taken from within the resection cavity and had been optimistic read full article for recurrent tumor. 6 weeks just after sur gery, the patient is currently being observed closely with surveillance imaging. These two cases display that papillary glioneuronal tumors can behave more aggressively than described inside the literature. We hypothesize the substantial MIB index may perhaps be even more predictive in the far more aggressive lesions. These tumors really should be observed extremely closely with surveillance imaging postoperatively. Our knowledge using the to start with patient also demonstrates that in progressive disorder, radiation treatment may well be a helpful substitute therapy strategy.
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 Division of Neurosurgery, University of Minnesota Health care School, Minneapolis, MN, 2Departments of Neurology and 3Neurosurgery, Oregon Wellness Science University, Portland, OR, 4Department of Neurosurgery and Neuro Oncology, SU6668 Sherbrooke University, Sherbrooke, Quebec, Canada The prognosis for sufferers with diffuse pontine gliomas remains poor. New solutions are required for this sickness. From 1984 to 1998, 8 individuals, median age 11 many years, with DPG have been taken care of with monthly osmotic blood brain barrier disruption chemotherapy applying intra arterial carboplatin or methotrexate and intravenous cytoxan and etoposide. Patients presented for any median duration of 6 weeks with elevated intracranial pressure, lengthy tract indications, diplopia, ataxia, and nau sea/vomiting.
DPG was demonstrated on MRI scan in seven patients and on CT scan in 1 patient. Two individuals underwent tumor biopsy, one particular had an astro cytoma plus the other had an anaplastic astrocytoma. The median quantity of chemotherapy cycles that were administered by BBBD was ten. One patient who started out on carboplatin was converted to methotrexate, and 5 begun for the methotrexate protocol have been converted to carboplatin. MRI demonstrated partial responses in two sufferers, secure disorder in five patients, and disorder 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 through the to start with BBBD or intra arterial treatment was sixteen. 5 months. 1 patient was lost to fol lower up, date of death unknown. Even though the sample dimension is compact, the time to illness progression and survival instances are longer than people previously reported in other DPG series.