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-(a) Classical type medulloblastoma with hyperchromatic nucleus, with occasional mitosis structures (H&E; X20). (b) High proliferation index in medulloblastoma (Ki-67; X10).
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Posterior fossa tumors (PFTs) include medulloblastomas, atypical teratoid/rhabdoid tumors, pilocytic astrocytomas, ependymomas, and brainstem gliomas. We evaluated patients with surgery at our clinic, comparing epidemiological, clinical, radiological, and pathological characteristics of medulloblastoma and ependymoma to identify factors that might...
Context in source publication
Context 1
... antibody staining ranged from 5% to 80%, with an overall average of 46%. The average Ki-67 antibody positivity was 9.0% in ependymoma and 77.1% in medulloblastoma (p = 0.000) (Figure 4a and 4b). Two of the ependymomas (29%) were grade 1, and five (71%) were grade 2. The two patients who died were grade 2. Three of the medulloblastomas (25%) were desmoplastic and one of the patients who died had a desmoplastic medulloblastoma (Figure 5a and 5b). ...
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Background
Ependymomas, pilocytic astrocytomas, medulloblastomas and intracranial germ cell tumors occur relative frequently in children, but are rare central nervous system (CNS) tumors in adults. In this population-based survey, we established incidence, treatment and survival patterns for these tumors diagnosed in adult patients (≥18 years) over...
Citations
... Ependymomas, typically intraventricular tumors, can also appear in the posterior fossa and cerebellopontine angle. Ependymal differentiation is a key histological feature that differentiates them from medulloblastomas [28] . ...
Introduction
Medulloblastoma, a highly malignant embryonal tumor predominantly found in the pediatric population, typically arises within the cerebellum. This case report holds particular importance due to the rarity of medulloblastoma within the cerebellopontine angle (CPA). The distinct anatomical challenge posed by the CPA complex neurovascular structures, along with the absence of pathognomonic clinical or radiographic features, highlights the unique diagnostic and management challenge of this case.
Case presentation
A 5-year-old boy presented with mild, progressively worsening headaches on CT/MRI imaging, which revealed a solid mass in the left CPA. Radiologically, the lesion closely resembled a CPA meningioma. The patient underwent a left retrosigmoid suboccipital craniectomy, utilizing a modified park bench position and careful burrhole creation. Intraoperatively, the tumor exhibited well-defined margins, firm adherence to cranial nerves, and complex tissue characteristics. Postoperatively, histopathological analysis identified nodular medulloblastoma, WHO grade IV, with immunohistochemical markers confirming its subtype.
Discussion
This case highlights the critical role of surgical intervention in addressing rare tumors, emphasizing the need for multidisciplinary collaboration in both diagnosis and management to achieve a favorable outcome. Uncommon tumor locations, such as the CPA, require tailored approaches, and the utilization of advanced diagnostic techniques, including immunohistochemistry, aids in accurate subtype classification.
Conclusion
This case highlights the critical role of surgical intervention in addressing rare tumors, emphasizing the need for multidisciplinary collaboration in both diagnosis and management to achieve a favorable outcome.
... Gliomas mainly occur in middle-aged people, and they are the most malignant primary brain tumors, representing 70% of primary adult malignant brain tumors with a yearly incidence of ∼0.06% (Schulte et al., 2020;Hartanto et al., 2021;Miyake et al., 2021). Currently, the treatment of gliomas mainly includes surgical resection and postsurgical radiotherapy and chemotherapy (Yilmaz et al., 2020;Karschnia et al., 2021;van der Meer et al., 2021). Chemotherapies or chemoradiotherapies can reduce the tumor size and improve the prognosis, but these treatments have significant side effects, especially in the aged patients (Festuccia et al., 2020;Smith-Cohn et al., 2021). ...
Gambogic acid (GA) is a highly effective antitumor agent, and it is used for the treatment of a wide range of cancers. It is challenging to deliver drugs to the central nervous system due to the inability of GA to cross the blood–brain barrier (BBB). Studies have shown that ultrasound-targeted microbubble destruction can be used for transient and reversible BBB disruption, significantly facilitating intracerebral drug delivery. We first prepared GA–loaded porous-lipid microbubbles (GA porous-lipid/PLGA MBs), and an in vitro BBB model was established. The cell viability was detected by CCK-8 assay and flow cytometry. The results indicate that U251 human glioma cells were killed by focused ultrasound (FUS) combined with GA/PLGA microbubbles. FUS combined with GA/PLGA microbubbles was capable of locally and transiently enhancing the permeability of BBB under certain conditions. This conformational change allows the release of GA to extracellular space. This study provides novel targets for the treatment of glioma.
... Gliomas mainly occur in middle-aged people, and they are the most malignant primary brain tumors, representing 70% of primary adult malignant brain tumors with a yearly incidence of ∼0.06% (Schulte et al., 2020;Hartanto et al., 2021;Miyake et al., 2021). Currently, the treatment of gliomas mainly includes surgical resection and postsurgical radiotherapy and chemotherapy (Yilmaz et al., 2020;Karschnia et al., 2021;van der Meer et al., 2021). Chemotherapies or chemoradiotherapies can reduce the tumor size and improve the prognosis, but these treatments have significant side effects, especially in the aged patients (Festuccia et al., 2020;Smith-Cohn et al., 2021). ...
Glial cell line derived neurotropic factor (GDNF) plays a crucial role in the development and maintenance of glial cells, serotonergic and dopaminergic neurons. A positively therapeutic effect has been demonstrated on some animal neurodegenerative diseases. However, the inability to deliver the protein across blood brain barrier (BBB) into damaged brain region limits its clinical application. Here, we developed GDNF-loaded microbubbles (MBs) and achieved a local and precise delivery of GDNF into the brain through MRI-guided focused ultrasound-induced BBB disruption. To demonstrate the therapeutic effect, rat depression model was developed by chronic mild stress treatment. Typical depression behaviors were confirmed. MRI-guided focused ultrasound was used to irradiate the GDNF-loaded MBs. Obvious BBB opening was observed in the treated rat brains and a significant higher GDNF concentration was detected in the ultrasound-treated brain tissues. Behavioral tests demonstrated the increased GDNF could reverse the depressive-like behaviors induced by chronic mild stress, improve the expression of 5-HT 1B receptor and the protein p11, and increase the number of 5-HT or TPH2 immunoreactive neurons. In conclusion, our study provided an effective approach to deliver GDNF proteins into brain to treat rat depression through MRI-guided focused ultrasound-induced destruction of blood-brain barrier.
