• Journal of Korean Neurosurgical Society
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• 제47권1호
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• pp.68-70
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• 2010

We report a case of intracranial dissemination developing approximately 4 months after partial removal of a spinal cord anplastic astrocytoma in a 22-year-old male. He presented with paraplegia on initial admission at a local hospital. Spinal magnetic resonance (MR) images disclosed multiple intramedullary lesions at the T3-11. The tumor was partially removed. The final histologic diagnosis was anaplastic astrocytoma. Four months after the operation, he was admitted with the symptoms of headache and deterioration of consciousness. MR images showed enhanced lesions in the anterior horn of the left lateral ventricle, and septum pellucidum. He underwent computed tomography-guided stereotactic biopsy and histological appearance was consistent with anaplastic astrocytoma. The clinical course indicates that the tumor originated in the spinal cord and extended into the subarachnoid space, first the spinal canal and later intracranial.

• Journal of Korean Neurosurgical Society
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• 제56권3호
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• pp.261-264
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• 2014

We report perfusion weighted imaging (PWI) findings of nonenhanced anaplastic astrocytoma in a 30-year-old woman. Brain magnetic resonance imaging showed a nonenhanced brain tumor with mild peritumoral edema on the right medial frontal lobe and right genu of corpus callosum, suggesting a low-grade glioma. However, PWI showed increased relative cerebral blood volume, relative cerebral blood flow, and permeability of nonenhanced brain tumor compared with contralateral normal brain parenchyma, suggesting a high-grade glioma. After surgery, final histopathological analysis revealed World Health Organization grade III anaplastic astrocytoma. This case demonstrates the importance of PWI for preoperative evaluation of nonenhanced brain tumors.

• Investigative Magnetic Resonance Imaging
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• 제5권2호
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• pp.130-137
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• 2001

목적: 대뇌 교종(glioma)에서 상대적 뇌혈액용적(relative cerebral blood volume, rCBV)과 종양의 조직학적 등급(grade)을 비교하고자 하였다. 대상 및 방법 대뇌 교종으로 진단된 총 16명의 환자에서 수술 전에 고식적 T1 및 T2 강조 자기 공명영상 및 조영제를 이용한 관류 자기공명영상을 시행하였다. 교종은 교아세포종(glioblas tora)이 7예, 역형성 성상세포종(anaplastic astrocytoma)이 2예, 역형성 핍지교세포종(anaplastic oligodendroglioma)이 1예, 저등급 성상세포종(low-grade astrocytoma)이 5예, 저등급 핍지교종(low-grade oligodendroglioma)이 1예 있었다. 관류 자기공명영상으로 얻은 교종의 최대 rCBV을 종양의 조직학적 진단 및 등급과 비교 하였다. 결과: 교아세포종의 최대 rCBV은 반대편 정상 백질과 비교하여 433%-1330% (펑균 790%)로 현저히 증가되어 있었다. 강한 조영증강을 보인 역형성 핍지교종 1예의 최대 rCBV은 502%로 증가되어 있었으나 조영증강되지 않는 역형성 성상세포종 2예의 최대 rCBV은 각각66%, 284%로 비교적 낮았다. 저등급 성상세포종의 최대 rCBV은 80%-369% (굉균 202 %)였다. 저등급 핍지교종 1예는 최대 rCBV이 1450%로 교아세포종 보다 높았다. 결론: 관류 자기공명영상을 이용한 rCBV수치는 교아세포종과 저등급 성상세포종은 분명히 구분되었으나 조영증강되지 않는 역형성 성상세포종파 저등급 성상세포종 간에는 차이가 없었다.

• Journal of Korean Neurosurgical Society
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• 제30권11호
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• pp.1328-1331
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• 2001

Multiple primary brain tumors of different cell types are rare, accounting for 0.4% of all the primary brain tumors. Phakomatosis, irradiation, trauma and other factors have been associated with multiplicity of brain tumors. When these tumors are close or intermixed, the term "collision" has been used, and in these cases an explanation might be that one tumor stimulating the other. We report a patient with collision tumor of meningioma and anaplastic astrocytoma, who did not have a history of trauma, irradiation, or phakomatosis.

• Journal of Korean Neurosurgical Society
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• 제29권4호
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• pp.485-490
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• 2000

Objective : To study the expression of apoptosis and bcl-2 in the astrocytic tumors. Patients and Methods : A total of thirty-eight astrocytomas(9 cases in low grade astrocytoma, 12 cases in anaplastic astrocytoma and 17 cases in glioblastoma) are included in this study. Immunohistochemical stain for bcl-2 using monoclonal antibody, in situ end labelling technique for apoptosis were used. Results : The malignant group(anaplastic astrocytoma and glioblastoma) showed significantly higher apoptosis positive index(PI) compared to the benign group(low grade astrocytoma)(1.35 vs 0.14). However apoptosis PI and bcl-2 PI were not significantly different among three groups. Correlation between apoptosis PI and bcl-2 PI was not statistically significant(p=0.58). Conclusion : This result suggest that apoptosis PI and bcl-2 PI are not related the degree of malignancy in astrocytic neoplasm, but apoptosis PI in malignant group was higher possibly due to greater DNA damage.

• Journal of Korean Neurosurgical Society
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• 제54권2호
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• pp.125-127
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• 2013

Here, we report a rare case of an anaplastic astrocytoma masquerading as a hypertensive basal ganglia hemorrhage. A 69-year-old woman who had been under medical management for hypertension during the past 3 years suddenly developed right hemiparesis with dysarthria. Brain computed tomography (CT) scans with contrast and CT angiograms revealed an intracerebral hemorrhage (ICH) in the left basal ganglia, without an underlying lesion. She was treated conservatively, but underwent a ventriculoperitoneal shunt operation 3 months after the initial attack due to deteriorated mental status and chronic hydrocephalus. Three months later, her mental status deteriorated further. Magnetic resonance imaging (MRI) with gadolinium demonstrated an irregular enhanced mass in which the previous hemorrhage occurred. The final histological diagnosis which made by stereotactic biopsy was an anaplastic astrocytoma. In the present case, the diagnosis of a high grade glioma was delayed due to tumor bleeding mimicking hypertensive ICH. Thus, a careful review of neuroradiological images including MRI with a suspicion of tumor bleeding is needed even in the patients with past medical history of hypertension.

• Asian Pacific Journal of Cancer Prevention
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• 제15권15호
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• pp.6315-6319
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• 2014

Background: Immunohistochemical markers are considered as important factors in diagnosis of malignant astrocytomas. The aim of the current study was to investigate the frequency of the immunohistochemical markers neurofilament protein (NFP) and glial fibrillary acidic protein (GFAP) in malignant astrocytoma tumors in Firoozgar and Rasool-Akram hospitals from 2005 to 2010. Materials and Methods: In this cross-sectional study, immunohistochemical analysis of NFP and GFAP was performed on 79 tissue samples of patients with the diagnosis of anaplastic and glioblastoma multiform (GBM) astrocytomas. Results: The obtained results demonstrated that all patients were positive for GFAP and only 3.8% were positive for NFP. There was no significant association between these markers and clinical, demographic, and prognostic features of patients (p>0.05). Conclusions: NFP was expressed only in GBMs and not in anaplastic astrocytomas. It would be crucial to confirm the present findings in a larger number of tumors, especially in high grade gliomas.

• Journal of Korean Neurosurgical Society
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• 제29권10호
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• pp.1396-1401
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• 2000

Although direct surgical treatment of the lesion in the pons may cause severe neurologic morbidity, safe route to minimize injuries of the important structures in the pons should be considered. The authors operated four cases of intrapontine lesions via safe approach route without causing severe neurologic complications. Two cases were intrapontine tumors and other two were intrapontine hematoma. An anaplastic astrocytoma($3{\times}3{\times}3cm$) located bilaterally in the pons was approached via midline of the median sulcus, and a metastatic tumor($1.5{\times}1.5{\times}1.5cm$) located at the left posterolateral aspect in the upper pons was approached via suprafacial space. Two cases of hematoma were evacuated via median sulcus, and supra- and infrafacial spaces. Preoperatively, quadriplegia, swallowing difficulty, diplopia, speech disturbance, and nystagmus were noted in a patient with an anaplastic astrocytoma. A patient with metastatic tumor showed mild right hemiparesis, right hemisensory disturbance, diplopia, and dizziness. Two patients with hematoma in the pons were comatous, and had contracted, fixed pupils. Postoperatively, a patient with an anaplastic astrocytoma recovered and a patient with a metastatic tumor showed temporary hemifacial palsy. Mental status was fully recovered normal even though facial palsy, diplopia, severe ataxia, dizziness, and tremor persisted in both patients with pontine hematoma. Careful operation based on the anatomical knowledge of the floor of the 4th ventricle is of prime importance in appraoching to the intrapontine lesion with minimal injuries of the eloquent structures during surgery.

• Journal of Korean Neurosurgical Society
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• 제51권4호
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• pp.199-202
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• 2012

Objective: This retrospective study was performed to evaluate the role of chemotherapy in the management of patients with anaplastic astrocytoma (AA). Methods: We compared the survival outcome among the 3 different treatment protocol groups in a single institution. A total of 86 patients (39 men and 47 women) with newly diagnosed AA after surgery were analyzed. Among them, 31 patients (36.0%) were treated with radiotherapy only (RT Group), 30 patients (34.9%) were treated with nimustine-cisplatin chemotherapy before RT (ACNU-COOP group), and 25 patients (29.1 %) were treated with procarbazine, lomustine and vincristine (PCV) chemotherapy after radiotherapy (PCV group). Results: The median survival was 14.0, 30.0 and 72.0 months in RT, ACNU-COOP, and PCV group, respectively and showed significant differences (RT vs. ACNU-COOP; p=0.039, RT vs. PCV; 0.002, ACNU-COOP vs. PCV; 0.045). PCV group showed less toxicity rate (5 patients; 20%) than ACNU-COOP group (12 patients; 40%), while only 3 patients (9.6%) in RT group experienced grade 3 or 4 toxicities. Conclusion: An application of chemotherapy before or after radiotherapy is beneficial in prolonging the survival of patients with AA. Adjuvant PCV chemotherapy after radiotherapy is recommendable.

• Interdisciplinary Bio Central
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• 제5권1호
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• pp.1.1-1.8
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• 2013

High quality publicly-available transcriptomic data representing relationships in gene expression across a diverse set of biological conditions is used as a context network to explore transcriptomics of the CNS. The context network, 18367Hu-matrix, contains pairwise Pearson correlations for 22,215 human genes across18,637 human tissue samples1. To do this, we compute a network derived from biological samples from CNS cells and tissues, calculate clusters of co-expressed genes from this network, and compare the significance of these to clusters derived from the larger 18367Hu-matrix network. Sorting and visualization uses the publicly available software, MetaOmGraph (http://www.metnetdb.org/MetNet_MetaOm-Graph.htm). This identifies genes that characterize particular disease conditions. Specifically, differences in gene expression within and between two designations of glial cancer, astrocytoma and glioblastoma, are evaluated in the context of the broader network. Such gene groups, which we term outlier-networks, tease out abnormally expressed genes and the samples in which this expression occurs. This approach distinguishes 48 subnetworks of outlier genes associated with astrocytoma and glioblastoma. As a case study, we investigate the relationships among the genes of a small astrocytoma-only subnetwork. This astrocytoma-only subnetwork consists of SVEP1, IGF1, CHRNA3, and SPAG6. All of these genes are highly coexpressed in a single sample of anaplastic astrocytoma tumor (grade III) and a sample of juvenile pilocytic astrocytoma. Three of these genes are also associated with nicotine. This data lead us to formulate a testable hypothesis that this astrocytoma outlier-network provides a link between some gliomas/astrocytomas and nicotine.