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  • 1
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    Primary pituitary lymphoma successfully treated with Bruton’s tyrosine kinase inhibitor monotherapy: case report
    Serbian Neurosurgical Society ; 2023
    In:  Neurohirurgija - The Serbian Journal of Neurosurgery Vol. 3, No. 1 ( 2023-03-25)
    Details
    In: Neurohirurgija - The Serbian Journal of Neurosurgery, Serbian Neurosurgical Society, Vol. 3, No. 1 ( 2023-03-25)
    Kurzfassung: Introduction: Primary pituitary lymphoma (PPL) is a rare disease characterized by lymphoma confined to the sella or parasellar region without systemic involvement. The clinical symptoms of PPL may include headache, hypopituitarism, visual field disturbance and visual impairment. To date, there is no established standard treatment for this condition. Here, we present a case of successful treatment with a Bruton’s tyrosine kinase (BTK) inhibitor. Case report: A 78-years-old man with a history of severe left renal insufficiency caused by retroperitoneal fibrosis, and sequential right nephrostomy, underwent brain magnetic resonance imaging (MRI) due to the altered hormonal status. An enlarged pituitary stalk was noted and led to a diagnosis of lymphocytic hypopituitarism. Six months later, visual field disturbance and visual acuity deterioration developed, and an MRI revealed a neoplastic lesion and further enlargement of the stalk and the pituitary itself, with an obvious optic nerve compression. Expedited transsphenoidal partial resection was performed to relieve the compression. Pathohystology led to the diagnosis of the large B-cell lymphoma of the germinal center origin. Because of the patient’s poor renal function, high-dose methotrexate therapy was not an option; rather, the patient was treated with a BTK inhibitor - tirabrutinib. Symptoms improved within a week, and a follow-up MRI confirmed a marked reduction of the pituitary lesion. Conclusion: BTK inhibitors may be considered as a first-line treatment option for PPL, especially in patients with contraindications for other treatment protocols.
    Materialart: Online-Ressource
    ISSN: 2955-9170 , 2955-9162
    URL: Issue
    URL: Article
    DOI: 10.55005/sjns.v1i1
    DOI: 10.55005/v3i1.7
    Sprache: Unbekannt
    Verlag: Serbian Neurosurgical Society
    Publikationsdatum: 2023
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 2
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    Intrathecal and intraperitoneal germinomas occurring 20 years after total removal of a pineal teratoma : Case report
    Journal of Neurosurgery Publishing Group (JNSPG) ; 2002
    In:  Journal of Neurosurgery Vol. 96, No. 2 ( 2002-02), p. 364-367
    Details
    In: Journal of Neurosurgery, Journal of Neurosurgery Publishing Group (JNSPG), Vol. 96, No. 2 ( 2002-02), p. 364-367
    Kurzfassung: ✓ In 1980, a 10-year-old boy was admitted to the authors' hospital with consciousness disturbance and vomiting. Computerized tomography (CT) scans revealed a pineal mass lesion and hydrocephalus. The tumor was totally removed and a ventriculoperitoneal (VP) shunt was inserted. Histological investigation of a surgical specimen revealed that it was a teratoma. Five years later, the patient was readmitted to the same institution with polyuria. Magnetic resonance (MR) imaging revealed a mass lesion in the suprasellar region. The patient received systemic chemotherapy, and the tumor disappeared; however, 2 years after the chemotherapy, MR imaging demonstrated a right lateral ventricular mass. The tumor was totally resected, and histopathological investigation revealed a teratocarcinoma. Three years after the chemotherapy, CT scanning revealed suprasellar and right lateral ventricular tumor recurrences, for which the patient received irradiation and chemotherapy. The tumors disappeared and the patient achieved complete remission that lasted longer than 10 years. On January 25, 2000, however, he noticed hip pain. Lumbar MR imaging demonstrated a spinal tumor below L-4 and also an abdominal tumor. The abdominal tumor was totally removed, and the histological findings identified it as a germinoma. The patient received systemic chemotherapy and the tumor disappeared completely. The authors believe that the suprasellar tumor was a metachronous germinoma and that it had metastasized through the intrathecal route and the VP shunt.
    Materialart: Online-Ressource
    ISSN: 0022-3085
    URL: Article
    DOI: 10.3171/jns.2002.96.2.0364
    RVK:
    XA 10000
    RVK:
    XA 55270
    Sprache: Unbekannt
    Verlag: Journal of Neurosurgery Publishing Group (JNSPG)
    Publikationsdatum: 2002
    ZDB Id: 2026156-1
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 3
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    Human chorionic gonadotropin detection in cerebrospinal fluid of patients with a germinoma and its prognostic significance: assessment by using a highly sensitive enzyme immunoassay
    Journal of Neurosurgery Publishing Group (JNSPG) ; 2016
    In:  Journal of Neurosurgery: Pediatrics Vol. 18, No. 5 ( 2016-11), p. 573-577
    Details
    In: Journal of Neurosurgery: Pediatrics, Journal of Neurosurgery Publishing Group (JNSPG), Vol. 18, No. 5 ( 2016-11), p. 573-577
    Kurzfassung: Human chorionic gonadotropin (HCG) can be detected in a certain population of patients with a germinoma, but the frequency of germinoma HCG secretion and the prognostic value of HCG in the CSF are unknown. METHODS The authors measured HCG levels in sera and CSF in patients with a histologically confirmed germinoma by using a highly sensitive assay known as an immune complex transfer enzyme immunoassay (EIA), which is more than 100 times as sensitive as the conventional method, and they analyzed the correlation between HCG levels and the prognoses of patients with a germinoma. RESULTS HCG levels in sera and CSF of 35 patients with a germinoma were examined with the immune complex transfer EIA. The median CSF HCG levels in patients with a germinoma during the pretreatment and posttreatment evaluations were 192.5 pg/ml (range 1.2–13,116.5 pg/ml) and 18.7 pg/ml (1.2–283.9 pg/ml), respectively. Before treatment, the CSF HCG level was greater than the cutoff value in 85.7% of the patients with a germinoma. The authors compared survival rates among the patients by using a CSF HCG cutoff level of 1000 pg/ml, and the difference was statistically significant between the groups (p = 0.029, log-rank test). CONCLUSIONS Results of this study demonstrate that most germinomas secrete HCG. Patients with a germinoma that secretes higher amounts of HCG in their CSF experienced recurrence more frequently than those with lower CSF HCG levels.
    Materialart: Online-Ressource
    ISSN: 1933-0707 , 1933-0715
    URL: Article
    DOI: 10.3171/2016.4.PEDS1658
    RVK:
    XA 55270.2
    Sprache: Unbekannt
    Verlag: Journal of Neurosurgery Publishing Group (JNSPG)
    Publikationsdatum: 2016
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 4
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    Integrated molecular analysis reveals hypermethylation and overexpression of HOX genes to be poor prognosticators in isocitrate dehydrogenase mutant glioma
    Oxford University Press (OUP) ; 2023
    In:  Neuro-Oncology ( 2023-07-20)
    Details
    In: Neuro-Oncology, Oxford University Press (OUP), ( 2023-07-20)
    Kurzfassung: Diffuse gliomas represent over 80% of malignant brain tumors ranging from low-grade to aggressive high-grade lesions. Within isocitrate dehydrogenase (IDH)-mutant gliomas, there is a high variability in survival and a need to more accurately predict outcome. Methods To identify and characterize a predictive signature of outcome in gliomas, we utilized an integrative molecular analysis (using methylation, mRNA, copy number variation (CNV), and mutation data), analyzing a total of 729 IDH-mutant samples including a test set of 99 from University Health Network (UHN) and 2 validation cohorts including the German Cancer Research Center (DKFZ) and The Cancer Genome Atlas (TCGA). Results Cox regression analysis of methylation data from the UHN cohort identified CpG-based signatures that split the glioma cohort into 2 prognostic groups strongly predicting survival that were validated using 2 independent cohorts from TCGA and DKFZ (all P-values  & lt; .0001). The methylation signatures that predicted poor outcomes also exhibited high CNV instability and hypermethylation of HOX gene probes. Integrated multi-platform analyses using mRNA and methylation (iRM) showed that parallel HOX gene overexpression and simultaneous hypermethylation were significantly associated with increased mutational load, high aneuploidy, and worse survival (P-value  & lt; .0001). A 7-HOX gene signature was developed and validated using the most significantly associated HOX genes with patient outcome in both 1p/19q codeleted and non-codeleted IDHmut gliomas. Conclusions HOX gene methylation and expression provide important prognostic information in IDH-mutant gliomas that are not captured by current molecular diagnostics. A 7-HOX gene signature of outcome shows significant survival differences in both 1p/19q codeleted and non-codeleted IDH-mutant gliomas.
    Materialart: Online-Ressource
    ISSN: 1522-8517 , 1523-5866
    URL: Article
    DOI: 10.1093/neuonc/noad126
    Sprache: Englisch
    Verlag: Oxford University Press (OUP)
    Publikationsdatum: 2023
    ZDB Id: 2094060-9
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 5
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    Transient Ischemic Attack Due to Dissection of the Middle Cerebral Artery. Case Report. : —Case Report—
    Japan Neurosurgical Society ; 2001
    In:  Neurologia medico-chirurgica Vol. 41, No. 8 ( 2001), p. 399-401
    Details
    In: Neurologia medico-chirurgica, Japan Neurosurgical Society, Vol. 41, No. 8 ( 2001), p. 399-401
    Materialart: Online-Ressource
    ISSN: 0470-8105 , 1349-8029
    URL: Article
    DOI: 10.2176/nmc.41.399
    Sprache: Englisch
    Verlag: Japan Neurosurgical Society
    Publikationsdatum: 2001
    ZDB Id: 2178019-5
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 6
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    Immunotherapy of Nivolumab with Dendritic Cell Vaccination Is Effective against Intractable Recurrent Primary Central Nervous System Lymphoma: A Case Report
    Japan Neurosurgical Society ; 2017
    In:  Neurologia medico-chirurgica Vol. 57, No. 4 ( 2017), p. 191-197
    Details
    In: Neurologia medico-chirurgica, Japan Neurosurgical Society, Vol. 57, No. 4 ( 2017), p. 191-197
    Materialart: Online-Ressource
    ISSN: 0470-8105 , 1349-8029
    URL: Article
    DOI: 10.2176/nmc.cr.2016-0330
    Sprache: Englisch
    Verlag: Japan Neurosurgical Society
    Publikationsdatum: 2017
    ZDB Id: 2178019-5
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 7
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    Using gene expression profiling to identify a prognostic molecular spectrum in gliomas
    Wiley ; 2009
    In:  Cancer Science Vol. 100, No. 1 ( 2009-01), p. 165-172
    Details
    In: Cancer Science, Wiley, Vol. 100, No. 1 ( 2009-01), p. 165-172
    Materialart: Online-Ressource
    ISSN: 1347-9032 , 1349-7006
    URL: Issue
    URL: Article
    DOI: 10.1111/cas.2009.100.issue-1
    DOI: 10.1111/j.1349-7006.2008.01002.x
    Sprache: Englisch
    Verlag: Wiley
    Publikationsdatum: 2009
    ZDB Id: 2115647-5
    ZDB Id: 2111204-6
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 8
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    GEN-06 CLINICAL COURSE AFTER TUMOR RECURRENCE OF MGMT HYPERMETHYLATED GLIOBLASTOMA
    Oxford University Press (OUP) ; 2019
    In:  Neuro-Oncology Advances Vol. 1, No. Supplement_2 ( 2019-12-16), p. ii8-ii8
    Details
    In: Neuro-Oncology Advances, Oxford University Press (OUP), Vol. 1, No. Supplement_2 ( 2019-12-16), p. ii8-ii8
    Kurzfassung: MGMT methylation in glioblastoma is a biomarker for determining treatment responsiveness and predicting prognosis. We analyzed whether there were differences in the prognosis between glioblastoma with MGMT hypermethylation and other glioblastomas after tumor recurrence. We enrolled 184 patients who underwent radiation therapy and temozolomide chemotherapy after tumor resection for newly diagnosed glioblastoma. MGMT methylation was quantitatively analyzed using methylation-specific high resolution melting analysis. The cut-off value for MGMT methylation had a difference of 35% from the previous values. The subjects were split into three groups according to their MGMT methylation levels, 122 in the low (L) methylation group (levels of 0–34%), 40 in the medium (M) methylation group (levels of 35–69%), and 22 in the high (H) methylation group (levels of 70% or more). We mainly focused on and compared the progression after recurrence. The progression-free survival (PFS) rate and overall survival (OS) rate were significantly longer in the M and H groups than in the L group. There was no difference in PFS between group M and group H, but OS was significantly longer in group H. The details of treatment for the 16 of 22 patients who had recurrences in group H are as follows: temozolomide, n = 1; bevacizumab, n = 8; investigational drugs (peptide vaccines and immune checkpoint inhibitors), n = 3; and supportive care, n = 4. The median survival rate for these 16 patients after recurrence was 18 months. Even patients who received only supportive care had a median survival time ranging between 9 and 17 months. Our results indicate that MGMT hypermethylation in glioblastoma is effective to a certain degree with other treatments even after recurrence. Even patients who underwent only supportive care survived for a relatively longer period of time. Biologically, MGMT hypermethylation may be associated with a moderately slow-growing tumor.
    Materialart: Online-Ressource
    ISSN: 2632-2498
    URL: Article
    DOI: 10.1093/noajnl/vdz039.035
    Sprache: Englisch
    Verlag: Oxford University Press (OUP)
    Publikationsdatum: 2019
    ZDB Id: 3009682-0
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 9
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    ML-10 Tirabrutinib, a second-generation BTK inhibitor in relapsed and refractory primary CNS lymphoma: A single institute study
    Oxford University Press (OUP) ; 2021
    In:  Neuro-Oncology Advances Vol. 3, No. Supplement_6 ( 2021-12-06), p. vi23-vi23
    Details
    In: Neuro-Oncology Advances, Oxford University Press (OUP), Vol. 3, No. Supplement_6 ( 2021-12-06), p. vi23-vi23
    Kurzfassung: BACKGROUND: The prognosis of relapsed and refractory (r/r) primary CNS lymphoma (PCNSL) is poor, and the development of new therapeutic agents is desirable. Comprehensive genetic analysis of PCNSL has shown that MYD88 and CD79B are frequently mutated and are oncogenic drivers, suggesting that Bruton’s tyrosine kinase (BTK), which is located downstream of MYD88 and CD79B, may be a reasonable therapeutic target. Tirabrutinib is a second-generation oral BTK inhibitor recently approved in Japan for the treatment of r/r PCNSL. In this study, we evaluated the efficacy and safety of tiraburtinib treatment of r/r PCNSL at Saitama Medical University. MATERIAL AND METHODS: Eighteen patients with r/r PCNSL to HD-MTX-based regimens were treated with 480 mg tiraburtinib daily under fasting conditions until disease progression. RESULTS: The median age was 63.5 years, and the median KPS was 70. Nine patients (50%) achieved a CR, 2 (11%) had a partial response, 3 (17%) had stable disease, and 4 (22%) had progressive disease. After a median follow-up of 17.3 months, the median progression-free survival was 7.9 months, and the median overall survival was 23.6 months. There were four cases of long-term treatment lasting more than one year. Grade 3 or higher adverse events were observed in 1 case of maculopapular rash, 1 case of cardiac failure, 1 case of neutropenia, and 1 case of lymphopenia. CONCLUSION: Tiraburtinib can be administered relatively safely to patients with relapsed or refractory PCNSL, and a certain degree of efficacy can be expected. Which patients can be treated with tiraburtinib over the long term, when can stop tirabrutinib treatment for patients with long-term CR, and the mechanism of tiraburtinib resistance needs to be determined.
    Materialart: Online-Ressource
    ISSN: 2632-2498
    URL: Article
    DOI: 10.1093/noajnl/vdab159.089
    Sprache: Englisch
    Verlag: Oxford University Press (OUP)
    Publikationsdatum: 2021
    ZDB Id: 3009682-0
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 10
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    ML-8 HIGH-DOSE CHEMOTHERAPY SUPPORTED BY AN AUTOLOGOUS STEM CELL TRANSPLANT IN RELAPSED PRIMARY CNS LYMPHOMA
    Oxford University Press (OUP) ; 2022
    In:  Neuro-Oncology Advances Vol. 4, No. Supplement_3 ( 2022-12-03), p. iii21-iii21
    Details
    In: Neuro-Oncology Advances, Oxford University Press (OUP), Vol. 4, No. Supplement_3 ( 2022-12-03), p. iii21-iii21
    Kurzfassung: Many patients with primary CNS lymphoma (PCNSL) relapse despite complete response (CR) after initial therapy. Relapsed PCNSL (rPCNSL) has a poor prognosis, and no adequate standard of treatment has been established. Autologous stem cell transplant (ASCT)-assisted high-dose chemotherapy (HDC) for rPCNSL is a promising treatment option, as is thiotepa (TT), which has been used in malignant lymphoma as a treatment option for PCNSL. In March 2020, TT was approved in Japan as a pre-treatment for ASCT in malignant lymphoma. TBC, TT with busulfan and cyclophosphamide, and BCNU+TT are used in Europe and the US, but treatment-related mortality (TRM) has been reported in about 10% of patients. The regimen approved in Japan is Buslufan-TT(BuTT) therapy in combination with busulfan, which differs from TBC in dosage, and there is little information on efficacy and safety for rPCNSL. In our hospital, we have introduced BuTT therapy for rPCNSL in patients under 65 years of age. In this report, we describe our experience with this treatment. Subjects: Five patients with rPCNSL since May 2021, age & lt;66 years, PS 0-2, are included in this study. Methods After obtaining CR with (R)MPV therapy after relapse, peripheral blood stem cells were harvested after administration of G-CSF and plerixafor, pretreated with BuTT therapy (Bu: 3.2 mg/kg, Day-8, -7, -6, -5: TT: 5 mg/kg, Day-4, -3) and transplanted on Day 0. Results Adverse events of Grade 3 or higher were abdominal pain in 2 cases, diarrhea in 1 case, pharyngitis in 2 cases, sepsis in 1 case, and pleuritis in 1 case, but all recovered, and no TRM was observed. All five patients are currently alive without recurrence. Conclusion HDC/ASCT is expected to be a curative treatment for rPCNSL. Future issues include the establishment of an upper age limit for the indication.
    Materialart: Online-Ressource
    ISSN: 2632-2498
    URL: Article
    DOI: 10.1093/noajnl/vdac167.080
    Sprache: Englisch
    Verlag: Oxford University Press (OUP)
    Publikationsdatum: 2022
    ZDB Id: 3009682-0
    Standort Signatur Einschränkungen Verfügbarkeit
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