Cerebrospinal fluid cytology in patients with ependymoma

Qian, Xiaohua; Goumnerova, Liliana; Girolami, Umberto De; Cibas, Edmund S.

doi:10.1002/cncr.23799

Cited by 41 publications

(22 citation statements)

References 21 publications

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“…Evidence of spread of ependymoma cells into the CSF is a key factor in staging, prognosis, and treatment [15]. Subarachnoid spread of disease can be detected by MRI (Fig.…”

Section: Leptomeningeal Disseminationmentioning

confidence: 99%

“…Despite their location close to the ependymal surfaces of the ventricles and central canal of the spinal cord that could be expected to lead to a high incidence of exfoliation into the subarachnoid space, subarachnoid seeding is relatively uncommon in comparison to other primary central nervous system neoplasms such as medulloblastomas and malignant astrocytomas [15]. In general, CSF seeding is more common in higher-grade ependymomas, such as anaplastic ependymomas, and in younger children [15, 17, 19].…”

Section: Leptomeningeal Disseminationmentioning

confidence: 99%

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Imaging of ependymomas: MRI and CT

2009

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The imaging features of intracranial and spinal ependymoma are reviewed with an emphasis on conventional magnetic resonance imaging (MRI), perfusion MRI and proton magnetic resonance spectroscopy, and computed tomography. Imaging manifestations of leptomeningeal dissemination of disease are described. Finally, salient imaging features obtained in the postoperative period to evaluate completeness of surgical resection, and thereafter for long-term surveillance for disease recurrence, are reviewed.

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“…Evidence of spread of ependymoma cells into the CSF is a key factor in staging, prognosis, and treatment [15]. Subarachnoid spread of disease can be detected by MRI (Fig.…”

Section: Leptomeningeal Disseminationmentioning

confidence: 99%

Section: Leptomeningeal Disseminationmentioning

confidence: 99%

Imaging of ependymomas: MRI and CT

2009

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“…This is especially true for recurrent tumors (which occur with nearly all patients with high-grade gliomas), where imaging distinctions for remnant tumor, regrowth, or postradiation necrosis are difficult,31 and “pseudoprogression” (radiographic indications – usually, gadolinium enhancement – that appear as progressively growing tumor following radiation but later resolve or devolve into radiation necrosis) is another common problem 32,33. Tumor diagnostic/biomarker capabilities from an accessible compartment (blood/sera, urine, or saliva) would be a major advance for neuro-oncology, especially since there seem to be no circulating exfoliated brain tumor cells34 (cerebral spinal fluid offers mixed results35,36). Thus, most biomarker efforts for GBM are geared towards the determination of recurrent disease, either in the context of standard of care treatment or in a clinical trial setting, with an emphasis on clinical-level assessments.…”

Section: Biomarkers – General Considerationsmentioning

confidence: 99%

Glioblastoma extracellular vesicles: reservoirs of potential biomarkers

Redzic¹,

Ung²,

Graner³

2014

PGPM

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Glioblastoma multiforme (GBM) is the most frequent and most devastating of the primary central nervous system tumors, with few patients living beyond 2 years postdiagnosis. The damage caused by the disease and our treatments for the patients often leave them physically and cognitively debilitated. Generally, GBMs appear after very short clinical histories and are discovered by imaging (using magnetic resonance imaging [MRI]), and the diagnosis is validated by pathology, following surgical resection. The treatment response and diagnosis of tumor recurrence are also tracked by MRI, but there are numerous problems encountered with these monitoring modalities, such as ambiguous interpretation and forms of pseudoprogression. Diagnostic, prognostic, and predictive biomarkers would be an immense boon in following treatment schemes and in determining recurrence, which often requires an invasive intracranial biopsy to verify imaging data. Extracellular vesicles (EVs) are stable, membrane-enclosed, virus-sized particles released from either the cell surface or from endosomal pathways that lead to the systemic release of EVs into accessible biofluids, such as serum/plasma, urine, cerebrospinal fluid, and saliva. EVs carry a wide variety of proteins, nucleic acids, lipids, and other metabolites, with many common features but with enough individuality to be able to identify the cell of origin of the vesicles. These components, if properly interrogated, could allow for the identification of tumor-derived EVs in biofluids, indicating tumor progression, relapse, or treatment failure. That knowledge would allow clinicians to continue with treatment regimens that were actually effective or to change course if the therapies were failing. Here, we review the features of GBM EVs, in terms of EV content and activities that may lead to the use of EVs as serially accessible biomarkers for diagnosis and treatment response in neuro-oncology.

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“…Although it is a relatively benign tumor, cerebrospinal fluid (CSF) spread is found in 8-33% of patients (2,3). Moreover, subtentorial ependymoma is more inclined to exhibit CSF metastasis compared with supratentorial ependymoma (4).…”

Section: Introductionmentioning

confidence: 99%

Primary cerebellopontine angle ependymoma with spinal metastasis in an adult patient: A case report

et al. 2015

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Abstract. Subtentorial ependymoma is a common central nervous system tumor in young children, but is uncommon in adults. Ependymoma often arises from the cells lining the fourth ventricle. The present study reports a rare case of primary ependymoma that originated from the cerebellopontine angle, with local extension to the two internal auditory canals and remote spinal metastasis, in an adult male. A 50-year-old male presented with headache, tinnitus and bilateral hearing loss that had persisted for 4 months. Magnetic resonance imaging (MRI) revealed a mass in each of the cerebellopontine angles, which had spread to each internal auditory canal and wrapped the VII/VIII cranial nerve complex. A gross total resection was performed to remove the mass in the right side. Histological examination confirmed that the tumor was a World Health Organization grade II papillary ependymoma. Notably, the patient complained of urine retention post-surgery and massive occupational lesions in T3-T4 and L5-S2 were found on full spinal cord MRI. The patient then received combination therapy consisting of temozolomide, and whole-brain and spinal cord radiation. In the final follow-up examination, performed 13 months after treatment, slight shrinkage of the T3 lesion was observed, and no progression of the left cerebellopontine angle and S5-L2 lesions were identified on MRI. In summary, although this clinical entity is rare, the diagnosis of ependymoma and the possibility of spinal cord metastasis should be considered in subtentorial tumors. IntroductionSubtentorial ependymoma mainly occurs in young children and usually arises in the fourth ventricle (1). Although it is a relatively benign tumor, cerebrospinal fluid (CSF) spread is found in 8-33% of patients (2,3). Moreover, subtentorial ependymoma is more inclined to exhibit CSF metastasis compared with supratentorial ependymoma (4).Bilateral primary posterior fossa ependymoma originating from the cerebellopontine angle, termed primary cerebellopontine angle ependymoma, is a rare form of subtentorial ependymoma that predominantly occurs in infants and young children. The main symptom is headache due to progressively increasing intracranial pressure (5), while cranial nerve deficit is relatively uncommon. Surgical resection with subsequent radiotherapy is the primary treatment strategy for patients with ependymoma (6). The efficacy of conventional chemotherapy for this disease remains uncertain; however, temozolomide appears to be a promising adjuvant therapeutic approach for multifocal anaplastic ependymoma following surgical resection (7). The extent of surgical resection is the major determinant of overall survival in pediatric patients (8). However, the prognosis varies in different reports, with 5-year overall survival ranging between 50 and 64%, and progression-free survival ranging between 23 and 64% (5,9-11).The present study reports a rare case of primary cerebellopontine angle ependymoma extending to the internal auditory canals and spinal cord in an adult man. To the best...

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Cerebrospinal fluid cytology in patients with ependymoma

Cited by 41 publications

References 21 publications

Imaging of ependymomas: MRI and CT

Imaging of ependymomas: MRI and CT

Glioblastoma extracellular vesicles: reservoirs of potential biomarkers

Primary cerebellopontine angle ependymoma with spinal metastasis in an adult patient: A case report

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