Malignant transformation of an optic pathway glioma without prior radiation therapy

Zoeller, Garrett K.; Brathwaite, Carole; Sandberg, David I.

doi:10.3171/2009.12.peds09173

Cited by 29 publications

(16 citation statements)

References 18 publications

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“…Longterm survivors of radiation in childhood remain at risk for the subsequent development of additional tumors such as meningiomas and other glial neoplasms. 19,28,31 Weprin et al 30 reported on 3 patients with recurrent pediatric ependymomas treated using SRS, with 2 patients having poor outcomes. One patient survived, 1 died of disease progression, and 1 died of radiation necrosis.…”

Section: Stereotactic Radiosurgery As Adjuvant Management For Recurrementioning

confidence: 98%

Stereotactic radiosurgery for pediatric recurrent intracranial ependymomas

Kano

Yang

Kondziolka

et al. 2010

PED

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Object To evaluate the role of stereotactic radiosurgery (SRS) in patients with recurrent or residual intracranial ependymomas after resection and fractionated radiation therapy (RT), the authors assessed overall survival, distant tumor relapse, progression-free survival (PFS), and complications. Methods The authors retrospectively reviewed the records of 21 children with ependymomas who underwent SRS for 32 tumors. There were 17 boys and 4 girls with a median age of 6.9 years (range 2.9–17.2 years) in the patient population. All patients underwent resection of an ependymoma followed by cranial or neuraxis (if spinal metastases was confirmed) RT. Eleven patients had adjuvant chemotherapy. Twelve patients had low-grade ependymomas (17 tumors), and 9 patients had anaplastic ependymomas (15 tumors). The median radiosurgical target volume was 2.2 cm3 (range 0.1–21.4 cm3), and the median dose to the tumor margin was 15 Gy (range 9–22 Gy). Results Follow-up imaging demonstrated therapeutic control in 23 (72%) of 32 tumors at a mean follow-up period of 27.6 months (range 6.1–72.8 months). Progression-free survival after the initial SRS was 78.4%, 55.5%, and 41.6% at 1, 2, and 3 years, respectively. Factors associated with a longer PFS included patients without spinal metastases (p = 0.033) and tumor volumes < 2.2 cm3 (median tumor volume 2.2 cm3, p = 0.029). An interval ≥18 months between RT and SRS was also associated with longer survival (p = 0.035). The distant tumor relapse rate despite RT and SRS was 33.6%, 41.0%, and 80.3% at 1, 2, and 3 years, respectively. Factors associated with a higher rate of distant tumor relapse included patients who had spinal metastases before RT (p = 0.037), a fourth ventricle tumor location (p = 0.002), and an RT to SRS interval < 18 months (p = 0.015). The median survival after SRS was 27.6 months (95% CI 19.33–35.87 months). Overall survival after SRS was 85.2%, 53.2%, and 23.0% at 1, 2, and 3 years, respectively. Adverse radiation effects developed in 2 patients (9.5%). Conclusions Stereotactic radiosurgery offers an additional option beyond repeat surgery or RT in pediatric patients with residual or recurrent ependymomas after initial management. Patients with smaller-volume tumors and a later recurrence responded best to radiosurgery.

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Section: Stereotactic Radiosurgery As Adjuvant Management For Recurrementioning

confidence: 98%

Stereotactic radiosurgery for pediatric recurrent intracranial ependymomas

Kano

Yang

Kondziolka

et al. 2010

PED

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“…Moharir et al [21] used positron emission tomography and computed tomography to follow 18 patients with optic pathway gliomas, 3 of whom were reported as having high-grade tumors. Zoeller et al [22] recently reported the first case of malignant transformation of an optic pathway glioma in the absence of radiotherapy.…”

Section: Discussionmentioning

confidence: 99%

Opticochiasmatic Apoplexy in a Five-Year-Old

Ball¹,

Wetmore

Giannini

et al. 2011

Pediatr Neurosurg

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A 5-year-old female presented to the emergency department with a 24-hour history of nausea, vomiting and mental status changes. Imaging demonstrated hemorrhage from a suprasellar mass consistent with an optic nerve glioma. The patient was taken to surgery for an open biopsy and hematoma evacuation. Pathology revealed a grade 3 fibrillary astrocytoma. She was subsequently treated with carboplatin and vincristine and is now 2 years out without evidence of recurrence. Apoplexy is a rare presentation for an optic pathway glioma. To the authors’ knowledge, this is the first reported case in the pediatric population. Clinical presentation appears similar to the symptoms observed in pituitary apoplexy. Timely surgery should be directed at obtaining diagnostic tissue, prevention of long-term nervous system damage and evacuation of the hematoma where feasible.

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“…Optik sinir gliomunda tedavi yöntemi olarak izlem, eksternal radyoterapi ve kemoterapi uygulanabilir. 7,11 Gliomlarda tedavi tümörün kiazmayı tehdit edip etmemesine, görme keskinliğine ve tümörün neden olduğu komplikasyonlara bağlı olarak değişir. Bazı hastalarda tümör kendiliğinden gerileyebilir.…”

Section: Sonuçlarunclassified

Orbita Nörojenik Tümörlerinin Klinik ve Tedavi Özellikleri

Kızıltunç¹,

Günduz²,

Erden³

2013

tjo

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ÖzetAmaç: Orbita nörojenik tümörlerinin klinik ve tedavi özelliklerinin değerlendirilmesi Ge reç ve Yön tem: Ankara Üniversitesi Tıp Fakültesi Göz Hastalıkları Anabilim Dalı Tümör Bölümü'nde 1998-2011 yılları arasında orbital nörojenik tümör tanısı alan 35 hastanın dosyaları retrospektif olarak tarandı. Sonuçlar: Olguların yaş ortalaması 28.3 yaş (2-67) idi. Başvuruda 20 (%57) olguda proptozis, 11 (%31) olguda göz hareketlerinde kısıtlılık vardı. Olguların 21'ine (%60) cilt yoluyla, 7'sine (%20) konjonktival yolla orbitotomi yapıldı. Olguların 3'ü (%8) daha önce dış merkezde opere edilmişti. 4 (%12) olguya klinik olarak tanı konuldu. Olguların 11'ine (%31,4) total eksizyonel biyopsi, 7'sine (%20) subtotal eksizyonel biyopsi, 10'una (%28,6) insizyonel biyopsi yapıldı. Histopatolojik ve klinik tanıya göre olguların 14'ünde (%40) menenjiom, 12'sinde (%34) periferik sinir kılıfı tümörü, 9'unda (%26) optik sinir gliomu saptandı. Menenjiom olgularının 6'sı (%43) optik sinir kılıf menenjiomu, 5'i (%36) sfenoid kanat menenjiomu, 2'si (%14) ektopik menenjiom, 1'i (%7) perisellar menenjiomdu. Periferik sinir kılıfı tümörlerinin 6'sı ( Ma te ri al and Met hod:The records of 35 patients with orbital neurogenic tumors who were diagnosed and treated at Ankara University Faculty of Medicine, Department of Ophthalmology, between 1998 and 2011 were evaluated retrospectively. Re sults: Orbitotomy via a cutaneous approach was performed in 21 (60%) cases and orbitotomy via a transconjunctival approach was performed in 7 (20%) cases. Three (8%) cases had been operated at different centers. Four (12%) cases were diagnosed clinically. Total excisional biopsy was performed in 11 (31.4%) cases, subtotal excisional biopsy was performed in 7 (20%), and incisional biopsy was performed in 10 (28.6%) cases. 14 (40%) 35 cases were diagnosed as meningioma, 12 (34%) as peripheral nerve sheath tumor, and 9 (26%) cases were diagnosed as optic nerve glioma. Six (43%) meningioma cases were optic nerve sheath meningioma, 5 (36%) were sphenoid wing meningioma, 2 (14%) were ectopic meningioma, and 1 (7%) was perisellar meningioma. Six (50%) of peripheral nerve sheath tumors were schwannoma, 2 (16%) were solitary neurofibroma, 4 (34%) were plexiform neurofibroma. External beam radiotherapy was performed in 15 (42.8%) cases, cyberknife radiosurgery in 1 (2.8%) , chemotherapy in 1 (2.8%), and enucleation ( because of neovascular glaucoma and vitreous hemorrhage) was performed in 1 (2.8%) case. Dis cus si on: The most common orbital neurogenic tumors are meningioma, peripheral nerve sheath tumor, and optic nerve glioma. For meningioma and glioma, external beam radiotherapy is required; for schwannoma and solitary neurofibroma, total excisional biopsy is the preferred treatment. The success of visual and anatomic results are high after treatment. (Turk J Ophthalmol 2013; 43: 335-9)

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Malignant transformation of an optic pathway glioma without prior radiation therapy

Cited by 29 publications

References 18 publications

Stereotactic radiosurgery for pediatric recurrent intracranial ependymomas

Stereotactic radiosurgery for pediatric recurrent intracranial ependymomas

Opticochiasmatic Apoplexy in a Five-Year-Old

Orbita Nörojenik Tümörlerinin Klinik ve Tedavi Özellikleri

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