Proteomic analysis of hemangioblastoma cyst fluid

Gläsker, Sven; Vortmeyer, Alexander O.; Lonser, Russell R.; Lubensky, Irina A.; Okamoto, Hiroaki; Xia, John B.; Li, Jie; Milne, Erin; Kowalak, Jeffrey A.; Oldfield, Edward H.; Zhuang, Zhengping

doi:10.4161/cbt.5.5.2657

Cited by 34 publications

(28 citation statements)

References 27 publications

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“…Hemangioblastomas, despite their benign histological appearance (10, 30-32, 53, 94), can cause symptoms through mass effect and edema related to cyst formation and development (54, 55, 96, 99). The contents of the hemangioblastoma cyst have always been controversial.…”

Section: Insights Into Neurological Diseases From Proteomicsmentioning

confidence: 99%

Application and Implementation of Selective Tissue Microdissection and Proteomic Profiling in Neurological Disease

Jagannathan

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et al. 2009

Neurosurgery

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OBJECTIVE Proteins are the primary components of cells and are vital constituents of any living organism. The proteins that make up an organism (proteome) are constantly changing and are intricately linked to neurological disease processes. The study of proteins, or proteomics, is a relatively new but rapidly expanding field with increasing relevance to neurosurgery. METHODS We present a review of the state-of-the-art proteomic technology and its applications in central nervous system diseases. RESULTS The technique of “selective microdissection” allows an investigator to selectively isolate and study a pathological tissue of interest. By evaluating protein expression in a variety of central nervous system disorders, it is clear that proteins are differentially expressed across disease states, and protein expression changes markedly during disease progression. CONCLUSION Understanding the patterns of protein expression in the nervous system has critical implications for the diagnosis and treatment of neurological disease. As gatekeepers in the diagnosis, evaluation, and treatment of central nervous system diseases, it is important for neurosurgeons to develop an appreciation for proteomic techniques and their utility.

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Section: Insights Into Neurological Diseases From Proteomicsmentioning

confidence: 99%

Application and Implementation of Selective Tissue Microdissection and Proteomic Profiling in Neurological Disease

Jagannathan

Szerlip

et al. 2009

Neurosurgery

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“…6,[9][10][11] We did not evaluate the biochemical composition of peritumoral cystic fluid associated with pituitary macroadenoma and the operating surgeon did not notice a proteinaceous or xanthochromic fluid during the course of resection. All macroadenomas were resected transsphenoidally, either as primary resection or in the initial approach, so observation of the surrounding peritumoral cysts and the response to surgical decompression was not possible.…”

Section: Discussionmentioning

confidence: 99%

Peritumoral cysts associated with pituitary macroadenoma

Herde¹,

Hoang

Tran

et al. 2015

JNS

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OBJECT Peritumoral cysts are benign nonneoplastic cysts that are found adjacent to extraaxial brain tumors such as meningiomas, schwannomas, craniopharyngiomas, and esthesioneuroblastomas. Peritumoral cysts associated with pituitary macroadenomas have not been previously described in the literature. The authors report 6 cases of giant macroadenoma-associated peritumoral cysts and delineate their imaging spectrum. METHODS The authors retrospectively reviewed the records of 179 patients diagnosed with pituitary macroadenomas who underwent tumor resection at their institution and had preoperative MRI scans available for review. The patients were evaluated for the presence of associated peritumoral cysts. Clinical presentation, histopathology, follow-up time, tumor and peritumoral cyst dimensions were recorded. Signal intensity on T1-weighted, T2-weighted, diffusion-weighted, and FLAIR sequences, as well as pre- and postcontrast appearance, were determined. RESULTS Six patients (3.4%) with associated peritumoral cysts were identified in our cohort of 179 patients with pituitary macroadenoma. Twelve patients in the cohort had giant macroadenomas (≥ 4.0 cm), and 50% of these tumors had associated peritumoral cysts with significant extrasellar extension of the macroadenoma. Only tumors with craniocaudal, transverse, and anteroposterior diameters of 3.6 × 3.4 × 4.2 cm to 7.0 × 7.4 × 6.8 cm (mean 5.3 × 5.1 × 5.6 cm), respectively, had associated peritumoral cysts. The growth pattern in all tumors was suprasellar, with predominant anterior and lateral extension. Cysts showed T1-weighted, T2-weighted, and FLAIR hyperintensity in 67%, 67%, and 60% of patients, respectively. There was no contrast enhancement of the cyst wall or fluid contents in any patient. Postoperatively, cysts had completely resolved (4 of 5) or significantly decreased in size (1 of 5). One patient was lost to follow-up. CONCLUSIONS Macroadenoma-associated peritumoral cysts are rare, benign, and likely nonneoplastic fluid collections that do not represent neoplasm. These cysts display a predictable pattern of hyperintensity on T1-weighted, T2-weighted, and FLAIR sequences and do not enhance. They most likely represent proteinaceous CSF in a sulcus or cistern that becomes trapped (encysted) by anterolateral extension of unusually large macroadenomas. Peritumoral cysts may facilitate resection of the associated macroadenoma by providing a cleavage plane.

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“…A HBL presenting as a solid nodule can grow in size but can also rapidly develop into one or multiple cysts in or around the nodule even in patients without VHL. Emerging proteomic analysis data have shown that cyst formation associated with HBL, whether peritumoural or intratumoural, is a consequence of vascular leakage secondary to upregulation of vascular endothelial growth factor (VEGF); and anti-VEGF therapy may effectively control cyst formation 9. Initially, the extravasation of fluid produces a small region of oedema surrounding the tumour and equilibrium is achieved.…”

Section: Discussionmentioning

confidence: 99%

Development of a small solid cerebellar haemangioblastoma into a large pseudocyst with a mural nodule in a patient without VHL; the importance of regular follow-up

et al. 2014

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Haemangioblastomas (HBLs) are rare central nervous system tumours accounting for only 1.2-2.5% of all intracranial tumours. While most HBLs occur sporadically, 36-40% of cases are associated with von Hippel-Lindau (VHL) syndrome. Owing to its benign nature, sporadic cases are usually detected only when symptoms occur due to mass effect. Thus, the natural history of HBLs has only been studied in association with VHL syndrome. We present a case of sporadic HBL with a rapid evolution of its small nodule into an enlarging mural nodule with a large pseudocyst that resulted in increased intracranial pressure. Craniotomy for complete tumour removal was performed and the patient fully recovered. This case implies a regular follow-up of HBL might be mandatory even in patients without VHL.

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Proteomic analysis of hemangioblastoma cyst fluid

Abstract: Intratumoral hemangioblastoma cyst fluid originates from serum. Cyst formation associated with hemangioblastoma, whether peri- or intratumoral, is a consequence of vascular leakage. Anti-VEGF therapy may effectively control hemangioblastoma cyst formation.

Cited by 34 publications

References 27 publications

Application and Implementation of Selective Tissue Microdissection and Proteomic Profiling in Neurological Disease

Application and Implementation of Selective Tissue Microdissection and Proteomic Profiling in Neurological Disease

Peritumoral cysts associated with pituitary macroadenoma

Development of a small solid cerebellar haemangioblastoma into a large pseudocyst with a mural nodule in a patient without VHL; the importance of regular follow-up

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