• Brain Tumor Research and Treatment
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• v.6 no.2
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• pp.97-100
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• 2018

Meningioma is relatively common, benign, and extra-axial tumor accounting for about 20% of primary brain and spinal cord tumors. The World Health Organization (WHO) classified these tumors into Grade I (benign), Grade II (atypical), and Grade III (anaplastic) meningioma. Grade I meningioma which is slowly growing tumor and have some rare subtypes. Among them, metaplastic subtype is defined as a tumor containing focal or widespread mesenchymal components including osseous, cartilaginous, lipomatous, myxoid or xanthomatous tissue, singly or in combinations. We report a rare metaplastic meningioma overspreading nearly whole cerebral convexity from main extra-axial tumor bulk in the parietal lobe.

• Journal of Korean Neurosurgical Society
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• v.39 no.2
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• pp.136-140
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• 2006

The authors report three microcystic meningiomas with its characteristic immunohistochemical findings and chromosomal pattern. Three patients with surgically treated microcystic meningioma were studied for its radiological, histopathological findings, and chromosomal analysis was done in the one patient. Tumors were convexity meningioma in the frontal area. The tumors were enhanced homogenously in the two, and enhanced in homogenously with multiple small cysts in the other one on preoperative magenetic resonance image. Pathological examination showed marked nuclear pleomorphism, many small cysts, hyaline thickening in blood vessel wall, and mucinous background, compatable to microcystic type. EMA and vimentin were positive on the immunohistochemical stain. Chromosomal analysis showed tetrasomies of chromosome 5, 13, 17, and 20, and trisomies of chromosome 6, 7, 9, 11, 12, 16, 19, and 21, which are quite different from those of benign meningioma.

• Korean Journal of Head & Neck Oncology
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• v.18 no.2
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• pp.219-222
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• 2002

Malignant glomus tumor is a very rare disease originating from the paraganglia system through the body. Glomus tumor, also known as paraganglioma, usually are considered benign, and arises in a variety of head and neck locations, most of which include the carotid body, the vagus nerve, and the jugulotympanic area. The most widely accepted management of benign glomus tumor is surgical extiration. Here, we report a case of recurrent laryngeal glomus tumor which is proven malignant and metastatic to the brain and the lungs. We have treated the patient with combination chemotherapy and radiation to the brain, the result of which is partial response in terms of decreased size of metastatic lung lesions.

• Radiation Oncology Journal
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• v.21 no.1
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• pp.10-18
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• 2003

Purpose : To evaluate the role of fractlonated sterotactic radiotherapy (FSRT) in the management of benign brain tumors, we reviewed the clinical, and radiographic responses of patients treated. Methods and Materials : Between March 1995 and March 2002, 36 patients with benign brain tumors were treated by FSRT. The pathological diagnoses consisted of pituitary adenomas (12 patients), cranio-pharyngiomas (5 patients), meningiomas (10 patients), and acoustic neurinomas (9 patients). Radiotherapy doses of 25 to 35 Gy (3~6 Gy/fraction, 5~10 fractions) were prescribed to the 85~90% isodose line, depending upon the location, size and volume of the tumors. The median clinical and radiographical follow up periods were 31 (range, 2~74) and 21 (range, 4~56) months, respectively. Results : In the 35 patients that could be evaluated for their clinical response, 13 (37.1%) were considered improved, 16 (45.7%) stable and 6 (17.2%) worse. Of the 33 patients who had radiographic studies, tumor shrinkage was noted in 17 (51.5%), tumor stabilization in 13 (39.4%), and tumor progression in 3 (9.1%). Of the 17 tumor shrinkage patients, 7 (21.2%) showed a complete response. Acute radiation-induced complications occurred iin 11 (30.6%) patients. Conclusions : FSRT is considered a safe and effective treatment method for begin brain tumors, but large numbers of patients, with relatively long follow-up periods are needed to assess the exact role or effect of FSRT.

• Journal of Korean Neurosurgical Society
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• v.60 no.1
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• pp.102-107
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• 2017

A true collision tumor is a rare entity composed of two histologically distinct neoplasms coinciding in the same organ. This paper reports a unique case of cerebral collision tumor consisting of two benign components. On the first hand, meningioma which is usually a benign lesion arising from the meningothelial cell in the arachnoidal membrane. On the other, cerebral cavernoma which is a well-circumscribed, benign vascular hamartoma within the brain. To our knowledge, there is no previously documented case of cerebral collision tumor consisting of two benign components. A 56-year-old Caucasian male suffered in 2002 from an atypical meningioma WHO $II^{\circ}$ located in the left lateral ventricle. Three years after the tumor extirpation, the patient suffered from a hematoma in the fourth ventricle due to a recurrently haemorrhaged cavernoma. In 2008, a recurrence of the tumor in the left lateral ventricle was discovered. Additionally, another tumor located in the quadrigeminal lamina was detected. After surgical resection of the tumor in the left lateral ventricle, the pathological examination confirmed the diagnosis of a collision tumor consisting of components of a meningioma WHO $II^{\circ}$ and a cavernoma. Postoperatively, no adjuvant treatment was needed and no tumor recurrence is discovered up to the present. A possible explanation for the collision of those two different tumors may be migration of tumor cells mediated by the cerebrospinal fluid. After 5-years of follow-up, there is no sign of any tumor recurrence; therefore, surgical tumor removal without adjuvant therapy seems to be the treatment of choice.

• Journal of Korean Neurosurgical Society
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• v.42 no.1
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• pp.27-34
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• 2007

Objective : On the magnetic resonance image (MRI) of the infiltrating brain tumor, enhancement is usually higher in malignant tumor than in benign tumor, and tumor cells can invade into the peritumoral area without definite enhancement. In various pathological conditions, the blood brain barrier (BBB) becomes changed to pathological condition, allowing various materials extravasating into the interstitial space, and degree of enhancement is depend on the pathology. Authors performed dynamic MRI on enhancing and surrounding edematous area in order to evaluate the degrees of opening of BBB, to differentiate tumor from non-tumorous condition, and to determine its relationship with the recurrence of the tumor. Methods : Dynamic MRI was performed in 25 patients. Dynamic scans were done every 15 seconds after administration of Gd-DTPA on the enhancing and surrounding area for maximum 300 seconds, and the patterns of enhancement were ana lysed. The enhancement curve with initial steep increase followed by slow decrease was defined as "N pattern", those with initial steep increase followed by additional slow increase as "T pattern", and those with initial steep increase followed by plateau as "E pattern". Histopathological findings were compared with the dynamic scan. Results : The graphs taken from enhancing area showed "T pattern" regardless of pathology. In the surrounding area, "T pattern" was noticed in the malignant tumors, but "E pattern" or "N pattern" was noted in low-grade or benign tumors and non-tumorous condition. "T pattern" in the surrounding area was related to the malignant with tumor cell infiltration and recurrence. Conclusion : The results suggest that the malignant tumor infiltration changes the condition of BBB enough to extravasate the Gd-DTPA. Enhancement pattern in the surrounding edematous area may be a useful information to differentiate the malignant glioma with the low-grade and benign tumors or other non-tumorous conditions.

• The Korean Journal of Nuclear Medicine
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• v.33 no.3
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• pp.337-340
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• 1999

Thallium-201 brain SPECT is utilized in the diagnosis of brain tumor especially in cases where CT or MRI findings alone cannot differentiate malignant lesion from benign. Recently we came across two cases of positive T1-201 brain SPECT in clinically suspected brain tumor patients that turned out to be hemorrhagic cerebral infarction instead on biopsy. The findings in these cases demonstrate that thallium-201 accumulation may occur by the breakdown of the blood-brain barrier and phagocytic cell infiltration in the liquefaction stage of infarction.

• Journal of Chest Surgery
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• v.33 no.2
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• pp.199-202
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• 2000

Primary pulmonary meningioma is an extremely rare disease. It is mostly benign and asymptomatic. This tumor shows the same cytohigstologic appearance as brain or spinal cord meninioma. It can be diagnosed as a primary pulmonary meningioma only if there is no evidence of metastasis from the brain or spinal cord meningioma. We experienced a case of primary pulmonary meningioma in a 60-year-old woman who had asymptomatic 2 cm-sized solitary pulmonary tumor in the right lower lobe. It is rather peripherally located. Fine needle aspiration cytology has suggested the possibility of either well-differentiated epithelial malignancy such as papillary adenocarcinoma or mucoepidermoid carcinoma or metastatic carcinoma such as from ductal carcinoma of the breast. Right lower lobectomy was performed. The tumor was bilobated and soild with yellowish color. pathologically it proved to be a primary pulmonary and solid with yellowish color. Pathologically it proved to be a primary pulmonary meningioma because there was no evidance of brain or spinal cord tumor. To the best of our knowledge this is the first case reported in Korea. We report this case with review of the literature.

• The Korean Journal of Nuclear Medicine
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• v.26 no.2
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• pp.360-364
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• 1992

Treatment for the brain tumors consist of surgery, chemotherapy, and a variety of methods of irradiation. Therapy is aimed to destroy the tumor, but necrosis and edema occur concurrently. Conventional structural imaging techniques such as CT or MRI are unable to reliably distinguish persistent and recurrent tumor from necrosis or edema. T1-201 has been shown to be useful in the evaluation of the myocardial viability by comparing the early uptake and redistribution image. The aim of this study is to evaluate the clinical usefulness of the early uptake and delayed washout images of the T1-201 brain SPECT in the brain tumors. In the pathologically diagnosed various brain tumor patients, brain SPECT was done with rotating gamma camera 15 minutes and 3 hours after T1-201 injection, and the T1-201 uptake in the tumor was compared with the skull and scalp activity. In the glioblastoma multiforme, meningioma and metastatic tumor, the T1-201 uptake was higher than low grade glioma in both 15 minute and 3 hour images (p<0.02). In the low grade glioma,3 hour T1-201 uptake was significantly lower than 15 minute uptake (p<0.05) but in the glioblastoma, meningioma and metastatic tumor there was no significant difference. There was no significant difference in the T1-201 uptake among the glioblastoma, meningioma and metastatic tumors. In one matastatic tumor, T1-201 uptake was decreased after radiation therapy. T1-201 brain SPECT could distinguish the benign and malignancy, and seems to be useful in the follow-up after treatment. But one of the early or delayed SPECT seems not to be necessary for these purposes.

• Journal of Korean Neurosurgical Society
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• v.65 no.6
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• pp.861-867
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• 2022

Objective : High-dose radiation is well known to induce and modulate the immune system. This study was performed to evaluate the correlation between clinical outcomes and changes in natural killer cell activity (NKA) after Gamma Knife Radiosurgery (GKS) in patients with brain cancer. Methods : We performed an open-label, prospective, cross-sectional study of 38 patients who were treated with GKS for brain tumors, including metastatic and benign brain tumors. All of the patients underwent GKS, and blood samples were collected before and after GKS. NKA was measured using an enzyme-linked immunosorbent assay kit, to measure interferon-gamma (IFNγ) secreted by ex vivo-stimulated NK cells from whole blood. We explored the correlations between NK cell-produced IFNγ (NKA-IFNγ) levels and clinical parameters of patients who were treated with GKS for brain tumors. Results : NKA-IFNγ levels were decreased in metastatic brain tumor patients compared to those with benign brain tumors (p<0.0001). All the patients who used steroid treatment to reduce brain swelling after GKS had an NKA-IFNγ level of zero except one patient. High NKA-IFNγ levels were not associated with a rapid decrease in brain metastasis and did not increase after GKS. Conclusion : The activity of NK cells in metastatic brain tumors decreased more than that in benign brain tumors after GKS.