• Journal of Korean Neurosurgical Society
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• v.63 no.5
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• pp.657-663
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• 2020

Objective : Metaplastic meningioma is an extremely rare subtype of World Health Organization (WHO) grade I meningioma. It has distinctive histological subtypes according to its own mesenchymal components. Owing to its scarcity, clinical or radiological features of a metaplastic meningioma are poorly described. Methods : Between 2004 and 2018, we analyzed total 1814 cases surgically proven meningioma for 15 years. Among them, metaplastic meningioma was diagnosed in 11 cases. Magnetic resonance images were taken for all patients, and computed tomography scan was taken for 10 patients. Results : WHO grade I meningiomas were 1376 cases (75.9%), 354 cases (19.5%) in WHO grade II, and 84 cases (4.6%) in WHO grade III meningiomas. Metaplastic meningioma was 11 cases as 0.8% of WHO grade I meningioma and 0.6% of entire meningiomas for 15 years. Among the entire 11 metaplastic meningiomas, five tumors (45%) were diagnosed as a lipomatous subtype with rich fat components, four (36%) as an osseous subtype with extensive bone formation and two (18%) as a xanthomatous subtype. There was no cartilaginous subtype metaplastic meningioma in our study. Lipomatous and osseous metaplastic meningioma have peculiar radiological characteristics according to mesenchymal components. Conclusion : We investigated a rare metaplastic meningioma subtype based on our 15-year surgical experience with meningiomas. Further investigation will be necessary for the clear clarification of tumor nature of this rare tumor.

• Journal of Yeungnam Medical Science
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• v.31 no.1
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• pp.61-64
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• 2014

Craniopharyngiomas are rare primary intracranial tumors. Despite their benign histological appearance, they are often associated with an unfavorable prognosis. The typical manifestations upon diagnosis are headache, visual impairment, polyuria/polydypsia, growth retardation, disturbance of pubertal development, and significant weight gain. The treatment options include radical surgery or radiotherapy, or a combination of these modalities. Slipped capital femoral epiphysis (SCFE) is the most common adolescent hip disorder. SCFE occurs when the capital femoral epiphysis displaces posteriorly on the femoral neck at the level of the physis. The etiology of SCFE is thought to be multifactorial and may include obesity, growth surges, and less common endocrine disorders. The related endocrine disorders include hypothyroidism, growth hormone supplementation, hypogonadism, and panhypopituitarism. Reported herein is a case of panhypopituitarism caused by craniopharyngioma combined with SCFE.

• Journal of Korean Neurosurgical Society
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• v.52 no.6
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• pp.517-522
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• 2012

Objective : Meningiomas represent 18-20% of all intracranial tumors and have a 20-50% 10-year recurrence rate, despite aggressive surgery and irradiation. Hydroxyurea, an inhibitor of ribonucleotide reductase, is known to inhibit meningioma cells by induction of apoptosis. We report the long-term follow-up result of hydroxyurea therapy in the patients with recurrent meningiomas. Methods : Thirteen patients with recurrent WHO grade I or II meningioma were treated with hydroxyurea (1000 $mg/m^2/day$ orally divided twice per day) from June 1998 to February 2012. Nine female and 4 male, ranging in age from 32 to 83 years (median age 61.7 years), were included. Follow-up assessment included physical examination, computed tomography, and magnetic resonance imaging (MRI). Standard neuro-oncological response criteria (Macdonald criteria) were used to evaluate the follow-up MRI scans. The treatment was continued until there was objective disease progression or onset of unmanageable toxicity. Results : Ten of the 13 patients (76.9%) showed stable disease after treatment, with time to progression ranging from 8 to 128 months (median 72.4 months; 6 patients still accruing time). However, there was no complete response or partial response in any patients. Three patients had progressive disease after 88, 89, 36 months, respectively. There was no severe (Grade III-IV) blood systemic disorders and no episodes of non-hematological side effects. Conclusion : This study showed that hydroxyurea is a modestly active agent against recurrent meningiomas and can induce long-term stabilization of disease in some patients. We think that hydroxyurea treatment is well tolerated and convenient, and could be considered as an alternative treatment option in patients with recurrent meningiomas prior to reoperation or radiotherapy.

• Clinical and Experimental Pediatrics
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• v.51 no.12
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• pp.1363-1367
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• 2008

Cavernous hemangioma can occur in the entire brain but rarely in cerebellum, especially in the pediatric age group. Headache, seizure, gait disturbance, recurrent bleeding may be seen. This tumor is a relatively benign condition but if the lesion located in the posterior fossa or the brain stem bleeds, irreversible brain damage may occur because of its restrictive space. Moreover, it must be differentiated from malignant tumors. We report 12.6 year-old boy who represented posterior neck myalgia as the presenting symptom. The pain continued for about a month despite analgesic medications. Brain MRI showed intracranial hemorrhage in the left cerebellum (4.5 cm) representing repeated hemorrhages at different times and originated from the cavernous hemangioma accompanied by mild hydrocephalus. The lesion was surgically removed successfully and the cavernous hemangioma was confirmed by pathologic findings. After the follow-up period of 14 months, he is in good condition without any complications.

• Journal of Life Science
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• v.15 no.4 s.71
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• pp.668-672
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• 2005

Nasal tumors have been reported frequently in dogs and nasal discharge has been the primary presenting complaint in nasal tumor patients. A 10-year-old 7 kg male mixed breed dog was presented to the animal hospital for evaluation of severe bloody nasal discharge. After physical examination, blood examination and X-ray examination, magnetic resonance imaging (MRI) examination was also conducted. Based on MRI nasal tumor which does not extend cranial vault was diagnosed. The nasal tumor was confirmed as adenosquamous cell carcinoma by histopathological examination after necropsy. The invasive characteristics of the neoplasm were documented by MRI. MRI was very valuable diagnostic tool for identifying extracranial and intracranial tumor invasion in a small animal.

• Journal of Korean Neurosurgical Society
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• v.30 no.7
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• pp.934-938
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• 2001

Oligodendrogiomas account for about 4 per cent of intracranial gliomas and surgery is known to be an essential first step to establish an accurate diagnosis and when oligodendrogliomas recur with or without anaplastic features after initial resection, radiation and chemotherapy consisting of the administration of procarbazine, lomustine, and vincristine are usually indicated. We report our experience of an excellent result with intraventricular methotrexate chemotherapy for a patient with disseminated anaplastic oligodendroglioma. A 29-year-old male patient presented with diplopia and headache for two months. MRI showed a irregular, faintly enhanced mass in the posterior fossa. The hisotological diagnosis was an anaplaplastic oligodendroglioma and he was treated with chemotherapy of PCV regimen and radiotherapy followed by surgery. CSF dissemination was revealed by a follow-up MRI during the period. Intraventricular methotrexate(0.175mg/kg) was given twice a week for 4 weeks through ommaya reservoir and the size of the multiple tumors was decreased significantly on follow-up MRI. This case report suggests that an aggressive treatment involving intravent-ricular chemotherapy may be helpful even when anaplastic oligodendrogliomas disseminates to leptomeninges.

• Journal of Yeungnam Medical Science
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• v.7 no.1
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• pp.113-119
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• 1990

The stereotactic radiosurgery using ionizing radiation of high energy is a technique for exadicating intracranial small tumors, which are inaccessible or unsuitable for open surgical technique. For such a small field radiosurgery. TLD or film dosimetry is essential. The three dimensional dose planning of radiosurgery was performed with dose planning computer system (Therac 2300). The target dose distribution and its error according to patient position were discussed. And were measured of circular cone which specially designed in our Hospital. The position error of Rando Phantom compared with CT were O.4mm in the AP-LAT section and in the AP-VERT section, 1.0mm in the AP-VERT $45^{\circ}$section. The ratio of accuracy of the gantry and couch rotation were 1.5mm diamteter for centeral axis of I8MeV linear accelerator. Our study suggested that radiosurgery of small field in our department will be appropriate for clinical application.

• Journal of the Korean Society of Radiology
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• v.79 no.5
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• pp.294-301
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• 2018

Subependymomas are rare benign central nervous system tumor which account of 0.7% of all intracranial tumors. Subependymomas show characteristic MR findings according to their location. However, sometimes atypical findings could be found. In addition, subependymomas can occur very rarely in the spinal cord. We report two cases of pathologically confirmed subependymoma, one of which shows atypical appearances in spite of their intraventicular location and the other of which shows rare case of spinal intramedullary subependymoma. We review the clinical symptoms and radiologic findings of two cases.

• Journal of Korean Neurosurgical Society
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• v.29 no.9
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• pp.1215-1221
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• 2000

Objective : The clinical prognosis and biological behavior of atypical and especially malignant meningiomas are well known to be worse than benign meningioma, but the degree of biological aggressiveness in each classical subtypes of benign meningioma is controversy. This study was performed to see whether there is a difference in the proliferative activity between each different histological subtypes of benign meningioma as well as atypical meningioma. Methods : Paraffin-embedded surgical specimens of 27 meningiomas, including two recurrent tumors, were studied to evaluate proliferative activity by immunohistochemical method with monoclonal antibodies to proliferating cell nuclear antigen(PCNA) and MIB-1. The specimens consisted of 8 cases of meningothelial, 9 cases of transitional, 5 cases of fibroblastic subtypes and 5 cases of atypical meningiomas. Results : Mean PCNA labeling indices of meningothelial, transitional and fibroblastic meningiomas were $4.82{\pm}5.10%$, $9.01{\pm}4.25%$ and $5.66{\pm}5.32%$, but that of atypical meningiomas was $27.62{\pm}19.67%$, noting a higher value compared to all three subtypes of benign meningiomas. Mean Ki-67 labeling indices of the above 3 subtypes were $0.43{\pm}0.85%$, $0.44{\pm}1.08%$ and $0.24{\pm}0.18%$, and that of atypical meningiomas was also revealed to be of higher value ($0.84{\pm}0.59%$). PCNA and Ki-67 labeling indices were not statistically different between histological subtypes of benign meningioma(p>0.05), but the differences of both immunolabeling between benign and atypical meningiomas were statistically significant(p<0.05). Conclusion : Immunolabeling of PCNA and Ki-67 in intracranial meningiomas reveals no prognostic difference between meningothelial, transitional and fibroblastic subtypes in classical benign meningiomas by measuring expression of PCNA and Ki-67, but it seems to be helpful in differentiating benign and atypical meningioma, later showing more proliferative activity and biological aggressiveness.

• Radiation Oncology Journal
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• v.20 no.2
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• pp.93-99
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• 2002

Purpose : We intended to decrease late CNS reaction after radical radiotherapy for an intracranial germinoma by using combined neoadjuvant chemotherapy and involved-field radiotherapy. The efficacy in terms of its acute toxicity and short-term relapse patterns was analyzed. Materials and Methods : Eighteen patients were treated with combined neoadjuvant chemotherapy and radiotherapy between 1995 and 2001. The chemotherapy regimen used was the Children's Cancer Group (CCG) 9921A (cisplatin, cyclophosphamide, VP-16, vincristine) for 5 patients younger than 16 years, BEP (bleomycin, VP-16, cisplatin) for 12 patients, and EP (VP-16, cisplatin) for 1 patient. The radiotherapy covered the whole craniospinal axis for 5 patients, the whole brain for 1, and the partial brain (involved field) for 12. the primary lesion received tumour doses between 3,960 and 5,400 cGy. Results : The male to female ratio was 16:2 and the median age was 16 years old. The tumors were located in the pineal gland in 12 patients, in the suprasellar region in 1, in the basal ganglia In 1, in the thalamus in 1. Three patients had multiple lesions and ventricular seedings were shown at MRI. In 3 patients, tumor cells were detected in the cerebrospinal fluid and MRI detected a spinal seeding in 2 patients. The response to neoadjuvant chemotherapy was complete remission in 5 patients, partial remission in 12, and no response in 1. However, after radiotherapy, all except 1 patient experienced complete remission. The toxicity during or after chemotherapy greater than or equal to grade III was remarkable; hematologic toxicity was observed in 11 patients, liver toxicity in none, kidney toxicity in none, and gastrointestinal toxicity in one. One patient suffered from bleomycin-induced pneumonitis. Radiotherapy was therefore stopped and the patient eventually died of respiratory failure. The other 17 are alive without any evidence of disease or relapse during an average of 20 months follow-up. Conclusion : A high response rate and disease control was experienced, which was the same as observed other studies and the morbidity from chemotherapy-induced toxicity was similar. With these results, the results from adjuvant chemotherapy and involved-field radiotherapy cannot be concluded to be equal to those from extended-field radiotherapy. The long term follow-up study on later complications are required in order to draw definite conclusions on the optimal management with minimum side effects.