• Radiation Oncology Journal
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• v.10 no.2
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• pp.163-169
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• 1992

A retrospective analysis was performed on 53 patients with brain malignant astrocytoma and glioblastoma multiforme treated with surgical resection and postoperative radiotherapy in the period between January 1980 and June 1991. There were 13 patients with malignant astrocytoma, 40 patients with glioblastoma multiforme. Survival rates were analyzed according to histologic grade, age, performance status, extent of surgical resection, tumor location, symptom duration, total radiation dose and addition of chemo­therapy after radiation therapy. 5 year actuarial survival rate for malignant astrocytoma was $29.4\%$, for glioblastoma multiforme was $2.8\%$. Histologic grade, age, performance status, total radiation dose were statistitically significant prognostic factors.

• Journal of Korean Neurosurgical Society
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• v.45 no.6
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• pp.381-385
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• 2009

The first case of intracranial metastases of a cervical intramedullary low-grade astrocytoma without malignant transformation in adult is presented in this report. Seven years ago, a 45 year-old male patient underwent biopsy to confirm pathologic characteristics and received craniocervical radiation and chemotherapy for a grade II astrocytoma in the cervical spinal cord. Two years later, posterior fusion was necessary for progressive kyphosis in the cervical spine. He was well for approximately 7 years after the primary surgery. Two months ago, he presented with partial weakness and incoordination with gait difficulty. MRI Scan demonstrated multiple small lesions in the cerebellar vermis and left hemisphere. After suboccipital craniectomy and posterior cervical exposure, the small masses in the cerebellar vermis and hemispheres were excised to a large extent by guidance of an intraoperative navigation system. The tumor at the cervical and brain lesions was classified as an astrocytoma (WHO grade II). When a patient with low-grade astrocytoma in the spinal cord has new cranial symptoms after surgery, radiaton, and chemotherapy, the possibility of its metastasis should be suspected because it can spread to the intracranial cavity even without malignant transformation as shown in this case.

• Journal of Korean Neurosurgical Society
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• v.29 no.4
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• pp.485-490
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• 2000

Objective : To study the expression of apoptosis and bcl-2 in the astrocytic tumors. Patients and Methods : A total of thirty-eight astrocytomas(9 cases in low grade astrocytoma, 12 cases in anaplastic astrocytoma and 17 cases in glioblastoma) are included in this study. Immunohistochemical stain for bcl-2 using monoclonal antibody, in situ end labelling technique for apoptosis were used. Results : The malignant group(anaplastic astrocytoma and glioblastoma) showed significantly higher apoptosis positive index(PI) compared to the benign group(low grade astrocytoma)(1.35 vs 0.14). However apoptosis PI and bcl-2 PI were not significantly different among three groups. Correlation between apoptosis PI and bcl-2 PI was not statistically significant(p=0.58). Conclusion : This result suggest that apoptosis PI and bcl-2 PI are not related the degree of malignancy in astrocytic neoplasm, but apoptosis PI in malignant group was higher possibly due to greater DNA damage.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.15
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• pp.6315-6319
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• 2014

Background: Immunohistochemical markers are considered as important factors in diagnosis of malignant astrocytomas. The aim of the current study was to investigate the frequency of the immunohistochemical markers neurofilament protein (NFP) and glial fibrillary acidic protein (GFAP) in malignant astrocytoma tumors in Firoozgar and Rasool-Akram hospitals from 2005 to 2010. Materials and Methods: In this cross-sectional study, immunohistochemical analysis of NFP and GFAP was performed on 79 tissue samples of patients with the diagnosis of anaplastic and glioblastoma multiform (GBM) astrocytomas. Results: The obtained results demonstrated that all patients were positive for GFAP and only 3.8% were positive for NFP. There was no significant association between these markers and clinical, demographic, and prognostic features of patients (p>0.05). Conclusions: NFP was expressed only in GBMs and not in anaplastic astrocytomas. It would be crucial to confirm the present findings in a larger number of tumors, especially in high grade gliomas.

• Radiation Oncology Journal
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• v.20 no.3
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• pp.199-205
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• 2002

Purpose : This study was peformed to determine the optimal radiation therapy field for the treatment of malignant astrocytoma and glioblastoma multiforme. Materials and Methods : From Jan. 1994 to Mar. 2000, 21 patients with malignant astrocytoma and glioblastoma multiforme, confirmed as recurrent by follow up MRI after surgery and radiation therapy, were analyzed. The distance from the margin of the primary lesion to the recurrent lesion was measured. The following factors were analyzed to Investigate the influence of these factors to recurrence pattern; tumor size, degree of edema, surgical extent, gamma knife radiosurgery and multiple lesions. Results : Among the 21 patients, 18 $(86\%)$ were recurred within 2 cm from the primary lesion site. 12 within 1 cm, 6 between 1 and 2 cm. The other 3 patients all with multiple lesions, were recurred at 3, 4, 5 cm, from the primary lesion site. The recurrence pattern was not influenced by the factors of tumor size, extent of edema, surgical extent, or gamma knife radiosurgery. However, patients with multiple lesions showed a tendency of recurrence at sites further from the primary lesion. Conclusions : Most $(86\%)$ of the recurrences of malignant astrocytoma and glioblastoma multiforme occurred within 2 cm from the primary lesion site. The width of treatment field does not need to be changed according to tumor size, degree of edema, surgical extent, or gamma knife radiosurgery. However, the treatment field for multiple lesions appears to be wider than that for a single lesion.

• The Journal of the Korean life insurance medical association
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• v.32 no.1
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• pp.21-27
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• 2013

In case of neoplasm claims, it is important to make a decision of differentiating malignant and benign. In Korean insurance market, there are many insurance products that cover cancer. In the insurance claims adjustment, differentiation between malignant and benign is according to histologic findings. However there are many neoplasms of bad clinical course in spite of benign histopathologic classification. In this article; astrocytoma, thymoma, gastrointestinal stromal tumor, colonic intramucosal carcinoma, gastric high grade adenoma/dysplasia, carcinoid tumor, MALT lymphoma, revision of Korean Classification of Disease-6th edition, and bladder tumors are reviewed in terms of differentiation between malignant and benign in the insurance claims. It may be helpful for claims staff to review important neoplasms in terms of differentiation between malignant and benign.

• Journal of Korean Neurosurgical Society
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• v.57 no.6
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• pp.469-472
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• 2015

Undifferentiated sarcomas are rarely identified in the intracranial region. A 23-year-old man was admitted with a chief complaint of headache. Initial magnetic resonance images showed signs of low-grade glioma in the frontal lobe. Stereotactic biopsy was performed, and a diagnosis of diffuse astrocytoma was confirmed. Three months later, the patient presented with a high-grade tumor as seen on imaging studies. He underwent total resection of the tumor and histopathological tests identified an undifferentiated sarcoma. The patient died eight months later due to massive tumor bleeding. To the best of our knowledge, this is the first report of undifferentiated sarcoma arising from low-grade glioma without any chemotherapy or radiotherapy.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.23
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• pp.10319-10323
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• 2015

Background: The incidence rate of brain tumors has increased more than 40% in the past 20 years, especially in adults. We aimed to study the clinical and pathological findings of central nervous system (CNS) tumor patients and to evaluate their 5 year survival rates. Materials and Methods: The archives of all patients with CNS tumors in 6 health care centers in Yazd, Iran, from 2006 to 2013, were studied. Patients data were extracted using a checklist which included age, sex, date of reference and diagnosis, date of death, clinical signs, radiography findings, pathology report, size and location of tumor, patient treatment and grade of tumor. Results: A total of 306 patient records were studied in the 8 year period. The most prevalent type of tumor was astrocytoma (n=113, 36.9%). The frequency of almost all tumor types was statistically higher in male patients (p=0.025). In most cases surgery with radiotherapy was the treatment of choice (49.3%). The most frequent symptom reported was headache (in 60.8% of patients) followed by convulsions (15.7%). Most of the tumors were located in the right hemisphere (46.1%) and the frontal and parietal lobe (26% and 12%, respectively). Radiography findings displayed edema with a nonhomogeneous lesion in majority of the patients (87%). The survival fraction of the patients with malignant tumors decreased over time (0.807 in the first year and 0.358 at the end of the $5^{th}$ year). Conclusions: Astrocytoma was the more common CNS tumor with male predominance. Overall survival rates of malignant tumors decreased over time and this was in relation with tumor grade.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.6
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• pp.3979-3985
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• 2013

Background: Although primary malignant CNS tumors are registered in the national cancer registry (NCR) of Iran, there are no available data on the incidence of the primary malignant or benign CNS tumors and their common histopathologies in the country. This study analyzed the 10-year data of the Iranian NCR from March 21, 2000 to March 20, 2010, including a systematic review. Materials and Methods: The international and national scientific databases were searched using the search keywords CNS, tumor, malignancy, brain, spine, neoplasm and Iran. Results: Of the 1,086 primary results, 9 papers were selected and reviewed, along with analysis of 10-year NCR data. The results showed that primary malignant brain tumors have an overall incidence of 2.74 per 100,000 person-years. The analysis of the papers revealed a benign to malignant ratio of 1.07. The most common histopathologies are meningioma, astrocytoma, glioblastoma and ependymoma. These tumors are more common in men (M/F=1.48). Primary malignant spinal cord tumors constitute 7.1% of the primary malignant CNS tumors with incidence of 0.21/100,000. Conclusions: This study shows that CNS tumors in Iran are in compliance with the pattern of CNS tumors in developing countries. The NCR must include benign lesions to understand the definitive epidemiology of primary CNS tumors in Iran.

• Journal of Korean Neurosurgical Society
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• v.49 no.6
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• pp.334-338
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• 2011

Objective : The incidence of leptomeningeal dissemination from malignant glioma is rare, so the clinical features of this are not well documented yet We attempted to determine the clinical features of leptomeningeal dissemination from malignant gliomas. Methods : We retrospectively analyzed 11 cases of leptomeningeal dissemination of malignant glioma, who were treated at our institution between 2006 and 2009. We investigated the clinical features of these patients by considering the following factors : tumor locations, the events of ventricular opening during surgery and the cerebrospinal fluid (CSF) profiles, including the cytology. Results : The group was composed of 9 males and 2 females. The histological diagnosis of their initial intracranial tumors were 4 primary glioblastoma, 3 anaplastic astrocytoma, 1 anaplastic oligoastrocytoma, 2 ganglioglioma and 1 pleomorphic xanthoastrocyotma with anaplastic features. The mean age of the patients at the time of the initial presentation was $42.8{\pm}10.3$ years. The mean time between surgery and the diagnosis of spinal dissemination was $12.3{\pm}7.9$ (3-28) months. The mean overall survival after dissemination was $2.7{\pm}1.3$ months. All our patients revealed a history of surgical opening of the ventricles. Elevated protein in the CSF was reported for eight patients who had their CSF profiles checked. Conclusion : We propose that in the malignant gliomas, the surgical opening of ventricles can cause the spinal leptomeningeal dissemination and the elevated protein content of CSF may be a candidate marker of leptomeningeal dissemination.