• 대한자기공명의과학회:학술대회논문집
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• 대한자기공명의과학회 2003년도 제8차 학술대회 초록집
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• pp.38-39
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• 2003

To evaluate the clinical characteristics and outcome of the patients with disseminated pilocytic astrocytoma compared to non-disseminated disease and to discuss treatment options for disseminated disease. We Identified patients with disseminated pilocytic astrocytoma from our Tumor Registry over 21 years of period and reviewed medical records and neuroimages to determine location of the tumor, pattern of dissemination, clinical characteristics, treatment, and outcome. 24 controls without dissemination, matched for age at diagnosis, tumor histology, and primary location were selected from the same registry and case/control comparison was done using Kaplan-Meier survival analysis.

• Journal of Korean Neurosurgical Society
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• 제59권5호
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• pp.533-536
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• 2016

Pilocytic astrocytomas (PAs) are World Heath Organization Grade I tumors and are most common in children. PA calcification is not a common finding and has been reported more frequently in the optic nerve, hypothalamic/thalamus and superficially located cerebral tumors. We present a cerebellar PA in a 3-year-old male patient with cystic components and massive calcification areas. The residual tumor grew rapidly after the first operation, and the patient was operated on again. A histopathological examination revealed polar spongioblastoma-like cells. Massive calcification is not a common feature in PAs and can lead to difficulties in radiological and pathological differential diagnoses.

• Journal of Korean Neurosurgical Society
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• 제49권6호
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• pp.363-366
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• 2011

Cerebellar pilocytic astrocytomas (PAs) are benign gliomas predominantly found in the pediatric population. Intracranial hemorrhages are extremely rare in initial presentations of cerebellar PAs. There are no reports in the medical literature of adult cerebellar PA cases presenting with intratumoral hemorrhage. We report 2 cases of adult cerebellar pilocytic astrocytomas with intratumoral hemorrhage. The first case is a 37-year-old woman presenting with severe headache, nausea, and vomitting. Computed tomography demonstrated an acute hemorrhage adjacent to the right cerebellar hemisphere and hydrocephalus. Magnetic resonance imaging (MRI) revealed a cerebellar vermian tumor with the hemorrhage as a mixed isoin-tense area in the T2-weighted image, and as a mixed hyperintense area in the contrast-enhanced T1-weighted image. The second case is a 53-year-old man presenting with headache for 3 weeks. MRI revealed a cerebellar hemispheric tumor with the hemorrhage as a mixed hyperintense area. It had a cystic mass with a heterogeneous enhanced mural nodule in the gadolinium-enhanced T1-weighted image and a fluid-fluid level within the cyst in the T2-weighted image. Both of them underwent radical resections of their respective lesions. Histological examination of the specimens revealed typical astrocytoma, including a hemorrhagic portion. Both patients recovered postoperatively and continue to do well at present. The medical literature on hemorrhagic cerebellar PAs is also reviewed.

• Journal of Korean Neurosurgical Society
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• 제48권5호
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• pp.445-447
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• 2010

Pilomyxoid astrocytoma (PMA) is a newly recognized variant of a pilocytic astrocytoma. This report describes a case of a pilomyxoid astrocytoma that occurred in the opticohypothalamus. The patient was a 18-year-old girl who complained decreased visual acuity and visual field over a period of two years. Magnetic resonance imaging (MRI) showed an irregular lobulated tumor with heterogeneous enhancement at the suprasellar region involving the hypothalamus. The mass was partially removed via the subfrontal approach. Its pathology was confirmed to be PMA. Adjuvant chemotherapy with cisplatin and vincristine was started following tumor resection. After four cycles, the mass showed a partial response to the chemotherapy. Although long-term outcome is yet to be determined, the administration of combined cisplatin and vincristine treatment seems to be an effective regimen for a pilomyxoid astrocytoma.

• Asian Pacific Journal of Cancer Prevention
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• 제15권3호
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• pp.1333-1337
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• 2014

Background: Astrocytic tumors, the most common primary glial tumors of the central nervous system, are classified from low to high grade according to the degree of anaplasia and presence of necrosis. Despite advances in therapeutic management of high grade astrocytic tumors, prognosis remains poor. In the present study, the frequency and prognostic significance of c-erb-B2 in astrocytic tumors was investigated. Materials and Methods: Records of 72 patients with low- and high-grade astrocytic tumors were evaluated. The expression of C-erbB-2 was determined immunohistochemically and intensity was recorded as 0 to 3+. Tumors with weak staining (1+) or no staining (0) were considered Her-2 negative, while tumors with moderate (2+) and strong (3+) staining were considered Her-2 positive. Results: Of the 72 patients, 41 (56.9%) had glioblastoma (GBM), 10 (13.9%) had diffuse astrocytoma, 15 (20.8%) had anaplastic astrocytoma, 6 (8.3%) had pilocytic astrocytoma. C-erbB-2 overexpression was detected in the tumor specimens of 17 patients (23.6%). Six (8.3%) tumors, all GBMs, exhibited strong staining, 2 (2.7%) specimens, both GBMs, exhibited moderate staining, and 9 specimens, 5 of them GBMs (12.5%), exhibited weak staining. No staining was observed in diffuse astrocytoma and pilocytic astrocytoma specimens. Median overall survival of patients with C-erbB-2 negative and C-erbB-2 positive tumors were 30 months (95%CI: 22.5-37.4 months) and 16.9 months (95%CI: 4.3-29.5 months), respectively (p=0.244). Conclusions: Although there was no difference in survival, C-erbB-2 overexpression was observed only in the GBM subtype.

• Interdisciplinary Bio Central
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• 제5권1호
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• pp.1.1-1.8
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• 2013

High quality publicly-available transcriptomic data representing relationships in gene expression across a diverse set of biological conditions is used as a context network to explore transcriptomics of the CNS. The context network, 18367Hu-matrix, contains pairwise Pearson correlations for 22,215 human genes across18,637 human tissue samples1. To do this, we compute a network derived from biological samples from CNS cells and tissues, calculate clusters of co-expressed genes from this network, and compare the significance of these to clusters derived from the larger 18367Hu-matrix network. Sorting and visualization uses the publicly available software, MetaOmGraph (http://www.metnetdb.org/MetNet_MetaOm-Graph.htm). This identifies genes that characterize particular disease conditions. Specifically, differences in gene expression within and between two designations of glial cancer, astrocytoma and glioblastoma, are evaluated in the context of the broader network. Such gene groups, which we term outlier-networks, tease out abnormally expressed genes and the samples in which this expression occurs. This approach distinguishes 48 subnetworks of outlier genes associated with astrocytoma and glioblastoma. As a case study, we investigate the relationships among the genes of a small astrocytoma-only subnetwork. This astrocytoma-only subnetwork consists of SVEP1, IGF1, CHRNA3, and SPAG6. All of these genes are highly coexpressed in a single sample of anaplastic astrocytoma tumor (grade III) and a sample of juvenile pilocytic astrocytoma. Three of these genes are also associated with nicotine. This data lead us to formulate a testable hypothesis that this astrocytoma outlier-network provides a link between some gliomas/astrocytomas and nicotine.

• Journal of Korean Neurosurgical Society
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• 제30권4호
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• pp.430-436
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• 2001

Objective : The proliferative potential of intracranial glioma affects the histological malignancy and prognosis of patients with these tumors. In this study, we present the relationship between MIB-1 labeling index(LI) and clinical variables which might play the major role in determining the prognosis of patient with astrocytic tumors. Patients and Methods : Excised tumor specimens from a total of 52 patients were stained to detect monoclonal MIB-1-Ki-67 antibody by avidin-biotin complex immunohistochemistry. The MIB-1 LI was evaluated with histological grades, demograpghic data, and survival time. The statistical significance of their correlation was analyzed by Pearson correlation test. Results : The 52 patients included 30 male patients and 22 female patients. The tumors according to the criteria of the World Health Organization(WHO) classification were verified as pleomorphic xanthoastrocytoma in one, pilocytic astrocytomas 4, astrocytomas 1, anaplastic astrocytomas 3, and glioblastomas 31. MIB-1 LI in astrocytic ttumors showed no correlation with age and gender. However, the patients under 10 years had the longest survival time, whereas short survival time was observed in the older patients. The mean MIB-1 LI of different tumor grades were as follows : pleomorphic xanthoastrocytoma, $4.40{\pm}0.00$ ; pilocytic astrocytoma, $4.53{\pm}3.09$ ; astrocytoma, $5.50{\pm}6.03$ ; anaplastic astrocytoma, $12.68{\pm}12.50$ ; Glioblastoma, $21.31{\pm}19.63$. Although the levels of MIB-1 LI were varied in individual tumors, the MIB-1 LI was increased in parallel with the histological grades. Glioblstomas showed significantly higher MIB-1 LI compared with that of anaplastic astrocytomas and low grade astrocytomas (p = 0.001). The mean survival time of entire group of patients was also well correlated with MIB-1 LI in astrocytic tumors(p = 0.015). Moreover, the mean survival time of the entire group of patients with Lis < 10 was $125.33{\pm}113.57weeks$, and the mean survival of those with $Lis{\geq}10$ was $60.71{\pm}62.58weeks$. This difference was also statistically significant(p = 0.004). Conclusion : The results of this study suggest that MIB-1 LI correlates with histological grades and might play a significant role in predicting the survival of patients with astrocytic tumors.

• Journal of Korean Neurosurgical Society
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• 제51권4호
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• pp.219-221
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• 2012

A 20-month-old boy presented with a intraparenchymal mass in the right frontoparietal area manifesting as complex partial seizure, secondary generalization and left hemiparesis. Magnetic resonance images (MRI) of the brain showed inhomogeneously enhancing mass in the right frontoparietal area which has irregular margin and perilesional edema. Based on the radiological findings, a preoperative diagnosis was an intraaxial tumor, such as pilocytic astrocytoma or dysembryoplastic neuroepithelial tumor. The patient underwent a surgery including frontal craniotomy. The tumor had a partially extreme adherence to the surrounding brain tissue but it showed no dural attachment. Gross-total resection of the tumor was achieved. Postoperative follow-up computed tomography scans showed no residual tumor. The pathological findings confirmed the tumor as a WHO grade I meningioma, transitional type. Nine months after the surgery, follow-up brain MRI showed no recurrence of the tumor, porencephaly in site where the tumor was resected; the patient's symptoms had fully recovered. We report the case of a meningioma in a 20-month-old boy.

• Journal of Yeungnam Medical Science
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• 제37권2호
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• pp.128-132
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• 2020

Tanycytic ependymoma is a rare variant of ependymoma that commonly affects the cervical and thoracic spinal cord. It usually arises as intramedullary lesions, and extramedullary cases are extremely rare. We report a case of a 44-year-old woman who was diagnosed with tanycytic ependymoma in her lumbar spine at level 2-3. The tumor mass developed in an intradural extramedullary location. Histopathologically, tanycytic ependymoma can be misdiagnosed as schwannoma or pilocytic astrocytoma. Immunohistochemical findings such as strong positivity for glial fibrillary acidic protein, perinuclear dot-like positive patterns for epithelial membrane antigen, and focal positivity for S100 protein are helpful in diagnosing tanycytic ependymoma. It is important to be aware of this rare tumor to ensure appropriate patient management and accurate prognosis.

• Radiation Oncology Journal
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• 제15권1호
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• pp.1-10
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• 1997

목적 : 저분화 성상세포종 치료에 있어서 방사선 치료 역할을 생존율과 치료 실패 양상으로 평가하고 생존율에 영향을 미치는 예후인자를 분석한다. 대상 및 방법 : 1990년 1월부터 1995년 12월까지 서울 중앙 병원에서 아전절제술과 조직생검으로 확진된 저분화 성상세포종 환자 중 천막 하부를 제외한 총 51(남:여=28:23)예를 대상으로 하여 후향적으로 방사선 치료 성적을 분석하였다. 방사선 치료는 최저 4820cGy, 최고 6000cGy를 분할 치료하였고 치료 부위는 종양에 2-3cm 여유를 두고 국소조사하였다. 추적률은 $96\%$이었으며 추적 관찰 기간의 중앙값은 48개월이었다. 생존율은 Kaplan-Meier법으로 분석하였다. 결과 : 총 51예의 2년 및 5년 전체 생존율은 $83.4\% 및 $54.8\% 이었고 2년 및 5년 무진행 생존율은 $67.4\% 및 $48.7\%이였다. 전체 생존율에 영향을 주는 예Gn인자는 Karnofsky 수행도 (p=0.024), T 병기(p=0.014), 조직학적 유형(p=0.012), 방사선 조사야(p=0.003), 방사선 반응도(p=0.0004)이었다. 그러나 절제 정도(아전 절제술 대 생검) 및 방사선 선량(56OOcGy 이상 대 이하)은 생존율에 영향을 주지 못했다. 방사선치료후에 진행을 보이지 않은 45예중 17예 ($37.8\%)에서 국소 재발을 보였으며, 6예에서는 방사선 치료 직후 진행을 보여 총 23예 ($45.1\%)에서 국소실패를 보였다. 2예를 제외한 28예의 무진행 생존자들은 모두 신체적으로 지능적으로 정상이었다. 결론 : 본 연구에서는 비교적 추적 기간이 짧지만 저분화 성상세포종에 대한 방사선 치료후 5년 생존율과 무진행 생존율은 $54.8\%와 $48.7\%로 우수하였다. Karnofsky 수행도가 높을수록, T병기가 낮을수록, Pilocytic 유형인 경우, 방사선 치료에 반응할수록 양호한 예후를 보였다. 그러나 주 치료 실패 요인인 국소실패율을 감소시키기 위한 다각도의 연구가 필요하리라 사료된다.