A national perspective of adult gangliogliomas

Varshneya, Kunal; Sarmiento, J. Manuel; Nuño, Miriam A; Lagman, Carlito; Mukherjee, Debraj; Nuño, Karla; Babu, Harish; Patil, Chirag G.

doi:10.1016/j.jocn.2015.12.028

Cited by 11 publications

(25 citation statements)

References 33 publications

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“…In 3 out of 16 (19%) of the remaining operations, residual tumor tissue was left behind intentionally to preserve function or limit surgical morbidity, and in 1 out of 16 (6%) operations, residual contrast enhancement was noted on the postoperative MRI. In a study of Varshneya et al, of 198 adult patients with low and high-grade gangliogliomas, the authors found overall gross total resection rate of 59% [ 34 ]. Of 348 children with low-grade ganglioglioma or gangliocytoma in a Surveillance, Epidemiology, and End Results (SEER) Database study by Dudley et al, surgery was performed on 91.6% of cases, with GTR achieved in 68.3% [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

Lighting Up the Tumor—Fluorescein-Guided Resection of Gangliogliomas

Höhne

Acerbi

Falco

et al. 2020

JCM

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(1) Background: Gangliogliomas comprise a small number of brain tumors. They usually present as World Health Organization (WHO) grade I, and they delineate on gadolinium-enhanced MRI; the surgical goal is wide radical resection, and the course thereafter is usually benign. Fluorescein sodium (FL) tends to accumulate in areas with altered blood–brain barrier (BBB). Thus far, the results provided by prospective and retrospective studies show that the utilization of this fluorophore may be associated with better visualization and improvement of resection for several tumors of the central nervous system. In this study, we retrospectively studied the effect of fluorescein sodium on visualization and resection of gangliogliomas. (2) Methods: Surgical databases in three neurosurgical departments (Regensburg University Hospital; Besta Institute, Milano, Italy; and Liv Hospital, Istanbul, Turkey), with approval by the local ethics committee, were retrospectively reviewed to find gangliogliomas surgically removed by a fluorescein-guided technique by the aid of a dedicated filter on the surgical microscope from April 2014 to February 2020. Eighteen patients (13 women, 5 men; mean age 22.9 years, range 3 to 78 years) underwent surgical treatment for gangliogliomas during 19 operations. Fluorescein was intravenously injected (5 mg/kg) after general anesthesia induction. Tumors were removed using a microsurgical technique with the YELLOW 560 Filter (YE560) (KINEVO/PENTERO 900, Carl Zeiss Meditec, Oberkochen, Germany). (3) Results: No side effects related to fluorescein occurred. In all tumors, contrast enhancement on preoperative MRI correlated with bright yellow fluorescence during the surgical procedure (17 gangliogliomas WHO grade I, 1 ganglioglioma WHO grade II). Fluorescein was considered helpful by the operating surgeon in distinguishing tumors from viable tissue in all cases (100%). Biopsy was intended in two operations, and subtotal resection was intended in one operation. In all other operations considered preoperatively eligible, gross total resection (GTR) was achieved in 12 out of 16 (75%) instances. (4) Conclusions: The use of FL and YE560 is a readily available method for safe fluorescence-guided tumor resection, possibly visualizing tumor margins intraoperatively similar to contrast enhancement in T1-weighted MRI. Our data suggested a positive effect of fluorescein-guided surgery on intraoperative visualization and extent of resection during resection of gangliogliomas.

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Section: Discussionmentioning

confidence: 99%

Lighting Up the Tumor—Fluorescein-Guided Resection of Gangliogliomas

Höhne

Acerbi

Falco

et al. 2020

JCM

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“…60,61 Gangliogliomas are commonly located in the temporal lobe, and the most significant predictors of survival are low tumor grade and younger age. 62 SEGAs are typically located at the caudothalamic groove adjacent to the foramen of Monro. Though they are generally slow-growing and histologically benign, they can also be associated with manifestations such as hydrocephalus, intracranial pressure, and seizures.…”

Section: Grade I Gliomasmentioning

confidence: 99%

Central Nervous System Cancers, Version 3.2020, NCCN Clinical Practice Guidelines in Oncology

Nabors

Portnow

Ahluwalia

et al. 2020

Journal of the National Comprehensive Cancer Network

352

238

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The NCCN Guidelines for Central Nervous System (CNS) Cancers focus on management of adult CNS cancers ranging from noninvasive and surgically curable pilocytic astrocytomas to metastatic brain disease. The involvement of an interdisciplinary team, including neurosurgeons, radiation therapists, oncologists, neurologists, and neuroradiologists, is a key factor in the appropriate management of CNS cancers. Integrated histopathologic and molecular characterization of brain tumors such as gliomas should be standard practice. This article describes NCCN Guidelines recommendations for WHO grade I, II, III, and IV gliomas. Treatment of brain metastases, the most common intracranial tumors in adults, is also described.

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“…The efficacy of chemotherapy for adjuvant or recurrent ganglioglioma is uncertain and remains controversial (48), with a high risk of serious adverse events. Recommendations for the use of radiotherapy at progression are based on case reports and small cohorts, particularly in the spinal cord (49).…”

Section: Discussionmentioning

confidence: 99%

Prolonged Response Induced by Single Agent Vemurafenib in a BRAF V600E Spinal Ganglioglioma: A Case Report and Review of the Literature

et al. 2019

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Spinal ganglioglioma is a rare low-grade, slow-growing tumor of the central nervous system affecting mostly children and young adults. After surgery, some patients show tumor recurrence and/or malignant transformation. Gangliogliomas harbor molecular deficiencies such as mutations in the B-rapidly accelerated fibrosarcoma ( BRAF ) gene, resulting in activation of a downstream signaling pathway and cancer development. Vemurafenib is a BRAF inhibitor used to treat patients with BRAF V600E -mutated cancer. Although a few studies have reported the clinical responses in gangliogliomas, the sequence and duration of treatment have not been established. We describe a case of an adult with a progressive BRAF V600E mutant spinal cord ganglioglioma 9 years after surgery who was treated with vemurafenib. This treatment resulted in a partial response within 2 months, which was sustained for more than a year. The patient then decided to stop treatment because of side effects. Despite this decision, the tumor showed no sign of progression 21 months after treatment discontinuation. This is the first reported case of a response to vemurafenib in an adult with progressive spinal cord BRAF V600E -mutated ganglioglioma which was sustained after treatment discontinuation.

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A national perspective of adult gangliogliomas

Cited by 11 publications

References 33 publications

Lighting Up the Tumor—Fluorescein-Guided Resection of Gangliogliomas

Lighting Up the Tumor—Fluorescein-Guided Resection of Gangliogliomas

Central Nervous System Cancers, Version 3.2020, NCCN Clinical Practice Guidelines in Oncology

Prolonged Response Induced by Single Agent Vemurafenib in a BRAF V600E Spinal Ganglioglioma: A Case Report and Review of the Literature

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