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1. Moll GW, Bock HG: Two tumors detected by thyroid assessment in two children. Endocr Pract; 2001 Nov-Dec;7(6):467-73
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  • [Title] Two tumors detected by thyroid assessment in two children.
  • OBJECTIVE: To describe the early detection of two tumors in two children by recognition of unusual features in initial thyroid assessments.
  • In addition, we describe RET proto-oncogene studies in one of them.
  • RESULTS: A 14.5-year-old boy was referred for assessment because of short stature in conjunction with lack of physical growth and development.
  • His physical examination was remarkable for height at the 50th percentile (height age, 11.5 years), weight at the 50th percentile (weight age, 13 years), and prepubertal male status.
  • A parasellar tumor was detected and removed; histopathologic examination revealed that it was a craniopharyngioma.
  • The patient requires lifelong multihormonal therapy for his panhypopituitarism and has responded with physical growth.
  • Our second patient, a 7.5-year-old girl, was referred because of a painless left thyroid nodule of 4 months' duration.
  • Her physical examination was remarkable for (1) upper lip swelling, (2) intermittent rash, and (3) a goiter with painless mobile left and right nodules.
  • Genetic studies showed that she was positive for the RET multiple endocrine neoplasia IIB mutation.
  • CONCLUSION: Attention to thyroid physical findings and laboratory studies can promptly lead to correct diagnoses and management of some rare and life-threatening tumors in children.
  • [MeSH-major] Carcinoma, Medullary / diagnosis. Craniopharyngioma / diagnosis. Thyroid Neoplasms / diagnosis
  • [MeSH-minor] Adolescent. Child. Female. Humans. Hypopituitarism / drug therapy. Male. Multiple Endocrine Neoplasia / genetics. Puberty, Delayed / etiology. Thyroidectomy. Thyrotropin / blood. Thyroxine / blood

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  • (PMID = 11747285.001).
  • [ISSN] 1530-891X
  • [Journal-full-title] Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
  • [ISO-abbreviation] Endocr Pract
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 9002-71-5 / Thyrotropin; Q51BO43MG4 / Thyroxine
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2. Nagasaki K, Tsumanuma I, Yoneoka Y, Jinguji S, Ogawa Y, Kikuchi T, Uchiyama M: Metabolic effects of growth hormone replacement in two pediatric patients with growth without growth hormone. Endocr J; 2010;57(9):771-5
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  • Growth without growth hormone (GH) has occasionally been described in patients who have had tumors removed in the hypothalamic-pituitary area.
  • Two children in whom the growth without GH phenomenon occurred after therapy for brain tumors participated in this study.
  • Case 1 is a 15-yr-old Japanese girl, diagnosed as having Langerhans cell histiocytosis with multiple intracranial lesions at the age of two.
  • She showed a slight body fat increase, dyslipidemia and fatty liver.
  • Case 2 is a 10-yr-old Indonesian boy, diagnosed with craniopharyngioma at the age of three.
  • In both cases, GH replacement therapy was started at 0.042 mg/kg/week for 12 months.
  • Body composition, BMD, and visceral abdominal area were measured every 3 months.
  • Serum fasting blood glucose, insulin, ALT, lipid profile, leptin, and adiponectin levels were also measured every 3 months.
  • Case 1 showed improvement of transaminase (ALT from 64 to 16 IU/L) and triglyceride (from 239 to 129 mg/dL) over 12 months, but did not show a decrease in visceral fat area or of body fat percentage.
  • Case 2 showed a decrease in body fat percentage and visceral fat area, accompanied by elevated serum adiponectin and decreased leptin levels.
  • In conclusion, twelve months GH replacement therapy improves metabolic abnormalities in pediatric patients with growth without GH.
  • [MeSH-major] Growth / drug effects. Hormone Replacement Therapy. Human Growth Hormone / therapeutic use
  • [MeSH-minor] Adiponectin / blood. Adolescent. Body Composition / drug effects. Child. Craniopharyngioma / surgery. Dyslipidemias / metabolism. Empty Sella Syndrome / drug therapy. Fatty Liver / metabolism. Female. Humans. Leptin / blood. Male. Pituitary Neoplasms / surgery

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  • (PMID = 20660985.001).
  • [ISSN] 1348-4540
  • [Journal-full-title] Endocrine journal
  • [ISO-abbreviation] Endocr. J.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / ADIPOQ protein, human; 0 / Adiponectin; 0 / Leptin; 12629-01-5 / Human Growth Hormone
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3. Jakacki RI, Cohen BH, Jamison C, Mathews VP, Arenson E, Longee DC, Hilden J, Cornelius A, Needle M, Heilman D, Boaz JC, Luerssen TG: Phase II evaluation of interferon-alpha-2a for progressive or recurrent craniopharyngiomas. J Neurosurg; 2000 Feb;92(2):255-60
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Phase II evaluation of interferon-alpha-2a for progressive or recurrent craniopharyngiomas.
  • OBJECT: Craniopharyngiomas originate from the same cells as squamous cell skin carcinoma, which can be treated successfully with interferon-alpha (IFNalpha)-2a.
  • The authors evaluated the activity and toxicity of systemic IFN in young patients with craniopharyngiomas.
  • METHODS: Fifteen patients between the ages of 4.2 and 19.8 years who had progressive or recurrent craniopharyngiomas were enrolled in this study.
  • Nine of these patients had never received external-beam radiation therapy.
  • Therapy consisted of 8,000,000 U/m2 IFNalpha-2a administered daily for 16 weeks (induction phase) followed by the same dose three times per week for an additional 32 weeks (maintenance phase).
  • Of the 12 patients who could be evaluated, radiological studies demonstrated a response to treatment in three with predominantly cystic tumors (one minor response, one partial response, and one complete response); one of these patients also showed improvement in visual fields.
  • The size of the cystic component of the tumors often increased temporarily during the first several months of therapy.
  • Three patients met the criteria for progressive disease during therapy.
  • The median time to progression was 25 months.
  • The need for radiation therapy in patients treated with IFN was delayed for 18 to 35 months (median 25 months) in six patients.
  • All patients developed transient flulike symptoms shortly after receiving the first dose of IFN.
  • Other toxicities (predominantly hepatic, neurological, and cutaneous) were seen in nine (60%) of the 15 patients during the first 8 weeks of treatment but resolved after temporary discontinuation and/or dose reduction.
  • CONCLUSIONS: Interferon-alpha-2a is active against some childhood craniopharyngiomas; its toxicity precludes administration of high daily doses, and the optimum dose level and schedule remain to be defined.
  • [MeSH-major] Craniopharyngioma / drug therapy. Interferon-alpha / administration & dosage. Neoplasm Recurrence, Local / drug therapy. Pituitary Neoplasms / drug therapy
  • [MeSH-minor] Adolescent. Adult. Child. Child, Preschool. Combined Modality Therapy. Cranial Irradiation. Disease Progression. Dose-Response Relationship, Drug. Drug Administration Schedule. Female. Humans. Injections, Subcutaneous. Magnetic Resonance Imaging. Male. Pituitary Gland / pathology. Radiotherapy, Adjuvant. Recombinant Proteins. Treatment Outcome

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  • (PMID = 10659012.001).
  • [ISSN] 0022-3085
  • [Journal-full-title] Journal of neurosurgery
  • [ISO-abbreviation] J. Neurosurg.
  • [Language] eng
  • [Publication-type] Case Reports; Clinical Trial; Clinical Trial, Phase II; Journal Article
  • [Publication-country] UNITED STATES
  • [Chemical-registry-number] 0 / Interferon-alpha; 0 / Recombinant Proteins; 76543-88-9 / interferon alfa-2a
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4. Rohrer TR, Langer T, Grabenbauer GG, Buchfelder M, Glowatzki M, Dörr HG: Growth hormone therapy and the risk of tumor recurrence after brain tumor treatment in children. J Pediatr Endocrinol Metab; 2010 Sep;23(9):935-42
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  • [Title] Growth hormone therapy and the risk of tumor recurrence after brain tumor treatment in children.
  • To assess the effect of human growth hormone (hGH) therapy and other factors on tumor recurrence after treatment of pediatric brain tumors (BTs), we retrospectively analyzed data from 108 craniopharyngioma, medulloblastoma, and ependymoma patients.
  • Risk factors were identified using multifactorial univariate regression analysis.
  • There were significant correlations for completeness of tumor removal and recurrence-free survival (RFS).
  • This difference was found only for medulloblastomas and accounted for by higher rates of incomplete tumor removal in non-hGH patients.
  • Craniopharyngioma recurrence correlated only with RFS.
  • Malignant BT recurrence correlated with completeness of tumor removal, chemotherapy, and RFS.
  • 4 children developed SMNs, 3/4 after hGH therapy.
  • We conclude that hGH therapy after treatment of pediatric BTs does not increase tumor recurrence risk.
  • [MeSH-major] Brain Neoplasms / therapy. Human Growth Hormone / adverse effects. Neoplasm Recurrence, Local / etiology
  • [MeSH-minor] Adolescent. Child. Child, Preschool. Female. Humans. Infant. Infant, Newborn. Male. Neoplasms, Second Primary / etiology. Retrospective Studies. Risk

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  • (PMID = 21175094.001).
  • [ISSN] 0334-018X
  • [Journal-full-title] Journal of pediatric endocrinology & metabolism : JPEM
  • [ISO-abbreviation] J. Pediatr. Endocrinol. Metab.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 12629-01-5 / Human Growth Hormone
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5. Bahuleyan B, Menon G, Nair S: Immediate postoperative death due to hypothalamic injury following surgery for craniopharyngioma. J Clin Neurosci; 2009 Jun;16(6):850-1
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  • [Title] Immediate postoperative death due to hypothalamic injury following surgery for craniopharyngioma.
  • Autonomic disturbances due to hypothalamic injury that result in postoperative death are rare complications following surgery for craniopharyngioma.
  • We discuss the case of a child who died due to hypothalamic injury following radical excision of a multi-compartmental craniopharyngioma.
  • [MeSH-major] Autonomic Nervous System Diseases / etiology. Craniopharyngioma / surgery. Hypothalamus / injuries. Neurosurgical Procedures / adverse effects. Pituitary Neoplasms / surgery. Postoperative Complications / etiology
  • [MeSH-minor] Child. Craniotomy. Decompression, Surgical. Diabetes Insipidus / drug therapy. Diabetes Insipidus / etiology. Fatal Outcome. Heart Failure / etiology. Heart Failure / physiopathology. Humans. Hypotension / etiology. Hypotension / physiopathology. Magnetic Resonance Imaging. Male. Malignant Hyperthermia / etiology. Third Ventricle / pathology. Third Ventricle / surgery


6. Hofman R, Rosingh HJ: Unilateral hearing loss as primary symptom of craniopharyngioma in a six-year-old girl. J Laryngol Otol; 2008 Mar;122(3):e10
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  • [Title] Unilateral hearing loss as primary symptom of craniopharyngioma in a six-year-old girl.
  • OBJECTIVE: We report a rare case of otological presentation of craniopharyngioma.
  • METHOD: Case report and review of world literature concerning presentations of craniopharyngioma.
  • Magnetic resonance scanning revealed a massive, cystic craniopharyngioma exerting pressure on the patient's ventricular system and brainstem and also invading the internal acoustic canal.
  • The patient's hearing loss completely recovered, and she experienced no neurological or endocrinological side effects of the treatment.
  • Craniopharyngioma have a prevalence of 0.13-2:100,000.
  • CONCLUSION: Craniopharyngioma is a rare disease.
  • [MeSH-major] Craniopharyngioma / complications. Hearing Loss, Unilateral / etiology. Pituitary Neoplasms / complications
  • [MeSH-minor] Child. Craniotomy / methods. Female. Humans. Reflex, Babinski / drug therapy. Treatment Outcome

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  • (PMID = 18252012.001).
  • [ISSN] 1748-5460
  • [Journal-full-title] The Journal of laryngology and otology
  • [ISO-abbreviation] J Laryngol Otol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] England
  • [Number-of-references] 6
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9. Lustig RH, Post SR, Srivannaboon K, Rose SR, Danish RK, Burghen GA, Xiong X, Wu S, Merchant TE: Risk factors for the development of obesity in children surviving brain tumors. J Clin Endocrinol Metab; 2003 Feb;88(2):611-6
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  • [Title] Risk factors for the development of obesity in children surviving brain tumors.
  • Hypothalamic obesity, a syndrome of intractable weight gain due to hypothalamic damage, is an uncommon but devastating complication for children surviving brain tumors.
  • We undertook a retrospective evaluation of the body mass index (BMI) curves for the St. Jude Children's Research Hospital brain tumor population diagnosed between 1965 and 1995 after completion of therapy to determine risk factors for the development of obesity.
  • Inclusion criteria were: diagnosis less than 14 yr of age, no spinal cord involvement, ambulatory, no supraphysiologic hydrocortisone therapy (>12 mg/m(2) x d), treatment and follow-up at St. Jude Children's Research Hospital, and disease-free survival greater than 5 yr (n = 148).
  • Risk factors examined were age at diagnosis, tumor location, histology, extent of surgery, hydrocephalus requiring ventriculoperitoneal shunting, initial high-dose glucocorticoids, cranial radiation therapy, radiation dosimetry to the hypothalamus, intrathecal chemotherapy, and presence of endocrinopathy.
  • Analyses were performed both between groups within a risk factor and against BMI changes for age in normal children older than 5.5 yr (the age of adiposity rebound).
  • Risk factors were: age at diagnosis (P = 0.04), radiation dosimetry to the hypothalamus (51-72 Gy, P = 0.002 even after hypothalamic and thalamic tumor exclusion), and presence of any endocrinopathy (P = 0.03).
  • In addition, risk factors when compared with BMI slope for the general American pediatric population included: tumor location (hypothalamic, P = 0.001), tumor histology (craniopharyngioma, P = 0.009; pilocytic astrocytoma, P = 0.043; medulloblastoma, P = 0.039); and extent of surgery (biopsy, P = 0.03; subtotal resection, P = 0.018).
  • These results verify hypothalamic damage, either due to tumor, surgery, or radiation, as the primary cause of obesity in survivors of childhood brain tumors.
  • In particular, hypothalamic radiation doses of more than 51 Gy are permissive.
  • These results reiterate the importance of the hypothalamus in energy balance, provide risk assessment criteria for preventative measures before the development of obesity in at-risk patients, and suggest therapeutic strategies to reduce the future development of obesity.
  • [MeSH-major] Brain Neoplasms / epidemiology. Craniopharyngioma / epidemiology. Obesity / epidemiology
  • [MeSH-minor] Astrocytoma / drug therapy. Astrocytoma / epidemiology. Astrocytoma / radiotherapy. Cerebellar Neoplasms / drug therapy. Cerebellar Neoplasms / epidemiology. Cerebellar Neoplasms / radiotherapy. Child. Child, Preschool. Disease-Free Survival. Humans. Hypothalamus / physiology. Medulloblastoma / drug therapy. Medulloblastoma / epidemiology. Medulloblastoma / radiotherapy. Retrospective Studies. Risk Factors

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  • (PMID = 12574189.001).
  • [ISSN] 0021-972X
  • [Journal-full-title] The Journal of clinical endocrinology and metabolism
  • [ISO-abbreviation] J. Clin. Endocrinol. Metab.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / R25 CA023944; United States / NCI NIH HHS / CA / P30CA12765
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
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10. Lehman NL: The ubiquitin proteasome system in neuropathology. Acta Neuropathol; 2009 Sep;118(3):329-47
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  • In neuropathology, alteration of the UPS, or mutations in UPS target proteins may result in signaling abnormalities leading to the initiation or progression of tumors such as astrocytomas, hemangioblastomas, craniopharyngiomas, pituitary adenomas, and medulloblastomas.
  • Dysregulation of the UPS may also contribute to tumor progression by perturbation of DNA replication and mitotic control mechanisms, leading to genomic instability.
  • In neurodegenerative diseases caused by the expression of mutant proteins, the cellular accumulation of these proteins may overload the UPS, indirectly contributing to the disease process, e.g., sporadic Parkinsonism and prion diseases.
  • Defects or dysfunction of the UPS may also underlie cognitive disorders such as Angelman syndrome, Rett syndrome and autism, and muscle and nerve diseases, e.g., inclusion body myopathy and giant axon neuropathy.
  • The potential for the UPS as a target of pharmacological therapy is also discussed.
  • [MeSH-minor] Brain Diseases / metabolism. Brain Neoplasms / metabolism. Humans. Neurodegenerative Diseases / metabolism. Substrate Specificity

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  • (PMID = 19597829.001).
  • [ISSN] 1432-0533
  • [Journal-full-title] Acta neuropathologica
  • [ISO-abbreviation] Acta Neuropathol.
  • [Language] eng
  • [Grant] United States / NINDS NIH HHS / NS / K08 NS045077
  • [Publication-type] Journal Article; Review
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Ubiquitin; EC 3.4.25.1 / Proteasome Endopeptidase Complex
  • [Number-of-references] 149
  • [Other-IDs] NLM/ PMC2716447
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11. Binder G, Weber S, Ehrismann M, Zaiser N, Meisner C, Ranke MB, Maier L, Wudy SA, Hartmann MF, Heinrich U, Bettendorf M, Doerr HG, Pfaeffle RW, Keller E, South German Working Group for Pediatric Endocrinology: Effects of dehydroepiandrosterone therapy on pubic hair growth and psychological well-being in adolescent girls and young women with central adrenal insufficiency: a double-blind, randomized, placebo-controlled phase III trial. J Clin Endocrinol Metab; 2009 Apr;94(4):1182-90
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  • [Title] Effects of dehydroepiandrosterone therapy on pubic hair growth and psychological well-being in adolescent girls and young women with central adrenal insufficiency: a double-blind, randomized, placebo-controlled phase III trial.
  • CONTEXT AND OBJECTIVE: The efficacy of oral dehydroepiandrosterone (DHEA) in the treatment of atrichia pubis and psychological distress in young females with central adrenal insufficiency is unknown.
  • Our study aimed to evaluate this therapy.
  • Inclusion criteria were ACTH deficiency plus two or more additional pituitary deficiencies, serum DHEA less than 400 ng/ml, and pubertal stage more than B2.
  • Exclusion criteria were cerebral radiation with more than 30 Gy, tumor remission less than 1 yr, amaurosis, hypothalamic obesity, psychiatric disorders, and unstable hormone medication.
  • INTERVENTION: Patients were randomized to placebo (n = 12) or 25 mg HPLC-purified DHEA/d (n = 11) orally for 12 months after stratification into a nontumor (n = 7) and a tumor group (n = 16).
  • MAIN OUTCOME MEASURES: Clinical scoring of pubic hair stage was performed at 0, 6, and 12 months (primary endpoint), and psychometrical evaluation (Symptom Check-List-90-R and the Centre for Epidemiological Studies-Depression Scale) at 0 and 12 months (secondary endpoint).
  • RESULTS: In the placebo group, four patients dropped out because of recurrence of craniopharyngioma, manifestation of type 1 diabetes, and change of residence (n = 2); in the DHEA group, one patient dropped out because of recurrent anxiety attacks.
  • DHEA substitution resulted in normalization of DHEA sulfate and androstanediol glucuronide morning serum levels 2 h after drug intake (P < 0.006), and of its 24 h urinary metabolite levels (P < 0.0001), placebo had no effect.
  • Morning serum levels of androstenedione increased in the DHEA group (P < 0.02) but did not normalize.
  • The DHEA group exhibited significant progress in pubic hair growth from Tanner stage I-III to II-V (mean: +1.5 stages), whereas the placebo group did not (relative risk 0.138; 95% confidence interval 0.021-0.914; P = 0.0046).
  • Importantly, eight of the 10 Symptom Check-List-90-R scores, including those for depression, anxiety, and interpersonal sensitivity, and the global severity index improved in the DHEA group in comparison to the placebo group (P < 0.048).
  • CONCLUSIONS: In adolescent girls with central adrenal insufficiency, daily replacement with 25 mg DHEA orally is beneficial: atrichia pubis vanishes, and psychological well-being improves significantly.
  • [MeSH-major] Adrenal Insufficiency / drug therapy. Adrenocorticotropic Hormone / deficiency. Dehydroepiandrosterone / therapeutic use. Hair / growth & development. Hypopituitarism / drug therapy
  • [MeSH-minor] Adolescent. Adult. Blood Pressure / drug effects. Blood Pressure / physiology. Brain Neoplasms / epidemiology. Double-Blind Method. Female. Humans. Hydrocortisone / therapeutic use. Obesity / epidemiology. Young Adult

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  • (PMID = 19126625.001).
  • [ISSN] 1945-7197
  • [Journal-full-title] The Journal of clinical endocrinology and metabolism
  • [ISO-abbreviation] J. Clin. Endocrinol. Metab.
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase III; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 459AG36T1B / Dehydroepiandrosterone; 9002-60-2 / Adrenocorticotropic Hormone; WI4X0X7BPJ / Hydrocortisone
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12. Pettorini BL, Inzitari R, Massimi L, Tamburrini G, Caldarelli M, Fanali C, Cabras T, Messana I, Castagnola M, Di Rocco C: The role of inflammation in the genesis of the cystic component of craniopharyngiomas. Childs Nerv Syst; 2010 Dec;26(12):1779-84
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  • [Title] The role of inflammation in the genesis of the cystic component of craniopharyngiomas.
  • BACKGROUND: Craniopharyngioma accounts for 5-10% of childhood tumors and, despite of the benign histological features, its clinical course can be malignant because of critical anatomical relationships with neural and vascular structures and the possible morbidity associated to resection.
  • Only a few studies have addressed the molecular characterization of the cyst fluid so far and the mechanisms of action of intracystic agents are not clearly understood yet.
  • METHODS: The acidic soluble proteins contained in the cystic fluid of six patients with cystic craniopharyngioma, three of them treated with intratumoral interferon-α, were analyzed.
  • A high performance liquid chromatography electrospray ionization mass spectrometry analysis was performed.
  • FINDINGS: The antimicrobial peptides α-defensins 1-3 relevant for innate immunity were detected in the cystic fluid before the intratumoral treatment.
  • Amount of peptides significantly decreased in cystic fluid during pharmacological treatment.
  • INTERPRETATION: Detection of α-defensins 1-3 excludes that cyst fluid formation can derive from disruption of blood-brain barrier and suggests the involvement of innate immune response in pathology of craniopharyngioma cyst formation.
  • The reduction of α-defensins could derive both from direct antitumoral effect of interferon-α on squamous epithelial cells of craniopharyngioma cyst and from its immuno-modulatory effects on the recruitment of cells of innate immune systems.
  • Additional studies will be necessary to establish the role of these molecules in the pathogenesis of craniopharyngioma, and further investigations will be necessary to confirm the efficacy of the antitumoral activity of interferon-α.
  • [MeSH-major] Craniopharyngioma / immunology. Cysts / immunology. Inflammation / immunology. Pituitary Neoplasms / immunology
  • [MeSH-minor] Child. Child, Preschool. Chromatography, High Pressure Liquid. Cyst Fluid / chemistry. Cyst Fluid / immunology. Female. Humans. Immunity, Innate / immunology. Immunologic Factors / administration & dosage. Injections, Intraventricular. Interferon-alpha / administration & dosage. Male. Spectrometry, Mass, Electrospray Ionization. alpha-Defensins / analysis. alpha-Defensins / immunology. alpha-Defensins / metabolism

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  • (PMID = 20668862.001).
  • [ISSN] 1433-0350
  • [Journal-full-title] Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery
  • [ISO-abbreviation] Childs Nerv Syst
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Immunologic Factors; 0 / Interferon-alpha; 0 / alpha-Defensins
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13. Linnert M, Gehl J: Bleomycin treatment of brain tumors: an evaluation. Anticancer Drugs; 2009 Mar;20(3):157-64
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  • [Title] Bleomycin treatment of brain tumors: an evaluation.
  • Bleomycin has been used in the treatment of brain tumors for over 30 years.
  • Currently, we are evaluating electrochemotherapy (the use of electric pulses to enhance uptake of bleomycin) for patients with secondary brain tumors.
  • Using the keywords 'brain' and 'bleomycin', a database search without date restriction was performed and over 500 articles were found.
  • Twenty-five articles were used for this study based on relevance determined by: (i) clinical studies, (ii) use of bleomycin, and (iii) direct injection into brain tissue or cysts.
  • There were two main indications for the use of bleomycin directly into the brain: (i) cystic tumors in the form of craniopharyngiomas and (ii) solid brain tumors such as glioblastomas and astrocytomas.
  • One death was directly related to this treatment, where very high doses were used.
  • Two patients developed loss of vision and two patients had hearing loss because of the treatment.
  • All cases with severe and moderate adverse effects except one were patients with craniopharyngiomas and probably because of tumor localization in the deep brain.
  • In conclusion, bleomycin injection into the brain has been fairly well tolerated at doses much higher than that used in electrochemotherapy.
  • [MeSH-major] Antimetabolites, Antineoplastic / therapeutic use. Bleomycin / therapeutic use. Brain Neoplasms / drug therapy
  • [MeSH-minor] Adolescent. Adult. Aged. Blindness / chemically induced. Brain Edema / chemically induced. Child. Child, Preschool. Craniopharyngioma / drug therapy. DNA Damage. Deafness / chemically induced. Electroporation. Female. Glioma / drug therapy. Humans. Infant. Injections, Spinal. Male. Middle Aged. Pituitary Neoplasms / drug therapy. Young Adult

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  • (PMID = 19396014.001).
  • [ISSN] 1473-5741
  • [Journal-full-title] Anti-cancer drugs
  • [ISO-abbreviation] Anticancer Drugs
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antimetabolites, Antineoplastic; 11056-06-7 / Bleomycin
  • [Number-of-references] 43
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14. Stieber VW: Radiation therapy for visual pathway tumors. J Neuroophthalmol; 2008 Sep;28(3):222-30
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  • [Title] Radiation therapy for visual pathway tumors.
  • The multimodality management of visual pathway tumors frequently involves radiation.
  • Most commonly, photons are delivered via multiple focused beams aimed at the tumor while sparing adjacent tissues.
  • The dose can be delivered in multiple treatments (radiation therapy) or in a single treatment (radiosurgery).
  • Children with visual pathway gliomas should be treated with chemotherapy alone, delaying the use of radiation therapy until progression.
  • Definitive radiation therapy of optic nerve sheath meningiomas results in stable vision in most patients.
  • Radiation therapy or radiosurgery for pituitary tumors can result in control of both tumor growth and hormone hypersecretion.
  • Postoperative radiation therapy or radiosurgery of craniopharyngiomas significantly improves local control rates compared with surgery alone.
  • Radiation therapy is highly effective for eradicating orbital pseudolymphoma and lymphoma.
  • The risk of complications from radiation treatment is dependent on the organ at risk, the cumulative dose it receives, and the dose delivered per fraction.
  • [MeSH-major] Optic Nerve / radiation effects. Optic Nerve Diseases / radiotherapy. Optic Nerve Glioma / radiotherapy. Radiotherapy / methods
  • [MeSH-minor] Craniopharyngioma / complications. Craniopharyngioma / pathology. Craniopharyngioma / radiotherapy. Humans. Lymphoma / complications. Lymphoma / pathology. Lymphoma / radiotherapy. Meningioma / complications. Meningioma / pathology. Meningioma / radiotherapy. Pituitary Neoplasms / complications. Pituitary Neoplasms / pathology. Pituitary Neoplasms / radiotherapy. Pseudolymphoma / complications. Pseudolymphoma / pathology. Pseudolymphoma / radiotherapy. Radiation Dosage

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  • (PMID = 18769290.001).
  • [ISSN] 1536-5166
  • [Journal-full-title] Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society
  • [ISO-abbreviation] J Neuroophthalmol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 106
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15. Hilczer M, Smyczynska J, Stawerska R, Lewinski A: Final height and growth hormone secretion after completion of growth hormone therapy in patients with idiopathic growth hormone deficiency and with abnormalities of the hypothalamic-pituitary region. Neuro Endocrinol Lett; 2005 Feb;26(1):19-24
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  • [Title] Final height and growth hormone secretion after completion of growth hormone therapy in patients with idiopathic growth hormone deficiency and with abnormalities of the hypothalamic-pituitary region.
  • AIMS: The aim of the study was an evaluation of final height and growth hormone (GH) secretion after completion of GH therapy (retesting) in patients with GH deficiency (GHD).
  • PATIENTS AND METHODS: The analysis comprised 53 patients (43 boys, 10 girls) with childhood-onset GHD, who completed GH therapy and reached final height.
  • Magnetic resonance imaging (MRI), performed in all the patients, led to the following groups: pituitary stalk interruption syndrome (PSIS), pituitary hypoplasia (HP), craniopharyngioma (CP) -- patients after tumour excision, patients with normal hypothalamic-pituitary region (NP).
  • In retesting, GH secretion was significantly (p<0.005) lower in PSIS and CP than in HP and in NP and also (p<0.05) in HP than in NP.
  • Permanent severe GHD was confirmed in all the patients with PSIS and CP and in some patients with HP (37.5%), while it was excluded in all the patients with normal pituitary in MRI.
  • CONCLUSIONS: It seems that in patients with PSIS and CP, the confirmation of persistent character of GHD needs no retesting, while in patients with normal MRI results, GHD diagnosis should be established with special attention.
  • [MeSH-major] Body Height / drug effects. Growth Hormone / therapeutic use. Human Growth Hormone / blood. Human Growth Hormone / deficiency. Hypothalamo-Hypophyseal System / abnormalities
  • [MeSH-minor] Adolescent. Age of Onset. Child. Craniopharyngioma / surgery. Female. Humans. Magnetic Resonance Imaging. Male. Pituitary Diseases / blood. Pituitary Diseases / drug therapy. Pituitary Diseases / surgery. Pituitary Gland / abnormalities. Pituitary Neoplasms / surgery


16. Cavalheiro S, Di Rocco C, Valenzuela S, Dastoli PA, Tamburrini G, Massimi L, Nicacio JM, Faquini IV, Ierardi DF, Silva NS, Pettorini BL, Toledo SR: Craniopharyngiomas: intratumoral chemotherapy with interferon-alpha: a multicenter preliminary study with 60 cases. Neurosurg Focus; 2010 Apr;28(4):E12
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  • [Title] Craniopharyngiomas: intratumoral chemotherapy with interferon-alpha: a multicenter preliminary study with 60 cases.
  • OBJECT: The authors assessed the efficacy of intratumoral interferon-alpha (IFNalpha)-based chemotherapy in pediatric patients with cystic craniopharyngiomas.
  • METHODS: In a prospective multicenter study of 60 pediatric patients, the authors assessed the efficacy of intratumoral INFalpha2A-based chemotherapy.
  • RESULTS: Sixty cases of cystic craniopharyngioma were analyzed.
  • The cohort consisted of 35 male and 25 female children (mean age 11 years).
  • CONCLUSIONS: This has been the largest documented series of intratumoral chemotherapy using INFalpha for the control of cystic craniopharyngiomas.
  • The treatment has proved efficacious; there was no mortality, and morbidity rates were low.
  • [MeSH-major] Craniopharyngioma / drug therapy. Interferon-alpha / administration & dosage. Pituitary Neoplasms / drug therapy
  • [MeSH-minor] Child. Child, Preschool. Cohort Studies. Drug Administration Schedule. Female. Humans. Infant. Injections, Intralesional. Magnetic Resonance Imaging. Male. Neuronavigation. Prospective Studies. Treatment Outcome. Tumor Burden

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  • (PMID = 20367356.001).
  • [ISSN] 1092-0684
  • [Journal-full-title] Neurosurgical focus
  • [ISO-abbreviation] Neurosurg Focus
  • [Language] eng
  • [Publication-type] Clinical Trial; Comparative Study; Journal Article; Multicenter Study
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Interferon-alpha
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17. Okońska M, Birkholz D, Korpal-Szczyrska M, Adamkiewicz-Drozyńska E, Alska A, Magnuszewska H: [The evaluation of the influence of growth hormone therapy on growing process and metabolic functions in patients after treatment of craniopharyngioma]. Pediatr Endocrinol Diabetes Metab; 2010;16(1):19-24
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  • [Title] [The evaluation of the influence of growth hormone therapy on growing process and metabolic functions in patients after treatment of craniopharyngioma].
  • [Transliterated title] Ocena wpływu terapii hormonem wzrostu na przebieg wzrastania i funkcje metaboliczne u pacjentów po leczeniu craniopharyngioma.
  • INTRODUCTION: Craniopharyngioma (CP) is a tumor, which damages pituitary function because of its localization.
  • The growth hormone therapy (rGH) profits in the increase of growth rate and also may have metabolic effects like body weight reduction.
  • AIM OF THE STUDY: The evaluation of benefits from rGH therapy in patients cured from CP.
  • MATERIAL AND METHODS: 12 patients (7 boys and 5 girls) treated for CP with surgery; 3 of them also underwent radiotherapy.
  • The mean age at examination time was 11.7 yrs; remission time 2.96 yrs; rGH therapy started on average 3.69 yrs after the surgery.
  • Height (hSDS), weight, BMI were measured after the surgery, before and after 1 yr of rGH treatment.
  • Height velocity (HV) was evaluated before and after 1 yr of rGH therapy.
  • Pituitary GH-function was assessed.
  • Cholesterol, LDL, HDL, triglycerides and HbA1c were estimated before and after one year of rGH therapy.
  • HSDS after oncological treatment (OT) average -1.66 SD and decreased significantly until rGH therapy; weight after OT average 28.45 kg and until rGH therapy increased significantly; BMI after OT average 19.26 and increased significantly until rGH therapy as well.
  • After one year of rGH therapy hSDS and HV increased significantly; they average -1.65SD and 10.21 cm/yr respectively.
  • During rGH therapy neither tumor recurrence nor severe side effects were observed.
  • CONCLUSIONS: rGH therapy of patients cured from CP influences profitably not only growth rate, but also BMI reduction and the decrease in cholesterol LDL and HbA1c.
  • [MeSH-major] Craniopharyngioma / complications. Growth Disorders / drug therapy. Human Growth Hormone / therapeutic use. Pituitary Neoplasms / complications
  • [MeSH-minor] Child. Female. Humans. Male. Overweight / drug therapy. Overweight / etiology. Recombinant Proteins

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  • (PMID = 20529601.001).
  • [ISSN] 2081-237X
  • [Journal-full-title] Pediatric endocrinology, diabetes, and metabolism
  • [ISO-abbreviation] Pediatr Endocrinol Diabetes Metab
  • [Language] pol
  • [Publication-type] Clinical Trial; English Abstract; Journal Article
  • [Publication-country] Poland
  • [Chemical-registry-number] 0 / Recombinant Proteins; 12629-01-5 / Human Growth Hormone
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18. Serowka K, Chiu Y, Gonzalez I, Gilles F, McComb G, Krieger M, Dhall G, Britt B, Ji L, Sposto R, Finlay JL: Central nervous system (CNS) tumors in the first six months of life: the Children's Hospital Los Angeles experience, 1979-2005. Pediatr Hematol Oncol; 2010 Mar;27(2):90-102
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  • [Title] Central nervous system (CNS) tumors in the first six months of life: the Children's Hospital Los Angeles experience, 1979-2005.
  • BACKGROUND: The authors report the experience at the Children's Hospital Los Angeles with brain tumors diagnosed before 6 months of age, describing the characteristics of the patients, their tumors, treatment strategies, and prognostic factors.
  • METHODS: Thirty-three children who were identified between 1979 and 2005 were included.
  • There were 11 gliomas, 9 choroid plexus tumors, 8 medulloblastomas and supratentorial primitive neuroectodermal tumors (PNET), 2 atypical teratoid/rhabdoid tumors (ATRT), and 1 each of ependymoma, craniopharyngioma, and immature teratoma.
  • Locations of primary tumors included 21 supratentorial (64%) and 7 posterior fossa, and 5 tumors involved both compartments.
  • The treatment strategies included 5 patients with biopsy only, 18 less than gross total resections (<GTRx), and 9 GTRx.
  • Fourteen children (42%) received chemotherapy.
  • Three patients (9%) received irradiation, 1 at initial diagnosis and 2 at relapse.
  • Nine patients (27%) demonstrated metastases, 6 at diagnosis and 3 at relapse.
  • RESULTS: The Kaplan Meier analysis of event-free survival (EFS) and overall survival (OS) for all patients is 21 +/- 9% and 35 +/- 9% at 5 years.
  • The 5-year OS for children achieving a GTRx is 64 +/- 21% and for those with <GTRx is 27 +/- 10% (p = .08).
  • [MeSH-major] Brain Neoplasms
  • [MeSH-minor] Female. Hospitals, Pediatric. Humans. Infant. Infant, Newborn. Los Angeles / epidemiology. Male. Prognosis. Survival Rate. Treatment Outcome

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  • (PMID = 20201690.001).
  • [ISSN] 1521-0669
  • [Journal-full-title] Pediatric hematology and oncology
  • [ISO-abbreviation] Pediatr Hematol Oncol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
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19. Kitahara M, Ishikawa S, Hara K, Kanno S, Ogata F, Naruo K, Yaguchi A: [Changes in peripheral lymphocytes count in unconscious patients treated at home with Japanese herbal medicines (Hozai)]. Gan To Kagaku Ryoho; 2002 Dec;29 Suppl 3:526-9
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  • We investigated changes in peripheral white blood cells count, lymphocytes count, and serum albumin level in five unconscious patients administered Japanese herbal medicines (Hozai).
  • The causes of unconsciousness were intracerebral hemorrhage in 3, cerebral infarction in 1, and craniopharyngioma in 1.
  • To assess the effect of Hozai on the immune system of unconscious patients, we investigated these parameters before and after treatment.
  • We observed normalization of WBC counts, increase of lymphocytes count, and unchanged levels of serum albumin after Hozai treatment.
  • One of the problems affecting unconscious patients treated at home is infectious diseases, especially respiratory infections.
  • These results suggest that Hozai treatment might be useful adjuvants to support the general condition of the patients treated at home.
  • [MeSH-major] Consciousness Disorders / immunology. Drugs, Chinese Herbal / therapeutic use. Medicine, Kampo. Phytotherapy. Serum Albumin / metabolism
  • [MeSH-minor] Aged. Cerebral Hemorrhage / complications. Cerebral Hemorrhage / drug therapy. Female. Humans. Leukocyte Count. Lymphocyte Count. Male. Middle Aged

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  • (PMID = 12536844.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Drugs, Chinese Herbal; 0 / Serum Albumin
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20. Bommakanti K, Panigrahi M, Yarlagadda R, Sundaram C, Uppin MS, Purohit AK: Optic chiasmatic-hypothalamic gliomas: is tissue diagnosis essential? Neurol India; 2010 Nov-Dec;58(6):833-40
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  • [Title] Optic chiasmatic-hypothalamic gliomas: is tissue diagnosis essential?
  • The advocated treatment is mainly primary radiotherapy without a histological diagnosis.
  • Hence primary radiotherapy without histological confirmation may have deleterious consequences.
  • AIM: The aim of the paper was to analyze the sensitivity and specificity of magnetic resonance imaging (MRI) in these lesions and to analyze the feasibility of primary radiotherapy.
  • They were grouped into three groups on the basis of radiological features and treated with a suspected diagnosis.
  • The final diagnosis was correlated with preoperative diagnosis, and the feasibility of managing these lesions without a histopathological confirmation is discussed.
  • RESULTS: The three radiological groups were: Group-1 solid tumors with or without microcysts in 9 patients (histology: 8 pilocystic astrocytomas and 1 tuberculoma); Group-2 mixed tumors with solid and cystic components in 9 patients (histology: 7 pilocytic astrocytomas and 2 craniopharyngiomas); Group-3 ring enhancing lesions in 6 patients (all the 6 patients initially received antituberculous treatment, in 3 patients the lesion resolved and in the remaining 3 patients the lesion was subjected to biopsy as it did not resolve, the biopsy was suggestive of pilocytic astrocytoma).
  • Thus, MRI was shown to have a sensitivity of 83.33% and a specificity of 50% for diagnosing optic chiasmatic-hypothalamic gliomas.
  • CONCLUSIONS: Various lesions like craniopharyngiomas, tuberculomas can mimic optic chiasmatic-hypothalamic gliomas radiologically, and it is not possible to diagnose them with certainty on the basis of radiological findings alone.
  • Biopsy and tissue diagnosis should always be sought before instituting radiotherapy or chemotherapy for optic chiasmatic-hypothalamic gliomas.
  • [MeSH-major] Glioma / diagnosis. Hypothalamic Neoplasms / diagnosis. Optic Chiasm / pathology. Optic Nerve Neoplasms / diagnosis
  • [MeSH-minor] Adolescent. Biopsy / methods. Child. Child, Preschool. Contrast Media. Female. Humans. Magnetic Resonance Imaging / methods. Male. Young Adult

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  • [CommentIn] Neurol India. 2011 Jan-Feb;59(1):144 [21339694.001]
  • (PMID = 21150045.001).
  • [ISSN] 0028-3886
  • [Journal-full-title] Neurology India
  • [ISO-abbreviation] Neurol India
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] India
  • [Chemical-registry-number] 0 / Contrast Media
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21. Kobayashi K, Higashima M, Mutou K, Kidani T, Tachibana O, Yamashita J, Koshino Y: Severe delirium due to basal forebrain vascular lesion and efficacy of donepezil. Prog Neuropsychopharmacol Biol Psychiatry; 2004 Nov;28(7):1189-94
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  • A 68-year-old man had suffered for a month from delirium of mixed type caused by the right basal forebrain vascular lesion after surgery for craniopharyngioma.
  • Magnetic resonance imaging (MRI) showed hemorrhagic infarcts in the head of the right caudate nucleus and the right basal forebrain of the medial septal nucleus, diagonal band of Broca and nucleus basalis of Meynert.
  • Donepezil administration dramatically improved his intractable delirium at the 19th post-donepezil administration day, but this was followed by amnestic symptoms.
  • [MeSH-major] Basal Ganglia Cerebrovascular Disease / drug therapy. Delirium / drug therapy. Delirium / etiology. Indans / therapeutic use. Nootropic Agents / therapeutic use. Piperidines / therapeutic use. Prosencephalon / pathology
  • [MeSH-minor] Aged. Basal Nucleus of Meynert / pathology. Craniopharyngioma / complications. Craniopharyngioma / surgery. Humans. Magnetic Resonance Imaging. Male. Pituitary Neoplasms / complications. Pituitary Neoplasms / surgery. Postoperative Complications / drug therapy. Postoperative Complications / psychology. Sleep Wake Disorders / drug therapy. Sleep Wake Disorders / etiology. Vision Disorders / complications

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  • (PMID = 15610933.001).
  • [ISSN] 0278-5846
  • [Journal-full-title] Progress in neuro-psychopharmacology & biological psychiatry
  • [ISO-abbreviation] Prog. Neuropsychopharmacol. Biol. Psychiatry
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Indans; 0 / Nootropic Agents; 0 / Piperidines; 8SSC91326P / donepezil
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22. Fraioli MF, Moschettoni L, Catena E, Fraioli C: Cystic craniopharyngioma: trans-sphenoidal surgery and intra-cystic apposition of "bleomycin wax". Acta Neurochir (Wien); 2010 Feb;152(2):293-6
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  • [Title] Cystic craniopharyngioma: trans-sphenoidal surgery and intra-cystic apposition of "bleomycin wax".
  • BACKGROUND: The current therapeutic approach to craniopharyngioma is multidisciplinary.
  • Sub-total removal, followed by adjuvant treatments, especially in large cystic tumours, is an accepted regime reported by many authors.
  • CASE REPORT: A young patient with an intra- and suprasellar cystic craniopharyngioma was operated on via a microsurgical trans-sphenoidal approach, achieving sub-total removal and bleomycin mixed with bone wax ("bleomycin wax") applied to the capsular remnant.
  • There was no evidence of tumour recurrence after a follow-up period of 5.4 years.
  • CONCLUSIONS: The intra-operative use of "bleomycin-wax" should be limited to those patients in whom intra-operative CSF fistula does not occur.
  • [MeSH-major] Bleomycin / administration & dosage. Craniopharyngioma / drug therapy. Craniopharyngioma / surgery. Pituitary Neoplasms / drug therapy. Pituitary Neoplasms / surgery. Sphenoid Bone / surgery
  • [MeSH-minor] Antibiotics, Antineoplastic / administration & dosage. Child. Cysts / drug therapy. Cysts / pathology. Diabetes Insipidus / drug therapy. Diabetes Insipidus / etiology. Drug Combinations. Epithelial Cells / pathology. Humans. Magnetic Resonance Imaging. Male. Nasal Cavity / anatomy & histology. Nasal Cavity / surgery. Neurosurgical Procedures. Optic Chiasm / pathology. Optic Chiasm / surgery. Palmitates / administration & dosage. Pituitary Gland / pathology. Pituitary Gland / surgery. Postoperative Complications / drug therapy. Postoperative Complications / etiology. Sella Turcica / pathology. Sella Turcica / surgery. Treatment Outcome. Waxes

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  • (PMID = 19390776.001).
  • [ISSN] 0942-0940
  • [Journal-full-title] Acta neurochirurgica
  • [ISO-abbreviation] Acta Neurochir (Wien)
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Austria
  • [Chemical-registry-number] 0 / Antibiotics, Antineoplastic; 0 / Drug Combinations; 0 / Palmitates; 0 / Waxes; 11056-06-7 / Bleomycin; 8021-48-5 / bone wax
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23. Marcus KJ, Goumnerova L, Billett AL, Lavally B, Scott RM, Bishop K, Xu R, Young Poussaint T, Kieran M, Kooy H, Pomeroy SL, Tarbell NJ: Stereotactic radiotherapy for localized low-grade gliomas in children: final results of a prospective trial. Int J Radiat Oncol Biol Phys; 2005 Feb 1;61(2):374-9
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  • [Title] Stereotactic radiotherapy for localized low-grade gliomas in children: final results of a prospective trial.
  • PURPOSE: To evaluate the efficacy of stereotactic radiotherapy (SRT) for small, localized, pediatric brain tumors and to determine the patterns of failure.
  • Of the 81 patients, 50 had low-grade astrocytoma, 23 had residual or recurrent craniopharyngioma, 4 had posterior fossa ependymoma, and 4 had other histologic types.
  • All patients underwent biopsy for diagnosis, with the exception of patients with neurofibromatosis and radiographic evidence of an optic system tumor.
  • This report focused on the patients with low-grade gliomas only.
  • Of the 50 patients, 26 were males and 24 females; the median age was 9 years (range, 2-26 years).
  • The indications for treatment of patients with low-grade gliomas were progression during or after chemotherapy or progression after surgery alone.
  • Immobilization was accomplished with a removable head-frame.
  • CT and MRI fusion was used for treatment planning.
  • The target volume generally included the preoperative tumor plus a 2-mm margin for the planning target volume.
  • Three to nine arcs were used to deliver a mean total dose of 52.2 Gy in 1.8-Gy daily fractions.
  • RESULTS: With a median follow-up of 6.9 years (range, 0.9-10.2 years), the progression-free survival rate was 82.5% at 5 years and 65% at 8 years.
  • Five patients, all with optic system/hypothalamic primary tumors, developed central nervous system dissemination 1.0-7.4 years after SRT.
  • One patient developed a presumed radiation-induced primitive neuroectodermal tumor 6 years after initial treatment.
  • Six patients died, three of dissemination, two of progression to higher grade tumors, and one of a secondary radiation-induced tumor.
  • All 6 cases of local progression were within the primary tumor bed at the time of progression and had received the full prescription dose.
  • CONCLUSION: Stereotactic radiotherapy provides excellent local control for children with small, localized low-grade glial tumors.
  • Marginal failures have not been observed, supporting the use of limited margins to minimize late sequelae using stereotactic immobilization and planning techniques.
  • [MeSH-major] Astrocytoma / surgery. Brain Neoplasms / surgery. Radiosurgery
  • [MeSH-minor] Adolescent. Adult. Child. Child, Preschool. Confidence Intervals. Disease Progression. Disease-Free Survival. Female. Humans. Male. Neoplasm Recurrence, Local / drug therapy. Prospective Studies. Radiotherapy Dosage

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  • (PMID = 15667955.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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24. Pancucci G, Massimi L, Caldarelli M, D'Angelo L, Sturiale C, Tamburrini G, Tufo T, Di Rocco C: [Pediatric craniopharyngioma: long-term results in 61 cases]. Minerva Pediatr; 2007 Jun;59(3):219-31
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  • [Title] [Pediatric craniopharyngioma: long-term results in 61 cases].
  • [Transliterated title] Craniofaringioma pediatrico: risultati a lungo termine in 61 casi.
  • AIM: The aim of this study was to analyze the long-term results of the surgical management of craniopharyngioma in children by reviewing a series of patients consecutively treated in a single institution, and to assess the efficacy of intratumoral chemotherapy with interferon-alpha.
  • METHODS: Sixty-one paediatric patients (38 males and 23 females; mean age: 8 years) have been surgically treated in the last 20 years.
  • The goal of surgery was to remove the tumour as much as possible.
  • RESULTS: All the 55 surviving patients enjoy a normal social life, except for 3 of them (visual and/or neurological deficits); endocrine function, compromised in 3/5 of cases, is managed by chronic hormone replacement; neuropsychological assessment is satisfactory in almost all the cases.
  • Although obesity does not seem to be an important social limit, it represents a real management problem.
  • Interferon-a was useful in transitorily arresting the growing cystic craniopharyngiomas.
  • CONCLUSION: The current experience confirms the still remarkable challenges in the treatment of craniopharyngioma in childhood.
  • Surgery should aim not only at removing the tumour, but also at preserving the late neuro-endocrinological functions.
  • Intracystic chemotherapy with interferon-alpha might represent an effective option to postpone the surgical operation until the maturation of the hypothalamic-hypophyseal pathway is completed.
  • However, it can not replace the traditional surgical management.
  • [MeSH-major] Brain / pathology. Craniopharyngioma / therapy. Hypophysectomy. Pituitary Neoplasms / therapy
  • [MeSH-minor] Adolescent. Antineoplastic Agents / therapeutic use. Chemotherapy, Adjuvant. Child. Child, Preschool. Female. Follow-Up Studies. Humans. Infant. Injections, Intralesional. Interferon-alpha / therapeutic use. Magnetic Resonance Imaging. Male. Radiotherapy, Adjuvant. Recombinant Proteins. Retrospective Studies. Treatment Outcome

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  • (PMID = 17519867.001).
  • [ISSN] 0026-4946
  • [Journal-full-title] Minerva pediatrica
  • [ISO-abbreviation] Minerva Pediatr.
  • [Language] ita
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Italy
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Interferon-alpha; 0 / Recombinant Proteins; 76543-88-9 / interferon alfa-2a
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25. Mottolese C, Szathmari A, Berlier P, Hermier M: Craniopharyngiomas: our experience in Lyon. Childs Nerv Syst; 2005 Aug;21(8-9):790-8
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  • [Title] Craniopharyngiomas: our experience in Lyon.
  • OBJECTIVE: We reviewed our experience in surgical treatment of craniopharyngiomas.
  • Surgical treatment of craniopharyngiomas in children represents a challenge for neurosurgeons because it presents a different set of surgical problems.
  • Post-surgical quality of life is related to the anatomical relationship between the hypothalamic region, vascular structures and optic pathways.
  • Two groups of patients were distinguished: a group of 36 patients treated with surgical direct surgery; a second group of 24 patients treated only with intracystic chemotherapy with bleomycin (18 patients) or associated with surgery (six patients).
  • In the first group, the removal of lesion was total in 74% of cases.
  • All patients presented ante-pituitary insufficiency and diabetes insipidus, which required substitutive treatment.
  • In the group treated with bleomycin, 18 patients presented a primary cystic or a mixed form of craniopharyngioma and six patients showed a cystic recurrence.
  • The dose used varied from 30 mg to a maximal dose of 150 mg, with a middle dose of 60 mg in the large majority of cases.
  • In this group, the cyst disappeared in 12 patients and reduced to 30% of its initial volume, and stabilization of the lesion was achieved in the other six patients.
  • CONCLUSION: Our experience showed that in the group treated with intracystic chemotherapy alone, results were better with a low rate of morbidity and mortality.
  • In cases of cystic craniopharyngiomas, we considered bleomycin as the treatment of choice.
  • For solid forms or for cases resistant to intracystic chemotherapy with bleomycin, direct surgery has to be proposed.
  • [MeSH-major] Craniopharyngioma / surgery. Cysts / surgery. Pituitary Neoplasms / surgery
  • [MeSH-minor] Adolescent. Child. Child, Preschool. Female. France. Humans. Infant. Magnetic Resonance Imaging. Male. Neurosurgical Procedures. Radiosurgery. Tomography, X-Ray Computed

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  • (PMID = 15971075.001).
  • [ISSN] 0256-7040
  • [Journal-full-title] Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery
  • [ISO-abbreviation] Childs Nerv Syst
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Review
  • [Publication-country] Germany
  • [Number-of-references] 46
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26. Moschovi M, Alexiou GA, Dastamani A, Stefanaki K, Prodromou N, Hatzigiorgi H, Karamolegou K, Tzortzatou-Stathopoulou F: Alpha-fetoprotein secretion in a craniopharyngioma. Are craniopharyngiomas part of the germ cell tumor family? Acta Neurol Belg; 2010 Sep;110(3):272-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Alpha-fetoprotein secretion in a craniopharyngioma. Are craniopharyngiomas part of the germ cell tumor family?
  • Brain CT and MRI revealed a suprasellar cystic and partially solid mass with calcifications.
  • These findings were suggestive for a brain germ cell tumor.
  • Therefore, systemic chemotherapy was started.
  • After two courses there was a reduction in the levels of AFP but the tumor size remained unchanged.
  • Subtotal tumor excision was performed that revealed the presence of a craniopharyngioma.
  • One month later there was enlargement of the cystic part of the tumor, while serum AFP was elevated.
  • The child received again systemic chemotherapy and placement of a reservoir into the cystic part of the tumor.
  • Analysis of the intracystic flouid revealed the presence of beta-HCG and AFP.
  • One year later the patient was stable but with complete loss of vision.
  • These observations support the theory of a germ cell tumor family, in which craniopharyngioma and germ cell tumor present the two sides of the same entity, while between them a wide variety of tumors, with variable type of secretion of AFP and/or beta-HCG, may exist.
  • [MeSH-major] Craniopharyngioma. Neoplasms, Germ Cell and Embryonal / classification. Pituitary Neoplasms. alpha-Fetoproteins / secretion
  • [MeSH-minor] Female. Humans. Infant. Tomography, X-Ray Computed

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  • (PMID = 21114138.001).
  • [ISSN] 0300-9009
  • [Journal-full-title] Acta neurologica Belgica
  • [ISO-abbreviation] Acta Neurol Belg
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Belgium
  • [Chemical-registry-number] 0 / AFP protein, human; 0 / alpha-Fetoproteins
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27. Trivin C, Busiah K, Mahlaoui N, Recasens C, Souberbielle JC, Zerah M, Sainte-Rose C, Brauner R: Childhood craniopharyngioma: greater hypothalamic involvement before surgery is associated with higher homeostasis model insulin resistance index. BMC Pediatr; 2009;9:24
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  • [Title] Childhood craniopharyngioma: greater hypothalamic involvement before surgery is associated with higher homeostasis model insulin resistance index.
  • BACKGROUND: Obesity seems to be linked to the hypothalamic involvement in craniopharyngioma.
  • METHODS: 27 children with craniopharyngioma were classified as either grade 0 (n = 7, no hypothalamic involvement), grade 1 (n = 8, compression without involvement), or grade 2 (n = 12, severe involvement).
  • RESULTS: Despite having similar body mass indexes (BMI), the grade 2 patients had higher glucose, insulin and HOMA before surgery than the grade 0 (P = 0.02, <0.05 and 0.02 respectively) and 1 patients (P < 0.02 and <0.03 for both insulin and HOMA).
  • The grade 0 (5.8 +/- 4.9) and 1 (7.2 +/- 5.3) patients gained significantly less weight (kg) during the year after surgery than did the grade 2 (16.3 +/- 7.4) patients.
  • The pre-surgery HOMA was positively correlated with these weight changes (P < 0.03).
  • The data for the whole population before and 6-18 months after surgery showed increases in BMI (P < 0.0001), insulin (P < 0.005), and leptin (P = 0.0005), and decreases in sOB-R (P < 0.04) and ghrelin (P < 0.03).
  • CONCLUSION: The hypothalamic involvement by the craniopharyngioma before surgery seems to determine the degree of insulin resistance, regardless of the BMI.
  • [MeSH-major] Craniopharyngioma / pathology. Hypothalamus / pathology. Insulin Resistance. Obesity / etiology. Pituitary Neoplasms / pathology
  • [MeSH-minor] Adolescent. Blood Glucose / analysis. Child. Child, Preschool. Female. Ghrelin / blood. Homeostasis. Hormone Replacement Therapy. Humans. Hydrocortisone / blood. Hypophysectomy. Hypopituitarism / drug therapy. Hypopituitarism / etiology. Insulin-Like Growth Factor I / analysis. Leptin / blood. Male. Models, Biological. Receptors, Leptin / blood. Retrospective Studies. Single-Blind Method. Thyroxine / blood. Weight Gain

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  • (PMID = 19341477.001).
  • [ISSN] 1471-2431
  • [Journal-full-title] BMC pediatrics
  • [ISO-abbreviation] BMC Pediatr
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Blood Glucose; 0 / Ghrelin; 0 / Leptin; 0 / Receptors, Leptin; 67763-96-6 / Insulin-Like Growth Factor I; Q51BO43MG4 / Thyroxine; WI4X0X7BPJ / Hydrocortisone
  • [Other-IDs] NLM/ PMC2675525
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28. Rittinger O, Kranzinger M, Jones R, Jones N: Malignant astrocytoma arising 10 years after combined treatment of craniopharyngioma. J Pediatr Endocrinol Metab; 2003 Jan;16(1):97-101
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  • [Title] Malignant astrocytoma arising 10 years after combined treatment of craniopharyngioma.
  • Craniopharyngioma is the third most common intracranial tumor in childhood.
  • Following surgery, virtually all patients present with hypopituitarism and are at considerable risk of tumor recurrence.
  • Secondary tumors, however, are rare, occurring usually 10 years after diagnosis and associated with poor prognosis.
  • We report on a 5 year-old boy in whom craniopharyngioma was diagnosed due to unilateral visual loss.
  • After surgery he underwent conventional radiation therapy with a total tumor dose of 55 Gy, and had hormonal support with DDAVP, thyroxine, and a variable dose of hydrocortisone.
  • Growth velocity declined slowly in the first 4 years, but improved later on again without GH therapy despite abnormal provocative tests.
  • At the age of 15 years he developed peripheral facial nerve palsy due to a malignant astrocytoma (WHO grade III/IV).
  • Repeated conventional radiation therapy with an additional stereotactic boost and chemotherapy could not prevent the fatal outcome.
  • This observation may temper the use of radiosurgery in benign intracranial tumors.
  • [MeSH-major] Astrocytoma / diagnosis. Brain Stem Neoplasms / diagnosis. Craniopharyngioma / radiotherapy. Craniopharyngioma / surgery. Neoplasms, Second Primary / diagnosis. Pituitary Neoplasms / radiotherapy. Pituitary Neoplasms / surgery
  • [MeSH-minor] Child, Preschool. Combined Modality Therapy. Fatal Outcome. Hormones / blood. Humans. Magnetic Resonance Imaging. Male. Neoplasm Invasiveness. Time Factors

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  • (PMID = 12585346.001).
  • [ISSN] 0334-018X
  • [Journal-full-title] Journal of pediatric endocrinology & metabolism : JPEM
  • [ISO-abbreviation] J. Pediatr. Endocrinol. Metab.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Hormones
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29. Crom DB, Smith D, Xiong Z, Onar A, Hudson MM, Merchant TE, Morris EB: Health status in long-term survivors of pediatric craniopharyngiomas. J Neurosci Nurs; 2010 Dec;42(6):323-8; quiz 329-30
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Health status in long-term survivors of pediatric craniopharyngiomas.
  • Craniopharyngiomas are the third most common pediatric brain tumor and most common pediatric suprasellar tumor.
  • Contemporary treatment of craniopharyngiomas uses limited surgery and radiation in an effort to minimize morbidity, but the long-term health status of patients treated in this fashion has not been well described.
  • The purpose of this study was to analyze the health status of long-term survivors of pediatric craniopharyngioma treated primarily with radiation and conservative surgical resection.
  • Medical records of all long-term survivors of craniopharyngioma treated at St. Jude Children's Research Hospital and then transferred to the long-term follow-up clinic were reviewed.
  • Of these, 51 (93%) were alive at the time of this analysis.
  • The median age at diagnosis was 7.1 years (range, 1.2-17.6 years), and 29 (57%) were male.
  • At the time of analysis, the median survival was 7.6 years (range, 5.0-21.3 years).
  • Diagnosis and treatment included surgical biopsy, resection (n = 50), and radiation therapy (n=48).
  • Only 1 patient received chemotherapy.
  • In a small percentage of patients, complications may result in death even during extended remission of craniopharyngioma.
  • Because of the broad spectrum or morbidities experienced, survivors of craniopharyngioma continue to benefit from multidisciplinary care.

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  • (PMID = 21207770.001).
  • [ISSN] 0888-0395
  • [Journal-full-title] The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses
  • [ISO-abbreviation] J Neurosci Nurs
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / P30 CA021765; United States / NCI NIH HHS / CA / CA 21765
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Other-IDs] NLM/ NIHMS756555; NLM/ PMC4895693
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30. Albert A, Cruz O, Montaner A, Vela A, Badosa J, Castañón M, Morales L: [Congenital solid tumors. A thirteen-year review]. Cir Pediatr; 2004 Jul;17(3):133-6
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  • [Title] [Congenital solid tumors. A thirteen-year review].
  • [Transliterated title] Tumores sólidos congénitos. Revisión de 13 años.
  • Tumors diagnosed during the first month of life are infrequent: 0.5 to 2% of all childhood neoplasms.
  • This is an interesting group of tumors because their type, relative incidence, natural history and response to treatment differ from those seen in older children.
  • AIM: To contribute the experience of our institution in congenital tumors the last 13 years.
  • MATERIAL AND METHODS: The records of all neonates (< 31 days old) diagnosed with solid tumors since January 1990 to December 2002 have been retrospectively reviewed.
  • RESULTS: Twenty-seven neonates have been diagnosed with tumors in the last 13 years.
  • Neuroblastoma was the commonest tumor (10 cases, 37%), of which 4 were stage I, 4 stage IV-S and 2 stage III.
  • There were 8 teratomas (3 sacrocoxigeal, 1 retroperitoneal, 1 in the CNS, 1 orbitary and two oronasal), two hepatic tumors (1 hepatoblastoma, 1 hemangioendothelioma, two CNS tumors, two giant nevus (one on a hamartoma), and one each Wilms tumor, infantile fibrosarcoma and myofibroblastic tumor.
  • Treatment was surgical resection alone in 17 cases (68%) and surgery + chemotherapy in 8 (32%) (5 neuroblastomas, one CNS tumor, one Wilms tumor and one presacral teratoma who developed a yolk sac tumor); 3 patients died (11%): one at surgery, one of tumoural airway obstruction at birth and one with craniopharyngioma.
  • Among the 14 tumors that were initially not malignant, two can be locally agressive, one was an immature teratoma, the giant nevus with hamartoma developed in situ melanoma, the other nevus had meningeal melanosis with hydrocephalus, and one mature presacral teratoma developed a yolk sac tumor.
  • CONCLUSIONS: Diagnosis of congenital tumors is performed earlier in recent years due to the wide use of prenatal ultrasound.
  • Their natural history is more benign than in other age groups, except for CNS tumors and very large or obstructing tumors.
  • The histological patern is not determinant of the outcome.
  • Complete surgical excision is the treatment of choice, most cases not need adjuvant chemotherapy.
  • We ought to pass this message on to our colleagues in prenatal diagnosis, so parents get reliable information.
  • [MeSH-major] Central Nervous System Neoplasms / congenital. Kidney Neoplasms / congenital. Liver Neoplasms / congenital. Neuroblastoma / congenital. Skin Neoplasms / congenital. Soft Tissue Neoplasms / congenital. Teratoma / congenital. Wilms Tumor / congenital
  • [MeSH-minor] Female. Follow-Up Studies. Humans. Infant, Newborn. Male. Neoplasm Recurrence, Local. Postoperative Complications. Pregnancy. Prenatal Diagnosis. Time Factors


31. Chanson JB, Anheim M, Lagha-Boukbiza O, Fleury M, Sellal F, Tranchant C: [Severe generalized dystonia due to postradiotherapy cerebral calcifications]. Rev Neurol (Paris); 2008 May;164(5):477-80
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  • [Transliterated title] Dystonie généralisée sévère liée à des calcifications cérébrales postradiques.
  • We report a very severe case of generalized dystonia due to postradiotherapy basal ganglia calcifications.
  • CASE REPORT: An 8-year-old girl received 53 grays radiotherapy after surgery for craniopharyngioma.
  • One year later she developed generalized dystonia.
  • Computed tomography showed bilateral basal ganglia calcifications, especially of the lenticular nuclei.
  • Pharmacological treatment with tetrabenazine, clonazepam and trihexiphenydile allowed a very limited improvement of dystonia; the course was complicated by dystonic storms and decompensations resulting from the iatrogenous panhypopituitarism.
  • CONCLUSION: This case illustrates a severe complication of cranial irradiation which should be considered in the indications of this treatment, especially for children.
  • [MeSH-major] Anti-Dyskinesia Agents / therapeutic use. Calcinosis / complications. Calcinosis / etiology. Dystonia / drug therapy. Dystonia / etiology. Radiotherapy / adverse effects
  • [MeSH-minor] Basal Ganglia / pathology. Brain Neoplasms / complications. Brain Neoplasms / radiotherapy. Child. Clonazepam / therapeutic use. Craniopharyngioma / complications. Craniopharyngioma / radiotherapy. Female. GABA Modulators / therapeutic use. Humans. Hypopituitarism / drug therapy. Hypopituitarism / etiology. Tetrabenazine / therapeutic use. Tomography, X-Ray Computed. Trihexyphenidyl / therapeutic use

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  • (PMID = 18555882.001).
  • [ISSN] 0035-3787
  • [Journal-full-title] Revue neurologique
  • [ISO-abbreviation] Rev. Neurol. (Paris)
  • [Language] fre
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] France
  • [Chemical-registry-number] 0 / Anti-Dyskinesia Agents; 0 / GABA Modulators; 5PE9FDE8GB / Clonazepam; 6RC5V8B7PO / Trihexyphenidyl; Z9O08YRN8O / Tetrabenazine
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32. Liu AK, Bagrosky B, Fenton LZ, Gaspar LE, Handler MH, McNatt SA, Foreman NK: Vascular abnormalities in pediatric craniopharyngioma patients treated with radiation therapy. Pediatr Blood Cancer; 2009 Feb;52(2):227-30
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  • [Title] Vascular abnormalities in pediatric craniopharyngioma patients treated with radiation therapy.
  • BACKGROUND: Craniopharyngioma is a benign brain tumor that can be treated with some combination of surgery, intracystic chemotherapy and radiation therapy.
  • Treatment for craniopharyngioma, especially radiation therapy, is associated with a variety of long-term toxicities including vascular abnormalities.
  • We report on the incidence of vascular abnormalities seen in the children with craniopharyngioma who received radiation therapy at our institution.
  • PROCEDURE: We reviewed our experience with craniopharyngioma patients who received radiation therapy from 1995 to 2008.
  • We reviewed clinical data including surgery, chemotherapy, radiation therapy and imaging for vasculopathy.
  • RESULTS: Twenty of the 22 children with craniopharyngioma who received radiation therapy had imaging available.
  • Six of the 20 were found to have some type of vasculopathy.
  • One had bilateral temporal cavernomas, one had moyamoya syndrome, one had an aneurysm of the internal carotid artery and three children had decreases in the caliber of the carotid or cerebral arteries, but were asymptomatic.
  • Two of the six children with abnormalities also received intracystic bleomycin prior to radiation therapy.
  • CONCLUSIONS: We report a high incidence of vascular abnormalities in children with craniopharyngioma.
  • [MeSH-major] Craniopharyngioma / complications. Craniopharyngioma / radiotherapy. Vascular Diseases / etiology
  • [MeSH-minor] Adolescent. Bleomycin / adverse effects. Bleomycin / therapeutic use. Child. Child, Preschool. Combined Modality Therapy. Female. Humans. Male. Radiotherapy / adverse effects. Retrospective Studies

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  • [Copyright] (c) 2008 Wiley-Liss, Inc.
  • (PMID = 18937328.001).
  • [ISSN] 1545-5017
  • [Journal-full-title] Pediatric blood & cancer
  • [ISO-abbreviation] Pediatr Blood Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 11056-06-7 / Bleomycin
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33. Giavoli C, Ferrante E, Bergamaschi S, Ronchi CL, Lania AG, Spada A, Beck-Peccoz P: An unusual case of recurrent autoimmune hypophysitis. Exp Clin Endocrinol Diabetes; 2010 May;118(5):287-90
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  • [Title] An unusual case of recurrent autoimmune hypophysitis.
  • Autoimmune hypophysitis (AH) is an inflammatory disease that can present either as empty sella or as pituitary mass.
  • A 16-years-old girl was admitted at our Unit for primary amenorrhea.
  • A pituitary MRI performed 2 years before for severe headache demonstrated a large sellar and suprasellar lesion.
  • As a craniopharyngioma was suspected, the consultant neurosurgeon suggested the removal of the lesion.
  • Hormonal replacement therapy was started, obtaining a good clinical and biochemical control.
  • Four years later, severe headache and a MRI suggestive of pituitary adenoma recurred.
  • A MRI performed 3 months later did not show any pituitary lesion and empty sella was again described.
  • This patient represents one of the few reported cases of recurrent hypophysitis and demonstrates that both pituitary enlargement and empty-sella can be seen in the same patient at different times of his history.
  • [MeSH-major] Pituitary Diseases / radiography
  • [MeSH-minor] Adolescent. Adrenal Cortex Hormones / therapeutic use. Amenorrhea / etiology. Autoimmune Diseases / pathology. Empty Sella Syndrome / pathology. Female. Human Growth Hormone / therapeutic use. Humans. Hypogonadism / drug therapy. Hypopituitarism / pathology. Pituitary Neoplasms / pathology. Tomography, X-Ray Computed

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  • (PMID = 19691013.001).
  • [ISSN] 1439-3646
  • [Journal-full-title] Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association
  • [ISO-abbreviation] Exp. Clin. Endocrinol. Diabetes
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Adrenal Cortex Hormones; 12629-01-5 / Human Growth Hormone
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