OBJECTIVE: To compare the age distribution and characteristic MR imaging findings of ependymoma for each typical location within the neuraxis. MATERIALS AND METHODS: During a recent eleven-year period, MR images of 61 patients with histologically proven ependymomas were obtained and retrospectively reviewed in terms of incidence, peak age, location, size, signal intensity, the presence or absence of cyst and hemorrhage, enhancement pattern, and other associated findings. RESULTS: Among the 61 patients, tumor location was spinal in 35 (57%), infrartentorial in 19 (31%), and supratentorial in seven (12%). In four of these seven, the tumor was located in brain parenchyma, and in most cases developed between the third and fifth decade. Approximately half of the infratentorial tumors occurred during the first decade. The signal intensity of ependymomas was nonspecific, regardless of their location. A cystic component was seen in 71% (5/7) of supratentorial, 74% (14/19) of infratentorial, and 14% (5/35) of spinal cord tumors. Forty- nine percent (17/35) of those in the spinal cord were associated with rostral and/or caudal reactive cysts. Intratumoral hemorrhage occurred in 57% (4/7) of supratentorial, 32% (6/19) of infratentorial, and 9% (3/35) of spinal cord tumors. In 17% (6/35) of spinal ependymomas, a curvilinear low T2 signal, suggesting marginal hemorrhage, was seen at the upper and/or lower margins of the tumors. Peritumoral edema occurred in 57% (4/7) of supratentorial, 16% (3/19) of infratentorial and 23% (8/35) of spinal cord tumors. Seventy-two percent (5/7) of supratentorial and 95% (18/19) of infratentorial tumors showed heterogeneous enhancement, while in 50% (17/34) of spinal cord tumors, enhancement was homogeneous. CONCLUSION: Even though the MR imaging findings of ependymomas vary and are nonspecific, awareness of these findings, and of tumor distribution according to age, is helpful and increases the likelihood of correct preoperative clinical diagnosis.
Adult ; Age Distribution ; Brain Neoplasms/*diagnosis/epidemiology ; Ependymoma/*diagnosis/epidemiology ; Female ; Human ; *Magnetic Resonance Imaging ; Male ; Retrospective Studies ; Spinal Cord Neoplasms/*diagnosis/epidemiology ; Support, Non-U.S. Gov't

OBJECTIVETo analyse the diagnosis points of intracranial malignant melanoma.

METHODSThere were ten patients with intracranial malignant melanoma (but without clear extracranial primary lesion), whose epidemiology, clinical symptom, physical sign and imaging data were analysed.

RESULTSMost of patients were young men, The Clinical symptom or physical sign are similar to brain tumor or cerebral hemorrhage, but the course was shot, two cases of among having skin melanotic nevus. As for most of cases, CT were high density, MRI T1WI showed high signal and T2WI low signal, which often had hemorrhage. Histological examination showed all cases were malignant melanoma. Preoperative misdiagnosis was up to eight cases (80%).

CONCLUSIONSFor preoperative accurate diagnosis, this disease's epidemiology, clinical symptom, extracranial physical sign and imaging data points could be synthetical analysed.

Adolescent ; Adult ; Brain Neoplasms ; diagnosis ; epidemiology ; pathology ; Diagnosis, Differential ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Melanoma ; diagnosis ; epidemiology ; pathology ; Middle Aged ; Tomography, X-Ray Computed

BACKGROUNDAlthough the first leading cause of death in China was malignant neoplasms (mortality, 374.1 per 100,000 person-years), the full impact of primary brain tumors (PBT) on the healthcare system is not completely described because there are a few well documented reports about the epidemiologic features of brain tumors. This study aimed to report a comprehensive assessment on the prevalence of PBT.

METHODSA multicenter cross-sectional study on brain tumor (MCSBT) in China was initiated in five regional centers: Daqing (northeast), Puyang (north of China), Shiyan (center of China), Ma'anshan (center of China) and Shanghai (southeast). Prevalence rate was calculated by counting the number of people living with a PBT between October 1, 2005 and September 30, 2006 and dividing by the total population of the five communities at January 1, 2006. Estimates of prevalence were expressed as percentages and grouped according to gender and to age in fifteen-year categories. Within these strata, the rates were estimated with 95% confidence intervals (CI) using the accurate calculation of CI for Poisson distribution. A chi-square test was used to compare the various frequencies with α < 0.05. Age-standardized prevalence with the direct method was calculated with the ten-year age-specific prevalence and the age distribution of the Chinese population in 2010, obtained from World population prospects: the 2008 revision.

RESULTSWe estimated that the overall prevalence of PBT was 24.56 per 100,000 (95%CI, 14.85 to 34.27), and the overall prevalence of PBT in female population (30.57 per 100,000 and its 95%CI ranged from 19.73 to 41.41) was higher than that in male population (18.84 per 100,000 and its 95%CI ranged from 10.33 to 27.35). However, the discrepancy between genders was not statistically significant because the 95%CI overlapped. Of 272 cases of newly diagnosed PBT, the proportion of histological subtypes by age groups, gender was statistically different (χ(2) = 52.6510, P < 0.0001). More than half of all reported tumors (52.57%) were either gliomas or meningiomas. For the youngest (aged from 0 - 19) strata of the population, glioma appeared to occur more than other subtypes, accounting for 55.56% of all of cases. The majority of brain tumors presented in those aged from 20 to 59 years was pituitary adenomas (45.12%) and gliomas (31.10%). Opposed to brain tumors in adults and teenage, gliomas only accounted for 22.22%. Meanwhile, the median ages at diagnosis of the patients with PBT were similar between males and females except for pituitary adenomas (male: 59 years old; female: 45 years old).

CONCLUSIONSAge standardized prevalence of PBT is 22.52 per 100,000 (95%CI, 13.22 to 31.82) for all populations, 17.64 per 100,000 (95%CI, 9.41 to 25.87) for men, and 27.94 per 100,000 (95%CI, 17.58 to 38.30) for women. Age standardization to China's 2010 population yielded an estimated population of 304 954 cases with PBT. Our prevalence estimates provide a conservative basis on which to plan health care services and to develop programmatic strategies for surviving. In the future, it would be helpful to have long-term observed survival rates that would make the assumptions and the resulting imprecision in the current estimates unnecessary.

Adolescent ; Adult ; Age Distribution ; Aged ; Brain Neoplasms ; diagnosis ; epidemiology ; Child ; Child, Preschool ; China ; epidemiology ; Cross-Sectional Studies ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Prevalence ; Young Adult

The epidemiology of cancer has long been suggested that cancer is multistep disease. We suspect some of these steps might be lated with activation of oncogenes and loss of tumor suppressor genes in primary brain tumors. Moreover, recent reports suggest that astrocytomas have shown alterations in chromosome 17p, and this chromosomal location that encodes the p53 protein, as well as c-fos gene may take an important role in the carcinogenesis of human primary brain tumors. Expression of p53 protein was detected in 12 of 17 cases(70.6%) of glioblastoma multiforme, 4 of 6 cases(66.6%) of anaplastic astrocytoma with positive nuclear p53 staining. All low grade astrocytomas and normal brain tissue failed to express p53. Correlation of p53 protein levels with mRNA alterations or genomic DNA alterations may help to guide future therapy or diagnosis of brain tumors. On the other hand, the level of c-fos oncoprotein expression may be correlated with the degree of cell differentiation and proliferation. The presence of these expression in low-grade astrocytoma suggest that activation of the c-fos gene is an early step in tumor development.
Astrocytoma ; Brain Neoplasms ; Brain* ; Carcinogenesis ; Cell Differentiation ; Diagnosis ; DNA ; Epidemiology ; Genes, fos ; Genes, Tumor Suppressor ; Glioblastoma ; Glioma* ; Hand ; Humans ; Immunohistochemistry ; Oncogenes ; RNA, Messenger

To investigate the incidence and pattern of occurrence of primary brain tumors in Koreans, 2,616 cases of histologically confirmed primary intracranial tumors, which were operated on in our department between 1976 and 1995, were reviewed. In all cases, age, sex, tumor type, location and date of diagnosis were recorded, and tumors were pathologically classified according to the WHO Histological Type of CNS tumors, revised in 1993. The tumors studied included all those within the intracranial region, except for vascular or infectious masses and epidermoid or dermoid cysts associated with congenital dermal sinus. The total number of adult patients was 2,232(85.3%), while the number of pediatric cases(below 16 years of age) was 384(14.7%). The mean age of the patients was 36.4 years, and the male : female ratio(M:F ratio) was 1 : 1.06. Common tumors were those involving neuroepithelial tissue(874 cases ; 33.4%), the sellar region(787 cases ; 30.1%), the meninges(572 cases ; 21.9%), cranial and spinal nerves(232 cases ; 8.9%), and germ cell tumors(GCT)(59 cases ; 2.3%). Meningiomas, pituitary adenomas, and schwannomas occurred at a higher rate in females(M:F ratio : 1:1.92,1:1.21,1:1.19, respectively). GCT, medulloblastomas, craniopharyngiomas, and hemangioblastomas, on the other hand, occurred more often in males (M:F ratio : 1:0.44, 1:0.46, 1:0.67, 1:0.72, respectively). Common pediatric tumors were astrocytic tumors (23.2%), medulloblastomas(19.3%), and craniopharyngiomas(11.2%). The age distribution of tumors was similar to that found in other epidemiologic studies. Between 1976 and 1993, with the introduction of computerized tomography(CT), the reported incidence of primary intracranial tumors has increased by an average of 13% annually. The relative incidences of pituitary adenoma, glioma, hemangioblastoma and primitive neuroecrodermal tumors(PNET) have increased since 1988, when magnetic resonance imaging(MRI) was installed in our hospital.
Adult ; Age Distribution ; Brain Neoplasms ; Craniopharyngioma ; Dermoid Cyst ; Diagnosis ; Epidemiologic Studies ; Epidemiology ; Female ; Germ Cells ; Glioma ; Hand ; Hemangioblastoma ; Humans ; Incidence ; Male ; Medulloblastoma ; Meningioma ; Neurilemmoma ; Pituitary Neoplasms ; Spina Bifida Occulta

Objective To analyze the disease spectrum and clinicopathological characteristics of central nervous system(CNS)diseases diagnosed based on pathological findings in Tibet. Methods We collected the data of all the cases with CNS lesions in Tibet Autonomous Region People's Hospital from January 2013 to December 2020.The clinicopathological features were analyzed via light microscopy,immunohistochemical staining,and special staining. Results A total of 383 CNS cases confirmed by pathological diagnosis were enrolled in this study,with a male-to-female ratio of 188∶195 and an average age of(40.03±17.39)years(0-74 years).Among them,127(33.2%)cases had non-neoplastic diseases,with a male-to-female ratio of 82∶45 and an average age of(31.99±19.29)years;256(66.8%)cases had neoplastic diseases,with a male-to-female ratio of 106∶150 and an average age of(44.01±14.87)years.The main non-neoplastic diseases were nervous system infectious diseases,cerebral vascular diseases,meningocele,cerebral cyst,and brain trauma.Among the infectious diseases,brain abscess,granulomatous inflammation,cysticercosis,and hydatidosis were common.The main neoplastic diseases included meningioma,pituitary adenoma,neuroepithelial tumor,schwannoma,metastatic tumor,and hemangioblastoma.The meningioma cases consisted of 95.4%(103/108)cases of grade Ⅰ,3.7%(4/108)cases of grade Ⅱ,and only 1(1/108,0.9%)case of grade Ⅲ.Among the neuroepithelial tumor cases,the top three were glioblastoma,grade Ⅲ diffuse glioma,and ependymoma. Conclusions There are diverse CNS diseases confirmed by pathological diagnosis in Tibet,among which non-neoplastic diseases account for 1/3 of all the cases.Infectious and vascular diseases are the most common non-neoplastic diseases in Tibet,and tuberculosis and parasitic infections are relatively common.The types and proportion of brain tumors in Tibet are different from those in other regions of China,and meningioma is the most common in Tibet,with higher proportion than neuroepithelial tumor.
Adolescent ; Adult ; Aged ; Brain Neoplasms/diagnosis* ; Central Nervous System Diseases/pathology* ; Child ; Child, Preschool ; Ependymoma ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Meningeal Neoplasms ; Middle Aged ; Retrospective Studies ; Tibet/epidemiology* ; Young Adult

This study was performed to validate the effectiveness and safety of concurrent chemoradiotherapy and adjuvant therapy with temozolomide for newly diagnosed glioblastoma multiforme as a standard treatment protocol. Between 2004 and 2011, patients newly diagnosed with glioblastoma who were treated with temozolomide during concurrent chemoradiotherapy and adjuvant chemotherapy were included from a single institution and analyzed retrospectively. The primary endpoint was overall survival, and the secondary endpoints were progression-free survival, response, and safety. A total of 71 patients were enrolled in this study. The response rate was 41% (29/71), and the tumor control rate was 80% (57/71). In the 67 patients who completed the concurrent chemoradiotherapy with temozolomide, the median overall survival was 19 months and the 1- and 2-yr overall survival rates were 78.3% and 41.7%, respectively. The median progression free survival was 9 months, and the 1- and 2-yr progression free survival rates were 33.8% and 14.3%, respectively. The mean duration of survival after progression of disease in salvage treatment group was 11.9 (1.3-53.2) months. Concurrent chemoradiotherapy with temozolomide resulted in grade 3 or 4 hematologic toxic effects in 2.8% of the patients. The current protocol of temozolomide during and after radiation therapy is both effective and safe and is still appropriate as the standard protocol for treatment of glioblastoma. An active salvage treatment might be required for a better prognosis.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antineoplastic Agents, Alkylating/administration & dosage ; Brain Neoplasms/diagnosis/*mortality/*therapy ; Chemoradiotherapy, Adjuvant/methods/mortality ; Comorbidity ; Dacarbazine/administration & dosage/*analogs & derivatives ; Female ; Glioblastoma/diagnosis/*mortality/*therapy ; Hematologic Diseases/*mortality ; Humans ; Longitudinal Studies ; Male ; Middle Aged ; Prevalence ; Radiotherapy, Conformal/mortality ; Republic of Korea/epidemiology ; Risk Factors ; Survival Rate ; Treatment Outcome ; Young Adult