Despite concentrated basic and clinical research efforts including the initial successful combination of surgery, radiotherapy and chemotherapy with BCNU, significant progress in the treatment of human brain tumors have been slow and looks for more successful strategies developed based upon the information from animal model system. It is to recreate in the laboratory under experimental condition a model of human brain tumors. Although no unique model of the numerous animal tumors resembling the spontaneous human brain tumors developed in these days, experimental animal models to have own specific adventages can be induced by exposure to oncogenic viruses or chemical carcinogens. Intracerebral injection of oncorna viruses can produce glioblastoma mutiformes, astrocytomas and sarcomas, while medulloblastoma, choroids plexus papilloma and ependymomas can be induced by papova viruses, and human adenovirus may cause neuroblastoma, medulloepithelioma and retinoblastomas. Chemical induction in adult animals and transplacental chemical induction were ependymoblastomas, glioma, gliosarcoma and malignant neurinomas. Reproducibility of location, cell type, and time of tumor appearances;expense;growth in tissue culture;trauma to brain;nature of vasculature, and amount of brain and tumor tissue available for examination are the variables to be considered in choosing a model to use in evaluating drug and other therapies, cell kinetics and immunological studies.
Adenoviruses, Human ; Adult ; Animals ; Astrocytoma ; Brain Neoplasms* ; Brain* ; Carcinogens ; Carmustine ; Choroid ; Drug Therapy ; Ependymoma ; Glioblastoma ; Glioma ; Gliosarcoma ; Humans ; Kinetics ; Medulloblastoma ; Models, Animal ; Neurilemmoma ; Neuroblastoma ; Neuroectodermal Tumors, Primitive ; Oncogenic Viruses ; Papilloma ; Radiotherapy ; Retinoblastoma ; Sarcoma

From 1957 to Jun 1987, authors experienced 8 cases of pediatric brain tumor located in the cerebellopontine angle(CPA) which were operated upon at the Department of Neurosurgery of Seoul National University Hospital. The proportion of the pediatric CPA tumors in the total pediatric brain tumors was 4% (8/197), and that in the pediatric posterior fossa tumors was 8% (8/100). The pathologic diagnoses of the 8 cases were ependymoma (2 cases), medulloblastoma (2 cases), astrocytoma ( 1 case), primitive neuroectodermal tumor (1 case), trigeminal schwannoma (1 case) and Masson's hemangioendothelioma (1 case). The proportion of CPA location in the posterior fossa ependymomas was 13% (2/16), and those of the posterior fossa medulloblastomas and astrocytomas were 4% (2/50 and 1/28, respectively). The initial presentations were symptoms of increased intracranial pressure in 5 cases, and those of cranial nerve dysfunction in 3 cases. On admission, all of 8 cases showed signs of increased intracranial pressure and among the cranial nerve dysfunctions, facial nerve dysfunction was most common (5 cases). It seemed that it was due to close relationship between these tumors and fourth ventricle, and the patients' age which was too young to complain of subtle subjective sensory dysfunctions. The operative findings showed medial displacement and compression of the cerebellum, brain stem and cranial nerves, enlargement of surrounding subarachnoid space or arachnoid cyst formation, tumor growth into the cranial nerve canals, and encasement of nerves or vessels by the tumor. The sites of origin were lateral recess of fourth ventricle in 4 cases (2 ependymomas and 2 medulloblastomas), and surrounding brain tissue in the other 2 glioma cases. And a representative case was presented.
Arachnoid ; Astrocytoma ; Brain ; Brain Neoplasms ; Brain Stem ; Cerebellopontine Angle* ; Cerebellum ; Cranial Nerves ; Diagnosis ; Ependymoma ; Facial Nerve ; Fourth Ventricle ; Glioma ; Hemangioendothelioma ; Infratentorial Neoplasms ; Intracranial Pressure ; Medulloblastoma ; Neurilemmoma ; Neuroectodermal Tumors, Primitive ; Neuroma, Acoustic* ; Neurosurgery ; Seoul ; Subarachnoid Space

We analyzed the 43 cases of the posterior fossa tumors at the Busan Paik Hospital, Inje Medical College from January 1980 to December 1986. The posterior fossa tumors included 12 cases of cerebellar astrocytoma, 10 cases of acoustic neurinoma, 5 cases of medulloblastoma, 5 cases of brain stem glioma, 2 cases of meningioma, 2 cases of hemangioblastoma, 2 cases of tuberculoma, 1 case of glioblastoma multiforme, 1 case of oliodendroglioma, 1 case of rhabdomyosarcoma, 1 case of glomus jugulare tumor and 1 case of arteriovenous malformation. The posterior fossa tumors were occupied on the cerebellar hemisphere in 18 cases, the cerebellar vermis in 8 cases, the cerebellar pontine angle in 12 cases and the brain stem in 5 cases. The 25 cases out of the 43 cases of the posterior fossa tumors were accompanied with hydrocephalus. The 10 cases received the radiation therapy and/or the chemotherapy after operation. After treatment of the posterior fossa tumors, 52.6% favorable outcome, 34.2% unfavorable outcome and 13.2% mortality were estimated.
Arteriovenous Malformations ; Astrocytoma ; Brain Stem ; Busan ; Drug Therapy ; Glioblastoma ; Glioma ; Glomus Jugulare Tumor ; Hemangioblastoma ; Hydrocephalus ; Infratentorial Neoplasms* ; Medulloblastoma ; Meningioma ; Mortality ; Neuroma, Acoustic ; Rhabdomyosarcoma ; Tuberculoma

Mutation in the p53 suppressor gene is the most common genetic alteration found in human cancers including primary brain tumors. Ki-67 labeling index(LI) is known to be a marker of proliferating activity. The purpose of this study was to verify whether an immunohistochemical expression of p53 antibody and Ki-67 LI could be related to different clinicopathologic parameters including histologic grade, size, invasiveness and recurrence of the brain tumors. Materials were based on the 147 surgically resected brain tumors during the last two years. Of the 147 brain tumors, there were 35 astrocytic tumors, 35 meningiomas, 10 oligodendrogliomas, 7 craniopharyngiomas, 5 dysembryoplastic neuroepithelial tumors, 4 medulloblastomas, 5 ependymomas, 23 pituitary adenomas, 9 schwannomas, and 14 other brain tumors. The p53 expression and Ki-67 LI were higher in malignant brain tumors including astrocytic tumors, medulloblastoma, PNET and gliosarcoma. The p53 positivity was correlated with histologic grades and tumor recurrence. The brain tumors with a high Ki-67 LI(>6%) also showed a close relationship to a higher histologic grading, radiological invasiveness and recurrence. There was no evident correlation with the age and tumor size with p53 expression and Ki-67 LI. These results suggest that p53 overexpression and high proliferation potential of the tumor cells are associated with the higher histologic grade and aggressive clinical course in the central nervous system tumors.
Brain Neoplasms* ; Brain* ; Central Nervous System Neoplasms ; Craniopharyngioma ; Ependymoma ; Genes, Suppressor ; Gliosarcoma ; Humans ; Medulloblastoma ; Meningioma ; Neoplasms, Neuroepithelial ; Neurilemmoma ; Neuroectodermal Tumors, Primitive ; Oligodendroglioma ; Pituitary Neoplasms ; Recurrence

To determine the T-cell mediated immunological status in patients with brain tumors, the percentages of active and total T-lymphocytes forming rosettes with sheep erythrocytes, were measured in sixteen patients with primary intracranial tumors;six benign astrocytomas, four glioblastomas, one medulloblastoma, two craniopharyngiomas and three meningiomas. The percentages of active and total T-lymphocytes were significantly decreased in all glioblastomas and two among six astrocytomas, but normal in all meningiomas.
Astrocytoma ; Brain Neoplasms ; Craniopharyngioma ; Erythrocytes ; Glioblastoma ; Humans ; Medulloblastoma ; Meningioma ; Sheep ; T-Lymphocytes*

Intrathird ventricular tumors that mainly occupy the ventricle cavity without extending to the neighbouring structures are rare. These tumors are developed from the choroids plexus, tela, ependyma, subjacent neuroglia and embryonic cell rest. The authors experienced 11 cases of rare intrathird ventricular tumors during the past 10 years. During the same period, number of surgically proven brain tumors were 990 and intrathird ventricular tumors comprised 1.1%. These are two cases of choroids plexus papillomas, three craniopharyngiomas, two germ cell tumors, one meningioma, one glioependymal cyst, one ependymoma, one astrocytoma. Suprasellar craniopharyngiomas, thalamic gliomas, optic and hypothalamic gliomas were excluded. The age distribution was from 6 years old to 59 years old. The clinical manifestation was characteristic in that they usually had the sudden intermittent headache without specific localizing signs. Surgical approach to this area is by transcallosal or transcortical approach. Surgical total removal was quite feasible by either approach and outcome was rather favorable.
Age Distribution ; Astrocytoma ; Brain Neoplasms ; Child ; Choroid ; Craniopharyngioma ; Ependyma ; Ependymoma ; Glioma ; Headache ; Humans ; Meningioma ; Middle Aged ; Neoplasms, Germ Cell and Embryonal ; Neuroglia ; Optic Nerve Glioma ; Papilloma ; Papilloma, Choroid Plexus

Intrathird ventricular tumors that mainly occupy the ventricle cavity without extending to the neighbouring structures are rare. These tumors are developed from the choroids plexus, tela, ependyma, subjacent neuroglia and embryonic cell rest. The authors experienced 11 cases of rare intrathird ventricular tumors during the past 10 years. During the same period, number of surgically proven brain tumors were 990 and intrathird ventricular tumors comprised 1.1%. These are two cases of choroids plexus papillomas, three craniopharyngiomas, two germ cell tumors, one meningioma, one glioependymal cyst, one ependymoma, one astrocytoma. Suprasellar craniopharyngiomas, thalamic gliomas, optic and hypothalamic gliomas were excluded. The age distribution was from 6 years old to 59 years old. The clinical manifestation was characteristic in that they usually had the sudden intermittent headache without specific localizing signs. Surgical approach to this area is by transcallosal or transcortical approach. Surgical total removal was quite feasible by either approach and outcome was rather favorable.
Age Distribution ; Astrocytoma ; Brain Neoplasms ; Child ; Choroid ; Craniopharyngioma ; Ependyma ; Ependymoma ; Glioma ; Headache ; Humans ; Meningioma ; Middle Aged ; Neoplasms, Germ Cell and Embryonal ; Neuroglia ; Optic Nerve Glioma ; Papilloma ; Papilloma, Choroid Plexus

Tumors of the central nervous system are the second most frequent neoplasm in children. In a review of 43 children with brain tumor under the age of 16 evaluated at a pediatric and neurosurgical department at Severance Hospital Yonsei University during a 61/2 year period, following results were obtained. 1. All 43 cases were diagnosed by pathological examination as well as brain CT scan. The sex ratio of male and female was equal. The age distribution was highest between 13-14 year of age and 7% of them were under 1 year of age. 2. There was a small preponderance of infratentorial tumors (51%) over supratentoral tumors (49%). 3. Among 43 verified brain tumors by pathological examination, glioma represented 75%, of which astrocytoma was the commonest neoplasm being 19 cases (45%) and remainder were medulloblastoma 10 cases (23%), choroid plexus droglioma 2 cases (5%), ependymoma 1case (2%). The rest were craniopharyngioma 6 cases (14%), choroid plexus papilloma 1 case (2%), neuroblastoma 2 cases (5%), pineal teratoma 1 case (2%), melanotic neuroectodermal turmor 1 case (2%). 4. The most common symptom was headache occuring 63% of the patients followed by vomiting, motor weakness, visual disturbance, gait distrubance, mental disturbance and seizure in order of trequency. Neurological signs showed positive Babinski sign, papilledema, cerebellar sign, 6th nerve palsy and facial weakness. 5. Plain skull X-ray changes were noted in 26 out of the 43 cases (61%). Those were suture separation of skull noted 35% of tumors followed in frequency by increased digital marking, sella changes and calcification. 6. In brain CT scan studies, the most common abnormal finding was solid mass shadow followed by cystic mass shadow, solid and cystic mass shadow. After contrast infusion, diffuse enhancement was the most common features. 7. 27 cases were treated by operation only, 15 by operation and radiotherapy, 1 by operation, radiation and chemotherapy. 8. Progonsis of brain tumor was very poor. 5 of 43 cases died within 1 month of diagnosis, 1 year survival rate was 19%, and 2 year survival rate was 16%. The survival rate was better in the group of patients in whom total or subtotal resection combined with radiotherapy was performed. 53% of cases were not able to follow-up or discharged anainst advice without proper treatment.
Abducens Nerve Diseases ; Age Distribution ; Astrocytoma ; Brain Neoplasms* ; Brain* ; Central Nervous System ; Child* ; Choroid Plexus ; Craniopharyngioma ; Diagnosis ; Drug Therapy ; Ependymoma ; Female ; Follow-Up Studies ; Gait ; Glioma ; Headache ; Humans ; Infratentorial Neoplasms ; Male ; Medulloblastoma ; Neural Plate ; Neuroblastoma ; Papilledema ; Papilloma, Choroid Plexus ; Radiotherapy ; Reflex, Babinski ; Seizures ; Sex Ratio ; Skull ; Survival Rate ; Sutures ; Teratoma ; Tomography, X-Ray Computed ; Vomiting

Primary fourth ventricular neoplasms are common in children but rare in adults, and the disease categories encountered differ according to the patient's age. This study reviewed the records of patients aged 16 years or over, who underwent magnetic resonance (MR) imaging and were found to have fourth ventricular lesions. Most patients then underwent surgical resection, leading to specific pathologic diagnosis. The various fourth ventricular tumors encountered were ependymoma (n=8), subependymoma (n=1), choroid plexus papilloma (n=3), astrocytoma (n=3), medulloblastoma (n=1), lymphoma (n=2), epidermoid cyst (n=2), meningioma (n=1), melanoma (n=1), cavernous hemangioma (n=1) and metastasis (n=1). We describe the various tumors located mainly in the fourth ventricle and review their clinical presentation and the radiological findings, the majority of which were nonspecific. In some cases, however, specific signal intensity or the growth pattern of the tumors was useful for differential diagnosis.
Adult* ; Astrocytoma ; Brain Neoplasms ; Child ; Diagnosis ; Diagnosis, Differential ; Ependymoma ; Epidermal Cyst ; Fourth Ventricle ; Glioma, Subependymal ; Hemangioma, Cavernous ; Humans ; Lymphoma ; Magnetic Resonance Imaging* ; Medulloblastoma ; Melanoma ; Meningioma ; Neoplasm Metastasis ; Papilloma, Choroid Plexus

BACKGROUND: Numerous studies reported a usefulness of 5-aminolevulinic acid (5-ALA) fluorescence-guided surgery (FGS) in high grade gliomas. However, fluorescence patterns and intensities are variable among gliomas. In this study, we report our extensive experience with FGS in various gliomas, focusing on epidemiological data of fluorescence patterns. METHODS: A total of 827 histologically proven glioma patients out of 900 brain tumor patients who had undergone FGS using 5-ALA during the period of 8.5 years between July 2010 and January 2019 were analyzed. Indications of FGS in glioma surgery are evidence for possible high-grade foci in putative gliomas in preoperative MRI. RESULTS: Among the 827 gliomas, the number of cases corresponding to 2016 World Health Organization (WHO) grade IV, III, II, and I are 528 (58.7%), 193 (21.4%), 87 (9.7%) and 19 (2.1%), respectively. In terms of fluorescence rate, grade IV gliomas showed positive fluorescence in 95.4% of cases including strong intensity in 85.6%. Grade III gliomas showed fluorescence in about half of cases (55.0%), but 45.0% of the cases showed no fluorescence at all. Anaplastic oligodendroglioma had a higher positive rate (63.9%) than anaplastic astrocytoma (46.2%). Both grade II and I gliomas still showed positive fluorescence in about one-fourth of cases (24.1% and 26.3% respectively). Among them ependymoma and pilocytic astrocytoma were fluorescence-prone tumors. CONCLUSION: This epidemiological data of 5-ALA fluorescence in various grades of glioma provides a basic reference to the clinical application of FGS with 5-ALA in glioma surgery.
Astrocytoma ; Brain Neoplasms ; Ependymoma ; Fluorescence ; Glioblastoma ; Glioma ; Humans ; Magnetic Resonance Imaging ; Oligodendroglioma ; World Health Organization