1.Awake Surgery for Angiocentric Glioma in the Eloquent Area in an Adolescent: A Case Report
Yuma YANO ; Ryosuke MATSUDA ; Fumi OKADA ; Maiko TAKEDA ; Ryosuke MAEOKA ; Ichiro NAKGAWA
Brain Tumor Research and Treatment 2024;12(1):75-79
Angiocentric glioma (AG) is an extremely rare tumor that often develops in adolescents. Awake surgery for AG occurring in the eloquent area has not been reported to date. We report a case involving a righthanded 15-year-old boy with AG. He presented with a first-time generalized tonic-clonic seizure and was rushed to the local hospital. CT of the head indicated a left frontal low-density mass with no calcification. He was subsequently referred to our hospital. Comparison with a CT scan obtained two years prior due to mild head trauma indicated that the lesion showed a trend toward enlargement. The lesion was located in the anterior and lateral portions of the primary motor cortex, and MRI showed homogenous hypointensity on T1-weighted and hyperintensity on T2-weighted images. Contrast-enhanced MRI showed a linear contrast effect. The patient underwent awake surgery with successful intraoperative brain mapping and total resection, and brain function was preserved. Pathological analysis revealed AG. He returned to his normal life and has shown no recurrence without additional treatment for 2 years. Thus, awake surgery for complete tumor resection while preserving brain function is effective and safe even in adolescents with AGs.
2.Effect of Intraoperative Ventricular Opening on Recurrence Patterns Following Bis-Chloroethyl-Nitrosourea Wafer Implantation for Newly Diagnosed Glioblastoma
Ryosuke MATSUDA ; Ryosuke MAEOKA ; Takayuki MORIMOTO ; Tsutomu NAKAZAWA ; Noriaki TOKUDA ; Masashi KOTSUGI ; Yasuhiro TAKESHIMA ; Kentaro TAMURA ; Shuichi YAMADA ; Fumihiko NISHIMURA ; Young-Soo PARK ; Ichiro NAKAGAWA
Journal of Korean Neurosurgical Society 2025;68(1):60-66
Objective:
: To evaluate the effect of ventricular opening (VO) on recurrence patterns in patients with newly diagnosed glioblastoma (GBM) treated with bis-chloroethyl-nitrosourea (BCNU) wafer implantation.
Methods:
: This single-center retrospective study included 40 patients with newly diagnosed GBM who received BCNU wafer implantation after tumor resection between March 2013 and February 2022. The patients were categorized into two groups based on whether VO occurred during the GBM resection. While 18 patients had VO, 22 did not have VO. In cases with VO, the ventricular wall defect is closed with gelatin or oxidized regenerated cellulose and fibrin glue before BCNU wafer implantation. Recurrence patterns—classified as local, diffuse, distant, or multifocal—and time to recurrence were compared between patients with and without VO.
Results:
: The median follow-up period for the entire cohort was 32.2 months (interquartile range, 16.7–38 months). Median survival time was comparable between patients with VO and patients without VO (38 vs. 26 months, p=0.53). Recurrence occurred in 31/40 patients (77.5%) in entire cohort. The incidence of recurrence was comparable between patients with VO and patients without VO (14 [77.8%] vs. 17 [77.3%], p=1.0). No significant differences were seen between the two groups in time to recurrence (p=0.59) or recurrence patterns (p=0.35).
Conclusion
: Ventricular opening during surgery with BCNU wafer implantation does not seem to influence the recurrence patterns. Ventricular opening does not induce distant recurrence if appropriate ventricular closure is performed.
3.Effect of Intraoperative Ventricular Opening on Recurrence Patterns Following Bis-Chloroethyl-Nitrosourea Wafer Implantation for Newly Diagnosed Glioblastoma
Ryosuke MATSUDA ; Ryosuke MAEOKA ; Takayuki MORIMOTO ; Tsutomu NAKAZAWA ; Noriaki TOKUDA ; Masashi KOTSUGI ; Yasuhiro TAKESHIMA ; Kentaro TAMURA ; Shuichi YAMADA ; Fumihiko NISHIMURA ; Young-Soo PARK ; Ichiro NAKAGAWA
Journal of Korean Neurosurgical Society 2025;68(1):60-66
Objective:
: To evaluate the effect of ventricular opening (VO) on recurrence patterns in patients with newly diagnosed glioblastoma (GBM) treated with bis-chloroethyl-nitrosourea (BCNU) wafer implantation.
Methods:
: This single-center retrospective study included 40 patients with newly diagnosed GBM who received BCNU wafer implantation after tumor resection between March 2013 and February 2022. The patients were categorized into two groups based on whether VO occurred during the GBM resection. While 18 patients had VO, 22 did not have VO. In cases with VO, the ventricular wall defect is closed with gelatin or oxidized regenerated cellulose and fibrin glue before BCNU wafer implantation. Recurrence patterns—classified as local, diffuse, distant, or multifocal—and time to recurrence were compared between patients with and without VO.
Results:
: The median follow-up period for the entire cohort was 32.2 months (interquartile range, 16.7–38 months). Median survival time was comparable between patients with VO and patients without VO (38 vs. 26 months, p=0.53). Recurrence occurred in 31/40 patients (77.5%) in entire cohort. The incidence of recurrence was comparable between patients with VO and patients without VO (14 [77.8%] vs. 17 [77.3%], p=1.0). No significant differences were seen between the two groups in time to recurrence (p=0.59) or recurrence patterns (p=0.35).
Conclusion
: Ventricular opening during surgery with BCNU wafer implantation does not seem to influence the recurrence patterns. Ventricular opening does not induce distant recurrence if appropriate ventricular closure is performed.
4.Effect of Intraoperative Ventricular Opening on Recurrence Patterns Following Bis-Chloroethyl-Nitrosourea Wafer Implantation for Newly Diagnosed Glioblastoma
Ryosuke MATSUDA ; Ryosuke MAEOKA ; Takayuki MORIMOTO ; Tsutomu NAKAZAWA ; Noriaki TOKUDA ; Masashi KOTSUGI ; Yasuhiro TAKESHIMA ; Kentaro TAMURA ; Shuichi YAMADA ; Fumihiko NISHIMURA ; Young-Soo PARK ; Ichiro NAKAGAWA
Journal of Korean Neurosurgical Society 2025;68(1):60-66
Objective:
: To evaluate the effect of ventricular opening (VO) on recurrence patterns in patients with newly diagnosed glioblastoma (GBM) treated with bis-chloroethyl-nitrosourea (BCNU) wafer implantation.
Methods:
: This single-center retrospective study included 40 patients with newly diagnosed GBM who received BCNU wafer implantation after tumor resection between March 2013 and February 2022. The patients were categorized into two groups based on whether VO occurred during the GBM resection. While 18 patients had VO, 22 did not have VO. In cases with VO, the ventricular wall defect is closed with gelatin or oxidized regenerated cellulose and fibrin glue before BCNU wafer implantation. Recurrence patterns—classified as local, diffuse, distant, or multifocal—and time to recurrence were compared between patients with and without VO.
Results:
: The median follow-up period for the entire cohort was 32.2 months (interquartile range, 16.7–38 months). Median survival time was comparable between patients with VO and patients without VO (38 vs. 26 months, p=0.53). Recurrence occurred in 31/40 patients (77.5%) in entire cohort. The incidence of recurrence was comparable between patients with VO and patients without VO (14 [77.8%] vs. 17 [77.3%], p=1.0). No significant differences were seen between the two groups in time to recurrence (p=0.59) or recurrence patterns (p=0.35).
Conclusion
: Ventricular opening during surgery with BCNU wafer implantation does not seem to influence the recurrence patterns. Ventricular opening does not induce distant recurrence if appropriate ventricular closure is performed.
5.Effect of Intraoperative Ventricular Opening on Recurrence Patterns Following Bis-Chloroethyl-Nitrosourea Wafer Implantation for Newly Diagnosed Glioblastoma
Ryosuke MATSUDA ; Ryosuke MAEOKA ; Takayuki MORIMOTO ; Tsutomu NAKAZAWA ; Noriaki TOKUDA ; Masashi KOTSUGI ; Yasuhiro TAKESHIMA ; Kentaro TAMURA ; Shuichi YAMADA ; Fumihiko NISHIMURA ; Young-Soo PARK ; Ichiro NAKAGAWA
Journal of Korean Neurosurgical Society 2025;68(1):60-66
Objective:
: To evaluate the effect of ventricular opening (VO) on recurrence patterns in patients with newly diagnosed glioblastoma (GBM) treated with bis-chloroethyl-nitrosourea (BCNU) wafer implantation.
Methods:
: This single-center retrospective study included 40 patients with newly diagnosed GBM who received BCNU wafer implantation after tumor resection between March 2013 and February 2022. The patients were categorized into two groups based on whether VO occurred during the GBM resection. While 18 patients had VO, 22 did not have VO. In cases with VO, the ventricular wall defect is closed with gelatin or oxidized regenerated cellulose and fibrin glue before BCNU wafer implantation. Recurrence patterns—classified as local, diffuse, distant, or multifocal—and time to recurrence were compared between patients with and without VO.
Results:
: The median follow-up period for the entire cohort was 32.2 months (interquartile range, 16.7–38 months). Median survival time was comparable between patients with VO and patients without VO (38 vs. 26 months, p=0.53). Recurrence occurred in 31/40 patients (77.5%) in entire cohort. The incidence of recurrence was comparable between patients with VO and patients without VO (14 [77.8%] vs. 17 [77.3%], p=1.0). No significant differences were seen between the two groups in time to recurrence (p=0.59) or recurrence patterns (p=0.35).
Conclusion
: Ventricular opening during surgery with BCNU wafer implantation does not seem to influence the recurrence patterns. Ventricular opening does not induce distant recurrence if appropriate ventricular closure is performed.