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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Malignant meningiomas are rarely encountered neoplasms. Few studies have examined MIB1 (marker of cell proliferation) or p53 (tumor suppressor gene) immunoreactivity in these tumors. This study retrospectively examines 23 malignant meningiomas (defined by the presence of either unequivocal brain invasion or metastasis) including MIB1 and p53 immunohistochemistry. The patients included 13 women and 10 men who ranged in age from 22 to 82 years (mean 63 years). Initial clinical presentation included weakness or numbness in 10 patients, visual signs or symptoms in 7 patients, and headaches in 6 patients. Histologically, nuclear pleomorphism was present in 23 of 23 tumors, disorganized architecture in 22 of 22, necrosis in 20 of 23, prominent nucleoli in 17 of 23, and hypervascularity in 4 of 23. One to 18 mitotic figures per 10 high power fields (HPF) (mean 6.1) were observed. Metastases were present in six patients (bone: 3 patients; lung: 2 patients; skin: 2 patients; kidney: 1 patient; and liver: 1 patient). MIB1 indices (positive tumor cells per 1,000 tumor cells evaluated x 100) in 20 tumors ranged from 1.3 to 24.2 (mean 11.7). p53 nuclear staining was observed in only 2 of 20 tumors. Follow-up information was available in 21 patients: 6 died of tumor (mean 27 months); 9 are alive with residual tumor (mean 35 months); 5 are alive with no evidence of tumor (mean 12 months); and 1 died 13 days postoperatively. There was no obvious correlation of the MIB1 index and tumor behavior. The majority of malignant meningiomas are characterized by nuclear pleomorphism, architectural disorganization, necrosis, prominent nucleoli, and increased mitoses. MIB1 labeling in most malignant meningiomas was high, consistent with the generally rapid growth of these tumors. Only a rare malignant meningioma demonstrated p53 alteration by immunostaining.
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PMID:Malignant meningioma: a clinicopathologic study of 23 patients including MIB1 and p53 immunohistochemistry. 865 46

Pure protoplasmic astrocytomas are a group of rarely encountered low grade astrocytic neoplasms. Relatively few studies have specifically examined this subset of tumors. A series of 18 protoplasmic astrocytomas in 14 males and four females (age range 2.5-52, mean 22 years) were studied in order to examine MIB1 (a marker of cell proliferation) and p53 (a tumor suppressor gene) immunoreactivity. All patients presented with seizures (mean duration 94 months) and three with headaches also. Eight tumors were located in the temporal lobe and six in the frontal lobe. All tumors were characterized by a proliferation of astrocytes with round nuclear contours arranged against a microcystic background. Only rare foci of mild vascular proliferation (3 tumors), rare mitotic figures (1 tumor), and mild nuclear atypia (3 tumors) were observed. Most tumors were primarily cortical in location. Necrosis was not seen in any of the tumors. MIB1 indices (number of MIB1 positive tumor cells/1000 tumor cells evaluated x 100) ranged from 0 to 4.3 (mean 0.7); in five tumors, no MIB1 staining was observed. p53 immunoreactivity was noted in 5 of 18 tumors (28%). Five patients received adjuvant radiation therapy and one adjuvant chemotherapy. At last known follow-up, 11 patients are alive with no evidence of residual tumor (mean 70 months), six patients are alive with evidence of residual tumor (mean 58 months), and one patient died of complications unrelated to the tumor (36 months) postoperatively. Based on these findings, the conclusions presented are as follows: (i) MIB1 indices are generally low in these tumors, corroborating the clinical impression of a slow growing neoplasm; and (ii) p53 immunoreactivity is observed in a minority of protoplasmic astrocytomas.
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PMID:MIB1 and p53 immunoreactivity in protoplasmic astrocytomas. 897 Jan 95

Four children, who were treated for supratentorial primitive neuro-ectodermal tumours between 1986 and 1995 at Kyushu University Hospital, are here presented. The initial characteristic symptoms and signs of these patients included vomiting and headache, followed by motor weakness. All patients underwent direct surgery for their tumours while 2 also received a course of postoperative radio-therapy. After these treatments, 3 died within 4 months after diagnosis, whereas one infant, who underwent a total removal of the tumour but had no adjuvant therapy, is still alive after a follow-up period of 4 years. Most of the tumour cells of these 4 cases were poorly differentiated neuro-ectodermal cells, but some also showed variable differentiation along the glial and/or neuronal lines. While such differentiation had no impact on the clinical course of the patients, the malignant potential as assessed by the percentage of MIB1-positive cells showed a good correlation with the clinical features; the 3 cases with a rapid clinical course had MIB1 staining indices of more than 2%, and one case, who survived more than 4 years, had the same indices of 0.2% as found in benign tumours. Although "PNETs" of Hart and Earl share certain clinical features, they may be a group of tumours heterogeneous in their origins, histogenesis, and biological behaviours.
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PMID:Supratentorial primitive neuroectodermal tumours: a report of four cases with an unusual clinical course in one patient. 963 57

Spindle cell oncocytoma (SCO) of the pituitary gland is a relatively recently established, very rare subtype of adenohypophysis tumours that was introduced as a distinct clinicopathological entity in the fourth edition of WHO classification of the central nervous system tumours (2007). It is non-endocrine neoplasm of the anterior pituitary that occurs in adults and usually follows a benign clinical course, corresponding to WHO grade I. Up to now, pituitary SCO have been reported occasionally and only 14 cases of SCO have been documented in the literature. Because of their rarity, the pathogenesis and natural history of these tumours have not been fully characterized. We report two additional cases of SCO occurring in females aged 63 years (Case 1) and 65 years (Case 2), who presented with pan-hypopituitarism, headache and visual field defect. In both cases, the magnetic resonance imaging showed solid sellar mass of moderate size with suprasellar extension. The clinical and radiological features suggested non-functioning pituitary macroadenomas without evidence of invasive growth. One patient presented with tumour recurrence 3 years after undergoing the previous surgical removal of tumour, which was initially misdiagnosed as schwannoma. The first tumour was removed by transsphenoidal surgery and the second one by frontal craniotomy. Histologically and immunohistochemically, both tumours displayed the features typical for SCO of the pituitary. They were composed of interwoven fascicles of spindle cells exhibiting abundant eosinophilic cytoplasm of oncocytic or granular appearance. Mitoses were rarely observed and necrosis was absent. In one case, the advanced lymphocytic infliltration was observed within neoplastic tissue. The tumour cells exhibited immunoreactivity for S-100 protein, galectin-3, vimentin and epithelial membrane antigen but they were negative for GFAP, anterior pituitary neuroendocrine markers (prolactin, growth hormone, TSH, ACTH, FSH, LH), chromogranin, synaptophysin, cytokeratin CK (AE1/AE3), smooth muscle actin, desmin, CD34 and CD68. MIB1 labeling index did not exceed 10%. Ultrastructurally, the tumour cells were rich in mitochondria with lamellar cristae. Moreover, in Case 2 some tumour cells showed a number of giant mitochondria with severely destructed internal matrix. Spindle cell oncocytoma of the anterior pituitary is often misdiagnosed entity of uncertain histogenesis. It should be considered in the differential diagnosis of various sellar-region lesions of oncocytic morphology.
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PMID:Spindle cell oncocytoma of the adenohypophysis - a clinicopathological and ultrastructural study of two cases. 2092 1