Showing papers by "Hee-Won Jung published in 2001"

Biological behavior and tumorigenesis of subependymal giant cell astrocytomas.

Abstract: In spite of the benign nature of subependymal giant cell astrocytomas (SEGAs), some show massive hemorrhage, rapid growth, and tumor recurrence. This led us to investigate the biological behavior, cell dynamics, and tumorigenesis of SEGAs. All patients (4 men and 3 women; age range, 6-27 years; mean, 13.6 years) had features of tuberous sclerosis complex and obstructive hydrocephalus. One patient had intratumoral bleeding. In two patients, sequential neuroimaging showed a subependymal nodule growing to become a SEGA. All underwent surgical resection without radiation therapy. One tumor recurred and was treated surgically. There were no postoperative deaths. The presence of cytologic atypia, mitoses and vascular proliferation had no implication in terms of the clinical course. MIB-1 labeling indices were low (mean, 0.9), indicating low proliferative potential. Unexpectedly, bcl-2 staining was sparse and bax staining predominated in majority of cases. However, the mean value of terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling index was low. Immunohistochemically, tumors were positive for both glial and neuronal markers. In the majority of our cases, the expression of p53 was low. Only one tumor was focally positive for tuberin. SEGAs have low proliferative potential and apoptotic activity, and exhibit features of mixed glial-neuronal differentiation. In contrast to p53, tuberin is suggested to be the tumor suppressor in this tumor.

Postoperative spinal seeding of craniopharyngioma. Case report.

Abstract: The authors present a case of postoperative spinal seeding of papillary craniopharyngioma. This 27-year-old man who had previously undergone subtotal removal of a suprasellar craniopharyngioma was admitted because of low-back and right leg pain. Results of neurological examination showed a limitation in straight-leg raising in the right side with no sensorimotor changes. Magnetic resonance imaging of the lumbar spine demonstrated multiple enhanced intradural extramedullary masses causing spinal cord compression. Pathological examination of the tumor tissue obtained via laminectomy revealed papillary craniopharyngioma, which had the same histological features as those of the previous suprasellar tumor. Several ectopic recurrences of craniopharyngioma have been reported; however, the authors believe that this is the first published report of the spinal seeding of craniopharyngioma.

Chordoid meningioma with polyclonal gammopathy. Case report.

Abstract: The authors present a case of chordoid meningioma in a 55-year-old woman who manifested headache and personality change. Magnetic resonance imaging of the brain and cerebral angiography demonstrated a mass in the right frontal lobe that resembled a typical convexity meningioma. However, the pathological diagnosis was chordoid meningioma, a rare subtype of this tumor that usually occurs in adolescence and is known to be associated with Castleman syndrome. A meningothelial meningiomatous pattern suggestive of a meningothelial origin was focally present, and cytokeratin-positive squamoid cells were noted in the tumor. The lesion lacked dense infiltration of lymphocytes and plasma cells. Polyclonal gammopathy was the only sign of Castleman syndrome and hypochromic microcytic anemia was absent in this case. Polyclonal gammopathy resolved completely 6 months after total removal of the mass.

Establishment and characterization of nine human brain tumor cell lines.

Abstract: Dear Editor: The most common type of primary brain tumor is glioma, which includes astrocytomas, oligodendrogliomas, ependymomas, anaplastic astrocytomas, and glioblastomas (GBLs). GBL is the most frequent and malignant brain tumor and accounts for 12-15% of all primary brain tumors (Zulch, 1986). Oligodendroglioma accounts for 4.2% of all primary brain tumors (Mork et al., 1985). GBL has been cultured in vitro, and several human GBL cell lines have been reported recently (Manuelidis, 1965; Collins, 1983; Bakir et al., 1998; Perzelova et al., 1998). However, a very limited number of oligodendroglioma cell lines have been established and characterized. The abundance of established brain tumor cell lines and the diversity among them are of great advantage to cancer research. Well-characterized human malignant brain tumor cell lines can contribute significantly to the understanding of the biology of human brain tumors in many fields. Herein, we describe the characteristics of newly-established human brain tumor cell lines including six GBL (SNU-201, -444, -466, -489, -626, and -1105), two oligodendroglioma (SNU-738 and -791), and one primitive neuroectodermal tumor (PNET) (SNU-1118) cell lines. The cell lines were established from pathologically proven brain tumors (Table 1). Solid tumors were finely minced with scissors and dissociated into small aggregates by pipetting. Appropriate amounts of fine neoplastic tissue fragments were seeded into 25-cm 2 flasks. Tumor cells were initially cultured in ACL-4 medium supplemented with 5% heat-inactivated fetal bovine serum (AR5). The AR5 medium has proved useful in the establishment of human cancer cell lines (Park et al., 1995; Ku et al., 1997). The composition of AR5 medium has been described previously (Park et al., 1995). Once established, the cultures were maintained in Roswell Park Memorial Institute 1640 medium (GIBCO/BRL, Grand Island, NY) supplemented with 10% heat-inactivated fetal bovine serum. Cell cultures were maintained in a humidified incubator at 37 ~ C in an atmosphere containing 5% CO2. We began to establish human brain cancer cell lines in 1989 and have obtained a culture success rate of 26% (9 in 34 trials). All tumor lines grew as monolayers and showed high viability (85-95%) with varying doubling times (48-92 h) and absence of mycoplasma and bacteria contamination. Deoxyribonucleic acid (DNA) fingerprinting using two highly polymorphic microsatellite markers showed that the newly-established brain tumor cell lines were unique and unrelated (Fig. 1). These data excluded any possibility of cross-contamination between the cell lines. Clinical and morphologic characteristics are summarized in Table 1. The tumor cells from GBLs showed nuclear augulation, hyperchromatism, and pleomorphism. Mitoses were frequently noted, and vascular proliferation was prominent. Necroses were extensive in all tumors. In the original tumors of SNU-201, -466, -489, and -1105, pseudopalisading necrosis was noted. In immunohistochemical studies, the tumor cells expressed glial fibrillary acidic protein (GFAP), the marker for astrocytic cells, in the cytoplasm. The original tumor of SNU-444 was a recurrent GBL (Fig. 2A). Six months before initiation of the cell line, the patient had undergone craniotomy followed by radiation therapy. The initial tumor was diagnosed as GBL by histologic examination. The other patients in this study received no prior therapy. The original tumors of anaplastic oligodendrogliomas consisted of rather uniform cells with round, delicate nuclei and perinuclear halos (Fig. 2C). The tumors showed hypercellularity, nuclear hyperchromasia, conspicuous mitotic activity, and endothelial proliferation. Necrosis was present in the original tumor of SNU-738. In immunohistochemical studies, most of the tumor cells did not express GFAP. GFAP was focally expressed in the cytoplasm of minigemistocytes. The SNU-738 patient received no prior therapy. Five years before initiation of the cell line, the SNU-791 patient had undergone craniotomy, and the initial tumor was diagnosed as oligodendroglioma by histologic examination. The patient had received postoperative radiation therapy with 5550 rad. The cell line of SNU-1118 was derived from a PNET (Fig. 2E). One year before initiation of the cell line, the patient was diagnosed by biopsy as having a PNET. The extracranial component of the tumor was located in the left infratemporal fossa with the intracranial tumor in the left temporal lobe. The patient received 13 cycles of chemotherapy followed by craniotomy. The intracranial component of the tumor consisted of hypercellular primitive cells with extensive necrosis. The tumor cells had hyperchromatic nuclei and scanty cytoplasm (Fig. 2E). The tumor focally showed nodular arrangement. In immunohistochemical studies, the tumor cells focally expressed GFAP, S100 protein, neuron-specific enolase, vimentin, and desmin. The histological features were consistent with those of a PNET with glial, neuronal, and mesenchymal differentiation. The extracranial component of the tumor showed the histological features of a melanotic neuroectodennal tumor. The tumor was diagnosed as a malignant melanotic neuroectodermal tumor with glial, neuronal, and mesenchymal differentiation. The molecular mechanisms that underlie the development of brain tumor have not been elucidated. However, the inactivation of tumor suppressor genes has been increasingly recognized as a major mechanism in tumor development. This study demonstrated the inactivation of various tumor suppressor genes such as p53, p16, p15, PTEN, FHIT, and DCC in the nine new human brain cancer cell lines (Table 2). For the p53 gene, we examined exons 4-9, in which about 98% of the mutations have been detected (Nigro et al., 1989). Mutation of the p53 gene was found in five cell lines. The SNU201 cell line showed a point mutation of cagTAC to caaTAC at a splice acceptor of intron 4 (Fig. 3A); the SNU-444 line had a missense mutation of TGT (Cys) to TAT (Tyr) at codon 275; the SNU-

A cranio-orbital-zygomatic approach to dumbbell-shaped trigeminal neurinomas using the petrous window

Abstract: We applied a cranio-orbital-zygomatic approach that extends the temporal craniotomy more posteriorly and minimizes the frontal orbitotomy of an ordinary orbitozygomatic approach in order to provide wide access to the already eroded petrous apices along the long axis of trigeminal neurinomas. We treated seven dumbbell-shaped trigeminal neurinomas between 1991 and 1998 (mean follow-up, 38 months; range, 9 to 109 months). The configuration of the tumor mass was assessed on magnetic resonance imaging by measuring its long diameter in the middle and posterior fossae and the width of petrous erosion. Tumors were then classified into five types based on their distribution over the petrous ridge. Total removal was achieved in six patients, who showed no evidence of tumor recurrence during the follow-up period. The only major complication was one case of anesthesia dolorosa. The one patient with a subtotal removal developed a recurrence 12 months after surgery, in the posterior fossa. The cranioorbital-zygomatic approach could be an effective method for removing dumbbell-shaped trigeminal neurinomas, particularly in cases of wide petrous erosion from the tumor. If, however, the tumor has a larger posterior fossa component, this approach may not provide adequate exposure to achieve a total resection.

Long-term Results of Surgical Treatment of Craniopharyngioma: Experience with 100 Adult Patients.

Abstract: bjectives:The authors present a retrospective analysis of 100 consecutive adult patients harboring craniopha- ryngiomas who underwent microsurgical resection between 1981 and 1999 to assess the long-term outcome of surgical treatment and to determine the most optimal management strategy. Methods:The extent of surgical removal was divided into four categories;GTR(gross total removal RSTR(radical subtotal removal STR(subtotal removaland PR(partial removal. The median follow-up period was 50 months(4- 198. CT scan and/or MR imaging and hormonal status were evaluated to the last follow-up. Results:Visual disturbance was the most common presentation which was improved in 42 cases and aggravated in 19 cases following the operation. Hypopituitarism was detected in 56 patients preoperatively 82 during the imme- diate postoperative period and 76 at the last follow-up. Improvement of pituitary function was not observed in any of these patients. Twenty of 100 patients showed recurrence at the mean of 27 months(3 to 196. The median progression-free survival(PFS time of all patients was 145 months and 5-year PFS rate was 74%. Five-year PFS rate of GTR or RSTR group(71% was significantly higher than that of STR or PR group(30%(p=0.01. Postoperative radiation therapy significantly prolonged the PFS from 94 months in non-radiation group to 182 months(p=0.002. However there was no statistical difference in number of patients who required hormonal replacement therapy between radiation and non-radiation group.