World Neurosurg
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Glioma is the most frequent primary brain tumor. Immunotherapy is one of the most promising therapeutic approaches for gliomas. T cell immunoglobulin domain and mucin domain-3 can induce the malignancy of gliomas. The function of galectin-9 (GAL-9), as one of the ligands of T cell immunoglobulin domain and mucin domain-3, in glioma has remained elusive. The aim of this study was to characterize the expression of GAL-9 in patients with glioma. ⋯ Our results highlight the pivotal role of GAL-9 in regulation of immune suppressive features of gliomas and indicate that GAL-9 is a promising target for cancer immunotherapy and may lead to development of further therapies.
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To investigate if the implementation of white matter (WM) fiber tractography by diffusion tensor imaging in presurgical planning for supratentorial tumors proximal to eloquent WM tracts can alter a neurosurgeon's operative strategy. ⋯ DTI WM tractography helped neurosurgeons to correctly identify patients with interrupted motor and optic pathway tracts so they could be more aggressive with the extent of tumor resection, despite its inability to alter the operative approach.
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Incidentally discovered diffusely infiltrating low-grade gliomas (iDLGGs) are rare findings on neuroimaging that pose a challenge to neurosurgeons. There is a paucity of data regarding the natural history of these lesions, and thus management is controversial. We characterize the growth rates and patterns of iDLGGs in a cohort of patients who underwent serial magnetic resonance imaging before surgical treatment. ⋯ iDLGGs grow over time, and most exhibit an exponential pattern of growth. Tumor volume at the time of diagnosis is predictive of a faster growth rate, but not the pattern of growth.
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Observational Study
Anatomical Feasibility of Right Oblique Approach for L5-S1 Oblique Lumbar Interbody Fusion.
We compared left and right vascular anatomy at the L5-S1 disc space and validated the anatomical feasibility of the right oblique approach for L5-S1 oblique lumbar interbody fusion. ⋯ The vessels on the right side of the L5-S1 disc were located more laterally, and most vessels on the right side were arteries accompanying PVAT, which might minimize vessel manipulation. These results indicate that the right side of the L5-S1 disc could provide feasible access for oblique lumbar interbody fusion at L5-S1.
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Treatment of cystic craniopharyngiomas can be challenging and recurrences are frequent, even after total resection. In selected cases, less-aggressive surgery with the sole drainage of the cyst reliefs symptoms caused by mass effect and represents a valid alternative option, notably in pediatric population. We herein analyze a series of adult cystic craniopharyngiomas, managed with Ommaya Reservoir implant, focusing on local tumor control and eventual complications. ⋯ In selected patients, tailored procedures are required to achieve long-term tumor control and as well limit surgery-related morbidity. ORS could represent a safe and effective treatment option for cystic craniopharyngiomas, providing also reduced surgical-related morbidity, especially in recurrent lesions and in patients not suitable for radical surgery.