Clinical Oncology

[Treatments of brain tumors in adults – an up-date]

BAGÓ Attila György

FEBRUARY 10, 2015

Clinical Oncology - 2015;2(01)

[The prognosis of brain metastases is very poor. Surgery and radiotherapy provides the fi rst line treatment, while systemic therapy has limited value. Nevertheless, our knowledge is increasing: normal cells contribute signifi cantly to the homing and growth of tumor cells; the molecular profi le of the primary tumor and its metastases could be different, which infl uences the therapeutic strategies; the type of blood supply can change during the tumor growth. It would be very important to optimize the cooperation of the different therapeutic modalities, and to fi nd markers which could predict the risk of metastatization.]

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[Neoadjuvant treatment of rectal cancer]

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[Treatments of brain tumors in adults – an up-date]

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[Maximal safe resection is the fi rst step in the complex neurooncological therapy of adult brain tumors. Surgical management of brain tumors, including the surgical innovations (neuronavigation, intraoperative imaging, awake craniotomy, intraoperative electrophysiology) providing more radical resection with the safe preservation of neurological functions will be presented. In case of malignancy the surgery is followed by radiation and chemotherapy. In this review we describe the postoperative adjuvant therapeutical modatilites available for primary and metastatic tumors, emphasizing the modern chemotherapy of high grade gliomas and stereotactic radiosurgery of brain metastases. As a conclusion we summerize the guidelines and modalities for the most common adult brain tumors, according to histological type and grade.]

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[INTRODUCTION - Similar occirrence of neurofibromatosis and malignant melanoma is rare. We report a patient with neurofibromatosis, cutaneous melanoma, hyperthyreoidism and HCV positivity. CASE REPORT - A 43-year-old woman has been under care for neurofibromatosis for 16 years when she presented with increased serum ?- glutamyltransferase, alkaline phosphatase activity and anti-HCV antibody positivity at regular checkup. A pigmented lesion removed from her back histologically proved to be cutan melanoma. Interferon treatment was applied. She lost 8 kilograms in half a year which was caused not by the tumor progression, but hyperthyreoidism. A rapid clinical and laboratory improvement was observed for thyreostatic treatment and she regained her bodyweight. One year later she presented with a cough caused by pulmonary tumor. The tumor was surgically removed and histologically diagnosed as metastasis of melanoma. Cytostatic treatment was applied and she became asymptomatic. Four years after the diagnosis of melanoma she died of apoplexy. During the autopsy there was no sign of either melanoma or liver disease. CONCLUSIONS - The careful investigation of skin should be emphasised even in case of long established neurofibromatosis. The presented case shows an association of malignant melanoma and neurofibromatosis. In the background of loss of bodyweight even in a patient with history of malignant disease other causes should also be searched such as hyperthyreoidism especially during interferon therapy.]