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Cancers
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Brain and Spinal Cord Tumors: Symptoms, Diagnosis, and Treatment
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Brain and Spinal Cord Tumors: Symptoms, Diagnosis, and Treatment

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Causes, Screening and Diagnosis".

Deadline for manuscript submissions: 31 December 2024 | Viewed by 11286

Special Issue Editors

Dr. Alberto Feletti

E-Mail Website
Guest Editor
Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona—AOUI Verona, Verona, Italy
Interests: high grade glioma; low grade glioma; brain metastasis; meningioma; hemangioblastoma; VHL; vestibular schwannoma; intramedullary tumors
Dr. Takashi Sugawara

E-Mail Website
Co-Guest Editor
Department of Neurosurgery, Tokyo Medical and Dental University, Tokyo, Japan
Interests: skull base tumor; meningioma; schwannoma; chordoma; chondrosarcoma; sinonasal malignancy; skull base surgery

Special Issue Information

Dear Colleagues,

Tumors of the central nervous system include a wide range of different neoplasms with significantly diverging treatment protocols and prognosis. Some of them are part of more complex syndromes, which require proper diagnostic examinations and follow-up regimens. In recent years, new diagnostic tools and targeted therapies have emerged, along with the awareness of specific molecular characteristics with significant therapeutic and prognostic value.

We are pleased to invite you to submit your papers to this Special Issue, which will highlight the clinical features, diagnostic strategies, and treatment options for brain and spinal cord tumors, with particular emphasis on the new diagnostic and therapeutic options. Both clinical and basic/preclinical aspects will be covered.

In this Special Issue, original research articles and reviews are welcome, along with expert opinions, systematic reviews, and meta-analyses. Research areas may include (but are not limited to) the following: gliomas, meningiomas, ependymomas, metastases, hemangioblastomas, schwannomas, neurocutaneous syndromes, intraoperative neuromonitoring, diagnostic tools, new therapeutical strategies, prognostic factors, supportive care, and rehabilitation.

We look forward to receiving your contributions.

Dr. Alberto Feletti
Dr. Takashi Sugawara
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • brain
  • spinal cord
  • primary tumors
  • metastases
  • imaging
  • neuro-oncology

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Published Papers (7 papers)

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Research

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16 pages, 1266 KiB  
Article
Endoscopic-Assisted Microsurgical Meningioma Resection in the Skull Base via Minicraniotomy: Is There a Difference in Radicality and Outcome between Anterior Skull Base and Posterior Fossa?
by Thomas Kanczok, Gerrit Fischer, Sebastian Senger and Stefan Linsler
Cancers 2024, 16(7), 1391; https://doi.org/10.3390/cancers16071391 - 31 Mar 2024
Viewed by 1068
Abstract
Background: Keyhole-based approaches are being explored for skull base tumor surgery; aiming for reduced complications while maintaining resection success rates. This study evaluates skull base meningiomas resected using an endoscopic-assisted microsurgical keyhole approach, comparing outcomes with standard procedures. Methods: Between 2013 [...] Read more.
Background: Keyhole-based approaches are being explored for skull base tumor surgery; aiming for reduced complications while maintaining resection success rates. This study evaluates skull base meningiomas resected using an endoscopic-assisted microsurgical keyhole approach, comparing outcomes with standard procedures. Methods: Between 2013 and 2019; 71 out of 89 patients were treated using an endoscopic-assisted microsurgical procedure. A total of 42 meningiomas were localized at the anterior skull base and 29 in the posterior fossa. The surgical techniques and use of an endoscope were analyzed and compared in terms of complications, surgical radicality, outcome, and recurrences in the patients’ follow-up. Results: The two different cohorts yielded similar rates of GTR (anterior skull base: 80% versus posterior fossa: 82%). The complication rate was 31% for the posterior fossa and 16% for the anterior skull base. An endoscope was used in 79% of all cases. Tumor remnants were detected by means of endoscopic visualization in 58.6% of posterior fossa and 33% of anterior skull base meningiomas. The statistical analysis revealed significantly higher benefits from endoscope use in the posterior fossa cohort (p < 0.05). Conclusions: The results revealed that endoscopy was beneficial in both locations. The identification of remnant tumor tissue and the benefit of endoscopy were clearly higher in the posterior fossa. Endoscopic assistance is a very helpful tool for increasing radicality, providing a better anatomical overview during surgery, and better identifying remnant tumor tissue in skull base meningioma surgery. Full article
(This article belongs to the Special Issue Brain and Spinal Cord Tumors: Symptoms, Diagnosis, and Treatment)
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21 pages, 8009 KiB  
Article
Dielectric Spectroscopy Shows a Permittivity Contrast between Meningioma Tissue and Brain White and Gray Matter—A Potential Physical Biomarker for Meningioma Discrimination
by Anton Kordić and Antonio Šarolić
Cancers 2023, 15(16), 4153; https://doi.org/10.3390/cancers15164153 - 17 Aug 2023
Cited by 2 | Viewed by 1152
Abstract
The effectiveness of surgical resection of meningioma, the most common primary CNS tumor, depends on the capability to intraoperatively discriminate between the meningioma tissue and the surrounding brain white and gray matter tissues. Aiming to find a potential biomarker based on tissue permittivity, [...] Read more.
The effectiveness of surgical resection of meningioma, the most common primary CNS tumor, depends on the capability to intraoperatively discriminate between the meningioma tissue and the surrounding brain white and gray matter tissues. Aiming to find a potential biomarker based on tissue permittivity, dielectric spectroscopy of meningioma, white matter, and gray matter ex vivo tissues was performed using the open-ended coaxial probe method in the microwave frequency range from 0.5 to 18 GHz. The averages and the 95% confidence intervals of the measured permittivity for each tissue were compared. The results showed the absence of overlap between the 95% confidence intervals for meningioma tissue and for brain white and gray matter, indicating a significant difference in average permittivity (p ≤ 0.05) throughout almost the entire measured frequency range, with the most pronounced contrast found between 2 GHz and 5 GHz. The discovered contrast is relevant as a potential physical biomarker to discriminate meningioma tissue from the surrounding brain tissues by means of permittivity measurement, e.g., for intraoperative meningioma margin assessment. The permittivity models for each tissue, developed in this study as its byproducts, will allow more accurate electromagnetic modeling of brain tumor and healthy tissues, facilitating the development of new microwave-based medical devices and tools. Full article
(This article belongs to the Special Issue Brain and Spinal Cord Tumors: Symptoms, Diagnosis, and Treatment)
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12 pages, 1893 KiB  
Article
Metastasis Associated in Colorectal Cancer 1 (MACC1) mRNA Expression Is Enhanced in Sporadic Vestibular Schwannoma and Correlates to Deafness
by Maria Breun, Katharina Flock, Jonas Feldheim, Anja Nattmann, Camelia M. Monoranu, Pia Herrmann, Ralf-Ingo Ernestus, Mario Löhr, Carsten Hagemann and Ulrike Stein
Cancers 2023, 15(16), 4089; https://doi.org/10.3390/cancers15164089 - 14 Aug 2023
Viewed by 1214
Abstract
Vestibular schwannoma (VS) are benign cranial nerve sheath tumors of the vestibulocochlear nerve. Their incidence is mostly sporadic, but they can also be associated with NF2-related schwannomatosis (NF2), a hereditary tumor syndrome. Metastasis associated in colon cancer 1 (MACC1) is known to [...] Read more.
Vestibular schwannoma (VS) are benign cranial nerve sheath tumors of the vestibulocochlear nerve. Their incidence is mostly sporadic, but they can also be associated with NF2-related schwannomatosis (NF2), a hereditary tumor syndrome. Metastasis associated in colon cancer 1 (MACC1) is known to contribute to angiogenesis, cell growth, invasiveness, cell motility and metastasis of solid malignant cancers. In addition, MACC1 may be associated with nonsyndromic hearing impairment. Therefore, we evaluated whether MACC1 may be involved in the pathogenesis of VS. Sporadic VS, recurrent sporadic VS, NF2-associated VS, recurrent NF2-associated VS and healthy vestibular nerves were analyzed for MACC1 mRNA and protein expression by quantitative polymerase chain reaction and immunohistochemistry. MACC1 expression levels were correlated with the patients’ clinical course and symptoms. MACC1 mRNA expression was significantly higher in sporadic VS compared to NF2-associated VS (p < 0.001). The latter expressed similar MACC1 concentrations as healthy vestibular nerves. Recurrent tumors resembled the MACC1 expression of the primary tumors. MACC1 mRNA expression was significantly correlated with deafness in sporadic VS patients (p = 0.034). Therefore, MACC1 might be a new molecular marker involved in VS pathogenesis. Full article
(This article belongs to the Special Issue Brain and Spinal Cord Tumors: Symptoms, Diagnosis, and Treatment)
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17 pages, 459 KiB  
Article
Presurgical Executive Functioning in Low-Grade Glioma Patients Cannot Be Topographically Mapped
by Maud J. F. Landers, Lars Smolders, Geert-Jan M. Rutten, Margriet M. Sitskoorn, Emmanuel Mandonnet and Wouter De Baene
Cancers 2023, 15(3), 807; https://doi.org/10.3390/cancers15030807 - 28 Jan 2023
Cited by 1 | Viewed by 2265
Abstract
Executive dysfunctions have a high prevalence in low-grade glioma patients and may be the result of structural disconnections of particular subcortical tracts and/or networks. However, little research has focused on preoperative low-grade glioma patients. The frontotemporoparietal network has been closely linked to executive [...] Read more.
Executive dysfunctions have a high prevalence in low-grade glioma patients and may be the result of structural disconnections of particular subcortical tracts and/or networks. However, little research has focused on preoperative low-grade glioma patients. The frontotemporoparietal network has been closely linked to executive functions and is substantiated by the superior longitudinal fasciculus. The aim of this study was to investigate their role in executive functions in low-grade glioma patients. Patients from two neurological centers were included with IDH-mutated low-grade gliomas. The sets of preoperative predictors were (i) distance between the tumor and superior longitudinal fasciculus, (ii) structural integrity of the superior longitudinal fasciculus, (iii) overlap between tumor and cortical networks, and (iv) white matter disconnection of the same networks. Linear regression and random forest analyses were performed. The group of 156 patients demonstrated significantly lower performance than normative samples and had a higher prevalence of executive impairments. However, both regression and random forest analyses did not demonstrate significant results, meaning that neither structural, cortical network overlap, nor network disconnection predictors explained executive performance. Overall, our null results indicate that there is no straightforward topographical explanation of executive performance in low-grade glioma patients. We extensively discuss possible explanations, including plasticity-induced network-level equipotentiality. Finally, we stress the need for the development of novel methods to unveil the complex and interacting mechanisms that cause executive deficits in low-grade glioma patients. Full article
(This article belongs to the Special Issue Brain and Spinal Cord Tumors: Symptoms, Diagnosis, and Treatment)
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12 pages, 1936 KiB  
Article
Sporadic and von Hippel–Lindau Related Hemangioblastomas of Brain and Spinal Cord: Multimodal Imaging for Intraoperative Strategy
by Elio Mazzapicchi, Francesco Restelli, Jacopo Falco, Morgan Broggi, Laura Gatti, Pierpaolo Alongi, Laura Valentini, Paolo Ferroli, Ignazio G. Vetrano, Francesco DiMeco and Francesco Acerbi
Cancers 2022, 14(22), 5492; https://doi.org/10.3390/cancers14225492 - 9 Nov 2022
Cited by 3 | Viewed by 1598
Abstract
Hemangioblastomas (HBs) are rare, benign tumors often related to von Hippel–Lindau disease. They represent the most frequent primary cerebellar tumors in adults. Neurosurgical procedures aim to obtain a gross-total resection of tumor nodules, avoiding intra-postoperative hemorrhage. The introduction of new intraoperative imaging techniques [...] Read more.
Hemangioblastomas (HBs) are rare, benign tumors often related to von Hippel–Lindau disease. They represent the most frequent primary cerebellar tumors in adults. Neurosurgical procedures aim to obtain a gross-total resection of tumor nodules, avoiding intra-postoperative hemorrhage. The introduction of new intraoperative imaging techniques has considerably changed surgical strategies in neuro-oncology. We present an overview of clinical and radiological data of a mono-institutional retrospective cohort, focusing on the role of intraoperative multimodal imaging in surgical strategy. From 2015 to 2021, we identified 64 (81%) cranial (42 cerebellar, 8 supratentorial, and 14 of the brainstem) HBs and 15 (19%) spinal (4 cervical and 11 dorsal) HBs in 79 patients. Intraoperatively, indocyanine green videoangiography with FLOW800 was used in 62 cases (52 cranial and 10 spinal), intraoperative ultrasound and contrast-enhanced ultrasounds in 22 cases (18 cranial and 4 spinal HBs), and fluorescein in 10 cases (in 6 cranial and 2 spinal cases used as SF-VA). Gross total resection was achieved in 100% of the cases (53 mural nodule removal and 26 complete resections of the solid tumor). No side effects were reported following the combination of these tools. Multimodal intraoperative techniques provide valuable and reliable information to identify the tumor and its vasculature, guiding a more precise and safer resection and reducing the risk of recurrence. Full article
(This article belongs to the Special Issue Brain and Spinal Cord Tumors: Symptoms, Diagnosis, and Treatment)
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Review

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19 pages, 4372 KiB  
Review
Imaging Recommendations for Diagnosis, Staging, and Management of Central Nervous System Neoplasms in Adults: CNS Metastases
by Kajari Bhattacharya, Abhishek Mahajan and Soujanya Mynalli
Cancers 2024, 16(15), 2667; https://doi.org/10.3390/cancers16152667 - 26 Jul 2024
Viewed by 1002
Abstract
Brain metastases (BMs) are the most common central nervous system (CNS) neoplasms, with an increasing incidence that is due in part to an overall increase in primary cancers, improved neuroimaging modalities leading to increased detection, better systemic therapies, and longer patient survival. Objective: [...] Read more.
Brain metastases (BMs) are the most common central nervous system (CNS) neoplasms, with an increasing incidence that is due in part to an overall increase in primary cancers, improved neuroimaging modalities leading to increased detection, better systemic therapies, and longer patient survival. Objective: To identify cancer patients at a higher risk of developing CNS metastases and to evaluate associated prognostic factors. Methods: Review of imaging referral guidelines, response criteria, interval imaging assessment, modality of choice, as well as the association of clinical, serological, and imaging findings as per various cancer societies. Results: Quantitative response assessment of target and non-target brain metastases as well as an interval imaging protocol set up based on primary histological diagnosis and therapy status are discussed as per various cancer societies and imaging programs. Conclusion: Predictive factors in the primary tumor as well as independent variables of brain metastases like size, number, and response to therapy are necessary in management. The location of CNS metastases, symptomatic disease, as well as follow up imaging findings form a skeletal plan to prognosticate the disease, keeping in mind all the available new advanced therapy options of surgery, radiation, and immunotherapy that improve patient outcome significantly. Full article
(This article belongs to the Special Issue Brain and Spinal Cord Tumors: Symptoms, Diagnosis, and Treatment)
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19 pages, 964 KiB  
Review
The Regulation of m6A Modification in Glioblastoma: Functional Mechanisms and Therapeutic Approaches
by Simon Deacon, Lauryn Walker, Masar Radhi and Stuart Smith
Cancers 2023, 15(13), 3307; https://doi.org/10.3390/cancers15133307 - 23 Jun 2023
Cited by 5 | Viewed by 1998
Abstract
Glioblastoma is the most prevalent primary brain tumour and invariably confers a poor prognosis. The immense intra-tumoral heterogeneity of glioblastoma and its ability to rapidly develop treatment resistance are key barriers to successful therapy. As such, there is an urgent need for the [...] Read more.
Glioblastoma is the most prevalent primary brain tumour and invariably confers a poor prognosis. The immense intra-tumoral heterogeneity of glioblastoma and its ability to rapidly develop treatment resistance are key barriers to successful therapy. As such, there is an urgent need for the greater understanding of the tumour biology in order to guide the development of novel therapeutics in this field. N6-methyladenosine (m6A) is the most abundant of the RNA modifications in eukaryotes. Studies have demonstrated that the regulation of this RNA modification is altered in glioblastoma and may serve to regulate diverse mechanisms including glioma stem-cell self-renewal, tumorigenesis, invasion and treatment evasion. However, the precise mechanisms by which m6A modifications exert their functional effects are poorly understood. This review summarises the evidence for the disordered regulation of m6A in glioblastoma and discusses the downstream functional effects of m6A modification on RNA fate. The wide-ranging biological consequences of m6A modification raises the hope that novel cancer therapies can be targeted against this mechanism. Full article
(This article belongs to the Special Issue Brain and Spinal Cord Tumors: Symptoms, Diagnosis, and Treatment)
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