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Primary central nervous system lymphoma (PCNSL) is an extranodal type of lymphoma, which is treated with methotrexate (MTX)-based induction therapy. Although PCNSL is a hematological malignancy, patients with PCNSL may be treated at neurosurgery or hematology/oncology departments; however, the outcomes of PCNSL treatment have not been compared between these two departments. The present study compared the outcomes of 26 patients with newly diagnosed PCNSL that were treated at the Department of Neurological Surgery or Department of Hematology/Oncology (Wakayama Medical University Hospital, Wakayama, Japan) between January 2011 and December 2021. The relative dose intensity (RDI) and relative treatment intensity of MTX were assessed as indicators of the intensity of chemotherapy. The median RDI of MTX was 67 and 93% in the neurosurgery and hematology/oncology groups, respectively (P<0.001). The proportion of patients that achieved a complete response after high-dose MTX-based therapy was significantly higher in the hematology/oncology group than in the neurosurgery group (P=0.038). The estimated 2-year overall survival was 72 and 100% in the neurosurgery and hematology/oncology groups, respectively (P=0.046). As with the difference in the outcomes observed between pediatrics and hematology departments for adolescents with acute lymphoblastic leukemia, the outcomes of patients with PCNSL may differ between neurosurgery and hematology/oncology departments. [ABSTRACT FROM AUTHOR]

Osteoblastomas are benign bone tumors that produce prostaglandin and promote inflammation. The aim of the present study was to describe the clinical and radiological characteristics of a pediatric osteoblastoma case over an 8-month postoperative follow-up. The case involved an 11-year-old female patient with normal somatic development, presenting with a chief complaint of sleep disturbance. The patient had no spontaneous pain or other readily evident possible causes. Magnetic resonance imaging (MRI) revealed a neoplastic lesion in the sacrum, with peritumoral edema. Intraoperative fast-frozen biopsy raised the suspicion of osteosarcoma. However, the final diagnosis was osteoblastoma and a second operation was performed for total resection. The edematous peritumoral bone and muscle tissues were preserved. Following total removal of the tumor, the sleep disturbance resolved. Eight months after the surgery, MRI revealed no recurrence of the tumor and reduction of the peritumoral edema. On immunohistochemical examination, cyclooxygenase (COX)-1 and COX-2 were strongly positive, indicating that the tumor activated the arachidonic acid metabolic pathway and produced prostaglandin. The inflammatory process subsequently promoted the development of peritumoral edema and induced the sleep disturbance. [ABSTRACT FROM AUTHOR]

Carmustine wafers, which are locally delivered chemotherapy in the form of biodegradable implants, confer a survival benefit to patients with glioblastoma (GB) following surgical resection. While the adverse events of this method, including gas retention and perifocal edema, have been extensively investigated, the immediate efficacy of the implant has rarely been reported. To the best of our knowledge, this is the first reported case of GB in which the tumor rapidly regressed after partial surgical removal followed by implantation of carmustine wafers. A 77-year-old woman presented with motor aphasia and right hemiparesis. Neuroimaging revealed a tumor located in the left frontal lobe of the brain. The tumor was partially removed under 5-aminolevulinic acid fluorescence guidance and 8 carmustine wafers were implanted in the resection cavity. The histopathological findings suggested the diagnosis of GB. Genetic and immunohistochemical analyses revealed O6-methylguanine-DNA methyltransferase (MGMT) gene promoter methylation and low MGMT protein expression, respectively, in the tumor cells. One month after the operation, when adjuvant temozolomide chemotherapy was planned, computed tomography and magnetic resonance imaging revealed a marked regression of the residual tumor and perifocal edema. The patient's symptoms and signs had improved. As adjuvant temozolomide without radiation was therapeutically beneficial, the tumor gradually regressed and the patient has remained progression-free for >12 months after the operation. Therefore, adjuvant local chemotherapy with carmustine wafer implants was able to induce rapid regression of GB. [ABSTRACT FROM AUTHOR]