bluuebunny/crossref_metadata_2025 huggingface dataset:
B-220 Clinical Application of the “Clg-Fish” Technique for the Diagnosis of Multiple Myeloma
Authors: Eduardo Levi J , Correa Wengerkievicz Lopes A , Maia C A , Silva A M , Renault I Z , Ramos R M , Passos J V , Andrade C F , Silva E V , Gomes D M , Argolo S V , Castelo M C
Published: October 2024

Background

The international standard system [R2-ISS] for Multiple Myeloma (MM) includes genetic characteristics of malignant cells by fluorescent in situ hybridization -t(4;14), del(17p) and t(14;16) at diagnosis; We included interphase fluorescent in situ hybridization (cIg-FISH) of purified CD138 cells in this evaluation. The aim of this study is to evaluate the implementation of cIg-FISH in MM for disease diagnosis and stratification.

Methods

oBone marrow [BM] from patients with MM diagnosed by the European Myeloma Network (REM) criteria were evaluated. BM mononuclear cells obtained by density gradient centrifugation for 30 minutes, with Ficoll-Hypaque density medium; followed by immunoassay with anti-Kappa/anti-Lambda antibodies labeled with FISH probes. We detected the following abnormalities: t(4;14), t(14;16) and deletion of 17p13. The t(11;14) and the amplification/deletion of 1q21-q22 (CKS1B)/1p32.3 (CDKN2C). We used the probes: TP53, IGH::FGFR3, IGH::CCND1, IGH:MAF and CKS1B/CDKN2C, one hundred cells per probe. Signals exceeding the cutoff recommended by REM were considered abnormal. The viability of the method was tested on samples 24, 48 and 72 hours after collection.

Results

Genetic aberrations seen in 24 and 48 hs plasma cells, a specific rearrangement of 14q32.33 t(4;14) in the 48 hs sample; Samples processed for 72 hours resulted in cells that were unviable for analysis. Genetic aberrations were detected by cIg-FISH in cells from 40% of patients. We detected the following abnormalities t(4;14) (Fig.1A), del(17p) (Fig. 1B); deletion of 1p32.3 amplification (CDKN2C) 1q21 (Fig. 1 C-D). The cIg-FISH study detected genetic aberrations in MM as those recommended by the European Myelomat Network - t(4;14), t(14;16) and del(17p), by FISH analysis for risk stratification for MM.

Conclusions

The inclusion of cIg-FISH in risk stratification systems has clinical relevance because cIg-FISH is a standard tool for detecting genetic abnormalities and prognosing the disease.
B-345 The PSA and free PSA Concentrations in Serum of Apparently Healthy Subjects Using the Atellica IM hsPSA and fPSAII Assays
Authors: Olson Nissen K , Snyder J , Pagano M , Owusu A , Grosett M , Birmingham N , Christenson R , deFilippi C
Published: October 2024

Background

PSA assays are recommended in the screening for prostate cancer (PC) among males 50 years and older. Those with PSA results in the gray zone (between 4 ng/mL and 10 ng/mL) and a nonsuspicious digital rectal examination (DRE) may be further tested with the free PSA (fPSA) assays to improve detection of PC. PSA and fPSA are also detected in apparently healthy subjects. The goal of this study was to evaluate the distribution of high sensitivity PSA (hsPSA), fPSAII, and %fPSAII (fPSAII/hsPSA x 100) values generated on the Atellica® IM Analyzer among apparently healthy subjects by age decade.

Methods

Serum samples were prospectively collected from apparently healthy subjects at multiple sites across the United States: 673 males 50-70+ years presenting at primary care facilities for routine PSA testing (>120 samples in each age decade (50-59, 60-69, 70+ years) and 113 samples in each of two younger decades (30-39, 40-49 years). Distribution statistics include the mean, median, interquartile range, 2.5th, 95th, and 97.5th percentiles.

Results

In this study, using samples from healthy men 30-70+ years (N=786), it was observed that median hsPSA results increased with every decade from 0.682 ng/mL at 30-39 years to 2.183 ng/mL at age 70+ years. The 97.5th percentiles were below 4.0 ng/mL in men <50 years, and above 4.0 ng/mL in men >50 years. All men (100%) 30-49 years had an hsPSA result below 4.0, and 95.5% of men 50-59 years had an hsPSA result below 4.0. The percent of subjects with hsPSA values above the cut-off of 4.0 was 6.6% among men 60-69 years and 12.4% among men >70 years. Median hsPSA values for each age group were comparable to median PSA values reported for healthy men older than 50 years old without cancer undergoing routine health check-ups in the United States and other countries (median hsPSA value was 0.90 among men 50-59 years). For both hsPSA and fPSAII, it was observed that average values increased with each successive decade for subjects 30-70+ years. The range across decades was 0.904-2.183 ng/mL for hsPSA and 0.23-0.46 ng/mL for fPSAII. However, the average %fPSAII (fPSA/hsPSAx100) values did not consistently rise over time because hsPSA variances also increase, a pattern previously documented.

Conclusions

The distribution of Atellica® IM hsPSA and fPSAII assay values from apparently healthy males was determined.

CAUTION: Investigational Device. Not available for sale. Future availability cannot be guaranteed. The results are preliminary and were achieved in unique setting with no expected timeline for completion.
B-355 Assessment of Calcitonin Cutoff Values for Post-Thyroidectomy Surveillance in Patients with Medullary Thyroid Carcinoma: Findings from a Single-Center Investigation
Authors: Li S , Patton A , Lee J K , Scheidegger M , Azaryan I , Sipos J , Nabhan F , Jones J , Algeciras-Schimnich A , Ringel M D
Published: October 2024

Background

Patients with sporadic or hereditary Medullary Thyroid Carcinoma (MTC) often undergo total thyroidectomy and lymph node dissection, with postoperative surveillance relying on serum calcitonin levels and ultrasound examinations. According to American Thyroid Association (ATA) guidelines, detectable levels of serum calcitonin and Carcinoembryonic Antigen (CEA) post-thyroidectomy suggest potential disease persistence or recurrence, necessitating frequent monitoring for early detection. This study sought to reassess the role of postoperative calcitonin levels in identifying possible tumor recurrence.

Methods

A retrospective analysis was conducted using Siemens Atellica to test calcitonin levels in 562 samples collected between 09/27/2022 and 08/11/2023, at least 3 months post-total thyroidectomy. Imaging studies performed within 6 months of the calcitonin assessment were also reviewed. Sample pools with calcitonin concentrations near 3.00 and 5.00 pg/mL were utilized to determine the limit of quantification (LoQ). CEA results were included for comparison. Additionally, 16 serum samples were analyzed using the Roche Cobas system at a reference laboratory.

Results

Precision analysis around 3.00 and 5.00 pg/mL revealed coefficients of variation (CVs) of 16.49% and 8.87%, respectively. Comparison of calcitonin levels between Siemens Atellica and Roche Cobas systems demonstrated consistent levels < 5.00 pg/mL in 15 out of 16 samples, indicating alignment and reliability between the platforms. A calcitonin cutoff of 1.89 pg/mL yielded 43% sensitivity and 67% specificity, while a cutoff of 5.00 pg/mL resulted in 0% sensitivity and 100% specificity.

Conclusions

Our findings suggest that a 5 pg/mL calcitonin cutoff on the Siemens Atellica platform may be suitable for identifying tumor persistence or recurrence in post-thyroidectomy patients within our institution. However, individual laboratories should establish their LoQ criteria when interpreting calcitonin levels for postoperative monitoring of tumor recurrence.
Clock drift corrections for large aperture ocean bottom seismometer arrays: application to the UPFLOW array in the mid-Atlantic Ocean
Authors: Cabieces R , Harris K , Ferreira A M G , Tsekhmistrenko M , Hicks S P , Krüger F , Geissler W H , Hannemann K , Schmidt-Aursch M C
Published: September 2024

Accurate timing corrections for seismic data recorded by ocean bottom seismometers (OBSs) are essential for a wide range of applications. The synchronization of internal OBS clocks with Global Positioning System (GPS) is typically only possible prior to deployment on the seafloor and upon retrieval. Thus, untracked, clock errors in seismic data may accumulate over the deployment period. The measurement of the clock's offset from GPS at retrieval, referred to as ‘skew’, can be used to correct the data solely under the assumption of a uniform rate of clock drift throughout the whole deployment. However, clock errors can be non-linear. We, therefore, develop a new workflow along with an associated open-source, interactive graphical user interface to estimate clock drift of large aperture OBS arrays. We use the workflow to estimate OBS clock drift curves for 40 OBSs of the large-scale UPFLOW seafloor array in the Madeira–Azores–Canaries region deployed for ∼14 months in 2021–2022. We use the relative shift of daily empirical Green's functions obtained from seismic ambient noise recorded by all available data channels to track clock error. We find that 95 per cent of our OBS clock drift observations have a substantial non-linear component: most maximum deviations to linearity are ∼0.75–1 s (and up to 2 s) occurring mainly halfway through the deployment. We test our drift curves by using them to correct teleseismic earthquake recordings, which enables larger numbers of high-quality P-wave traveltime measurements than when using linear drift corrections. Our drift curves have on average an uncertainty of ∼0.11 s indicating the suitability of the corrected data for future seismological studies such as for seismic tomography, seismicity analysis and moment tensor inversions.
Complete mitochondrial genome characterisation of Ratha longimana (H. Milne Edwards, 1834) from the western Atlantic Ocean, with a phylogeny of the Xanthidae (Decapoda: Brachyura)
Authors: van der Meij Sancia E T , Xu Tao
Published: September 2024

The longhand rubble crab Ratha longimana inhabits coral reefs and rocky shores in the subtropical and tropical western Atlantic Ocean. This species was long considered to be the only chlorodielline species present in the area, but has since been transferred to the genus RathaLasley, Lai & Thoma, 2013 and is now thought to belong to an undescribed subfamily within Xanthidae MacLeay, 1838. Here we provide a complete mitochondrial assemblage and characterisation of this species. The assembled mitochondrial genome (hereafter mitogenome) of R. longimana is 15,819 bp in length and contains 13 protein coding genes (PCGs), 22 transfer RNA (tRNA) genes, and two ribosomal RNA (rRNA) genes. The 22 tRNA genes range from 62 to 69 bp in length. A mitochondrial gene order (MGO) analysis revealed a transposition of the tRNA genes Val (V) and 12S rRNA (rrnS) when compared to the ancestral brachyuran gene order, which is in line with earlier studies on xanthoid mitogenomes. Mitogenome data for xanthid crabs (as well as the superfamily Xanthoidea MacLeay, 1838) are currently scarce considering the species richness of the family, limiting the options for phylogenomic studies. This is partially remedied here by providing a new genomic resource for R. longimana.
Revisiting the formaldehyde masers – II. Effects of an H ii region and beaming
Authors: van der Walt D J
Published: September 2024

We present new results of a numerical study of the pumping of 4.8 and 14.5 GHz maser of o–$\mathrm{H_2CO}$ in the presence of a free–free radiation field. It is shown that in the presence of a free–free radiation field inversion of not only the $1_{10}{\!-\!}1_{11}$, but also the $2_{11}{\!-\!}2_{12}$ and other doublet state transitions occur. Further results are presented to illustrate how, as a consequence of the pumping scheme, the inversion of the $1_{10}{\!-\!}1_{11}$ and $2_{11}{\!-\!}2_{12}$ transitions respond to the free–free radiation fields associated with H ii regions with different emission measures and levels of geometric dilution with respect to the masing region. We also discuss the criticism raised in the past by various authors against the pumping of the 4.8 GHz $\mathrm{H_2CO}$ masers by a free–free radiation field. It is argued that the rarity of the $\mathrm{H_2CO}$ masers is not to be ascribed to the pumping scheme but to other factors such as, e.g. the evolution of the associated H ii region or the chemical evolution of the star-forming region that determines the $\mathrm{H_2CO}$ abundance or a combination of both.
HGGL-01 GLIOBLASTOMA MULTIFORM INVOLVING MULTIPLE BRAIN REGIONS ASSOCIATED WITH MUTATIONS IN EXON 4 OF ISOCITRATE DEHYDROGENASE 1 COMPLICATED BY ACUTE KIDNEY FAILURE: A CASE REPORT
Authors: Kamabu Larrey Kasereka , Ronald Oboth , Paul Okiror , Kataka Louange , Lekuya Hervé , Valimungighe Moise , Kangitsi Charles Kahindo
Published: October 2024

Glioblastoma multiform (GBM), WHO grade 4, is the most aggressive primary brain tumor in adults associated with poor prognosis. We present a case of a 43-year-old female, Muyira, diagnosed with GBM involving multiple brain regions and harboring mutations in exon 4 of isocitrate dehydrogenase 1, who subsequently developed acute kidney failure. The patient initially presented with progressive neurological symptoms, including headache and cognitive decline. Multiplanar multiecho MRI of the brain was performed with IV contrast in orthogonal plane and revealed a moderate sized multilobulated heterogeneously and predominantly peripherally enhancing mass lesion with irregular margins and central non enhancing areas of necrosis arising from the right corona radiata, insular cortex, external capsule, lentiform nucleus, temporal, and frontal white matter with blood products. Perilesional edema was seen. Effacement of sulcal spaces. Right sylvian fissure, compression over right ventricle and midline shift of 8mm toward left side. There was dilatation of the left lateral ventricle with periventricular cerebrospinal fluid ooze. Uncal herniation was right side. On MR spectroscopy large choline, creatinine levels were seen in the lesion with reduced N-acetyl aspartate levels as compared to the normal parenchyma. Findings were suggestive of neoplastic lesion mostly high-grade glioma. Polymerase chain reaction sequencing confirmed the presence of missense mutation R132H in exon 4 of isocitrate dehydrogenase 1 gene. Despite maximal safe surgical resection, the patient developed acute kidney failure secondary to the nephrotoxic effects of gadolinium. Management of both the primary brain tumor and renal complication necessitated a multidisciplinary approach involving neurosurgery, oncology, nephrology, and supportive care. Despite aggressive interventions, the patient’s condition deteriorated, highlighting the challenges in managing concurrent life-threatening conditions in patients with advanced GBM.
HGGL-03 DIFFUSE MIDLINE GLIOMA IN GHANA-AN ILL-FATED DIAGNOSIS
Authors: Adamaley Sedinam , Gbadamosi Hafisatu , Schandorf Ernestina , Dadzie Mary-ann , Bankah Patrick , Mensah Yaw Boateng , Adrah Henry , Tawiah JuliaEbo
Published: October 2024

PURPOSE

Diffuse midline gliomas (DMG) based on the updated WHO classification are pediatric-type diffuse high-grade gliomas common in children and young adults. They are highly aggressive with dismal outcomes. Unfortunately, not much is known about these tumours in Ghana. This study seeks to provide initial data on the subject.

METHODS

A 2-year retrospective review of cases seen at the Pediatric Multidisciplinary Team and Radiotherapy Department yielded 9 cases. Their demographics, clinical presentation, radiologic features, and therapeutic outcomes were documented.

RESULTS

A total of nine cases, 55.6% males (n = 5), and 44.4% females (n = 4) were documented with a median age of 7 years. They presented with symptoms of vomiting in 44.4% of cases, multiple cranial nerve palsies (CN III, CN VI) in 55.6% of cases, and ataxia in 33.3 cases. None presented with paralysis. Imaging showed brainstem lesions in all 9 cases and thalamic involvement in 11.1%. Acute hydrocephalus was a feature in 44% of cases requiring CSF diversion. Up to 6 cases were lost to follow-up with 3 mortalities.

CONCLUSION

With DMG imaging is key for diagnosis due to the pathognomonic features, surgery plays a minimal role due to limited access to the lesion and related complications. In our series, the majority of lesions were localized within the brainstem with nearly half the number presenting with acute hydrocephalus. Overall, the outcomes were poor. Understanding the local picture is vital to addressing this devastating pathology.
MNGA-01 ÉPILEPSIE LIÉE AU MÉNINGIOME: À PROPOS DE DEUX CAS
Authors: Mala Zeus
Published: October 2024

BACKGROUND

Meningiomas are the most common intracranial primary neoplasms. Seizures are a common manifestation of these tumors (10% to 50%).

PURPOSE

To present 2 cases of meningioma-related epilepsy and discuss the predictive factors for preoperative and postoperative seizures, their physiopathology and their management.

CASE REPORTS

The first patient is a 36-years-old male with a 16 years history of epilepsy revealing an underlying left frontoparietal meningioma which benefited from a Simpson grade 1 surgical resection with a seizure free postoperative outcome. The second patient is a 46-years-old man with a 6 months history of seizures revealing a right parieto-occipital meningioma requiring surgical removal with persistence of seizures on postoperative follow-up.

CONCLUSION

Seizures are a common occurrence both prior to and after meningioma resection, and can have a significant negative impact on patient quality of life. Further efforts are required for better understanding and predicting seizures in meningioma as well as plan their medical treatment.
MNGA-08 SKULL BASE TUMOR RESECTION IN LOW-RESOURCE SETTINGS: A REVIEW OF THREE CASES AT THE KENYATTA NATIONAL HOSPITAL
Authors: Nassozi Jalilarah , Kanja Simon , Boore John , Karanja Suzan
Published: October 2024

Skull-based tumors are challenging to treat surgically due to their proximity to vital structures and the risk of complications. In low-resource settings, the availability of advanced neurosurgical equipment and expertise is limited, which may affect the outcomes of these patients. We report the outcomes of three patients with skull base tumors who underwent surgery at the Kenyatta National Hospital, Kenya. We retrospectively reviewed the medical records and followed up with three patients who underwent surgery for skull base tumors between October and November 2023. We collected data on their demographic characteristics, clinical presentation, imaging findings, surgical procedures, histopathological diagnosis, and postoperative course. The three patients were male, aged 42, 40, and 36 years. The common presentation was with headache, but dizziness and other cerebellar deficits were common. Imaging revealed defined lesions in the posterior fossa, involving the cerebellum and brainstem. The differential diagnosis included hemangioblastoma and meningioma. The surgical approach with anatomically-specified craniotomy with resection of the tumor and decompression. The postoperative course was uneventful for the first and third patients, who showed improvement in their neurological symptoms and signs. The second patient had repeat surgery. Skull base tumor surgery in a low-resource setting can achieve favorable outcomes with careful patient selection, meticulous surgical technique, and multidisciplinary care. However, the challenges of limited resources and high complication rates remain. Further studies are needed to evaluate the long-term outcomes and quality of life of these patients.
OTHR-03 INFECTIOUS COMPLICATIONS OF ENDOSCOPIC ENDONASAL APPROACH: CASE REPORT AND REVIEW
Authors: DOSSOU Mèhomè Wilfried , COMPAORE Pascal , KAKOU Médard , PUGET Stéphanie
Published: October 2024

BACKGROUND

The innovative concept of rapid access to the sellar region was first demonstrated by Davide Giordano, an Italian anatomist, in 1897. In the 1990s, the introduction of rigid endoscopes gave rise to the trans-sphenoidal endonasal approach. This approach is always fraught with complications, the most frequent of which is CSF leakage. Infections on dural refection material in endonasal endoscopic surgery are rarely reported in the literature. We report a case of infection of the closure fat of a CSF breach after pituitary endonasal endoscopic surgery.

CASE REPORT

A 50-year-old patient was treated for a pituitary adenoma. He presented with left temporal hemianopia, decreased visual acuity, and acute headache. MRI revealed a heterogeneous sellar lesion compressing the chiasma. Endonasal endoscopic resection was performed, followed by plasty using a bone pack and sealing the sellar turcica with the middle turbinate. The postoperative period was complicated by rhinorrhea, which required repeat surgery and plasty using fat and fascial grafts and an external lumbar bypass. A few weeks after the operation, the patient reported frontal discomfort. Cerebral MRI revealed filling of the right sphenoidal sinus with the appearance of retention. Intraoperatively, a purulent discharge from the sphenoidal meatus and a greenish pateous formation were found and removed. Anatomopathological examination revealed a lesion compatible with aspergillosis, with no signs of malignancy. Mycological examination revealed section flavi aspergillus.

CONCLUSION

The endoscopic endonasal approach is an essential component of modern minimally invasive surgery. Despite the advantages of this approach, complications are possible. Infection of the dural defect reconstruction material is rare and its risk of occurrence is correlated with the patient’s state of health and co-morbidity.
OTHR-04 PATIENT SATISIFACTION WITH NURSING CARE AMONG PEDIATRIC CANCER PATIENTS ATTENDING UGANDA CANCER INSTITUTE MULAGO KAMPALA UGANDA
Authors: Rukundo Beatrice
Published: October 2024

PURPOSE

To assess the level of patients’ satisfaction with nursing care among pediatric cancer patients attending Uganda Cancer Institute in order to improve the quality of oncology services provided by the nurses to the pediatric patients at UCI.

INTRODUCTION

Patient satisfaction is significant and usually used as an indicator for measuring the degree of excellence in health care. Patient satisfaction is the patient’s perception of care received compared with the care expected. A survey carried out by the Ministry of Health (MoH) in 2020 showed that more than half of the patients who visit Ugandan hospitals have to wait for more than an hour before they can see a health worker only to be told there’s no medicine or equipment to assist in their diagnosis. A number of studies have been conducted, however, there was little information on patients’ satisfaction with nursing care among pediatric cancer patients attending Uganda Cancer Institute and this left grey area for the researcher to conduct the study in this health facility.

METHODS

The study was done among sample size of fifty-six (56) respondents who were the caregivers of children between 0-17 years getting treatment at UCI. A cross sectional study design was used for this research, quantitative method of data collection using a questionnaire.

RESULTS

The study findings showed the respondents largely were satisfied with nursing care but problems of accessing clean water for drinking (52%), failure to give diagnostic talk (68%), no comfortable rooms for privacy (52%), nurse patient ratio at (63%) and nurses’ failure to give follow up calls (84%) were among the dissatisfactions.

CONCLUSION

The researcher concluded majority of respondents were satisfied with nursing care at UCI pediatrics nursing care. However, they expressed dissatisfactions in some crucial areas that need immediate attention of the hospital management.
OTHR-07 A DESCRIPTIVE EPIDEMIOLOGICAL PROFILE OF BRAIN TUMOURS IN CAMEROON
Authors: Atemlefac Asong , Asonganyi Tateh , Fonkem Ekokobe
Published: October 2024

Cancer is a significant threat to public health and a leading cause of morbidity across the globe. In low- and middle-income countries, the delay in diagnosis and access to treatment has contributed to the poor outcome of brain tumors. In Cameroon, epidemiological studies on brain tumors are scarce, which contributes to the lack of knowledge of the disease behavior in our local community. We conducted a descriptive epidemiological analysis based on review of patient’s records at the Cameroon Oncology Center in Douala from 1/1/2018 to 31/12/2023. A total of 2600 charts were reviewed, of which 1.9% of the patients carried a brain tumors diagnosis. Females accounted for 34(68.0%) of the cases and the mean age was 45.4 years (SD=17.9). The most recorded types of brain tumors were brain metastasis (n=25, 50.0%), glioblastoma (n=7, 14.0%), and gliomas (n=6, 12.0%). The most common clinical manifestation associated with brain tumors included headaches (n=32, 34.4%), visual disturbance (n=18, 19.4%), and motor deficit (n=15, 16.1%).In this oncology center, Adults represent the most affected population with brain tumors because most of the children were managed at specialized pediatric oncology centers, with a female: male ratio of 3:1. Brain metastasis was the common type of brain tumor, headache was the most frequent clinical presentation.
OTHR-10 CENTRAL NERVOUS SYSTEM TUMORS IN LOME, TOGO
Authors: DOLEAGBENOU Agbéko Komlan , Komlan Doléagbenou Agbéko , Ablavi Adani – Ifè , Essosimna Kpélao , HKM Ahanogbé , Komi Egu , Kader Moumouni Abdel , Anthony Békéti Katanga
Published: October 2024

INTRODUCTION

Central nervous system (CNS) is a public health issue in Togo. This study aimed to describe the characteristics and the management of CNS tumors in Togo.

METHOD

We carried out a retrospective analysis of patients seen at Sylvanus Olympio Teaching Hospital, in Lomé, with histologically proven CNS tumors, between 2027 and 2022. The following parameters were analyzed: sex, age, symptoms, neurologic status, surgical procedure, and histopathological diagnosis.

RESULTS

There were 154 (130 intracranial tumors and 24 spinal tumors) patients operated. The mean age was 39.6 ± 28.2. for intracranial tumors, patients presented with headaches (46 %) and seizures (40 %). For spinal tumors, patients were admitted with paraparesis in 48 % of cases. Meningiomas (47 %) were the most frequent intracranial tumors.

CONCLUSION

Intracranial tumors are the most frequently managed of CNS tumors in Togo.
OTHR-12 INCIDENCE, CLINICAL PRESENTATION, MANAGEMENT AND ONE- AND TWO-YEAR SURVIVAL OF PATIENTS WITH MEDULLOBLASTOMA AT INKOSI ALBERT LUTHULI CENTRAL HOSPITAL, KWAZULU NATAL PROVINCE: A TEN YEAR REVIEW
Authors: Serventi Furaha , Malloum Abba Aji , Schroeder Kristin
Published: October 2024

OBJECTIVE

Epidemiology, clinical presentation, stage and multidisciplinary treatment modalities for Medulloblastoma (Mb) at Inkosi Albert Luthuli Central Hospital (IALCH) for the 10 year period from 2003 to 2012. It also evaluated the 1 and 2 year survival rate. Methodology: Single center- retrospective study of Mb patients below the age of 18 years in a low and middle income country (LMIC) setting.

RESULTS

The 30 patients included in the study, median age was 9 years. Male to female ratio of 1.3:1. 70% were black race. Average incidence was 14 per 1000 children years. Headache was most common symptom in 70% of the patients. Majority presented with advanced non metastatic disease (T3b). All patients had shunt insertion prior to debulking surgery and 60% had gross total resection. More than half of the cases had reduced dose irradiation (30.6Gy) to the cranial and spinal compared to 36% who had 36Gy. 96% received concurrent vincristine with radiotherapy. 89.7% received adjuvant chemotherapy and 82.8% completed 6 cycles. There was not enough data to determine any trends in the different modalities of treatment offered over the period of 10 years. One year survival rate was 83.33% [95% CI 64.55; 93.70%] and probability of surviving two years was 80.00% [95% CI 60.87%; 91.60%].

CONCLUSION

Children present with advanced stages requiring multi-level surgeries. Dedicated multi-disciplinary approach to treatment conferred decent survival outcomes despite the advanced stages at presentation. Similar successes were reflected in the only other study on the subject in Cape Town in a 3 decade retrospective study between the years 1985-2005. These studies highlight the importance of implementing multidisciplinary team management in parallel with modern radiotherapy techniques to improve survival for children with medulloblastoma. Current training programs like Access to Care Capetown could further improve the outcome in countries establishing or transitioning to new radiotherapy techniques.
OTHR-16 UNVEILING THE GAMUT OF SKULL TUMORS: A CALL FOR COLLABORATIVE ONCOLOGICAL CARE IN SUB-SAHARAN AFRICA
Authors: Koko Aliyu Muhammad , Lasseini Ali
Published: October 2024

INTRODUCTION

Primary and metastatic tumours of the skull are relatively rare and have variable histological characteristics. They have been reported to represent 0.8 to 1% of all bone tumours and majority were malignant with attendant morbidity and mortality. With the current advances in neurosurgical techniques, neuroimaging and improvement in histopathological diagnosis more cases are expected to be diagnosed and treated successfully. Only few studies in literature focused on the profile and outcome of skull tumours especially in sub-Saharan Africa. This study aims to unravel the spectrum of skull tumors and describe the profile and outcome of management of skull tumours in our centre.

METHODOLOGY

We retrospectively reviewed cases of skull tumours managed in our centre between July 2015 to March 2024. Clinical parameters and histological diagnoses were noted. Data analysed using spss version 25.0 IBM.

RESULTS

We found 69 cases of skull tumours, 21 (30.4%) were benign and 48 (69.6%) were malignant. Majority (54/69, 78.2%) were males, the mean age of presentation was 28 and 50 years for benign and malignant tumours respectively. 95.6% of cases were adults. All benign tumours were osteoma, the commonest primary malignant tumour was osteosarcoma (9/48) followed by fibrosarcoma (6/48), while the most common histological subtype of metastatic tumours was adenocarcinoma. There were 4 cases of malignant sino-nasal tumours invading the frontal skull. Tumours were mostly located in the vault (66/69). All benign tumour had good post-operative recovery and malignant were managed in conjunction with plastic surgeons and radio-oncologist. No post-operative mortality recorded.

CONCLUSION

Majority of skull tumours were malignant and were seen in adult males, cranial vault was more affected compared to skull base. Synergy in oncological care will improve outcomes of care of malignant skull tumors.
PADV-01 CHALLENGES OF NEURO-ONCOLOGY CARE IN ZIMBABWE
Authors: Simemeza Tinotenda
Published: October 2024

Due to the advent of covid 19 coupled with the socio-economic crisis in Zimbabwe, this has resulted in numerous challenges in terms of health care access and resultant diagnostic and treatment barriers for neuro-oncology cases. A retrospective analysis of the burden of neuro-oncology cases which have been seen at a single center in Zimbabwe over the past 5 years and the resultant diagnostic and treatment barriers that have incurred.

METHODS

An audit of brain tumor cases was done through the analysis of Outpatient department records, Neurosurgery Admission records, and Neurosurgery theatre records at Sally Mugabe Central hospital.

RESULTS

Total number of cases recorded for the period were 71. Meningiomas 11 (15,5%), Posterior fossa tumors 12 (17%), Gliomas 6 (0.08%), Craniopharyngiomas 6(0.08%), Metastasis 5(0.07%), Pituitary tumors 4(0.06%), choroid plexus papilloma 3(0.04%), Lymphoma 2(0.03%), Pineal region tumor 1(0.01%). 21(30%) tumors were unclassified. Posterior fossa tumors were most common in the pediatric population less than 10years of age. Meningiomas had a female to male ratio of 1.75: 1. 9 (12%) patients were operated on during the same period mostly pediatric tumors.

CONCLUSION

There is a great deal of institutional as well as patient related factors affecting the diagnosing and treatment of neuro-oncology care in Zimbabwe. This includes lack of operating time, inadequate intensive care facilities, a general unavailability of medical imaging services, delay in pathological reporting, unavailability and costly adjuvant treatment. This is leading to late diagnosis and suboptimal treatment of the various tumors. Although brain tumors are rare, they are not uncommon and there is thus need to improve service delivery to ensure early diagnosis and treatment to have good outcomes.
PDOC-05 MULTIPLE ISOCENTRE VMAT PLANNING FOR PAEDIATRIC CRANIOSPINAL IRRADIATION USING THE HALCYON LINEAR ACCELERATOR
Authors: Burger Hester , Groenewald Annemari , Naiker Thurandri , Parkes Jeannette
Published: October 2024

Paediatric brain tumours constitute the leading cause of cancer specific deaths worldwide. Many patients require craniospinal irradiation (CSI), one of the most technically demanding techniques in radiotherapy. Many LMIC centres have installed Varian Halcyon® linear accelerators and require a technique to execute CSI safely. This study evaluates a multiple isocentre VMAT planning strategy for CSI. The Halcyon is a ring based linac with a single 6MV flattening filter free (FFF) photon beam, a stacked and staggered double MLC for beam shaping and modulation, and no movable collimator jaws. Multiple isocentres are required for treatment fields longer than 28 cm. Paediatric CSI requires dose to be delivered to the entire thecal sac incorporating whole brain as well as entire spinal cord, resulting in long planning target volumes. In addition to the length of the treatment field, CSI treatments are complex due to the change in geometry of the target and the patient body over the length of the treatment field. Traditional 3D conformal radiotherapy techniques (3DCRT) require multiple isocentres with field matching and junction feathering. VMAT offers an alternative, but also require multiple fields to achieve coverage. A Halcyon based three isocentre VMAT technique was investigated and evaluated according to the QUANTEC criteria. Portal dosimetry quality assurance was performed on all fields to ensure they were clinically deliverable. High quality paediatric CSI VMAT treatments can be delivered on the Halcyon, using three isocentres with automatic feathering applied in field overlap regions. Two full arcs and one support arc were used for the brain area, with two posterior partial arcs per spine isocentre, each covering a total of 140 degrees posteriorly to limit integral dose and dose to the lungs and kidneys. Imaging and setup is required for every isocentre further than 8cm/10cm (Halcyon V2/V3 respectively) from the previous isocentre.
PDOC-06 LES DÉFIS DE LA PRISE EN CHARGE DES TUMEURS CÉRÉBRALES DE L’ENFANT AU NIGER À TRAVERS 3 OBSERVATIONS
Authors: HABIBOU Mahamane Laminou , HABIBOU Djaffar , KADRE Alio
Published: October 2024

INTRODUCTION

les progrès réalisés dans la prise en charge des tumeurs cérébrales restent insuffisants au Niger et beaucoup de défis restent à surmonter. Le but de ce travail est de montrer les obstacles dans l’amélioration de la prise en charge neuro-oncologique. Materiels, méthodes et resultats: nous apportons 03 cas de tumeurs cérébrales pediatriques prises en charge dans notre formation au courant de l’année 2023. Les âges de nos patients sont de 3,4 et 7 ans. 2 de nos patients étaient issus de niveau socio-économique bas. Les délais de diagnostique radiologique va riaient d’un an à 2 mois.tous nos patients ont bénéficié d’une prise en charge chirurgicale consistant à une exerese complète. Les délais d’obtention de l’histologie variait d’un à 2 mois. Il s’agissait de meningiome meningothelial de la base du crâne avec extension endo-sinusal maxillaire, de géant lipo-sarcome et d’astrocytome pilocytique de la fosse cérébrale postérieure. Un patient nécessitant une prise en charge complémentaire a abandonné le protocole.

CONCLUSION

les défis restent multiplent ne sont pas forcément liés aux ressources économiques. Le perfectionnement de tous les praticiens de la chaîne et la création des staffs multidisciplinaires peuvent être des ébauches dans les efforts dans ce combat.
PDOC-08 THE CLINICAL CHARACTERISTICS OF CHILDREN WITH CRANIOPHARYNGIOMA AND THEIR MANAGEMENT IN UGANDA: A RETROSPECTIVE REVIEW
Authors: Katasi Victoria Mwebe , Chintagumpala Murali , Munube Deogratius , Naitala Ronald , Kasirye Phillip , Muwonge Peter , Lubega Joseph , Zungu Jennifer , Akullo Anne , Namazzi Ruth , Nakirulu Annet , Nabaggala Cathy , Ssenyonga Peter , Onen Justine , Ssekabunga Julie , Kibudde Solomon , Wegoye Emmanuel
Published: October 2024

BACKGROUND

Craniopharyngiomas are benign brain tumors that mostly arise in the sellar/suprasellar region. Histologically though benign, these tumors can locally infiltrate with involvement of surrounding structures. They have a 5-year survival rate of above 80% in High Income Countries (HIC). Craniopharyngioma management includes surgery, radiotherapy and intracystic treatments, which requires a multi-disciplinary team. The morbidity associated with treatment must be weighed against tumor recurrence and quality of life after treatment. Endocrine deficiencies, especially growth hormone deficiency and visual deficits are common presenting features.

OBJECTIVE

To describe the clinical characteristics and management of children with craniopharyngioma managed at Mulago National Referral Hospital from March 2019 to December 2023. METHODOLOGY: A retrospective descriptive study was conducted among patients< 18 years of age, admitted to the Mulago National Referral Hospital (MNRH) from March 2019 to December 2023 with a radiological diagnosis of a craniopharyngioma.

RESULTS

A total of 151 children with a diagnosis of a brain tumor during this period were identified and of these 40 (26%) were diagnosed with craniopharyngioma. The median age was 8.4 years and 22 (55%) were males. Only 2 children had maximal safe resection (sub-total resection), one of whom later received adjuvant external beam radiotherapy. Thirty-eight patients had insertion of Ommaya reservoirs as their tumors were predominantly cystic. Two patients received intracystic bleomycin and 11 received radical external beam radiotherapy. Twenty-seven patients had no additional therapy after Ommaya reservoir placement. Fifteen (39%) of the patients had endocrine deficits with hypothyroidism, hypocortisolism and growth hormone deficiency being the most common. The median follow-up time was 1.45 years. The overall survival was 67.5%, 95%CI (42.5-83.5).

CONCLUSION

Management of patients with craniopharyngioma in Uganda is mostly conservative with the aim of intervention to preserve quality of life. Limited access to radiation therapy contributed to the poorer survival compared to HIC.
PDOC-11 A STUDY TO DETERMINE THE TREATMENT OUTCOMES OF GANGLIONEUROBLASTOMA IN PEDIATRIC CANCER PATIENTS AT AIC KIJABE HOSPITAL IN KENYA
Authors: Girisa Peres , Michelle Obat , Sarah Muma , Musau Helena , Christine Mwakio
Published: October 2024

BACKGROUND

Ganglioneuroblastoma is one of neurogenic tumors characterized by an interval spectrum of differentiation with elements of both malignant neuroblastoma and benign ganglioneuroma. They are mostly diagnosed by the first decade of life with median age at diagnosis of 22-48 months.

OBJECTIVES

The main objective of this study is to determine treatment outcome of ganglioneuroblastoma in pediatric cancer patients at AIC Kijabe Hospital.

METHODOLOGY

This is a retrospective study where children diagnosed with ganglioneuroblastoma at AICKH over a period of three years have been assessed. Inclusion criteria included children from ages 0-14 years diagnosed with ganglioneuroblastoma. Data was entered in a questionnaire and was analyzed using descriptive statistical methods. Children were evaluated based on histologic tissue diagnosis, staging scans, risk stratification and monitored along the course of treatment that included during surgery, chemotherapy and radiotherapy and followed up in one year post treatment for recurrence.

RESULTS

Ganglioneuroblastoma constituted 1.3 % of all childhood malignancies diagnosed compared to the more common variant neuroblastoma with an incidence of 8-10%, mainly predominated in the males. More than 75% had remission after one-year follow up, those who died was as a result of other factors not related to the disease. Surgery and combination chemotherapy regimen COJEC administered yielded benefits in the treatment outcome. Radiotherapy was considered in high-risk tumors.

CONCLUSIONS

Ganglioneuroblastoma is commoner in older children with a median age of 3-4 years with incidence noted more in male with thoracic type tends to be a common presentation. The disease was noted to be rare after 10 years of age and generally has a good overall survival and prognosis compared to neuroblastoma.
PDOC-12 PEDIATRIC BRAIN TUMOR INCIDENCE, AND TREATMENT MODALITY AT KILIMANJARO CHRISTIAN MEDICAL CENTER
Authors: Kingazi Shammah , Majaliwa Esther , Kambainei Lossim , Gwanika Yotham
Published: October 2024

INTRODUCTION

Pediatric brain tumors (PBT) a significant health concern, they are the primary cause of cancer-related deaths among children. PBTs in Low- and Middle-Income Countries are diagnosed late due to insufficient resources. This abstract describes Pediatric Brain tumor incidence and treatment modalities at Kilimanjaro Christian Medical Center (KCMC) Cancer Care Center (CCC), Moshi, Tanzania from December 2016 to March 2024.

METHOD

Data on pediatric patients treated at the CCC between Dec. 2016 and March 2024, were analyzed. Inclusion criteria were a primary brain tumor and patients aged 0-19 at the time of diagnosis. All patients were previously diagnosed by computer tomography/ magnetic resonance imaging. Variables retrospectively collected from patient’s medical records were: demographic characteristics (age, gender, Place of residence, and insurance status), previous history of malignant diseases, incidence date, and treatment modality.

RESULTS

Total of 748 cases of pedeatric cancer were diagnosed at CCC. Of all the pediatric cancers diagnosed, brain cancer accounted for 22(2.9%). Out of these cases of brain cancer, 63.6% were males and 36.4% were females.Majority of them came within the Kilimanjaro region. 41% were palliated while 59% had a curative intent at the time of diagnosis, 22.7% died between December 2016 to March 2024.Embryonal tumors were (40.9%) with a breakdown that includes 6 Medulloblastoma and 3 cases of Craniopharyngioma (teratoid/rhabdoid), gliomas (36.4%) with sub-types such as Ependymoma, Anaplastic Astrocytoma, Pilocytic Astrocytoma, Pineocytoma, Stem glioma, and Tectal glioma, unspecified cases (13.6%), and Pineoblastoma were (9.1%). Surgery was used in 40.9% of cases, radiotherapy in 31.8%, and chemotherapy in 72.7%. Chemoradiotherapy was used in 31.8% of cases. 13.6% of cases utilized a combined approach, including chemotherapy, radiotherapy, and surgery.

CONCLUSION

PBT incidence at KCMC is 2.9%, improving access to screening, accurate diagnosis and treatment modalities are essential in identifying and managing PBT in our setting.
PDOC-16 A RETROSPECTIVE AUDIT ON PRIMARY PEDIATRIC BRAIN TUMOURS TREATED AT DR GEORGE MUKHARI ACADEMIC HOSPITAL, GA-RANKUWA, SOUTH AFRICA
Authors: Zimani Arthur
Published: October 2024

OBJECTIVE

Pediatric brain tumours are the most common solid tumours affecting 30 000-40 000 children per year worldwide. These tumours are a leading cause of morbidity and mortality in children and adolescents worldwide. A single-center retrospective audit was performed to establish the characteristics of primary pediatric brain tumours at a tertiary referral hospital in Pretoria, South Africa. The study will help with setting up efficient screening and treatment protocols for pediatric neuro-oncology guarded by the study’s findings.

METHODS

The results from the analysis of the data recorded for the 29 patients in the study are presented in this chapter. The statistical analysis was descriptive, and all the procedures were performed on SAS (SAS Institute Inc, Cary, NC, USA), Release 9.4.

RESULTS

The most common age range was 0-4 years, with males (65.5%) affected more than females (34.5%). Headaches were reported in 69% of the patients, and vomiting was observed in 93.1%. Seizures were observed in 27.6% of patients and were associated with supratentorial tumours more than infratentorial tumours. On radiological examination, 45.5% of tumours were supratentorial, and the remainder, 54.5%, were infratentorial. Hydrocephalus was observed in 93.1% of patients and is associated mostly with infratentorial tumours. Pilocytic astrocytomas were the most common histological diagnosis at 20.7%, followed in second place by medulloblastomas and pineoblastomas, both at 10.3%.

CONCLUSION

The audit results are largely consistent with published literature in terms of gender profile, mean age at diagnosis, common presenting symptoms and signs and common histopathological types of Pediatric Brain Tumours. The small sample size and lack of sufficient clinical data make it difficult to make meaningful conclusions on some of the results.
TRLR-02 TARGETING GLIOBLASTOMA MICROENVIRONMENT TO UNLEASH IMMUNE FORCES
Authors: Janowski Miroslaw
Published: October 2024

Brain cancer has persistently eluded therapeutic advances over the past three decades. Here, we aim to raise awareness of the potential differences between the cancer microenvironment within the brain vs. peripheral organ cancers, which may contribute to the therapeutic setbacks observed in brain cancer treatment. While the blood-brain barrier has long been implicated in drug impermeability, its impact on brain cancer may extend far beyond mere drug exclusion. Studies have shown that soluble factors such as VEGF are more concentrated in brain cancer than in any other malignancies. Moreover, recent studies revealed that VEGF, TWEAK, and others can also press on the immune brakes. Therefore, we hypothesize that normalizing the tumor microenvironment could pave the way for effective therapeutic interventions, especially immunotherapy. Our in vitro studies confirmed abundant production of VEGF by glioblastoma 1 (GBM1) cell line, which is exceptionally well scavenged by the anti-VEGF antibody – bevacizumab. Moreover, in vitro, co-culture of T cells and GBM1 cell line without vascular component demonstrated no therapeutic activity of bevacizumab or typical immunotherapeutic drug – anti-PD1 checkpoint inhibitor – nivolumab given in monotherapies. However, a combination of both antibodies revealed therapeutic efficacy in a dose-dependent manner in our experimental system. Currently, intravenous delivery of bevacizumab is the standard of care in patients with glioblastoma recurrence, but its effectiveness has not been proven in this group of patients. Intravenous nivolumab failed in clinical trials. Based on our observations and the negligible penetration of antibodies to the brain, we hypothesize that transiently opening the blood-brain barrier may be necessary to enhance antibody delivery to the tumor microenvironment, alleviate immune suppression, and unlock immune cell activity. Therefore, achieving high antibody concentrations in brain cancer tissue, coupled with a combination of classic checkpoint inhibitors with scavengers of soluble immunosuppressive molecules, could herald a new era of brain cancer therapy.