gms | German Medical Science

57. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

11. bis 14.05.2006, Essen

In case of reoperation of a malignant glioma pure radiation necrosis is a rarity

Reine Strahlennekrose bei Reoperationen maligner Gliome ist eine Seltenheit.

Meeting Abstract

Suche in Medline nach

  • corresponding author J.A. Seidel - Neurochirurgische Abteilung der Universität Ulm
  • K. Seitz - Neurochirurgische Abteilung der Universität Ulm
  • H.-P. Richter - Neurochirurgische Abteilung der Universität Ulm

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 57. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. Essen, 11.-14.05.2006. Düsseldorf, Köln: German Medical Science; 2006. DocP 08.103

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2006/06dgnc320.shtml

Veröffentlicht: 8. Mai 2006

© 2006 Seidel et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: Malignant cerebral gliomas have a high risk for recurrent tumour growth. In case of suspicion of a tumour recurrence after malignant cerebral glioma a wait-and-see behaviour is often observed because regrowth and radiation necrosis are difficult to distinguish. Positrone emission tomography helps to differentiate tumour recurrence from radiation necrosis.

Methods: Between March 2000 and May 2005, we operated on 40 patients with suspected tumour recurrence. All Patients had had at least one previous surgery for a cerebral tumour (anaplastic astrocytoma/oligodendroglioma WHO III or glioblastoma). All patients had received adjuvant radiotherapy before reoperation. Adjuvant chemotherapy had been performed in 23 patients.

Results: Intraoperative tissue samples from all 40 patients were examined histopathologically and patients could be divided into five groups as follows: Pure tumour tissue (14 patients), mixture of recurrent tumour and radiation necrosis (16), extensive radiation necrosis and isolated tumour cells (7), pure radiation necrosis (2) and normal brain tissue (1).

Two patients had to be excluded from the follow-up (at least 12 months) because they were just re-operated. Patients with pure tumour tissue (group 1) showed in 79% (11/14) a definite recurrence, patients with a mixture of recurrent tumour and radiation necrosis (group 2) in 81% (13/16) and patients with extensive radiation necrosis and isolated tumour cells (group 3) in 80% (4/5). So there is no difference in probability of a new tumour growth among these three groups. And also two of those three cases where no tumour cells were discovered later on showed a tumour growth. 11C-Methionine PET was performed in 8 cases before reoperation. In seven patients the suspected formation showed an uptake highly suspicious of tumour tissue.

Conclusions: In our experience in case of reoperation of a malignant glioma pure radiation necrosis is a rarity. Mostly, at least some tumour cells are detected. For that reason in every suspicion of recurrence the wait-and-see behaviour is questionable. Whenever tumour recurrence is assumed, we recommend an early reoperation if indicated and chemotherapy in all cases.