Osseous metastasis of pineoblastoma: a case report and review of the literature.
ABSTRACT To review the literature on the occurrence of osseous metastases in recurrent pineoblastoma, and to report upon the feasibility and efficacy of treatment using intensive conventional chemotherapy to achieve a remission, followed by consolidation with marrow ablative chemotherapy and autologous hemopoietic stem cell rescue.
An adult with isolated extraneural, osseous and bone marrow metastases from a pineoblastoma, received conventional cyclical chemotherapy, followed by consolidation with marrow ablative chemotherapy (thiotepa, carboplatin and temozolomide) and autologous hemopoietic stem cell rescue.
A complete radiographic and histopathologic response was achieved after almost one year of conventional chemotherapy that was tolerated without significant sequelae. Following successful harvesting of peripheral blood stem cells, the patient underwent myeloablative chemotherapy with autologous stem cell rescue, without difficulty in hemopoietic reconstitution and without serious or permanent side effects.
Osseous metastases from pineoblastoma are an extremely rare occurrence. We conclude that conventional chemotherapy can achieve a complete response, and subsequent consolidation with marrow ablative chemotherapy and autologous hemopoietic stem cell rescue is feasible and well tolerated.
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ABSTRACT: Practically, the idea of P-V and Q-V curve is used to determine the maximal reactive margin at load buses to avoid voltage instability. Sometimes the voltage stability study may be limited to identify the violation of the bus voltage constraints. In this paper the p-q curve for the critical bus voltage magnitude is created. Using this p-q curve the probability of the critical voltage violation is estimated for uniformly distributed active and reactive power at a given load bus. The p-q curve is created on the basis of bus impedance, which can be measured or calculated. To illustrate the usefulness of p-q idea the simple numerical example is presented.Power Systems Conference and Exposition, 2004. IEEE PES; 11/2004
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ABSTRACT: The nonhematopoietic tumors most often diagnosed in the bone marrow are metastatic. Currently, accurate diagnosis of tumor metastasis requires integration of the clinical findings; morphological features; and results of immunohistochemical stains, cytogenetics, and molecular studies. This review focuses on a practical approach to the diagnosis of metastatic tumors in the bone marrow according to current standards of practice and discusses recent advances in understanding of tumor metastasis and the interaction between tumors and the bone marrow environment.Annals of Diagnostic Pathology 07/2006; 10(3):169-92. DOI:10.1016/j.anndiagpath.2006.04.001 · 1.11 Impact Factor
Article: Management of pineal region tumors.[Show abstract] [Hide abstract]
ABSTRACT: Tumors of the pineal region represent a diverse collection of tumors with a variety of natural histories. This diversity necessitates accurate histologic diagnosis to allow rational therapeutic planning. Evaluation of a pineal lesion should begin with craniospinal MRI and analysis of the cerebrospinal fluid (CSF). Whereas certainty of the histologic diagnosis is now a requirement for treatment in Western nations, some Asian centers continue to recommend a test dose of radiation therapy based on the high incidence of germinoma in those countries. If there is high clinical suspicion of a germinoma or tectal glioma, stereotactic or endoscopic biopsy may be pursued. All other lesions should be referred for open biopsy with microsurgical techniques. This approach provides adequate tissue for diagnosis, may be curative in low-grade tumors, and may substantially improve survival in patients with malignant tumors. If open surgery is not desired by the patient or practitioner, stereotactic or endoscopic biopsy may be followed by radiosurgery for localized, well-demarcated tumors. Radiation therapy is the first-line therapy for germinomas. Although the optimal radiation dosage and volume have not been decided, the current Children's Oncology Group trial may offer definitive evidence to address this dilemma in germ cell tumors. Evidence of CSF seeding requires craniospinal radiation and adjuvant chemotherapy regardless of tumor type. Diagnosis of any of the malignant tumors (non-germ cell tumors, pineoblastomas, and parenchymal tumors of intermediate determination) also requires craniospinal radiation (with local tumor doses of at least 50 Gy) and adjuvant chemotherapy (generally platinum based). Patients with tectal gliomas may undergo excision with or without postoperative radiation; however, they also may be observed with vigilant follow-up alone.Current Treatment Options in Oncology 12/2006; 7(6):505-16. DOI:10.1007/s11864-006-0025-6 · 3.24 Impact Factor