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Shaikh S, Othman H, Marriyam I, Nagaraju S, Kovacevic G, Dardis R. Intratumoral and Peritumoral Brain Abscess Concomitant with Glioblastoma: Report of Two Cases with Review of Literature. Asian J Neurosurg 2022; 17:310-316. [PMID: 36120638 PMCID: PMC9473804 DOI: 10.1055/s-0042-1750384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Intracranial abscess coexistent with a high grade glioma, without prior surgical intervention, is an unusual occurrence. This paper presents two such cases with
Nocardia farcinica
abscess surrounding the glioblastoma in an immunocompromised individual and
Enterococcus faecium
abscess within the glioblastoma in an immunocompetent patient. Adjuvant therapy was tapered as per each patient's clinical response. Till date, only eight cases of coexistent high-grade glioma and brain abscess have been reported in literature. This report stands distinct in highlighting the need to radiologically evaluate each foci of a multicentric cranial lesion on its own merit.
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Affiliation(s)
- Salman Shaikh
- Department of Neurosurgery, University Hospital Coventry and Warwickshire, Coventry, United Kingdom
| | - Hassan Othman
- Department of Neurosurgery, University Hospital Coventry and Warwickshire, Coventry, United Kingdom
| | - Iqra Marriyam
- Department of Neurosurgery, University Hospital Coventry and Warwickshire, Coventry, United Kingdom
| | - Santhosh Nagaraju
- Department of Pathology, University Hospital Birmingham, Birmingham, United Kingdom
| | - Gorana Kovacevic
- Department of Infectious Diseases, University Hospital Coventry and Warwickshire, Coventry, United Kingdom
| | - Ronan Dardis
- Department of Neurosurgery, University Hospital Coventry and Warwickshire, Coventry, United Kingdom
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2
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Rashed S, Vassiliou A, Ogborne R, McKenna G. Meningioma-associated abscess: an unusual case report and review of the literature. J Surg Case Rep 2022; 2022:rjab582. [PMID: 35047170 PMCID: PMC8763611 DOI: 10.1093/jscr/rjab582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 11/19/2021] [Accepted: 11/29/2021] [Indexed: 11/18/2022] Open
Abstract
Central nervous system (CNS) infection and neoplasm occur most often independently. Their concomitant presentation has been noted across different CNS tumours but is considered a rare entity. The phenomenon is mostly seen in relation to direct seeding of infection via frontal air sinuses. Here, we present an unusual case of an occipital meningioma associated with intraparenchymal paratumoural abscess formation. It is also the second documented to culture methicillin-susceptible Staphylococcus aureus. We then review and surmise the relevant literature of meningioma-associated abscess. We discuss the clinical presentations, aetiology, suspected pathogenesis, management and outcomes reported.
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Affiliation(s)
- Sami Rashed
- Neurosurgical Department, Royal London Hospital, London, UK
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3
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Bose RJC, Tharmalingam N, Garcia Marques FJ, Sukumar UK, Natarajan A, Zeng Y, Robinson E, Bermudez A, Chang E, Habte F, Pitteri SJ, McCarthy JR, Gambhir SS, Massoud TF, Mylonakis E, Paulmurugan R. Reconstructed Apoptotic Bodies as Targeted "Nano Decoys" to Treat Intracellular Bacterial Infections within Macrophages and Cancer Cells. ACS NANO 2020; 14:5818-5835. [PMID: 32347709 PMCID: PMC9116903 DOI: 10.1021/acsnano.0c00921] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Staphylococcus aureus (S. aureus) is a highly pathogenic facultative anaerobe that in some instances resides as an intracellular bacterium within macrophages and cancer cells. This pathogen can establish secondary infection foci, resulting in recurrent systemic infections that are difficult to treat using systemic antibiotics. Here, we use reconstructed apoptotic bodies (ReApoBds) derived from cancer cells as "nano decoys" to deliver vancomycin intracellularly to kill S. aureus by targeting inherent "eat me" signaling of ApoBds. We prepared ReApoBds from different cancer cells (SKBR3, MDA-MB-231, HepG2, U87-MG, and LN229) and used them for vancomycin delivery. Physicochemical characterization showed ReApoBds size ranges from 80 to 150 nm and vancomycin encapsulation efficiency of 60 ± 2.56%. We demonstrate that the loaded vancomycin was able to kill intracellular S. aureus efficiently in an in vitro model of S. aureus infected RAW-264.7 macrophage cells, and U87-MG (p53-wt) and LN229 (p53-mt) cancer cells, compared to free-vancomycin treatment (P < 0.001). The vancomycin loaded ReApoBds treatment in S. aureus infected macrophages showed a two-log-order higher CFU reduction than the free-vancomycin treatment group. In vivo studies revealed that ReApoBds can specifically target macrophages and cancer cells. Vancomycin loaded ReApoBds have the potential to kill intracellular S. aureus infection in vivo in macrophages and cancer cells.
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Affiliation(s)
- Rajendran J C Bose
- Department of Radiology, Molecular Imaging Program at Stanford (MIPS), Stanford University School of Medicine, Stanford University, 3155 Porter Drive, Palo Alto, California 94305, United States
| | - Nagendran Tharmalingam
- Infectious Disease Division, Department of Medicine, Rhode Island Hospital and Alpert Medical School of Brown University, Brown University, Providence, Rhode Island 02903, United States
| | - Fernando J Garcia Marques
- Department of Radiology, Canary Center at Stanford for Cancer Early Detection, Stanford University School of Medicine, Stanford University, 3155 Porter Drive, Palo Alto, California 94305, United States
| | - Uday Kumar Sukumar
- Department of Radiology, Molecular Imaging Program at Stanford (MIPS), Stanford University School of Medicine, Stanford University, 3155 Porter Drive, Palo Alto, California 94305, United States
| | - Arutselvan Natarajan
- Department of Radiology, Molecular Imaging Program at Stanford (MIPS), Stanford University School of Medicine, Stanford University, 3155 Porter Drive, Palo Alto, California 94305, United States
| | - Yitian Zeng
- Department of Radiology, Molecular Imaging Program at Stanford (MIPS), Stanford University School of Medicine, Stanford University, 3155 Porter Drive, Palo Alto, California 94305, United States
| | - Elise Robinson
- Department of Radiology, Molecular Imaging Program at Stanford (MIPS), Stanford University School of Medicine, Stanford University, 3155 Porter Drive, Palo Alto, California 94305, United States
| | - Abel Bermudez
- Department of Radiology, Canary Center at Stanford for Cancer Early Detection, Stanford University School of Medicine, Stanford University, 3155 Porter Drive, Palo Alto, California 94305, United States
| | - Edwin Chang
- Department of Radiology, Molecular Imaging Program at Stanford (MIPS), Stanford University School of Medicine, Stanford University, 3155 Porter Drive, Palo Alto, California 94305, United States
| | - Frezghi Habte
- Department of Radiology, Molecular Imaging Program at Stanford (MIPS), Stanford University School of Medicine, Stanford University, 3155 Porter Drive, Palo Alto, California 94305, United States
| | - Sharon J Pitteri
- Department of Radiology, Canary Center at Stanford for Cancer Early Detection, Stanford University School of Medicine, Stanford University, 3155 Porter Drive, Palo Alto, California 94305, United States
| | - Jason R McCarthy
- Masonic Medical Research Institute, 2150 Bleecker Street, Utica, New York 13501, United States
| | - Sanjiv S Gambhir
- Department of Radiology, Molecular Imaging Program at Stanford (MIPS), Stanford University School of Medicine, Stanford University, 3155 Porter Drive, Palo Alto, California 94305, United States
- Department of Radiology, Canary Center at Stanford for Cancer Early Detection, Stanford University School of Medicine, Stanford University, 3155 Porter Drive, Palo Alto, California 94305, United States
| | - Tarik F Massoud
- Department of Radiology, Molecular Imaging Program at Stanford (MIPS), Stanford University School of Medicine, Stanford University, 3155 Porter Drive, Palo Alto, California 94305, United States
| | - Eleftherios Mylonakis
- Infectious Disease Division, Department of Medicine, Rhode Island Hospital and Alpert Medical School of Brown University, Brown University, Providence, Rhode Island 02903, United States
| | - Ramasamy Paulmurugan
- Department of Radiology, Molecular Imaging Program at Stanford (MIPS), Stanford University School of Medicine, Stanford University, 3155 Porter Drive, Palo Alto, California 94305, United States
- Department of Radiology, Canary Center at Stanford for Cancer Early Detection, Stanford University School of Medicine, Stanford University, 3155 Porter Drive, Palo Alto, California 94305, United States
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Takayasu T, Yamasaki F, Shishido T, Takano M, Maruyama H, Sugiyama K, Kurisu K. Abscess Formation in Metastatic Brain Tumor with History of Immune Checkpoint Inhibitor: A Case Report. NMC Case Rep J 2019; 6:11-15. [PMID: 30701149 PMCID: PMC6350031 DOI: 10.2176/nmccrj.cr.2018-0126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 08/11/2018] [Indexed: 12/05/2022] Open
Abstract
We present the case of a 68-year-old man with brain metastasis from lung cancer and a history of immune checkpoint inhibitor administration, with overlapping abscess within the metastatic lesion. He initially received antibiotic treatment under a diagnosis of brain abscess because of a hyper-intense area on diffusion-weighted imaging inside the gadolinium-enhanced wall. The size of the enhanced lesion did not change much, but the extent of perifocal edema decreased after antibiotic treatment. After 2–4 months, the lesion gradually enlarged, and imaging characteristics changed from single cyst to multiple cysts. Surgical resection was performed and pathological examination revealed the lesion as metastasis from the lung tumor. Smear preparation of the tumor contents detected Gram-positive bacilli, confirming the dual pathology of metastasis and brain abscess. Discussing the pathogenesis, we speculated that therapy with durvalumab (MEDI4736), an anti-PD-L1 antibody, induced immune status modification including immunosuppressive regulation, which might have promoted abscess formation.
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Affiliation(s)
- Takeshi Takayasu
- Department of Neurosurgery, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Hiroshima, Japan
| | - Fumiyuki Yamasaki
- Department of Neurosurgery, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Hiroshima, Japan
| | - Takeo Shishido
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Hiroshima, Japan
| | - Motoki Takano
- Department of Neurosurgery, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Hiroshima, Japan
| | - Hirofumi Maruyama
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Hiroshima, Japan
| | - Kazuhiko Sugiyama
- Department of Clinical Oncology & Neuro-oncology Program, Hiroshima University Hospital, Hiroshima, Hiroshima, Japan
| | - Kaoru Kurisu
- Department of Neurosurgery, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Hiroshima, Japan
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Costa MS, Holderbaum CS, Wagner GP. Avaliação Neuropsicológica em Pacientes com Tumores Cerebrais: revisão sistemática da literatura. REVISTA DE PSICOLOGIA DA IMED 2018. [DOI: 10.18256/2175-5027.2018.v10i2.2676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Os tumores cerebrais (TC) são causados pelo crescimento anormal de células. As consequências dos TC podem envolver prejuízos físicos, cognitivos e emocionais. Objetiva-se identificar e descrever os prejuízos cognitivos associados aos TC, através de uma revisão sistemática da literatura. As buscas realizaram-se nas bases de dados internacionais PubMed/MEDLINE, LILACS, e SCOPUS, incluindo abstracts de artigos publicados de 2006 a 2016. Encontrou-se 501 artigos desses, 31 cumpriram os critérios de inclusão. Os TC, representam 5% das neoplasias, sendo alguns mais agressivos que outros. Apresenta-se como sintomas severos: déficits cognitivos, motores. A avaliação neuropsicológica auxilia na identificação de possíveis alterações cognitivas e no acompanhamento dos efeitos do tratamento, contribuindo para melhor qualidade de vida desses pacientes. Os resultados encontrados indicaram as Escalas Wechsler de Inteligência; Matrizes Progressivas de Raven, Figuras Complexas de Rey, Teste de Retenção Visual de Benton, e Token Test como os mais utilizados, e que evidenciaram como prejuízos os envolvendo a memória, a atenção e funções executivas. A localização mais frequente destes TC eram as regiões frontais e temporais e os gliomas o tipo de tumor mais investigado.
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Abscess within a Glioblastoma: Mimicking a Matryoshka Doll. World Neurosurg 2018; 113:146-152. [PMID: 29454130 DOI: 10.1016/j.wneu.2018.02.036] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 02/05/2018] [Accepted: 02/06/2018] [Indexed: 11/23/2022]
Abstract
BACKGROUND Abscess coexisting within a brain tumor is rare. Case reports in the literature primarily consist of sellar pathology and parenchymal lesions, including meningioma, glioma, and metastases. We report a case of glioblastoma with an intratumoral abscess in a middle-aged patient with no prior invasive procedure or systemic focus of infection. CASE DESCRIPTION A 45-year-old woman presented with new-onset generalized seizures and rapidly progressive left hemiparesis. Imaging showed a right frontal necrotic lesion with a peripherally enhancing wall and solid component posteriorly. There was no diffusion restriction within the lesion. She was afebrile, and there was no systemic focus of infection. With provisional diagnosis of malignant glioma, she underwent surgical resection of the lesion. A differential diagnosis of abscess was considered preoperatively because of the rapid increase in size of the lesion. At surgery, there was a pus-filled cavity with a few areas of grayish, soft, flimsy wall and thrombosed veins. This raised a strong suspicion of a coexisting abscess within a malignant glioma, which was confirmed by histopathologic and microbiologic examination. CONCLUSIONS It is important for neurosurgeons to be aware of this rare entity. The treatment protocol remains controversial and is primarily guided by expert opinion. It is important to aggressively treat the patient with antibiotics followed by adjuvant therapy for malignancy. The timing and administration of adjuvant therapy are unclear. We suggest a delay of chemotherapy until at least 4 weeks of therapy with sensitive antibiotics.
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Ignjatović J, Stojanov D, Radovanović Z, Ignjatović N, Benedeto-Stojanov D, Đorđević M, Aracki-Trenkić A, Stokanović V, Milojković B, Lazović L. DIAGNOSTIC VALUE OF DIFFUSION-WEIGHTED IMAGING AND APPARENT DIFFUSION COEFFICIENT IN PREOPERATIVE ASSESSMENTS OF BRAIN ABSCESSES. ACTA MEDICA MEDIANAE 2016. [DOI: 10.5633/amm.2016.0407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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