Acute cerebral hemorrhage mimicking glioblastoma on intraoperative magnetic resonance imaging: A case report

Intraoperative magnetic resonance imaging (iMRI) is important in neurosurgical practice, especially for glioma surgery. However, the well-reported possibility to mistake lesions for brain tumors (tumor mimics) with MRI also exists for iMRI. Here, we first report a case of glioblastoma with acute cerebral hemorrhage that mimicked a newly emerged brain tumor on iMRI. A 53-year-old man underwent a second surgery for recurrent glioblastoma. Intraoperatively, iMRI revealed a new, enhanced lesion near the resected area that was absent on preoperative MRI and difficult to differentiate from newly emerged tumors. Here, a recent preoperative MRI was helpful and the new lesion was actually a hematoma. Neurosurgeons must understand that, as acute intracerebral hemorrhaging can mimic brain tumors on iMRI, preoperative MRI should be conducted just before surgery to place iMRI findings in proper context and avoid unnecessary resections.

Imaging Mimics of Brain Tumors

Nonneoplastic entities may closely resemble the imaging findings of primary or metastatic intracranial neoplasia, posing diagnostic challenges for the referring provider and radiologist. Prospective identification of brain tumor mimics is an opportunity for the radiologist to add value to patient care by decreasing time to diagnosis and avoiding unnecessary surgical procedures and medical therapies, but requires familiarity with mimic entities and a high degree of suspicion on the part of the interpreting radiologist. This article provides a framework for the radiologist to identify "brain tumor mimics," highlighting imaging and laboratory pearls and pitfalls, and illustrating unique and frequently encountered lesions.

Imaging of Upper Limb Tumors and Tumorlike Pathology

Bone and soft tissue sarcomas are uncommon tumors that can occur within the upper extremity as well as elsewhere within the body. However, certain histopathological subtypes have increased affinity for the upper limb and even certain sites within the arm and hand. Other benign masses and tumor mimics, such as infection and traumatic lesions, are more common and imaging appearances can sometimes overlap with malignant lesions making diagnosis difficult. In this article, we explore the current options for imaging of these lesions as well as typical imaging appearances of the more common upper limb tumors.

Embedded multicellular spheroids as a biomimetic 3D cancer model for evaluating drug and drug-device combinations

Multicellular aggregates of cells, termed spheroids, are of interest for studying tumor behavior and for evaluating the response of pharmacologically active agents. Spheroids more faithfully reproduce the tumor macrostructure found in vivo compared to classical 2D monolayers. We present a method for embedding spheroids within collagen gels followed by quantitative and qualitative whole spheroid and single cell analyses enabling characterization over the length scales from molecular to macroscopic. Spheroid producing and embedding capabilities are demonstrated for U2OS and MDA-MB-231 cell lines, of osteosarcoma and breast adenocarcinoma origin, respectively. Finally, using the MDA-MB-231 tumor model, the chemotherapeutic response between paclitaxel delivery as a bolus dose, as practiced in the clinic, is compared to delivery within an expansile nanoparticle. The expansile nanoparticle delivery route provides a superior outcome and the results mirror those observed in a murine xenograft model. These findings highlight the synergistic beneficial results that may arise from the use of a drug delivery system, and the need to evaluate both drug candidates and delivery systems in the research and preclinical screening phases of a new cancer therapy development program.