Gliomas with intratumoral abscess formation: Description of new cases, review of the literature, and the role of 99mTC-Leukoscan

Abstract Abscess formation within a brain tumor is uncommon. Intrasellar or parasellar tumors are the most common neoplasms that develop such complications. Cerebral gliomas with abscesses are extremely rare. In this paper three rare cases of glioma associated with abscess formation are described. The diagnosis of brain tumor associated with abscess is particularly difficult by conventional neuroradiological studies. 99m Tc-labeled sulesomab can be useful in the diagnosis of brain tumors with intratumoral abscesses. There are no precise guidelines for the diagnosis and treatment of cerebral gliomas associated with abscesses formation for the low number of cases reported to date. Appropriate treatment, aimed at radical surgery, and a suitable antibiotic-protocol, deferring adjuvant postoperative therapy, is associated with a more favorable outcome. A review of the pertinent literature is also performed

Oxidative Stress: Harms and Benefits for Human Health

Oxidative stress is a phenomenon caused by an imbalance between production and accumulation of oxygen reactive species (ROS) in cells and tissues and the ability of a biological system to detoxify these reactive products. ROS can play, and in fact they do it, several physiological roles (i.e., cell signaling), and they are normally generated as by-products of oxygen metabolism; despite this, environmental stressors (i.e., UV, ionizing radiations, pollutants, and heavy metals) and xenobiotics (i.e., antiblastic drugs) contribute to greatly increase ROS production, therefore causing the imbalance that leads to cell and tissue damage (oxidative stress). Several antioxidants have been exploited in recent years for their actual or supposed beneficial effect against oxidative stress, such as vitamin E, flavonoids, and polyphenols. While we tend to describe oxidative stress just as harmful for human body, it is true as well that it is exploited as a therapeutic approach to treat clinical conditions such as cancer, with a certain degree of clinical success. In this review, we will describe the most recent findings in the oxidative stress field, highlighting both its bad and good sides for human health

High grade gliomas associated with abscess: description of a rare case and role of 99mTc-Leukoscan

Aim: Intrasellar or parasellar tumors are among the most common neoplasms that develop abscess as complication, due to direct extension of microbial flora from contiguous sinuses. Abscess formation within a brain tumor is uncommon. We describe an extremely rare case of high grade glioma associated with abscess formation. Material and Methods: The patient was a 50 year old woman with a recent history of epileptic seizures, fever and headache. Haematologic examination demonstrated leukocytosis and elevated C-reactive protein. Magnetic Resonance (MR) obtained before and after contrast medium administration revealed a lesion (> 3 cm in size) in the right temporo-parietal region consistent with brain abscess. Instead, MR spectroscopy (MRS) was conclusive for brain tumor. Patient underwent 99mTc-Leukoscan study of the brain obtained 4 and 24 hours after tracer administration (555 MBq) by dual-headed gamma camera equipped with low-energy high-resolution parallel-hole collimator (LEHRPAR). Scans were performed by planar (anterior, posterior and lateral views; magnification 1, matrix 256x256; 900 seconds per frame) and tomographic images (SPET; magnification 1, matrix 128x128; 180° rotation, a 3° step and shoot technique; 30s per frame). The study showed abnormal and non-homogeneous uptake of the tracer in the right temporo-parietal region corresponding to MR lesion and consistent with brain abscess. Craniotomy was performed and the lesion was totally removed. Histopathological examination permitted a diagnosis of glioblastoma with intralesion abscess. Conclusion: This extremely rare case demonstrated that the presence of brain abscess does not rule out cancer. The diagnosis of brain tumor associated with abscess is particularly difficult by conventional neuroradiological studies. Leukoscan can be useful in the diagnosis of brain abscesses and in differential diagnosis of cyst lesion and/or cystic brain tumor