Intracranial meningiomas and neurofibromatosis type 2

Purpose

In spite of the few clinical studies regarding the occurrence of intracranial meningiomas, their prognosis in neurofibromatosis type 2 (NF2) has not been accurately assessed and their management remains controversial. This study aims to compare NF2 patients with intracranial meningiomas to those without, and consequently to identify prognostic factors in attempt to improve the management of these tumors.

Methods

This retrospective study includes a total of 80 NF2 patients followed at Lille Hospital Center between 1987 and 2011. The diagnosis of NF2 was confirmed either because the patient met the Manchester criteria or by the presence of genetic mutation. Clinical, radiological and genetic data were retrospectively recorded and analyzed. Patients underwent annual cranial and spinal MRI. Both location and size of each tumor were reported.

Results

The mean follow-up period was 8.8 years (range 1–24 years; SD: ±0.8) and the mean age at diagnosis was 27.2 years (range 6–73 years; SD: ±1.7). Among all patients, 34 harbored intracranial meningiomas. Patients with intracranial meningiomas had a higher number of intracranial schwannomas, spinal tumors and cutaneous tumors (p?<?0.05). They underwent more surgical procedures (p?<?0.012). Twenty five intracranial meningiomas were surgically removed in 17 patients. The decision to perform surgery was taken in 10 cases for symptomatic tumors and in 15 cases for growing asymptomatic tumors determined by radiology. The histological analysis found a high rate of fibroblastic, transitional or grade 2 meningiomas preferentially located at the cerebri falx.

Conclusion

Intracranial meningiomas are common in NF2. They are associated with poor prognosis factors. Clinical and radiological monitoring could lead to early treatment of these tumors both when clinical symptoms are present and in case of proven radiological evolution, and thus trying to maintain a favorable functional prognosis for as long as possible.     

Traitement chirurgical des métastases vertébrales

The multiplicity of clinical presentations and the lack of consensus explain that the treatment of spine metastasis remains controversial. Optimal treatment requires a truly multidisciplinary approach, involving oncologists, interventional radiologists, radiation oncologists, rheumatologists and spine surgeons. Recent progress in all these areas have allowed to provide safe and effective therapeutic solutions tailored to each situation. We remind, in this work, the main progress in the surgical field, specifying the role of surgery in the current therapeutic arsenal.     

Non Hodgkin's lymphoma and chronic hepatitis C virus infection: a non-fortuitous association. Two case reports

Many authors suggest the role of hepatitis C virus (HCV) infection in the pathology of B-cell non Hodgkin's lymphomas; this is based on epidemiological, physiopathological and therapeutic arguments. The frequency of the association with hepatitis C virus infection is variable in the different study (1 to 30%). We report two cases of hepatitis C virus infection in association with non Hodgkin's lymphomas. The first case presented a low grad splenic and nodal non-Hodgkin's lymphoma associated with hepatitis C virus infection and complicated by hepato-cellular carcinoma. The second case presented a high grad nodal non-Hodgkin's lymphoma associated with HCV infection. Our cases report confirms the hypothesis of a key role of hepatitis C virus in the pathogenesis of B-cell lymphoproliferative disorders and in particular the non-Hodgkin's lymphoma. Although of several hypothesis concerning the ethiopathogenic mechanisms of this association, new studies will necessary to improve the real mechanism of this association     

Susceptibility of Neisseria gonorrhoeae to antimicrobial peptides from amphibian skin, dermaseptin, and derivatives

We evaluated the antimicrobial effect of antimicrobial peptides from frog skin belonging to the dermaseptin family against reference and clinical Neisseria gonorrhoeae strains, including penicillin-resistant strains. Dermaseptin S4 exhibited anti-N. gonorrhoeae activity against all strains with MICs ranging between 10 and 100 microg/mL. We then used derivatives of DS4 and determined the anti-N. gonorrhoeae activity of each of analogs. All the derivatives showed antimicrobial activity. Among the different molecules tested, we found that dermaseptins K4S4 (1-16)a and K4S4 (1-28) were the more potent to inhibit N. gonorrhoeae growth with MIC of 10 microg/mL against all strains.