Cerebellar cortex lesions in cases with subtentorial neoplastic changes.
The aim of the study was to perform neuropathological examinations of the brains of children and adults with various types of neoplasms situated in the subtentorial area. In view of the varied opinions on the central nervous system (CNS) lesions in the course of neoplastic diseases, it was interesting to analyze the cerebellar cortex damage. The study material included fifteen primary tumors in children and fourteen tumors in adults. In the former, two primary and three metastatic tumors were treated with irradiation and chemotherapy (ChTh). In the remaining cases such a treatment was not employed because of the clinical course of the disease. Among adult cases, eight primary and six metastatic tumors were observed. In all metastatic cases irradiation and ChTh were used, other primary tumors were untreated because of the short follow-up period. In all the investigated cases, cerebellar cortex damage was observed. Except for lesions surrounding the neoplastic proliferation, two types of changes were found: one with a prevalence of Purkinje cell loss was similar to the first type of paraneoplastic cerebellopathy, while in the other a granular cell layer lesions predominated. In the entire material the changes were particularly severe in the children, mostly in those with the damage of the granular cell layer, contrary to the prevalent opinions that the CNS damage in the course of neoplastic diseases is more common in adults. Another interesting observation was that the changes did not correlate with the type of tumor and the employed therapy. The results of this study may be interesting for clinicians who perform neurological examinations in pediatric long-survivors of subtentorial tumors.
Dambska
Maria
M
Department of Developmental Neuropathology, Medical Research Center, Polish Academy of Sciences, Warszawa.
Raczkowska
Barbara
B
D000293:Adolescent; D000328:Adult; D000368:Aged; D016588:Anticarcinogenic Agents / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000473:pathology* / Q000628:therapy; D002525:Cerebellar Cortex / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D008875:Middle Aged; D009410:Nerve Degeneration / Q000473:pathology*; D011689:Purkinje Cells / Q000473:pathology; D011878:Radiotherapy
D016588:Anticarcinogenic Agents