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Conference Presentations by Ibrahim C. Saikali
Curr. Oncol. 2021, 28, 1274-1279, 2021
Citation: Assi, H.I.; Kakati, R.T.; Berro, J.; Saikali, I.; Youssef, B.; Hourany, R.; Alameh, I.;... more Citation: Assi, H.I.; Kakati, R.T.; Berro, J.; Saikali, I.; Youssef, B.; Hourany, R.; Alameh, I.; Tabbarah, A.; Khoury, J.; Darwish, H.; et al. PTEN R130Q Papillary Tumor of the Pineal Region (PTPR) with Chromosome 10
Case presentation: A 40 year-old lady was diagnosed in February 2005 with a large choroid plexus ... more Case presentation: A 40 year-old lady was diagnosed in February 2005 with a large choroid plexus papilloma of the right lateral ventricle with small drop metastases in the posterior fossa and along the spinal cord. She underwent surgical resection of the primary tumor and received radiation therapy to the neuraxis (36 Gy CSI and 51.6 Gy to the tumor bed). Her disease remained stable for two years.
She presented with clinical worsening and radiological multifocal progression she received two cycles of nitrosourea without response. This was changed to combination chemotherapy with ifosfamide, carboplatin and etoposide.
Radiological and clinical stabilization were attained following three cycles, unfortunately progression was documented after the fifth cycle. Further surgeries were required for rapidly growing and symptomatic right cerebellopontine angle, dorsal brainstem, and cervical spinal metastases excision and finally for ventriculoperitoneal shunting.
In this setting of previous craniospinal irradiation, significant chemotherapy toxicity and only short-lived stabilization of the disease, bevacizumab was offered as single agent treatment in an attempt to spare further toxicities. She was treated with 5 mg/kg of bevacizumab every two weeks and achieved only radiological stabilization initially but an excellent clinical response after two treatments. Minimal radiological improvement was seen with subsequent MRI scans at 5 months.
Literature search did not yield any case of choroid plexus tumor treated with bevacizumab; we are reporting the first case. Although there was only minimal radiological improvement initially further response was seen with additional therapy. Bevacizumab seems to have some activity in this subtype of richly vascularized tumors and may be worth further evaluation in combination with chemotherapy.
Papers by Ibrahim C. Saikali
World Neurosurgery, Feb 1, 2019
Current Oncology, Mar 20, 2021
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Journal of Neurosurgery, Jul 1, 2002
Annals of Pediatric Surgery
Background Yolk sac tumor or endodermal sinus tumor is an uncommon malignant germ cell neoplasm. ... more Background Yolk sac tumor or endodermal sinus tumor is an uncommon malignant germ cell neoplasm. This tumor usually presents in childhood or young adulthood as a testicular or ovarian mass. Extragonadal sites such as mediastinal, intracranial, and sacrococcygeal have been described. A review of the literature revealed limited related cases. The clinical presentation, radiographic characteristics, operative findings, and patient outcomes are discussed. Case presentation We report the occurrence of a primary paraspinal germ cell tumor in a 28-month-old boy who presented with thoracic spinal cord compression. The patient presented with pain, weakness, paraplegia, and bowel and bladder disturbances. MRI was done and showed a retroperitoneal and paravertebral mass invading the left diaphragmatic crus, the lateral neural foramen, and the posterior paravertebral muscles. Morphologic and immunohistochemical features were consistent with a germ cell tumor, namely an endodermal sinus tumor (y...
Current Oncology, 2021
Papillary tumors of the pineal region (PTPR) can be observed among adults with poor prognosis and... more Papillary tumors of the pineal region (PTPR) can be observed among adults with poor prognosis and high recurrence rates. Standards of therapy involve total surgical excision along with radiation therapy, with no promising prospects for primary adjuvant chemotherapy, as long-term treatment options have not been explored. Chromosome 10 loss is characteristic of PTPR, and PTEN gene alterations are frequently encountered in a wide range of human cancers and may be treated with mTORC1 inhibitors such as everolimus. In parallel, there are no reports of treating PTPR with everolimus alone as a monopharmacotherapy. We report the case of a patient diagnosed with PTPR (grade III) characterized by a PTEN R130Q alteration with chromosome 10 loss that was treated with everolimus pharmacotherapy alone, resulting in an asymptomatic course and tumor regression, a rare yet notable phenomenon not described in the literature so far with potential to alter the management approach to patients with PTPR.
Rare Tumors, 2014
Choroid plexus papillomas (CPPs) are usually not malignant and occur in less than 1% of brain tum... more Choroid plexus papillomas (CPPs) are usually not malignant and occur in less than 1% of brain tumors in patients of all ages. They represent 3% of childhood intracranial neoplasms with a predilection in younger ages. Papillomas have an indolent course and carry a good long-term outcome if gross total surgical resection is achieved. However malignant evolution may occur, with a 10-30% incidence. Chemotherapy has been used with varied degrees of success. Most series are very small, some are only limited to case reports and cannot lead to guidelines or therapeutic recommendations. We are reporting the first case of recurrent CPP treated with 5 mg/kg of bevacizumab administered once every two weeks. Complete patient evaluations with follow-up contrast-enhanced magnetic resonance imaging (MRI) scans were obtained after the initial two treatments and every 8 weeks thereafter. Only after two treatments, the MRI scans showed radiological stabilization of the tumor, and the patient achieved ...
Journal of Neurosurgery, 2002
World Neurosurgery 134:123-127, February 2020, 2020
Introduction: Aneurysmal bone cyst is a vascular bone lesion, occurring most commonly in long bon... more Introduction: Aneurysmal bone cyst is a vascular bone lesion, occurring most commonly in long bones. Only 2% occurs in the head and neck and it is very rare in the ethmoid sinus.
Choroid plexus papillomas (CPPs) are usually not malignant and occur in less than 1% of brain tum... more Choroid plexus papillomas (CPPs) are usually not malignant and occur in less than 1% of brain tumors in patients of all ages. They repre
Journal of Neurosurgery, 2002
Curr. Oncol. 2021, 28, 1274-1279, 2021
Citation: Assi, H.I.; Kakati, R.T.; Berro, J.; Saikali, I.; Youssef, B.; Hourany, R.; Alameh, I.;... more Citation: Assi, H.I.; Kakati, R.T.; Berro, J.; Saikali, I.; Youssef, B.; Hourany, R.; Alameh, I.; Tabbarah, A.; Khoury, J.; Darwish, H.; et al. PTEN R130Q Papillary Tumor of the Pineal Region (PTPR) with Chromosome 10
Case presentation: A 40 year-old lady was diagnosed in February 2005 with a large choroid plexus ... more Case presentation: A 40 year-old lady was diagnosed in February 2005 with a large choroid plexus papilloma of the right lateral ventricle with small drop metastases in the posterior fossa and along the spinal cord. She underwent surgical resection of the primary tumor and received radiation therapy to the neuraxis (36 Gy CSI and 51.6 Gy to the tumor bed). Her disease remained stable for two years.
She presented with clinical worsening and radiological multifocal progression she received two cycles of nitrosourea without response. This was changed to combination chemotherapy with ifosfamide, carboplatin and etoposide.
Radiological and clinical stabilization were attained following three cycles, unfortunately progression was documented after the fifth cycle. Further surgeries were required for rapidly growing and symptomatic right cerebellopontine angle, dorsal brainstem, and cervical spinal metastases excision and finally for ventriculoperitoneal shunting.
In this setting of previous craniospinal irradiation, significant chemotherapy toxicity and only short-lived stabilization of the disease, bevacizumab was offered as single agent treatment in an attempt to spare further toxicities. She was treated with 5 mg/kg of bevacizumab every two weeks and achieved only radiological stabilization initially but an excellent clinical response after two treatments. Minimal radiological improvement was seen with subsequent MRI scans at 5 months.
Literature search did not yield any case of choroid plexus tumor treated with bevacizumab; we are reporting the first case. Although there was only minimal radiological improvement initially further response was seen with additional therapy. Bevacizumab seems to have some activity in this subtype of richly vascularized tumors and may be worth further evaluation in combination with chemotherapy.
World Neurosurgery, Feb 1, 2019
Current Oncology, Mar 20, 2021
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Journal of Neurosurgery, Jul 1, 2002
Annals of Pediatric Surgery
Background Yolk sac tumor or endodermal sinus tumor is an uncommon malignant germ cell neoplasm. ... more Background Yolk sac tumor or endodermal sinus tumor is an uncommon malignant germ cell neoplasm. This tumor usually presents in childhood or young adulthood as a testicular or ovarian mass. Extragonadal sites such as mediastinal, intracranial, and sacrococcygeal have been described. A review of the literature revealed limited related cases. The clinical presentation, radiographic characteristics, operative findings, and patient outcomes are discussed. Case presentation We report the occurrence of a primary paraspinal germ cell tumor in a 28-month-old boy who presented with thoracic spinal cord compression. The patient presented with pain, weakness, paraplegia, and bowel and bladder disturbances. MRI was done and showed a retroperitoneal and paravertebral mass invading the left diaphragmatic crus, the lateral neural foramen, and the posterior paravertebral muscles. Morphologic and immunohistochemical features were consistent with a germ cell tumor, namely an endodermal sinus tumor (y...
Current Oncology, 2021
Papillary tumors of the pineal region (PTPR) can be observed among adults with poor prognosis and... more Papillary tumors of the pineal region (PTPR) can be observed among adults with poor prognosis and high recurrence rates. Standards of therapy involve total surgical excision along with radiation therapy, with no promising prospects for primary adjuvant chemotherapy, as long-term treatment options have not been explored. Chromosome 10 loss is characteristic of PTPR, and PTEN gene alterations are frequently encountered in a wide range of human cancers and may be treated with mTORC1 inhibitors such as everolimus. In parallel, there are no reports of treating PTPR with everolimus alone as a monopharmacotherapy. We report the case of a patient diagnosed with PTPR (grade III) characterized by a PTEN R130Q alteration with chromosome 10 loss that was treated with everolimus pharmacotherapy alone, resulting in an asymptomatic course and tumor regression, a rare yet notable phenomenon not described in the literature so far with potential to alter the management approach to patients with PTPR.
Rare Tumors, 2014
Choroid plexus papillomas (CPPs) are usually not malignant and occur in less than 1% of brain tum... more Choroid plexus papillomas (CPPs) are usually not malignant and occur in less than 1% of brain tumors in patients of all ages. They represent 3% of childhood intracranial neoplasms with a predilection in younger ages. Papillomas have an indolent course and carry a good long-term outcome if gross total surgical resection is achieved. However malignant evolution may occur, with a 10-30% incidence. Chemotherapy has been used with varied degrees of success. Most series are very small, some are only limited to case reports and cannot lead to guidelines or therapeutic recommendations. We are reporting the first case of recurrent CPP treated with 5 mg/kg of bevacizumab administered once every two weeks. Complete patient evaluations with follow-up contrast-enhanced magnetic resonance imaging (MRI) scans were obtained after the initial two treatments and every 8 weeks thereafter. Only after two treatments, the MRI scans showed radiological stabilization of the tumor, and the patient achieved ...
Journal of Neurosurgery, 2002
World Neurosurgery 134:123-127, February 2020, 2020
Introduction: Aneurysmal bone cyst is a vascular bone lesion, occurring most commonly in long bon... more Introduction: Aneurysmal bone cyst is a vascular bone lesion, occurring most commonly in long bones. Only 2% occurs in the head and neck and it is very rare in the ethmoid sinus.
Choroid plexus papillomas (CPPs) are usually not malignant and occur in less than 1% of brain tum... more Choroid plexus papillomas (CPPs) are usually not malignant and occur in less than 1% of brain tumors in patients of all ages. They repre
Journal of Neurosurgery, 2002