Tumori mozga združeni s dugogodišnjom epilepsijom

master's thesis

• Title (english): Long-term epilepsy- associated brain tumors
• Author: Anja Raič
• Mentor: Kamelija Žarković (mentor)
• Committee member: Sven Seiwerth (predsjednik povjerenstva)
• Committee member: Slavko Gašparov (član povjerenstva)
• Committee member: Kamelija Žarković (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Pathology); Zagreb
• Defense date and country: 2018-07-13, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Pathology

Abstract

Pojam tumori mozga združeni s dugogodišnjom epilepsijom (LEATs– long-term epilepsy-associated tumors) odnosi se na rijetke, dobroćudne, spororastuće tumore koji se uglavnom javljaju u djece i mladih. Kao što samo ime kaže, takvi tumori izazivaju dugotrajnu epilepsiju, koja je rezistentna na farmakoterapiju te obično zahtijeva kirurško liječenje. Najčešće je riječ o parcijalnoj (žarišnoj) epilepsiji sa ili bez sekundarne generalizacije, koja se pojavljuje kao prvi, a često i jedini neurološki simptom tumora. Hoće li se epilepsija pojaviti ponajprije ovisi o lokalizaciji tumora. Kortikalna lokalizacija glavni je prediktivni čimbenik pojave epilepsije. Tumori smješteni u frontalnom, temporalnom i parijetalnom režnju češće izazivaju napadaje nego oni u okcipitalnom režnju. Histološki imaju vrlo pleomorfan izgled zbog čega ih je teško klasificirati koristeći postojeću WHO klasifikaciju. Uobičajeno se dijele u dvije skupine – glijalne i glioneuralne tumore. Sastoje se, dakle, od displastično promijenjenih neurona te neoplastično promijenjenih glija stanica. Gangliogliomi i disembrioplastični neuroepitelni tumori najčešće su opaženi entiteti te čine oko 65% ovih tumora. Iako su uglavnom dobroćudni, postoji mali rizik od progresije i relapsa. Glavni je cilj neuropatologa upravo identificirati takve tumore, koji nose rizik nepovoljnog ishoda. Kako bi se poboljšalo klasificiranje, i na taj način osiguralo adekvatno liječenje, pronalaze se novi molekularni i genetički markeri te je cilj u skorijoj budućnosti uvesti jedinstvenu fenotipsko-genotipsku dijagnostiku. Nadalje, intenzivno se provode i istraživanja mehanizma epileptogeneze čije bi razumijevanje omogućilo primjenjivanje ciljane individualizirane terapije.

Abstract (english)

The term long-term epilepsy-associated brain tumors (LEATs) refers to rare, benign, slowly growing tumors that usually occur in children and young adults. As the name says, these tumors cause long-term pharmacoresistant epilepsy, which usually requires surgical treatment. Focal epilepsy with or without secondary generalization occurs as the primary and often only neurogical symptom. Whether the epilepsy will appear or not, depends mostly of the tumor localization. The main predictor of epilepsy is cortical localization. Tumors located in the frontal, temporal or parietal lobe are more likely to cause seizures than those in the occipital lobe. Histologically, they have a pleomorphic appearance which makes them difficult to classify, using the existing WHO classification system. Generally, they are separated in two groups – glial and glioneural tumors. Hence, they consist of dysplastic-modified neurons and neoplastic-modified glial cells. Gangliogliomas and dysembryoplastic neuroepithelial tumors are the most frequently recognized entities, accounting for about 65% of the cases. Although they are mostly benign, there is a small risk of progression and relaps. The key objectives for the neuropathologist are to identify and predict tumors less likely to behave favorably. In order to improve classification, and therefore assure adequate treatment, new molecular and genetic markers are being found, and the goal is to introduce a unique phenotype-genotypic diagnostics in the near future. Furthermore, a number of new investigations of epileptogenic mechanisms are being conducted, in order to apply a targeted individualized therapy.

• Keywords: epilepsija; tumori mozga; neuropatologija
• Keywords (english): epilepsy; brain tumors; neuropathology
• Language: croatian
• URN:NBN: urn:nbn:hr:105:377975
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2019-01-02 09:08:25