$266 Tuesday, November 8, 2005 Poster Abstracts

Gironbs X ~, Alameda, F ~, Lafuente, JV e, Cruz-S~nchez FF x. 1Institute of Neurological and Gerontologiea[ Sciences. International University of Catalonia Barcelona. Spain; 2Department of Neurosciences. Universidad del Pal? Vasco. Leioa. Spain

Brain tmnor prognosis has not varied substantially in the last decades in spite of the advances in surgery, radiotherapy or the introduction of new drugs. This situation forces to rethink the conventional therapeutic, boardings based in the biology of these processes. It is tried to identify and to validate statistically excellent clinical and biological indicators to improve the diagnosis, treatment and prog- nosis of the patients with brain tmnors. In order to reach this objective, it is proposed a prospective and retrosprective study carrying out phenotypic and genotypic characterization of astrocytic gliomas correlated with an accurate follow-up of the patiens and using new biotechnological tools. One hundred astrocytic gliomas were used for the study. A tissue microarray was performed using immunohistolo- gical techniques. A panel of antibodies including: Ki67, p53, CD10, CD56, EGFR, Dl-dclnie, Ger2-Neu, CD57, GFAP and CD99. Results were correlated with clinical follow-up. The expresion of some antibodies allowed to recognize primary from secondary gliobla- stoma. Some antibodies appear also to be poor prognosis markers. (Financially supported by G03/114 Instituto de Saiffd Carlos III)

0654 Leptomeniffgeal metastases (LM)-case report

Kosti% S, Potic, J, Vrm~jes, D, Sujic, R, Smiljkovic, T, Cvijanovic, V, Sretenovic, S, Stanic, A, Malovia, J, Nikolic, V. Clinic Hospital Centre Zvezdara, Clinic of neurology and psyehiatry, Belgrade, SCG

Background: LM usually seen in patients with estableshed systemic malignancies witiffn 6 months to 3 years of initial diagnosis. The sine qua non for diagnosis is finding of malignant cells from CSF, but this is not often achieved. Case report: A 61 year old man, was admitted to hospital, after he evolved rapidly progressive vertigo, cephalea, dysphagia, dysphonia and occasional diplopia. Two years ago, he had partial laryngoectomy due to carcinoma larynx. One year ago undergone a surgery due to aneurism of abdominal aortha. Also, he had trombosis of deep veins of legs. He had 45 year long history of smoking 20 dgarettes per day. There were no fever, hypertension or diabetes mellitus. Routine blood analyses and physical examination were normal. Neurological exanffnation revealed ophthalmoplegia compl, lot. sin. and slight left-sided hemiparesis. Brain CT was normal. MRI with contrast showed ischaemia cerebelli l.sin, pontis 1.sin and discrete multiple ischaemic lesions supratent.pariet.bil. M R A was normal. Initially vascular lesions of t rund cerebri were suspected and treatment was directed in that way without any improvement. Few days later, there were truncal ataxia, lower back pain and lumbosacral radiculopathia 1.sin. Neurological examination revealed positive meningeal signs bil. Lmnbar puncture revealed slight pleocytosis with marked hypoglicor- rachia, without malignant cells. The CSF total protein content was 3,0 g/l. Electrodiagnostic studies showed mxonal sensorymotor polineuropathy, MRI cervical spinal cord was normal, Chest X rays and CT showed infiltratio lob.inf.dex. Antibiotherapy had been prescribed, but without improvement. Conciffsion: We discused the postmortem exanffnation, diferential diagnosis and literature on the subject reviewed.

0656 Brain Metastasis - Primary minor site, treatment and survival

1 1 Hirsh, K . Karolinska University Hospital- Sobza, Stoekhobn, Sweden

Background: Lung cancer har a poor prognosis and is a common cancer disease in the world. Brain metastasis is very common. The purpose of tiffs study was to evaluate the tmnor type, treatment, and survival among patients with brain metastasis in our department.

Method: Retrospective data analysis of all medical records concering patients with brain metastasis who have been treated at the Dept of Respiratory Medicine and Allergy and Dept of Neurosurgery, Karolniska University Hopsital Solna during 01012001 31122003. Results: The nmnber of patients were 223, 110 (49,3%) male and 113 (50,7%) female. 52,4% were smoker or ex-smoker, data on 36,2% wee missing. The most common type of primary tumor was lung cancer 77,1% followed by unkown cancer 9,4% and breast cancer 4,5%. In 58,3% of the patients the first symptom was from the brain metastasis. The most common treatment was stereotactic radiation 41,3<'/o, followed by surgery plus radiotherapy 10,8%. 67,3"/0 of the patients have also treated with oral steroids. 61% of the patients were dead at the end of 2003. Contusion: Brain metastasis is common among patients with lung cancer. Tiffs will lead to furthure worsning the prognosis. Patients who were treated with stereotactic radiotherapy had better survival.

0657 Topotecane/VP 16 - A new option in Chemotherapy of recurrent Malignant Glioma

Krausenec, p1 1Dept of Neurology', D-96049 Bamberg, Germany

Objective: Therapy options for recurrent malignant glioma are limited as patients are already preirradiated and had received standard chemotherapy. Complete blocking of the topoisomerases I + If by the combination of low doses of Topotecane and VP 16 is a new approach bearing some promise in pretreated pats. and was investigated in tiffs study. Patients and Methods: 15 patients with clinical progression and residual contrast enhancing tmnor mass of malignant glioma (WHO III-IV) in MRI o r contrasted CCT received 1-10 cycles of Top otecane/ VP 16 chemotherapy. Topotecane was administered at a dose of 0,4-0,8 mg/m/d continously over 5 day concomitant with oral VP 16 at a dose of 50-100 mg per day. 9 patients were treated simultaneously withintrathecal Ara-C for meningeal tmnor cell spread. All patients were preirradiated and had already received at least 2 different standard chemotherapies. Response was evaluated by McDonald% criteria based on CCT or MRL Results: One patient showed complete, two others partial response. 6 patients had stable disease and 4 an early progression. In 2 patients an evaluation is not yet possible because follow-up is too short. Median time to tmnor progression is > 3 months. 4 patients are under observation without tumor relapse (13 with short follow-up with less than 3 months). 8 patients died because of tumor progression up to now. The follow-up is 1-21 months, median follow-up is 7 months. Despite the low doses hematotoxicity was as expected the most frequent side effect beside moderate degree nausea and fatigue. No serious complicatons occurred. Conclusion: Topotecane/VPl6 chemotherapy is a favorable treatment option for heavily pretreated, progressive patients with recurrent malignant glioma.

0658 Mast Cells in Meningiomas

Marja-Liisa Karjalainen-Lindsberg ~, Perttu 3. Lnidsberg e. 1Departments of Pathology and," ~Neurology, Helsinki University Central Hospital, Finland

Mast cells (MC) mediate inmlediate hypersensitivity and contain potent matrix-degrading enzymes such as tryptase and chymase. We have recently demonstrated the significance of MC in regulating the permeability of blood-brain barrier (BBB). No reports exist on their role in cerebral neoplasms associated with expansive brain edema, which is a major cause of fatal outcomes. Using a mast cell-specific tryptase antibody, we stained sections of 58 meningiomas representing different Iffstological subtypes and grade of malignancy.