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Tumor Progression

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Tumor progression is a phenomenon where the pre-formed tumor acquires successive mutations to become clinically more aggressive and malignant. In the 1950s, Foulds first described the stepwise progression of cancer cells through successive stages.
Colon cancer is one of the best-documented examples of tumor progression. Early mutation in the APC gene in colon cells causes a small growth on the colon wall called a polyp. With time, this polyp grows into a benign, pre-cancerous tumor. Further...
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Author Spotlight: Using the Chick Embryo Brain as a Model for In Vivo and Ex Vivo Analyses of Human Glioblastoma Cell Behavior
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[A mixed germ cell tumor that underwent dramatic size changes].

Kazuyuki Kuwayama1, Hiroki Takai, Akira Nishiyama

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A pediatric pineal mixed germ cell tumor showed dramatic size changes, initially shrinking then growing during treatment. Avoid frequent imaging before diagnosis to prevent misinterpretation and ensure optimal surgical timing.

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Area of Science:

  • Pediatric Oncology
  • Neuro-oncology
  • Radiology

Background:

  • A 12-year-old boy presented with a two-month headache, found to have a pineal tumor and hydrocephalus.
  • Initial management included external ventricular drainage and two endoscopic biopsies.

Observation:

  • Nine computed tomography (CT) scans were performed, with tumor size decreasing before the second biopsy.
  • The tumor comprised both germinoma and teratoma components.
  • Despite chemotherapy and radiotherapy, the tumor enlarged, requiring surgical resection.

Findings:

  • Tumor size reduction may be linked to cyst leakage and CT irradiation exposure.
  • Subsequent tumor growth attributed to cyst re-accumulation and intracranial growing teratoma syndrome (iGTS).

Implications:

  • Frequent brain CTs and angiography should be limited before definitive pathological diagnosis.
  • Optimal timing for surgical resection should consider tumor size dynamics and potential iGTS.