Publications by authors named "Alexandre Vasiljevic"

Functional small pituitary neuroendocrine tumors (PitNETs) of the corticotroph type lead to Cushing disease (CD), a condition associated with significant morbidity and increased mortality. Pituitary MRI is the primary imaging modality used to localize the tumor, but it is inconclusive in up to 30% of cases. Accumulating retrospective evidence suggests that [C]methionine ([C]MET) PET could address this diagnostic gap.

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CNS embryonal tumors with PLAGL amplification (ET, PLAGL) are a recently described tumor type marked by amplification of one of the PLAG family genes, PLAGL1 or PLAGL2. Separately, a supratentorial, ependymoma-like CNS tumor type with PLAG family alteration, namely PLAGL1 fusion, was also reported (NET_PLAGL1). Here, we use DNA methylation profiling in combination with copy number, RNA-seq, and histological analysis to characterize and classify a novel group of CNS embryonal tumors harboring PLAG1 gene fusions (n=12).

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Background: Aggressive pituitary tumors and pituitary Carcinomas (PCs) represent very uncommon entities within the field of pituitary diseases. Unfortunately, treatment options after progression on temozolomide are limited. However, advances in the understanding of pituitary tumor genetics and their immunological landscape are paving the way for new targeted molecular therapies.

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Although gonadotroph tumor regrowth is frequent after pituitary surgery, the systematic use of adjuvant radiotherapy is limited by its long-term complications. In this context, it is important to predict which tumors are most likely to regrow after surgery, and especially, which tumors are most likely to regrow rapidly. Clinicopathological characteristics associated with the prognosis of radiotherapy-naïve, recurrent pituitary tumors are currently unknown.

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Aims: Embryonal tumours with PLAGL1 or PLAGL2 amplification (ET, PLAGL) show substantial heterogeneity regarding their clinical characteristics and have been treated inconsistently, resulting in diverse outcomes. In this study, we aimed to evaluate the clinical behaviour of ET, PLAGL and elucidate their response pattern across the different applied treatment regimens.

Methods: We conducted an in-depth retrospective analysis of clinical and serial imaging data of 18 patients with ET, PLAGL (nine each of PLAGL1 and PLAGL2 amplified).

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Background: Brain tumors are the deadliest solid tumors in children and adolescents. Most of these tumors are glial in origin and exhibit strong heterogeneity, hampering the development of effective therapeutic strategies. In the past decades, patient-derived tumor organoids (PDT-O) have emerged as powerful tools for modeling tumoral cell diversity and dynamics, and they could then help define new therapeutic options for pediatric brain tumors.

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Background: Medulloblastoma (MB) is one of the most prevalent embryonal malignant brain tumors. Current classification organizes these tumors into 4 molecular subgroups (WNT, SHH, Group 3, and Group 4 MB). Recently, a comprehensive classification has been established, identifying numerous subtypes, some of which exhibit a poor prognosis.

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Acromegaly due to ectopic secretion of growth hormone-releasing hormone (GHRH) is a rare disorder. The signs and symptoms of ectopic acromegaly are indistinguishable from acromegaly due to a somatotroph adenoma. A 35-year-old female presented with secondary amenorrhea for 10 years, intermittent headache, and reduced vision in both eyes for 4 years, which worsened over 4 months before presentation.

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Article Synopsis
  • - Pediatric diffuse midline gliomas (pDMG) are aggressive childhood cancers characterized by fatal outcomes and linked to specific genetic mutations, particularly K27M in histone H3.
  • - About 20 to 30% of these tumors have alterations in the BMP signaling pathway, specifically involving mutations in the BMP type I receptor ALK2, but the effects of BMP in non-mutated cases are not fully understood.
  • - Recent research reveals that BMP2 and BMP7 are active in both wild-type and mutant tumors, and they work with the K27M mutation to alter cell behavior, indicating that the BMP pathway could be a target for treatment in pDMG.
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Objective: Targeted therapy (TT) with BRAF/MEK inhibitors has emerged as a potential treatment in papillary craniopharyngiomas (PCPs). However, standardized data on large cohorts are lacking. Our study aimed to assess real-life efficacy and safety of BRAF/MEK inhibition in patients with PCPs.

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Pineal parenchymal tumors are rare neoplasms for which evidence-based treatment recommendations are lacking. These tumors vary in biology, clinical characteristics, and prognosis, requiring treatment that ranges from surgical resection alone to intensive multimodal antineoplastic therapy. Recently, international collaborative studies have shed light on the genomic landscape of these tumors, leading to refinement in molecular-based disease classification in the 5th edition of the World Health Organization (WHO) classification of tumors of the central nervous system.

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Article Synopsis
  • * The French Endocrine Society and associated organizations created a reference document to address the complexities of managing these tumors, which can recur and lead to serious health issues, including impaired quality of life for patients, especially those with hypothalamic syndrome.
  • * Recent research has identified two tumor types—papillary and adamantinomatous—with different molecular signatures and treatment strategies, prompting ongoing developments in therapeutic options, including new medications for associated symptoms like hyperphagia.
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  • Fontaine progeroid syndrome (FPS) is a newly identified genetic disorder linked to mutations in the SLC25A24 gene, resulting in severe physical abnormalities such as craniosynostosis and growth restrictions.
  • The first documented prenatal cases during the second trimester show different phenotypic features, including encephalocele and nephromegaly, while lacking some typical signs of FPS seen after birth.
  • The study highlights the importance of genetic testing methods like exome/genome sequencing for diagnosing rare syndromes, suggesting that FPS may involve a novel inheritance pattern.
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The aim of this multicenter prospective survey called PIT-EASY was to assess the relevance of the European Pituitary Pathology Group (EPPG) diagnostic tools for pituitary neuroendocrine tumors (PitNETs) to improve the quality of their histological diagnosis. Each center performed at least 30 histological cases of PitNETs using the EPPG tools and assessed their value using a scorecard with 10 questions. For each center, the histological cases were carried out by pathologists with varying levels of expertise in pituitary pathology defined as junior, intermediate, and expert.

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Article Synopsis
  • The study analyzed 81 patients treated for intracranial hemangioblastoma from 2000 to 2022 to identify factors predicting tumor progression and inform follow-up care.
  • The average age at diagnosis was 48 years, with 14% of patients having von Hippel-Lindau disease, and the most common tumor site was the cerebellar hemispheres (65%).
  • Key predictors of progression included younger age, presence of von Hippel-Lindau disease, multiple tumor locations, and partial resection, suggesting a need for extended postoperative follow-up of at least 10 years for patients with these risk factors.
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Purpose: MRI is the main imaging modality for pediatric brain tumors, but amino acid PET can provide additional information. Simultaneous PET-MRI acquisition allows to fully assess the tumor and lower the radiation exposure. Although symptomatic posterior fossa tumors are typically resected, the patient management is evolving and will benefit from an improved preoperative tumor characterization.

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We report here about two novel tumours classified as extraventricular neurocytomas (EVN) using DNA-methylation profiling, associated with NTRK2 fusions instead of the usual FGFR1 alterations so far attributed to this tumoural entity. We present the second detailed case of an intraventricular presentation in the MC EVN. Our findings broaden the spectrum of MC EVN and have implications in terms of diagnosis, therapy and terminology.

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Introduction: Brainstem tumors represent a challenge. Their management and prognosis vary according to anatomopathological findings and genetic and bio-molecular fingerprints. We present our experience with pediatric brainstem tumors.

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Background: Pineal cysts are a rare lesion of the pineal gland. Pineal cysts are benign lesions, generally asymptomatic, and are usually an incidental discovery on MRI performed for other problems. The management of pineal cysts in children remains a matter for debate.

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Article Synopsis
  • Craniopharyngiomas (CP) pose a significant surgical challenge due to their location and the risks involved in surgical removal; however, recent discoveries have highlighted the BRAF V600E mutation in papillary CP, leading to successful targeted therapies.
  • This study focuses on adamantinomatous craniopharyngioma, which currently lacks effective molecular treatment options, and reports on a case where an 84-year-old patient received anti-VEGF therapy due to surgical inoperability.
  • The patient showed notable improvements in tumor size and visual function after six weeks of anti-VEGF treatment, marking a potential breakthrough in managing adamantinomatous craniopharyngioma with targeted therapy.
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Toll-like receptor 3 (TLR3) is a pattern recognition receptor mainly known for its role in innate immune response to infection. Indeed, binding of double-stranded RNA (dsRNA) to TLR3 triggers a pro-inflammatory cascade leading to cytokine release and immune cell activation. Its anti-tumoral potential has emerged progressively, associated with a direct impact on tumor cell death induction and with an indirect action on immune system reactivation.

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This is a retrospective study conducted on patients with OPG, aged less than 19 years, treated with bevacizumab as a single agent, since 2010 at IHOPe (Institute of Pediatric Hematology and Oncology). Efficacy of the treatment was evaluated on the tumor response rate on MRI with a centralized review basing upon RAPNO criteria and with visual assessment basing upon a 0.2 log change in the logMAR scale.

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