Publications by authors named "Thomas Blauwblomme"

Introduction: Laser Interstitial Thermal Therapy under MRI control has emerged as a safe and efficient alternative to microsurgery in epilepsy and neurooncology procedures. Yet it has been used only recently in seldom European centers. Here, we report our 4 years' experience with LITT in children (complications, epileptic and oncologic outcomes).

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Objectives: Magnetic resonance-guided laser interstitial thermal therapy (MRgLITT) has emerged as a minimally invasive alternative for drug-resistant epilepsy and pediatric brain tumors, particularly in deep-seated lesions where open surgery presents significant risks. However, the multimodal imaging characteristics of lesions during and after MRgLITT remain underexplored. This study aims to describe the MRI features of MRgLITT-treated lesions in pediatric patients both intraoperatively and during long-term follow-up.

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According to the current World Health Organization classification of central nervous system tumors, the angiocentric glioma (AG) assigned a grade 1, characterized by recurrent MYB fusions. However, it also mentions that increased proliferative activity and other anaplastic features have been reported, but the clinical significance of such findings is unclear as an increased proliferative activity alone does not necessarily alter the benign behavior of AGs. Most cases with "anaplasia" were mainly described before the molecular era.

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Introduction: Epilepsy is a neurological disorder affecting over 50 million people globally, with around 30 % of them classified as having drug-resistant epilepsy (DRE). Temporal lobe epilepsy (TLE) is the most frequently encountered type of surgically treated epilepsy. The primary surgical approaches for TLE include anterior temporal lobectomy (ATL) and selective amygdalohippocampectomy (selAH).

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Netrin-1 signaling is an essential prototypical neuronal guidance mechanism during embryonic development that also regulates tumor cell survival in a variety of adult cancer entities. In line with these data, a monoclonal netrin-1 blocking antibody (anti-netrin-1 mAb/NP137) has been preclinically developed and netrin-1 blockade has recently been investigated in phase 1 and 2 clinical trials in several adult cancers. Here, we investigate the role of netrin-1 in the most common malignant pediatric brain cancer, Medulloblastoma.

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The neuroepithelial tumor, PATZ1-fused (NET-PATZ1), has been recently isolated as a distinct methylation class by DNA-methylation profiling and is characterized by recurrent PATZ1 fusions, in association with the EWSR1 or MN1 genes and a chromosome 22 chromothripsis. The clinical phenotype is mainly pediatric and features circumscribed supratentorial tumors. However, the histopathology is vastly heterogeneous (glial, glioneuronal, sarcomatous, multiphenotypic) and a cell of origin has not yet been identified, explaining the previsionary imprecise terminology of "NET".

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Purpose: Thalamic gliomas are found predominantly in children and can be classified into two main types with different prognoses and management: diffuse midline glioma (DMG) H3K27-altered and low-grade glioma (LGG). Our aim was to find imaging features distinguishing these tumors and to develop a diagnostic score.

Patients And Methods: A retrospective study spanning September 1999 to May 2021 involved pediatric patients with thalamic gliomas, categorized into H3K27-altered DMG and LGG groups.

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Purpose: Pituitary adenomas are much rarer in children than in adults. We aimed to analyze their imaging characteristics in this age group and to compare them according to the hormonal secretion. We conducted an observational monocentric retrospective study on clinical and imaging data.

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Aims: FGFR-fused central nervous system (CNS) tumours are rare and are usually within the glioneuronal and neuronal tumours or the paediatric-type diffuse low-grade glioma spectrum. Among this spectrum, FGFR2 fusion has been documented in tumours classified by DNA-methylation profiling as polymorphous low-grade neuroepithelial tumours of the young (PLNTY), a recently described tumour type. However, FGFR2 fusions have also been reported in glioneuronal tumours, highlighting the overlapping diagnostic criteria and challenges.

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CIC fusions have been described in two different central nervous system (CNS) tumor entities. On one hand, fusions of CIC or ATXN1 genes belonging to the same complex of transcriptional repressors, were reported in the CIC-rearranged, sarcoma (SARC-CIC). The diagnosis of this tumor type, which was recently added to the World Health Organization (WHO) Classification of CNS tumors, is difficult mainly because the data concerning its histopathology (as compared to its soft tissue counterpart), immunoprofile, and clinical as well as radiological characteristics are scarce in the literature.

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Objective: Guidelines for the management of pediatric severe traumatic brain injury (TBI) recommend external ventricular drainage for CSF drainage as a first-tier treatment in the intracranial pressure (ICP) pathway. However, ventriculostomy in children can sometimes be challenging because of the small size of the lateral ventricles. External lumbar drainage (ELD) may be a useful alternative; therefore, the authors analyzed the outcome of a cohort of pediatric patients who underwent ELD to manage intracranial hypertension (ICH).

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Article Synopsis
  • Constitutional mismatch repair deficiency (CMMRD) leads to a significant cancer risk, primarily resulting in high-grade gliomas in children due to mutations in mismatch repair genes.
  • Analysis of clinical and genetic data from 12 affected children revealed that 50% of their glioma samples expressed PDL1 and exhibited an ultra-hypermutated phenotype, with numerous mutations and specific driver mutations identified.
  • The research indicates that CMMRD gliomas have distinct oncogenic properties, differing from typical glioblastomas, suggesting potential for targeted therapies, particularly those targeting MAPK pathways and PD1 inhibitors.
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Focal cortical dysplasia, hemimegalencephaly and cortical tubers are paediatric epileptogenic malformations of cortical development (MCDs) frequently pharmacoresistant and mostly treated surgically by the resection of epileptic cortex. Availability of cortical resection samples has allowed significant mechanistic discoveries directly from human material. Causal brain somatic or germline mutations in the AKT/PI3K/DEPDC5/MTOR genes have been identified.

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Purpose: Supratentorial (ST) ependymoma subgroups are defined by two different fusions with different prognoses. Astroblastomas, MN1-altered, have ependymal-like histopathologic features and represent a differential diagnosis in children. We hypothesized that ZFTA-fused ependymoma and YAP1-fused ependymoma on the one hand, and astroblastoma, MN1-altered, on the other hand, show different MRI characteristics.

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gain-of-function mutations are frequently observed in sporadic arteriovenous malformations. The mechanisms underlying the progression of such -driven malformations are still incompletely understood, and no treatments for the condition are approved. Here, we show the effectiveness of sotorasib, a specific KRAS G12C inhibitor, in reducing the volume of vascular malformations and improving survival in two mouse models carrying a mosaic G12C mutation.

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Background: Children with constitutional mismatch repair deficiency (CMMRD) syndrome have an increased risk of high-grade gliomas (HGG), and brain imaging abnormalities. This study analyzes brain imaging features in CMMRD syndrome children versus those with HGG without CMMRD.

Methods: Retrospective comparative analysis of brain imaging in 30 CMMRD children (20 boys, median age eight years, 22 with HGG), seven with Lynch syndrome (7 HGG), 39 with type 1 neurofibromatosis (NF1) (four with HGG) and 50 with HGG without MMR or NF1 pathogenic variant ("no-predisposition" patients).

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Background: pathogenic variants (PV) have been recently identified as the most frequent variants predisposing to Sonic Hedgehog (SHH) medulloblastomas (MB); however, guidelines are still lacking for genetic counseling in this new syndrome.

Methods: We retrospectively reviewed clinical and genetic data of a French series of 29 -mutated MB.

Results: All patients developed SHH-MB, with a biallelic inactivation of found in 24 tumors.

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Article Synopsis
  • Genetic diseases linked to craniofacial malformations often result in issues with the craniocervical joint (CCJ), affecting mobility and potentially causing severe complications like headaches or spinal cord damage.
  • The study aimed to uncover the relationship between the anatomy and function of the CCJ, using data from nine cadaveric adults to analyze how bone shape influences movement.
  • Findings indicated that bone geometry significantly affects both primary and secondary movements of the CCJ, which may inform surgical approaches for correcting anomalies in children.
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Epilepsy surgery may be a curative therapy for patients with drug-resistant epilepsies when focal lesions or foci are identified. Genetic testing is not yet routinely included in many presurgical evaluation programs although recent evidence support that finding a germline genetic mutation could help to better delineate the patient candidacy to surgery and provide valuable information on the expected surgery outcome. In this study, we report nine patients presenting drug-resistant focal epilepsy enrolled in presurgical evaluation.

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The craniocervical junction (CCJ) forms the bridge between the skull and the spine, a highly mobile group of joints that allows the mobility of the head in every direction. The CCJ plays a major role in protecting the inferior brainstem (bulb) and spinal cord, therefore also requiring some stability. Children are subjected to multiple constitutive or acquired diseases involving the CCJ: primary bone diseases such as in FGFR-related craniosynostoses or acquired conditions such as congenital torticollis, cervical spine luxation, and neurological disorders.

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Objective: Adamantinomatous craniopharyngioma mainly affects children. Excessive weight gain is a major long-term complication. The primary objective of this study was to assess long-term weight changes in children treated for craniopharyngioma.

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A novel methylation class, "neuroepithelial tumor, with PLAGL1 fusion" (NET-PLAGL1), has recently been described, based on epigenetic features, as a supratentorial pediatric brain tumor with recurrent histopathological features suggesting an ependymal differentiation. Because of the recent identification of this neoplastic entity, few histopathological, radiological and clinical data are available. Herein, we present a detailed series of nine cases of PLAGL1-fused supratentorial tumors, reclassified from a series of supratentorial ependymomas, non-ZFTA/non-YAP1 fusion-positive and subependymomas of the young.

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Meningioangiomatosis (MAM) remains a poorly understood lesion responsible for epileptic disease. In the past, MAM was primarily described in the context of neurofibromatosis type 2 before being mainly reported sporadically. Moreover, the malformative or tumoral nature is still debated.

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Article Synopsis
  • Severe drug-resistant unilateral hemispheric epilepsy presents surgical challenges, leading to a shift from anatomical hemispherectomy to functional hemispherotomy, which has lower complications and improved outcomes.
  • A consensus statement was created by European epilepsy surgeons to outline history, indications, surgical techniques, and complications for hemispheric disconnection procedures.
  • This paper represents the first European consensus on the topic, providing an overview of current practices and emphasizing the need for further long-term outcome data, especially regarding minimal invasive techniques.
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