| |
| -
About Us |
| -
Appointments |
| -
BTC Textbook |
| -
Consultations |
| -
Education |
| -
Fellowship in the BTC |
| -
New Treatments |
| -
News, etc. |
| -
Research |
| -
Services |
| -
Spine Tumor Clinic |
| -
Staff |
| -
Support Groups |
| -
Therapies |
| -
Tumor Types |
| -
BT Links |
Search
BTC Web |
|
|
|
| -
Brain Tumor Center |
| -
Brain Tumor Research |
| -
Neuro-Oncology |
| -
Neurosurgery |
| -
Neurology |
| -
Radiation Oncology |
|
|
 |
|
David
N. Louis, MD
Chief, MGH Pathology
|
|
|
INNOVATIONS
IN TECHNOLOGIES, TECHNIQUES AND TREATMENTS FOR
BRAIN TUMORS
|
|
A
SHARPER IMAGE FOR SURGEONS
|
 |
“More
accurate imaging is one of the major advances in
brain tumor surgery over the last decade,”
says Robert Martuza, MD, chief of the Department
of Neurosurgery. “Preoperative and intraoperative
imaging with PET, CT and MRI scans can now anatomically
define tumors for surgeons, showing exactly where
they are and how they relate to blood vessels, nerve
fibers and brain functions.” With the new generation
of MRIs, which show changes to blood flow in response
to brain activity, for example, “when the patient
wiggles a finger or a toe, you can see the part
of the brain that lights up. Or when the patient
says a word, you can see which part of the brain
is used.” Innovations in image- and computer-guided
surgeries allow neurosurgeons to remove the tumor
without damage to the patient’s functioning
brain circuits. |
| |
|
|
One
surgical innovation made possible by improved technology
is endoscopic cranial base surgery, a minimally
invasive technique. It is performed at only a few
centers in the country, including at the Cancer
Center by neurosurgeon William Curry, MD, of the
Cranial Base Tumor Program, a subspecialty group
within the Pappas Center. Cranial base tumors are
especially challenging, explains Curry, because
they are located at sites where critical and delicate
blood vessels, nerves and brainstem tissue are closely
packed, surrounded by thick bone. A tumor in this
area often encases these arteries and nerves, compounding
the complexity of removing it. |
| |
|
Minimally
invasive cranial base surgery takes advantage of
natural pathways into the body, such as the nasal
opening, to avoid making a large incision. The surgeon
inserts an endoscope — a small tube with a
powerful light, camera and magnifying lenses —
through the nostrils, and video monitors display
a detailed image of the patient’s anatomy. |
| |
|
This
approach, which Curry performs with head and neck
cancer surgeons from the Massachusetts Eye and Ear
Infirmary, may be safer than traditional open surgery
for some tumors and shortens the patient’s
recovery period. |
| |
|
.Curry
recalls one patient, a 52-year-old program manager,who
had been treated for a skull base tumor several
years ago. When the patient began to experience
double vision and other neurological problems, several
surgeons near his home in Virginia told him that
his tumor had returned and was inoperable. |
| |
|
Curry
evaluated the patient earlier this year and found
a tumor the size of a tangerine. “We used an
endoscope and, without making a single incision,
removed about
80 percent of the tumor,” he says. “We
were able to take the pressure off his cranial nerves,
including his optic nerves, and prevent him from
losing his vision. He was ready to go back to work
in two weeks.” |
| |
|
 |
|
William
Curry, MD, (left)
and Robert Martuza, MD
|
|
“We
were able to take the
pressure off his nerves and
prevent him from losing his
vision. He was ready to go
back to work in two weeks.”
|
|
|
MOLECULAR
GUIDES TO DIAGNOSIS
|
|
Accurate
biopsy diagnosis is essential for the management of brain
tumors since different types of brain tumors are treated
in different ways. Specialized neuropathologists from
the Massachusetts General Hospital Pathology Service interpret
biopsies at the Cancer Center to ensure these tumors are
attacked with the most effective combination of surgery,
radiation and drugs. The pathology department also serves
as a consultation center for the diagnosis of unusual
tumor specimens from around the world. “It is exciting
that our depth of expertise in traditional biopsy interpretation
is now complemented by remarkable strengths in molecular
diagnosis,” says David N. Louis, MD, chief of Massachusetts
General Hospital’s Department of Pathology and Benjamin
Castleman Professor of Pathology at Harvard Medical School.
Many novel methods now enable pathologists to look directly
at abnormal chromosomes and genes in tumors. |
| |
|
Mass
General pathologists were the first to show that brain
tumors could be more precisely diagnosed through the examination
of molecular features, and the first to demonstrate that
molecular differences could guide therapies. Delivery
of new smart drugs that target a specific molecule will
require precise biopsy analysis to determine which drug
will have the greatest chance of destroying a tumor. A
new laboratory at the Cancer Center and Pathology Department
enables widespread testing of tumors for such molecular
changes. |
| |
|
|
Advancing
the Specialized Care of Individuals with Brain
Tumors
|
|
MGH
Brain Tumor Center
Yawkey Building 9th Floor
Boston, Massachusetts, 02114
|
Patients
& Families with questions about referrals, consultations
or appointments may contact:
Telephone: 617.724.8770
Fax: 617.724.8769
|
Physicians
with
questions may contact:
Tracy Batchelor, M.D.
Executive Director,
MGH Brain Tumor Center
|
| MassGeneral.org |
| MGH
Cancer Center |
|
|
|
![[Divider]](/images/barrule.gif){kind=small}
