[Effect of local injections of adriamycin on survival in malignant brain tumor: histopathological evaluation].

Two long survival cases of primary malignant glioma are reported in terms of histopathological consideration comparing first surgical specimens with second surgical specimens followed by intraneoplastic local injection of Adriamycin (ADM). Case 1. A 56-year-old female was admitted to our hospital on October 24, 1977, with the complaints of headache and motor weakness on the left side of extremeties. Neurological examination revealed hemiparesis, homonymous hemianopsia and agnosia on the left side. Initial CT scan showed irregular high-density enhancing lesions in right parieto-occipital region with surrounding low-density area. Case 2. A 18-year-old male was admitted to our hospital on May 9, 1977, with the complaints of headache and nausea. Initial CT scan showed high-density enhancing resion in the left parieto-temporal region. In the microscopic findings of the recurrent tumor and surrounding necrotic tissue, there were massive coagulation necrosis of the tumor tissues and fibrinoid necrosis of vascular channels. In the surrounding area of the massive coagulation necrosis and small hemorrhages, there were many reactive collagenous tissues, increasing vascular channels, and infiltrating lymphocytes, granulocytes and foreign body giants cells, as well as so-called organized necrotic tissues. Residual tumor cells mainly composed of giant cells, gemistocytic astrocytes and spindle cells. The tumor was characteristic in that the tumor cells showed occasionally sarcomatous transformation in the other area. Some of anaplastic glial cells were positively stained for GFA protein in Case 1. Positive staining for GFA protain in the recurrent brain tumor are less than that of primary brain tumor. The cases were also discussed from the view point of pathology.