MS-13 * NON-CONTIGUOUS LEPTOMENINGEAL METASTASIS OF OLFACTORY NEUROBLASTOMAS: A LONG-TERM MULTI-INSTITUTIONAL EXPERIENCE
Bibliographic record
Abstract
BACKGROUND: Olfactory neuroblastoma (ONB) is a malignant neoplasm centered along the roof of the nasal cavity near the cribriform plate. Although distant metastasis of this tumor has been reported in extra-cranial site, non-contiguous spread to the dura is rare. Here, we report the largest series of intracranial leptomeningeal distant metastasis of ONBs from multiple institutions over a twenty year period. Using imaging analysis, we identified that these lesions preferentially home to specific dural regions that share a common vascular supply, suggesting a similar mechanism of tumor spread. METHOD: This study was conducted under M.D. Anderson Cancer Center and the University of Toronto IRB-approved protocols. Image analyses were obtained using preoperative and postoperative MR images. Statistical analyses were performed with IBM SPSS Statistics v21.0.0. RESULTS: A total of 10 patients with non-contiguous dural-based metastasis of ONBs were identified from both institutions. The mean age of diagnosis was 50.4 ± 11.56 years, with median time to distant dural metastasis of 73.03 ± 3.32 months. The median overall survival was 133.93 ± 8.2 months. Nine out of ten patients harbored their first dural metastasis in the perisylvian region. Radiographically, dural ONB metastasis initially present with focal dural thickening that becomes progressively nodular in shape. With time, the nodular component change in the signal intensity with progressive cystic appearance demonstrated with hyperintense central core on T2 weighted MR imaging with peripheral contrast enhancement. CONCLUSION: Here, we present the first and largest series of non-contiguous dural-based metastasis of ONBs. The unique natural history and geographical distribution of these metastatic lesions suggest a common mechanism of tumor spread that target specific regions within the dura. More detailed investigation into this phenomenon will provide greater insight into the progression and the pathophysiological features that underlying this unique disease process.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".