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Pereira L, Kitumba D, Fontoura MG, João DA, Mascarenhas L, Resende M. A Rare Lesion in the Anterior Region of the Third Ventricle: Rosette-Forming Glioneuronal Tumor. Cureus 2024; 16:e51971. [PMID: 38333478 PMCID: PMC10853027 DOI: 10.7759/cureus.51971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2024] [Indexed: 02/10/2024] Open
Abstract
Rosette-forming glioneuronal tumor (RGNT) is a rare and indolent mixed glioneuronal tumor involving primarily the fourth ventricular region and occurring predominantly in young adults. We present a case of a 44-year-old woman presented with progressive headaches, vomiting, and a sudden decreasing level of consciousness. The magnetic resonance imaging showed a regular lesion within the anterior portion of the third ventricle and the patient underwent an endoscopic approach to remove the tumor that was exclusively within the anterior portion of the third ventricle. Histopathology showed an RGNT that was totally removed. We also report some unusual complications that are described in the literature and are related to ventricular endoscopy such as seizures and hydroelectrolyte disorders. With two years of follow-up, the patient had no complaints and no tumor progression was observed.
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Affiliation(s)
- Leopoldina Pereira
- Neurosurgery, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, PRT
| | - Djamel Kitumba
- Neurosurgery, Complexo Hospitalar de Doenças Cardio-Pulmonar Cardial Dom Alexandre do Nascimento, Luanda, AGO
| | - Mário Gil Fontoura
- Internal Medicine, Centro Hospitalar de Entre Douro e Vouga, Santa Maria da Feira, PRT
| | - David A João
- Pathology, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, PRT
| | - Lino Mascarenhas
- Neurological Surgery, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, PRT
| | - Mário Resende
- Neurological Surgery, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, PRT
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Szu JI, Tsigelny IF, Wojcinski A, Kesari S. Biological functions of the Olig gene family in brain cancer and therapeutic targeting. Front Neurosci 2023; 17:1129434. [PMID: 37274223 PMCID: PMC10232966 DOI: 10.3389/fnins.2023.1129434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 04/26/2023] [Indexed: 06/06/2023] Open
Abstract
The Olig genes encode members of the basic helix-loop-helix (bHLH) family of transcription factors. Olig1, Olig2, and Olig3 are expressed in both the developing and mature central nervous system (CNS) and regulate cellular specification and differentiation. Over the past decade extensive studies have established functional roles of Olig1 and Olig2 in development as well as in cancer. Olig2 overexpression drives glioma proliferation and resistance to radiation and chemotherapy. In this review, we summarize the biological functions of the Olig family in brain cancer and how targeting Olig family genes may have therapeutic benefit.
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Affiliation(s)
- Jenny I. Szu
- Department of Translational Neurosciences, Providence Saint John’s Health Center, Saint John’s Cancer Institute, Santa Monica, CA, United States
| | - Igor F. Tsigelny
- San Diego Supercomputer Center, University of California, San Diego, San Diego, CA, United States
- CureScience, San Diego, CA, United States
| | - Alexander Wojcinski
- Department of Translational Neurosciences, Providence Saint John’s Health Center, Saint John’s Cancer Institute, Santa Monica, CA, United States
- Pacific Neuroscience Institute, Santa Monica, CA, United States
| | - Santosh Kesari
- Department of Translational Neurosciences, Providence Saint John’s Health Center, Saint John’s Cancer Institute, Santa Monica, CA, United States
- Pacific Neuroscience Institute, Santa Monica, CA, United States
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3
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Lerond J, Morisse MC, Letourneur Q, Gimonnet C, Navarro S, Gaspar C, Idbaih A, Bielle F. Immune Microenvironment and Lineage Tracing Help to Decipher Rosette-Forming Glioneuronal Tumors: A Multi-Omics Analysis. J Neuropathol Exp Neurol 2022; 81:873-884. [PMID: 35984315 DOI: 10.1093/jnen/nlac074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Rosette-forming glioneuronal tumors (RGNT) are rare low-grade primary central nervous system (CNS) tumors. The methylation class (MC) RGNT (MC-RGNT) delineates RGNT from other neurocytic CNS tumors with similar histological features. We performed a comprehensive molecular analysis including whole-exome sequencing, RNAseq, and methylome on 9 tumors with similar histology, focusing on the immune microenvironment and cell of origin of RGNT. Three RGNT in this cohort were plotted within the MC-RGNT and characterized by FGFR1 mutation plus PIK3CA or NF1 mutations. RNAseq analysis, validated by immunohistochemistry, identified 2 transcriptomic groups with distinct immune microenvironments. The "cold" group was distinguishable by a low immune infiltration and included the 3 MC-RGNT and 1 MC-pilocytic astrocytoma; the "hot" group included other tumors with a rich immune infiltration. Gene set enrichment analysis showed that the "cold" group had upregulated NOTCH pathway and mainly oligodendrocyte precursor cell and neuronal phenotypes, while the "hot" group exhibited predominantly astrocytic and neural stem cell phenotypes. In silico deconvolution identified the cerebellar granule cell lineage as a putative cell of origin of RGNT. Our study identified distinct tumor biology and immune microenvironments as key features relevant to the pathogenesis and management of RGNT.
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Affiliation(s)
- Julie Lerond
- Institut du Cerveau-Paris Brain Institute-ICM, Inserm, CNRS, Sorbonne Université, AP-HP, SIRIC Curamus, Paris, France
| | - Mony Chenda Morisse
- AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Neurologie 2-Mazarin, Paris, France
| | | | | | - Soledad Navarro
- AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Neurochirurgie, Paris, France
| | - Cassandra Gaspar
- Sorbonne Université, Inserm, UMS Production et Analyse des données en Sciences de la vie et en Santé, PASS, Plateforme Post-génomique de la Pitié-Salpêtrière, Paris, France
| | - Ahmed Idbaih
- Sorbonne Université, AP-HP, Institut du Cerveau-Paris Brain Institute-ICM, Inserm, CNRS, Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Neurologie 2-Mazarin, Paris, France
| | - Franck Bielle
- Sorbonne Université, AP-HP, Institut du Cerveau-Paris Brain Institute-ICM, Inserm, CNRS, Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Service de Neuropathologie, Paris, France.,AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Onconeurotek, Paris, France
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4
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Lin CC, Mansukhani MM, Bruce JN, Canoll P, Zanazzi G. Rosette-Forming Glioneuronal Tumor in the Pineal Region: A Series of 6 Cases and Literature Review. J Neuropathol Exp Neurol 2021; 80:933-943. [PMID: 34498065 DOI: 10.1093/jnen/nlab089] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Resected lesions from the pineal region are rare specimens encountered by surgical pathologists, and their heterogeneity can pose significant diagnostic challenges. Here, we reviewed 221 pineal region lesions resected at New York-Presbyterian Hospital/Columbia University Irving Medical Center from 1994 to 2019 and found the most common entities to be pineal parenchymal tumors (25.3%), glial neoplasms (18.6%), and germ cell tumors (17.6%) in this predominantly adult cohort of patients. Six cases of a rare midline entity usually found exclusively in the fourth ventricle, the rosette-forming glioneuronal tumor, were identified. These tumors exhibit biphasic morphology, with a component resembling pilocytic astrocytoma admixed with variable numbers of small cells forming compact rosettes and perivascular pseudorosettes. Targeted sequencing revealed a 100% co-occurrence of novel and previously described genetic alterations in the mitogen-activated protein kinase (MAPK) and phosphoinositide 3-kinase (PI3K) signaling pathways, suggesting a synergistic role in tumor formation. The most common recurrent mutation, PIK3CA H1047R, was identified in tumor cells forming rosettes and perivascular pseudorosettes. A review of the literature revealed 16 additional cases of rosette-forming glioneuronal tumors in the pineal region. Although rare, this distinctive low-grade tumor warrants consideration in the differential diagnosis of pineal region lesions.
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Affiliation(s)
- Chun-Chieh Lin
- From the Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, New York, USA.,Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Mahesh M Mansukhani
- From the Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, New York, USA
| | - Jeffrey N Bruce
- Department of Neurosurgery, Columbia University Irving Medical Center, New York, New York, USA
| | - Peter Canoll
- From the Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, New York, USA
| | - George Zanazzi
- Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA.,Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
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Verbančič T, Ravnik J, Kavalar R. Rosette-forming glioneuronal tumor of the fourth ventricle; A case report and review of the literature. Clin Case Rep 2021; 9:e04355. [PMID: 34429970 PMCID: PMC8369514 DOI: 10.1002/ccr3.4355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 03/21/2021] [Accepted: 04/28/2021] [Indexed: 11/11/2022] Open
Abstract
Despite mostly indolent course and favorable postoperative outcome long-term follow-up studies are needed to identify the most appropriate therapeutic strategies to minimize surgical morbidity and neurologic injury in patients with RGNT.
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Affiliation(s)
- Tadeja Verbančič
- Department of PathologyUniversity Medical Centre MariborMariborSlovenia
| | - Janez Ravnik
- Department of NeurosurgeryUniversity Medical Centre MariborMariborSlovenia
| | - Rajko Kavalar
- Department of PathologyUniversity Medical Centre MariborMariborSlovenia
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Uchiyama T, Gomi A, Nobusawa S, Fukushima N, Matsubara D, Kawai K. A case of a rosette-forming glioneuronal tumor with clinicopathological features of a dysembryoplastic neuroepithelial tumor and fibroblast growth factor receptor 1 internal tandem duplication. Brain Tumor Pathol 2021; 38:250-256. [PMID: 33837479 DOI: 10.1007/s10014-021-00397-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 03/16/2021] [Indexed: 10/21/2022]
Abstract
Rosette-forming glioneuronal tumors (RGNTs) are benign WHO grade 1 tumors that occur in the ventricular system, particularly the fourth ventricle. RGNTs and dysembryoplastic neuroepithelial tumors (DNTs) are both categorized as neuronal and mixed neuronal-glial tumors and may be difficult to distinguish. Coexistence of the two tumor types has been reported. Here, we report a pediatric case of RGNT with DNT-like features showing intraventricular dissemination. The tumor occurred in the medial temporal lobe and presented with specific pathological glioneuronal elements including floating neurons, which are typical in DNTs, but was diagnosed as RGNT because of the presence of neurocytic rosettes. Genetic analysis detected fibroblast growth factor receptor 1 internal tandem duplication (FGFR1-ITD) of the tyrosine kinase domain, which was previously reported to be specific for DNT. RGNTs with FGFR1-ITD may show atypical clinical presentation and pathological features.
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Affiliation(s)
- Taku Uchiyama
- Department of Neurosurgery, Jichi Medical University Saitama Medical Center, 1-847 Amanumacho, Omiya-ku Saitama, Saitama, 330-8503, Japan.
| | - Akira Gomi
- Department of Pediatric Neurosurgery, Jichi Children's Medical Center Tochigi, Jichi Medical University, Tochigi, Japan
| | - Sumihito Nobusawa
- Department of Human Pathology, Gunma University Graduate School of Medicine, Gunma, Japan
| | | | | | - Kensuke Kawai
- Department of Neurosurgery, Jichi Medical University, Tochigi, Japan
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Hockman JT, El Tecle NE, Urquiaga JF, Alexopoulos G, Guzman MA, Coppens J. Dissemination Patterns and Short-Term Management of Multifocal Rosette-Forming Glioneuronal Tumors. World Neurosurg 2021; 149:86-93. [PMID: 33610864 DOI: 10.1016/j.wneu.2021.02.043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 02/09/2021] [Accepted: 02/10/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Multifocal rosette-forming glioneuronal tumors (RGNTs) are challenging to manage. Gross total resection is often impossible, and data on adjunctive therapies are limited. We reviewed cases of multifocal RGNTs in the literature with special focus on dissemination patterns and management. METHODS A literature review was conducted using PubMed and the key words "(multifocal OR multicentric OR satellite OR dissemination) AND glioneuronal." RESULTS There were 21 cases of multifocal RGNTs identified. Follow-up was available in 18 cases at a median of 17 months. Progression-free survival and overall survival at 1 year were 84% and 94%, respectively. Of all cases, 43% had cerebrospinal fluid (CSF) dissemination, 48% had intraparenchymal spread, and 10% had both. The presence of CSF dissemination led to palliative care and/or death in 20% of cases (n = 2). None of the cases with intraparenchymal spread progressed. Radiotherapy was used in 50% of cases with CSF dissemination, chemotherapy was used in 20%, and CSF shunting was used in 36%. No tumors with intraparenchymal spread required adjunctive therapy or shunting. CONCLUSIONS RGNTs with CSF dissemination are more likely to behave aggressively, and early adjunctive therapies should be discussed with patients. Tumors with intraparenchymal spread grow slowly, and maximal safe resection followed by observation is likely sufficient in the short term. Long-term behavior of multifocal RGNTs is still unclear.
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Affiliation(s)
- Jakob T Hockman
- Department of Neurosurgery, Saint Louis University School of Medicine, St. Louis, Missouri, USA; Department of Pathology, Saint Louis University School of Medicine, St. Louis, Missouri, USA
| | - Najib E El Tecle
- Department of Neurosurgery, Saint Louis University School of Medicine, St. Louis, Missouri, USA.
| | - Jorge F Urquiaga
- Department of Neurosurgery, Saint Louis University School of Medicine, St. Louis, Missouri, USA
| | - Georgios Alexopoulos
- Department of Neurosurgery, Saint Louis University School of Medicine, St. Louis, Missouri, USA
| | - Miguel A Guzman
- Department of Pathology, Saint Louis University School of Medicine, St. Louis, Missouri, USA
| | - Jeroen Coppens
- Department of Neurosurgery, Saint Louis University School of Medicine, St. Louis, Missouri, USA
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Abstract
Rosette-forming glioneuronal tumor is a rare World Health Organization grade I neoplasm, primarily involving the posterior fossa. Most cases have been reported in young adults. Although maximal surgical resection is advocated, a precise treatment modality is yet to be established. We describe an unusual presentation of rosette-forming glioneuronal tumor occurring in the optic pathway in a child. As the site of the tumor was not amenable to resection, he underwent radiotherapy and is currently well on follow-up.
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Wilson CP, Chakraborty AR, Pelargos PE, Shi HH, Milton CK, Sung S, McCoy T, Peterson JE, Glenn CA. Rosette-forming glioneuronal tumor: an illustrative case and a systematic review. Neurooncol Adv 2020; 2:vdaa116. [PMID: 33134925 PMCID: PMC7586144 DOI: 10.1093/noajnl/vdaa116] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background Rosette-forming glioneuronal tumors (RGNTs) are rare, low-grade, primary CNS tumors first described in 2002 by Komori et al. RGNTs were initially characterized as a World Health Organization (WHO) grade I tumors typically localized to the fourth ventricle. Although commonly associated with an indolent course, RGNTs have the potential for aggressive behavior. Methods A comprehensive search of PubMed and Web of Science was performed through November 2019 using the search term “rosette-forming glioneuronal tumor.” Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. English, full-text case reports and series with histopathological confirmation were included. Patient demographics, presentations, MRI features, tumor location, treatment, and follow-up of all 130 cases were extracted. Results A 19-year-old man with a history of epilepsy and autism presented with acute hydrocephalus. MRI scans from 2013 to 2016 demonstrated unchanged abnormal areas of cortex in the left temporal lobe with extension into the deep gray-white matter. On presentation to our clinic in 2019, the lesion demonstrated significant progression. The patient’s tumor was identified as RGNT, WHO grade I. One hundred thirty patients were identified across 80 studies. Conclusion RGNT has potential to transform from an indolent tumor to a tumor with more aggressive behavior. The results of our systematic review provide insight into the natural history and treatment outcomes of these rare tumors.
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Affiliation(s)
- Caleb P Wilson
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Arpan R Chakraborty
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Panayiotis E Pelargos
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Helen H Shi
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Camille K Milton
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Sarah Sung
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Tressie McCoy
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Jo Elle Peterson
- Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Chad A Glenn
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
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Mahavadi AK, Temmins C, Patel MR, Singh H. Supratentorial intraventricular rosette-forming glioneuronal tumors - Case report and review of treatment paradigms. Surg Neurol Int 2020; 11:138. [PMID: 32547825 PMCID: PMC7294172 DOI: 10.25259/sni_188_2019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 03/30/2020] [Indexed: 11/04/2022] Open
Abstract
Background Rosette-forming glioneuronal tumors (RGNT) are slow-growing WHO Grade I tumors that are characterized by mixed histology and rosette formation. Although typically located in the posterior fossa, these tumors can rarely originate elsewhere. Here, we describe the fourth case in literature where an RGNT was localized to the lateral ventricles and detail the treatment approach. Case Description A 41-year-old male presented with a 10 day history of gradually worsening headaches and mild gait difficulty. Computed tomography and magnetic resonance imaging (MRI) identified a heterogeneously enhancing 6.0 cm left lateral ventricular cystic mass with hydrocephalus. An interhemispheric transcallosal approach was performed for tumor debulking. The mass was emanating from the roof of the left lateral ventricle. Sub-total resection (STR) was achieved. Pathology showed a glioneuronal neoplasm with vague neurocytic rosettes and loose perivascular pseudorosettes. Tumor vessels were thickly hyalinized and contained eosinophilic granular bodies and Rosenthal fibers. Tumor stained positive for GFAP, S-100, OLIG2, and SOX10, and patchy positive for epithelial membrane antigen (EMA), D2-40, CD99, and p16. Neurocytic rosettes and perivascular structures stained positive for synaptophysin. The patient was discharged home uneventfully and remained intact at his 6-month follow-up visit. Long-term care included MRI surveillance with repeat surgery being considered in case of progression. Conclusion In this report, we describe the fourth case of an RGNT being isolated to the lateral ventricles and the first where it stained positive for EMA and D2-40. Our patient's uneventful recovery after STR indicates that surgery alone continues to be a viable initial treatment option.
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Affiliation(s)
- Anil K Mahavadi
- Department of Neurosurgery, University of Miami, Miami, Florida, United States
| | - Caroline Temmins
- Departments of Pathology, Santa Clara Valley Medical Center, San Jose, California, United States
| | - Mahesh R Patel
- Departments of Radiology, Santa Clara Valley Medical Center, San Jose, California, United States
| | - Harminder Singh
- Departments of Neurosurgery, Santa Clara Valley Medical Center, San Jose, California, United States
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Muhammad S, Hafez A, Karppinen A, Niemelä M. Surgical treatment of a rare rosette-forming glioneuronal tumor in the pineal region. Surg Neurol Int 2020; 11:68. [PMID: 32363063 PMCID: PMC7193215 DOI: 10.25259/sni_294_2019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 03/17/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Rosette-forming glioneuronal tumors (RGNTs) in the pineal region are rare. RGNTs have been described in the fourth ventricle, but rarely reported in other brain regions. Here, we report the radiological findings, surgical treatment, and short-term outcome of an RGNT found in the pineal region. CASE DESCRIPTION We present a case of a 22-year-old medical student with a 4-month history of headaches and diplopia. A previous magnetic resonance imaging scan revealed a mass in the pineal region, with heterogeneous contrast enhancement and hydrocephalus. Three months prior, an endoscopic biopsy and third ventriculocisternostomy were performed elsewhere; the diagnosis was neurocytoma Grade I, and radiotherapy was planned. The patient presented at our hospital for a second opinion, and we suggested surgical treatment. A near-total resection was performed in sitting position using a supracerebellar infratentorial microsurgical approach. The tumor was very soft and not well vascularized. Diplopia was initially worsened after the tumor was removed and relieved completely after 2 weeks. An 8-week follow-up examination revealed that the patient was free of symptoms. Histological analysis confirmed it was an RGNT. CONCLUSION Maximal safe resection in pineal region RGNTs is a feasible and recommended treatment option.
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Affiliation(s)
- Sajjad Muhammad
- Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Neurosurgery, Heinrich-Heine University Medical Center, Düsseldorf, Germany
| | - Ahmad Hafez
- Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Atte Karppinen
- Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Mika Niemelä
- Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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Rosette-forming glioneuronal tumor of the aqueduct of Sylvius: Case report and literature review. INTERDISCIPLINARY NEUROSURGERY 2020. [DOI: 10.1016/j.inat.2019.100584] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Silveira L, DeWitt J, Thomas A, Tranmer B. Disseminated Rosette-Forming Glioneuronal Tumor with Spinal Drop Metastasis, a Uniquely Aggressive Presentation of Rare Tumor. World Neurosurg 2019; 132:7-11. [DOI: 10.1016/j.wneu.2019.08.055] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 08/07/2019] [Accepted: 08/09/2019] [Indexed: 12/31/2022]
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Kwon SM, Kim JH, Byun J, Kim YH, Hong SH, Cho YH, Kim CJ. Malignant Transformation of a Rosette-Forming Glioneuronal Tumor to Glioblastoma. World Neurosurg 2019; 130:271-275. [PMID: 31203071 DOI: 10.1016/j.wneu.2019.06.042] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 06/02/2019] [Accepted: 06/03/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND A rosette-forming glioneuronal tumor (RGNT), a rare brain tumor, presents as a benign feature with a favorable outcome. To date, a few cases with aggressive behaviors, such as recurrence or dissemination, but none with malignant transformation, have been reported. We describe 1 case that recurred as glioblastoma after complete resection of the benign RGNT. CASE DESCRIPTION A man aged 58 years presented with headache and dizziness without neurologic symptoms. Magnetic resonance imaging showed a 4 × 2.5 cm, well-demarcated mass in the left cerebellar hemisphere. The patient underwent gross total resection of the tumor and a diagnosis of RGNT was made. There was no evidence of recurrence on serial follow-up. However, a recurrent heterogeneous enhancing mass in the previous surgical cavity was observed on a 7-year postoperative magnetic resonance imaging scan. Reoperation was performed and a histopathological study revealed a glioblastoma. CONCLUSIONS To the best of our knowledge, this is the first case of spontaneous malignant transformation of an RGNT. Our case may be helpful in better understanding the biological behavior and clinical outcome of RGNT. We emphasize the malignant potential of this rare tumor and the necessity of future large-scaled research for most appropriate therapeutic strategies.
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Affiliation(s)
- Sae Min Kwon
- Department of Neurosurgery, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| | - Jeong Hoon Kim
- Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
| | - Joonho Byun
- Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young-Hoon Kim
- Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seok Ho Hong
- Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young Hyun Cho
- Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chang Jin Kim
- Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Spena G, Panciani PP, Mattogno PP, Roca E, Poliani PL, Fontanella M. A multimodal staged approach for the resection of a Sylvian aqueduct rosette-forming glioneuronal tumor: A case report and literature review. INTERDISCIPLINARY NEUROSURGERY 2019. [DOI: 10.1016/j.inat.2018.05.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Jayapalan RR, Mun KS, Wong KT, Sia SF. Malignant Transformation of a Rosette-Forming Glioneuronal Tumor with IDH1 Mutation: A Case Report and Literature Review. World Neurosurg X 2019; 2:100006. [PMID: 31218281 PMCID: PMC6580885 DOI: 10.1016/j.wnsx.2018.100006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Accepted: 12/23/2018] [Indexed: 01/18/2023] Open
Abstract
Background Rosette-forming glioneuronal tumor (World Health Organization grade I) is considered as a benign tumor with very low potential for progression. The potential for malignant transformation of this tumor is not known and has never been reported before in literature. Case Description We report a 42-year-old man, diagnosed with rosette-forming glioneuronal tumor of the fourth ventricle with a positive isocitrate dehydrogenase 1 mutation, progressed to glioblastoma after 6 years from diagnosis. We discuss the clinical history, radiological findings, and histopathological characteristic with immunohistochemistry findings observed in this unique case. Conclusions Despite being acceptable as benign, based on our observations in this case, there is a potential for malignant transformation of rosette-forming glioneuronal tumor. The role of isocitrate dehydrogenase 1 mutation leading to malignant transformation could not be established as our finding is novel and further prospective studies are required to prove this association.
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Affiliation(s)
- Ronie Romelean Jayapalan
- Division of Neurosurgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- To whom correspondence should be addressed: Ronie Romelean Jayapalan, M.B.B.S., M.R.C.S.
| | - Kein Seong Mun
- Department of Pathology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Kum Thong Wong
- Department of Pathology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Sheau Fung Sia
- Division of Neurosurgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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17
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Muly S, Liu S, Lee R, Nicolaou S, Rojas R, Khosa F. MRI of intracranial intraventricular lesions. Clin Imaging 2018; 52:226-239. [DOI: 10.1016/j.clinimag.2018.07.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Revised: 05/26/2018] [Accepted: 07/23/2018] [Indexed: 01/25/2023]
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18
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Histopathological, molecular, clinical and radiological characterization of rosette-forming glioneuronal tumor in the central nervous system. Oncotarget 2017; 8:109175-109190. [PMID: 29312599 PMCID: PMC5752512 DOI: 10.18632/oncotarget.22646] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 10/29/2017] [Indexed: 12/27/2022] Open
Abstract
Objective A rosette-forming glioneuronal tumor (RGNT) is a rare entity originally described in the fourth ventricle. Recently, RGNTs occurring in extraventricular sites and those with malignant behaviors have been reported. The purpose of this study was to analyze the clinicoradiological and histopathological features, therapeutic strategies, and outcomes of RGNTs. Methods We enrolled 38 patients diagnosed with RGNTs pathologically between August 2009 and June 2016. CT and MRI, including diffusion-weighted imaging and spectroscopy, were performed. The surgical treatment and histopathological and molecular features were assessed. Additionally, we searched the relevant literatures and performed a pooled analysis of individual patient data. The potential risk factors of prognosis were analyzed. Results Our case series included 22 male and 16 female patients, with a mean age of 25.9 years. RGNTs involved the fourth ventricle (26.3%), cerebella (34.2%), supratentorial ventricular system (13.2%), spinal cord (10.5%), temporal lobe (10.5%), thalamus (7.9%), brain stem (7.9%), frontal lobe (5.3%), pineal region (5.3%), suprasellar region (2.6%), and basal ganglia (2.6%). Statistical analyses showed that pediatric age, purely solid appearance of the tumor, and inadequate resection (only partial removal or biopsy) were risk factors associated with progression events. Patients with subtotal resection appeared to do as well as those with gross total resection. Conclusions RGNTs can occur nearly anywhere in the CNS, at both supratentorial and infratentorial sites. Maximal safe surgical resection should be emphasized for treatment; whilst aggressive resection with the goal of complete resection may be unnecessary.
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19
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Morris C, Prudowsky ZD, Shetty V, Geller T, Elbabaa SK, Guzman M, AbdelBaki MS. Rosette-Forming Glioneuronal Tumor of the Fourth Ventricle in Children: Case Report and Literature Review. World Neurosurg 2017; 107:1045.e9-1045.e16. [PMID: 28826709 DOI: 10.1016/j.wneu.2017.07.150] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 07/24/2017] [Accepted: 07/26/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Rosette-forming glioneuronal tumor (RGNT) of the fourth ventricle is a rare World Health Organization (WHO) grade I neoplasm. Gross total resection (GTR) is the treatment of choice, and there is no firm evidence supporting other treatment options when GTR is not feasible. CASE DESCRIPTION We report a 6-year-old boy who, following an initial subtotal resection of a fourth ventricular RGNT, received an individualized chemotherapy protocol with vincristine, etoposide, and carboplatin for 3 cycles. The tumor was stable for 2 years after the completion of chemotherapy but then began to progress, at which point GTR was successfully performed. In addition, we completed a comprehensive literature review of RGNT cases. To date, a total of 104 cases have been reported, 33 of which are pediatric cases. Recurrence has been reported in only 7 cases of all ages (4 in the pediatric population). Radiotherapy has been used in several cases, but adjuvant chemotherapy has been reported only once following a recurrence. CONCLUSIONS We report a case of chemotherapy administration as a first-line treatment for a subtotally resected RGNT. Chemotherapy may be considered as an adjuvant therapy option for RGNT when GTR cannot be achieved. Furthermore, increased incidence of recurrence in the pediatric population may suggest that the tumor biology of RGNT in children differs from that in adults.
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Affiliation(s)
- Cynthia Morris
- Department of Child Neurology, St. Louis University School of Medicine, St. Louis, Missouri
| | | | - Vilaas Shetty
- Department of Radiology, St. Louis University School of Medicine, St. Louis, Missouri
| | - Thomas Geller
- Department of Child Neurology, St. Louis University School of Medicine, St. Louis, Missouri
| | - Samer K Elbabaa
- Department of Neurosurgery, St. Louis University School of Medicine, St. Louis, Missouri
| | - Miguel Guzman
- Department of Pathology, St. Louis University School of Medicine, St. Louis, Missouri
| | - Mohamed S AbdelBaki
- Division of Hematology, Oncology, and Bone Marrow Transplant, Nationwide Children's Hospital, Columbus, Ohio.
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20
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Kitamura Y, Komori T, Shibuya M, Ohara K, Saito Y, Hayashi S, Sasaki A, Nakagawa E, Tomio R, Kakita A, Nakatsukasa M, Yoshida K, Sasaki H. Comprehensive genetic characterization of rosette-forming glioneuronal tumors: independent component analysis by tissue microdissection. Brain Pathol 2017; 28:87-93. [PMID: 27893178 DOI: 10.1111/bpa.12468] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 11/23/2016] [Indexed: 12/30/2022] Open
Abstract
A rosette-forming glioneuronal tumor (RGNT) is a rare mixed neuronal-glial tumor characterized by biphasic architecture of glial and neurocytic components. The number of reports of genetic analyses of RGNTs is few. Additionally, the genetic background of the unique biphasic pathological characteristics of such mixed neuronal-glial tumors remains unclear. To clarify the genetic background of RGNTs, we performed separate comprehensive genetic analyses of glial and neurocytic components of five RGNTs, by tissue microdissection. Two missense mutations in FGFR1 in both components of two cases, and one mutation in PIK3CA in both components of one case, were detected. In the latter case with PIK3CA mutation, the additional FGFR1 mutation was detected only in the glial component. Moreover, the loss of chromosome 13q in only the neurocytic component was observed in one other case. Their results suggested that RGNTs, which are tumors harboring two divergent differentiations that arose from a single clone, have a diverse genetic background. Although previous studies have suggested that RGNTs and pilocytic astrocytomas (PAs) represent the same tumor entity, their results confirm that the genetic background of RGNTs is not identical to that of PA.
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Affiliation(s)
- Yohei Kitamura
- Department of Neurosurgery, Saiseikai Utsunomiya Hospital, 911-1 Takebayashimachi, Utsunomiya, Tochigi, 321-0974, Japan.,Department of Neurosurgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Takashi Komori
- Department of Laboratory Medicine and Pathology (Neuropathology), Tokyo Metropolitan Neurological Hospital, 2-6-1 Musashidai, Fuchu, Tokyo, 183-0042, Japan
| | - Makoto Shibuya
- Department of Laboratory Medicine, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji, Tokyo, 193-0998, Japan
| | - Kentaro Ohara
- Department of Pathology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.,Department of Pathology, Saiseikai Utsunomiya Hospital, 911-1 Takebayashimachi, Utsunomiya, Tochigi, 321-0974, Japan
| | - Yuko Saito
- Department of Laboratory Medicine, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashicho, Kodaira, Tokyo, 187-8551, Japan
| | - Saeko Hayashi
- Department of Neurosurgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.,Department of Neurosurgery, Eiju General Hospital, 2-23-16 Higashi-Ueno, Taito-ku, Tokyo, 110-8645, Japan
| | - Aya Sasaki
- Division of Diagnostic Pathology, Keio University Hospital, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Eiji Nakagawa
- Department of Child Neurology, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashicho, Kodaira, Tokyo, 187-8551, Japan
| | - Ryosuke Tomio
- Department of Neurosurgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Akiyoshi Kakita
- Department of Pathology, Brain Research Institute, Niigata University, 1 Asahimachi, Chuo-ku, Niigata, 951-8585, Japan
| | - Masashi Nakatsukasa
- Department of Neurosurgery, Saiseikai Utsunomiya Hospital, 911-1 Takebayashimachi, Utsunomiya, Tochigi, 321-0974, Japan
| | - Kazunari Yoshida
- Department of Neurosurgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Hikaru Sasaki
- Department of Neurosurgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
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21
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Duan L, Zhang Y, Fu W, Geng S. Rosette-Forming Glioneuronal Tumor Originating From the Spinal Cord: Report of 2 Cases and Literature Review. World Neurosurg 2017; 98:875.e1-875.e7. [DOI: 10.1016/j.wneu.2016.11.109] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 11/20/2016] [Accepted: 11/21/2016] [Indexed: 01/13/2023]
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22
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Kim JE, Cho HR, Xu WJ, Kim JY, Kim SK, Kim SK, Park SH, Kim H, Lee SH, Choi SH, Park S, Park CK. Mechanism for enhanced 5-aminolevulinic acid fluorescence in isocitrate dehydrogenase 1 mutant malignant gliomas. Oncotarget 2016; 6:20266-77. [PMID: 26008980 PMCID: PMC4653003 DOI: 10.18632/oncotarget.4060] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Accepted: 04/22/2015] [Indexed: 11/25/2022] Open
Abstract
Fluorescence-guided surgery using 5-aminolevulinic acid (5-ALA) has become the main treatment modality in malignant gliomas. However unlike glioblastomas, there are inconsistent result about fluorescence status in WHO grade III gliomas. Here, we show that mutational status of IDH1 is linked to 5-ALA fluorescence. Using genetically engineered malignant glioma cells harboring wild type (U87MG-IDH1WT) or mutant (U87MG-IDH1R132H) IDH1, we demonstrated a lag in 5-ALA metabolism and accumulation of protoporphyrin IX (PpIX) in U87MG-IDH1R132H cells. Next, we used liquid chromatography–mass spectrometry (LC-MS) to screen for tricarboxylic acid (TCA) cycle-related metabolite changes caused by 5-ALA exposure. We observed low baseline levels of NADPH, an essential cofactor for the rate-limiting step of heme degradation, in U87MG-IDH1R132H cells. High levels of NADPH are required to metabolize excessive 5-ALA, giving a plausible reason for the temporarily enhanced 5-ALA fluorescence in mutant IDH1 cells. This hypothesis was supported by the results of metabolic screening in human malignant glioma samples. In conclusion, we have discovered a relationship between enhanced 5-ALA fluorescence and IDH1 mutations in WHO grade III gliomas. Low levels of NADPH in tumors with mutated IDH1 is responsible for the enhanced fluorescence.
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Affiliation(s)
- Ja Eun Kim
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul National University Hospital, Jongno-gu, Seoul, Korea
| | - Hye Rim Cho
- Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, Jongno-gu, Seoul, Korea
| | - Wen Jun Xu
- College of Pharmacy, Natural Product Research Institute, Seoul National University, Sillim-dong, Gwanak-gu, Seoul, Korea
| | - Ji Young Kim
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul National University Hospital, Jongno-gu, Seoul, Korea
| | - Sung Kwon Kim
- Department of Neurosurgery, Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Jinju, Korea
| | - Seung-Ki Kim
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul National University Hospital, Jongno-gu, Seoul, Korea.,Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Jongno-gu, Seoul, Korea
| | - Sung-Hye Park
- Department of Pathology, Seoul National University College of Medicine, Seoul National University Hospital, Jongno-gu, Seoul, Korea
| | - Hyeonjin Kim
- Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, Jongno-gu, Seoul, Korea
| | - Se-Hoon Lee
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seung Hong Choi
- Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, Jongno-gu, Seoul, Korea
| | - Sunghyouk Park
- College of Pharmacy, Natural Product Research Institute, Seoul National University, Sillim-dong, Gwanak-gu, Seoul, Korea
| | - Chul-Kee Park
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul National University Hospital, Jongno-gu, Seoul, Korea
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23
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Cebula H, Chibbaro S, Santin MN, Kremer S, Chaussemy D, Proust F. Thalamic rosette-forming a glioneuronal tumor in an elderly patient: Case report and literature review. Neurochirurgie 2015; 62:60-3. [PMID: 26705911 DOI: 10.1016/j.neuchi.2015.10.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Revised: 08/13/2015] [Accepted: 10/10/2015] [Indexed: 01/28/2023]
Abstract
The rosette-forming glioneuronal tumor (RGNT) is a novel type of brain tumor recently listed in the WHO 2007 classification of central nervous system (CNS) tumors. We report the case of a 75-year-old woman harboring a thalamic RGNT with third ventricle dissemination. Age and location make the present case exceptional and which has never previously been reported. A review of the clinical, pathological and radiological features is presented along with the relevant literature.
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Affiliation(s)
- H Cebula
- Service de neurochirurgie, hôpital de Hautepierre, CHU de Strasbourg, 67098 Strasbourg, France.
| | - S Chibbaro
- Service de neurochirurgie, hôpital de Hautepierre, CHU de Strasbourg, 67098 Strasbourg, France
| | - M N Santin
- Service de neurochirurgie, hôpital de Hautepierre, CHU de Strasbourg, 67098 Strasbourg, France
| | - S Kremer
- Service de neuroradiologie, hôpital de Hautepierre, CHU de Strasbourg, 67098 Strasbourg, France
| | - D Chaussemy
- Service de neurochirurgie, hôpital de Hautepierre, CHU de Strasbourg, 67098 Strasbourg, France
| | - F Proust
- Service de neurochirurgie, hôpital de Hautepierre, CHU de Strasbourg, 67098 Strasbourg, France
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24
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Combination of diffusion tensor imaging and conventional MRI correlates with isocitrate dehydrogenase 1/2 mutations but not 1p/19q genotyping in oligodendroglial tumours. Eur Radiol 2015; 26:1705-15. [PMID: 26396108 DOI: 10.1007/s00330-015-4025-4] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Revised: 07/30/2015] [Accepted: 09/10/2015] [Indexed: 12/22/2022]
Abstract
OBJECTIVES To explore the correlations of conventional MRI (cMRI) and diffusion tensor imaging (DTI) values with the 1p/19 codeletion and IDH mutations in oligodendroglial tumours (OTs). METHODS Eighty-four patients with OTs who underwent cMRI and DTI were retrospectively reviewed. The maximal fractional anisotropy and minimal apparent diffusion coefficient (ADC) were measured and compared using the Mann-Whitney U test. Receiver operating characteristic curves, logistic regression analysis and four-table statistics analysis were performed to predict genotypings. RESULTS OTs with 1p/19q codeletion or IDH mutations were prone to locate in frontal (P = 0.106 and 0.005, respectively) and insular lobes and were associated with absent or blurry contrast enhancement (P = 0.040 and 0.013, respectively). DTI values showed significant differences between OTs with and without IDH mutations (P < 0.05) but not in OTs with and without 1p/19q loss. The Ki-67 index significantly correlated with IDH mutations (P = 0.002) but not with 1p/19q codeletion. A combination of DTI and cMRI for the identification of IDH mutations resulted in sensitivity, specificity, positive and negative predictive values of 92.2 %, 75.8 %, 93.8 % and 71.1 %, respectively. CONCLUSIONS Combination of DTI and cMRI correlates with isocitrate dehydrogenase 1/2 mutations but not 1p/19q genotyping in OTs. KEY POINTS • OTs with 1p/19q codeletion were associated with absent or blurry contrast enhancement • OTs with IDH mutations were also associated with absent or blurry contrast enhancement • OTs with IDH mutations were prone to locate in frontal and insular lobes • DTI values can provide a non-invasive method for assessing the IDH status of OTs • A combination of DTI and cMRI correlates with isocitrate dehydrogenase 1/2 mutations.
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25
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Bidinotto LT, Scapulatempo-Neto C, Mackay A, de Almeida GC, Scheithauer BW, Berardinelli GN, Torrieri R, Clara CA, Feltrin LT, Viana-Pereira M, Varella-Garcia M, Jones C, Reis RM. Molecular Profiling of a Rare Rosette-Forming Glioneuronal Tumor Arising in the Spinal Cord. PLoS One 2015; 10:e0137690. [PMID: 26371886 PMCID: PMC4570813 DOI: 10.1371/journal.pone.0137690] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 08/19/2015] [Indexed: 01/27/2023] Open
Abstract
Rosette-forming glioneuronal tumor (RGNT) of the IV ventricle is a rare and recently recognized brain tumor entity. It is histologically composed by two distinct features: a glial component, resembling pilocytic astrocytoma, and a component forming neurocytic rosettes and/or perivascular rosettes. Herein, we describe a 33-year-old man with RGNT arising in the spinal cord. Following an immunohistochemistry validation, we further performed an extensive genomic analysis, using array-CGH (aCGH), whole exome and cancer-related hotspot sequencing, in order to better understand its underlying biology. We observed the loss of 1p and gain of 1q, as well as gain of the whole chromosomes 7, 9 and 16. Local amplifications in 9q34.2 and 19p13.3 (encompassing the gene SBNO2) were identified. Moreover, we observed focal gains/losses in several chromosomes. Additionally, on chromosome 7, we identified the presence of the KIAA1549:BRAF gene fusion, which was further validated by RT-PCR and FISH. Across all mutational analyses, we detected and validated the somatic mutations of the genes MLL2, CNNM3, PCDHGC4 and SCN1A. Our comprehensive molecular profiling of this RGNT suggests that MAPK pathway and methylome changes, driven by KIAA1549:BRAF fusion and MLL2 mutation, respectively, could be associated with the development of this rare tumor entity.
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Affiliation(s)
- Lucas Tadeu Bidinotto
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, SP, Brazil
- Barretos School of Health Sciences, Dr. Paulo Prata—FACISB, Barretos, SP, Brazil
| | - Cristovam Scapulatempo-Neto
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, SP, Brazil
- Department of Pathology, Barretos Cancer Hospital, Barretos, SP, Brazil
- * E-mail: (RMR); (CSN)
| | - Alan Mackay
- Divisions of Molecular Pathology and Cancer Therapeutics, Institute for Cancer Research, London, Surrey, United Kingdom
| | | | - Bernd Walter Scheithauer
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States of America
| | | | - Raul Torrieri
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, SP, Brazil
| | | | | | - Marta Viana-Pereira
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal
- 3B's—PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Marileila Varella-Garcia
- University of Colorado Anschutz Medical Campus, Medical Oncology/Department of Medicine, Aurora, Colorado, United States of America
| | - Chris Jones
- Divisions of Molecular Pathology and Cancer Therapeutics, Institute for Cancer Research, London, Surrey, United Kingdom
| | - Rui Manuel Reis
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, SP, Brazil
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal
- 3B's—PT Government Associate Laboratory, Braga/Guimarães, Portugal
- * E-mail: (RMR); (CSN)
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26
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Chen SY, Wang W, Wang LM, Lin QT, Zhao GG, Xu G, Lu DH, Piao YS. Glioneuronal tumours with features of rosette-forming glioneuronal tumours of the fourth ventricle and dysembryoplastic neuroepithelial tumours: a report of three cases. Histopathology 2015; 68:378-87. [PMID: 26040650 DOI: 10.1111/his.12750] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 05/30/2015] [Indexed: 12/18/2022]
Abstract
AIMS To study three atypical glioneuronal tumours (GNTs), in order to shed light on the clinical and pathological features of this diverse tumour group. METHODS AND RESULTS Clinical and neuropathological data for each case were retrospectively reviewed. Case 1 involved a 17-year-old boy with left leg movement difficulty. A mass lesion in the basal ganglia was detected radiologically; histopathological features included neurocytic/perivascular rosettes and a pilocytic astrocytoma component. Case 2 involved a 33-year-old man with intractable epilepsy. His left parietal lobe contained a cyst-like mass, resembling dysembryoplastic neuroepithelial tumour and rosette-forming glioneuronal tumour of the fourth ventricle microscopically. Case 3 involved a 21-year-old woman with a mass lesion in the mesencephalic tegmentum extending to the third and fourth ventricles and the suprasellar region. The lesion contained perivascular/neurocytic rosettes and an oligodendroglioma-like component. None of the tumours expressed an isocitrate dehydrogenase I mutation of the R132H type or contained a 1p/19q deletion, a BRAF(V600E) mutation, or KIAA1549-BRAF fusion. CONCLUSIONS We describe three GNTs with atypical histopathology and locations. Additional cases and molecular studies are needed to better understand the biological nature of GNTs and to refine their classification system.
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Affiliation(s)
- Shi-Yun Chen
- Department of Neuropathology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Wei Wang
- Department of Neuropathology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Lei-Ming Wang
- Department of Neuropathology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Qing-Tang Lin
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Guo-Guang Zhao
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Geng Xu
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - De-Hong Lu
- Department of Neuropathology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yue-Shan Piao
- Department of Neuropathology, Xuanwu Hospital, Capital Medical University, Beijing, China
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27
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Rosette-forming glioneuronal tumor originating in the hypothalamus. Brain Tumor Pathol 2015; 32:291-6. [PMID: 26156565 DOI: 10.1007/s10014-015-0226-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2015] [Accepted: 06/21/2015] [Indexed: 12/22/2022]
Abstract
Rosette-forming glioneuronal tumors (RGNT) of the fourth ventricle are slow-growing tumors that primarily involve the fourth ventricular region. We here report the first patient, an 8-year-old girl, with an RGNT originating in the hypothalamus and manifesting with precocious puberty. After partial removal, the remaining tumor showed rapid enlargement, and the pathologic diagnosis at the second surgery revealed histopathologic features similar to those found in the initial samples, including biphasic patterns of neurocytic rosettes and GFAP-stained astrocytic components. These tumor cells had mildly atypical nuclei; however, mitotic figures and necrosis were absent. Eosinophilic granular bodies and a glomeruloid vasculature were found, but Rosenthal fibers were absent. The Ki-67 proliferative index was 3.5 % (vs 1.1 % at the initial surgery). No recurrence was recorded during the 3-year period after the proton radiotherapy.
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28
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Imaging features of rosette-forming glioneuronal tumours (RGNTs): A Series of seven cases. Eur Radiol 2015; 26:262-70. [DOI: 10.1007/s00330-015-3808-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Revised: 04/03/2015] [Accepted: 04/16/2015] [Indexed: 12/22/2022]
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29
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Schlamann A, von Bueren AO, Hagel C, Zwiener I, Seidel C, Kortmann RD, Müller K. An individual patient data meta-analysis on characteristics and outcome of patients with papillary glioneuronal tumor, rosette glioneuronal tumor with neuropil-like islands and rosette forming glioneuronal tumor of the fourth ventricle. PLoS One 2014; 9:e101211. [PMID: 24991807 PMCID: PMC4084640 DOI: 10.1371/journal.pone.0101211] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Accepted: 06/04/2014] [Indexed: 12/15/2022] Open
Abstract
Background and Purpose In 2007, the WHO classification of brain tumors was extended by three new entities of glioneuronal tumors: papillary glioneuronal tumor (PGNT), rosette-forming glioneuronal tumor of the fourth ventricle (RGNT) and glioneuronal tumor with neuropil-like islands (GNTNI). Focusing on clinical characteristics and outcome, the authors performed a comprehensive individual patient data (IPD) meta-analysis of the cases reported in literature until December 2012. Methods PubMed, Embase and Web of Science were searched for peer-reviewed articles reporting on PGNT, RGNT, and GNTNI using predefined keywords. Results 95 publications reported on 182 patients (PGNT, 71; GNTNI, 26; RGNT, 85). Median age at diagnosis was 23 years (range 4–75) for PGNT, 27 years (range 6–79) for RGNT, and 40 years (range 2–65) for GNTNI. Ninety-seven percent of PGNT and 69% of GNTNI were located in the supratentorial region, 23% of GNTNI were in the spinal cord, and 80% of RGNT were localized in the posterior fossa. Complete resection was reported in 52 PGNT (73%), 36 RGNT (42%), and 7 GNTNI (27%) patients. Eight PGNT, 3 RGNT, and 12 GNTNI patients were treated with chemo- and/or radiotherapy as the primary postoperative treatment. Follow-up data were available for 132 cases. After a median follow-up time of 1.5 years (range 0.2–25) across all patients, 1.5-year progression-free survival rates were 52±12% for GNTNI, 86±5% for PGNT, and 100% for RGNT. The 1.5-year overall-survival were 95±5%, 98±2%, and 100%, respectively. Conclusions The clinical understanding of the three new entities of glioneuronal tumors, PGNT, RGNT and GNTNI, is currently emerging. The present meta-analysis will hopefully contribute to a delineation of their diagnostic, therapeutic, and prognostic profiles. However, the available data do not provide a solid basis to define the optimum treatment approach. Hence, a central register should be established.
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Affiliation(s)
- Annika Schlamann
- Department for Radiation Oncology, University of Leipzig Medical Center, Leipzig, Saxony, Germany
| | - André O. von Bueren
- Department of Pediatrics and Adolescent Medicine, Division of Pediatric Hematology and Oncology, University of Göttingen Medical Center, Göttingen, Lower Saxony, Germany
| | - Christian Hagel
- Department of Neuropathology, University of Hamburg Eppendorf Medical Center, Hamburg, Germany
| | - Isabella Zwiener
- Institute for Medical Biostatistics, Epidemiology and Informatics, University of Mainz Medical Center, Mainz, Rhineland-Palatinate, Germany
| | - Clemens Seidel
- Department for Radiation Oncology, University of Leipzig Medical Center, Leipzig, Saxony, Germany
| | - Rolf-Dieter Kortmann
- Department for Radiation Oncology, University of Leipzig Medical Center, Leipzig, Saxony, Germany
| | - Klaus Müller
- Department for Radiation Oncology, University of Leipzig Medical Center, Leipzig, Saxony, Germany
- * E-mail:
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Chiba K, Aihara Y, Eguchi S, Tanaka M, Komori T, Okada Y. Rosette-forming glioneuronal tumor of the fourth ventricle with neurocytoma component. Childs Nerv Syst 2014; 30:351-6. [PMID: 23817994 DOI: 10.1007/s00381-013-2216-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2013] [Accepted: 06/19/2013] [Indexed: 12/29/2022]
Abstract
Rosette-forming glioneuronal tumor (RGNT) was first published in 2002 and was described as a benign and indolent tumor. It was also included in the 2007 World Health Organization (WHO) classification of tumors as a grade 1 tumor for its benign clinical behavior and the possibility of surgical cure. Pathologically, RGNT is a mixed neuronal-glial tumor which consists of two distinct histological components-one with uniform neurocytes forming rosettes and/or perivascular pseudorosettes and the other being astrocytic in nature resembling pilocytic astrocytoma (biphasic pattern). We present the clinical course and pathological findings of two distinctively different cases. The first one was a 4-year-old girl with head trauma and a tumor which was incidentally found by CT. Pathology revealed that the tumor contained neurocytoma components and areas of relatively high proliferative ability with the first report of the presence of midsized bright elliptic cells. The other case was a 19-year-old girl whose imaging studies showed hydrocephalus and a brain stem tumor. She underwent endoscopic third ventriculostomy and biopsy, followed by observation. An MRI taken 6 months later showed progression of the tumor and she subsequently had the tumor excised. We are considering the possibility for our RGNT cases to correspond to a higher WHO grade as they have shown rapid progression, contrary to the already established, and their character, origin, differential diagnosis, and treatment plans have been discussed.
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Affiliation(s)
- Kentaro Chiba
- Department of Neurosurgery, Tokyo Women's Medical University, 8-1 Kawada-cho Shinjuku-ku, 162-8666, Tokyo, Japan
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Smith AB, Smirniotopoulos JG, Horkanyne-Szakaly I. From the radiologic pathology archives: intraventricular neoplasms: radiologic-pathologic correlation. Radiographics 2013; 33:21-43. [PMID: 23322825 DOI: 10.1148/rg.331125192] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A variety of neoplasms may arise in the ventricular system. Intraventricular neoplasms may be discovered as an incidental finding at cross-sectional imaging or may manifest with varied symptoms depending on their location, including symptoms of increased intracranial pressure. These lesions may arise from various ventricular structures, including the ependymal lining (eg, ependymoma), subependymal layer (eg, subependymoma), or choroid plexus (eg, choroid plexus neoplasms), or they may have a cell of origin that has yet to be determined (eg, chordoid glioma). Other neoplasms involving the ventricular system include central neurocytoma, subependymal giant cell tumor, meningioma, rosette-forming glioneuronal tumor, and metastases. The differential diagnosis for intraventricular neoplasms can be broad, and many of them have similar patterns of signal intensity and contrast enhancement at imaging. However, the location of the lesion in the ventricular system-along with knowledge of the patient's age, gender, and underlying conditions-will help narrow the differential diagnosis.
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Affiliation(s)
- Alice Boyd Smith
- Department of Radiology and Radiological Sciences, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD 20814-4799, USA.
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Thurston B, Gunny R, Anderson G, Paine S, Thompson D, Jacques T, Ternier J. Fourth ventricle rosette-forming glioneuronal tumour in children: an unusual presentation in an 8-year-old patient, discussion and review of the literature. Childs Nerv Syst 2013; 29:839-47. [PMID: 23239254 DOI: 10.1007/s00381-012-1993-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Accepted: 11/28/2012] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Rosette-forming glioneuronal tumour of the fourth ventricle is a rarely described entity. While usually having an indolent course and hence classified as a WHO grade 1 tumour, the precise characteristics and risk of recurrence of this tumour are still unknown. In addition, the preferred treatment modality remains unclear. DISCUSSION We present a case of an 8-year old with an early recurrence of 9 months after undergoing a sub-total resection of her tumour. Following further resection, there was no tumour present on the 3-month follow-up. In order to better characterise this tumour entity, we performed a review of the available literature on the subject. We found that it mainly affected young adults and had a female predominance. While initially these tumours were described in the fourth ventricle, the current literature suggests that they may be found in a larger variety of sites within the brain and spinal cord. There are several reports of recurrence occurring between 9 months and 10 years following surgery. There is as yet no feature of the tumour that appears to predict the risk of recurrence. CONCLUSION This phenomenon warrants further examination to discover if there is a sub-section of tumours that is likely to recur, and until this is established, all patients should be followed up at regular intervals.
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Affiliation(s)
- Benjamin Thurston
- Paediatric Neurosurgery, Great Ormond Street Hospital NHS Foundation Trust, Great Ormond Street, London, UK
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Zhang J, Babu R, McLendon RE, Friedman AH, Adamson C. A comprehensive analysis of 41 patients with rosette-forming glioneuronal tumors of the fourth ventricle. J Clin Neurosci 2013; 20:335-41. [DOI: 10.1016/j.jocn.2012.09.003] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2012] [Accepted: 09/14/2012] [Indexed: 12/20/2022]
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Coexpression of glial and neuronal markers in the neurocytic rosettes of rosette-forming glioneuronal tumors. Brain Tumor Pathol 2013; 31:17-22. [PMID: 23329202 DOI: 10.1007/s10014-012-0133-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Accepted: 12/28/2012] [Indexed: 01/28/2023]
Abstract
Rosette-forming glioneuronal tumor of the fourth ventricle (RGNT) is a new entity in the WHO 2007 Classification of Tumors of the Central Nervous System. RGNT has two components: neurocytic rosettes and low-grade gliomas. Neurocytic rosettes are conventionally described as consisting of uniform neurocytes. However, some studies have reported rosette-forming tumor cells that expressed glial markers such as Olig2. We indicated the expression of glial markers including Olig2, cyclinD1, glial fibrillary acidic protein (GFAP), and platelet-derived growth factor receptor alpha (PDGFRα) in the neurocytic rosettes in our previous study, and we suggested that these tumor cells had a heterogeneous nature. In this study, we used double and triple immunostaining to demonstrate that these tumor cells have both glial and neuronal characteristics. We found that rosette-forming tumor cells coexpressed Olig2/cyclinD1 and synaptophysin. Furthermore, the cores of the rosettes coexpressed GFAP/PDGFRα in the peripheral zone and synaptophysin in the central zone. These findings imply that rosette-forming tumor cells have a similar nature to neuronal-glial progenitor cells, and we believe that the nomination "neurocytic rosette" may be unsuitable given their heterogeneous nature. Our study appears to clarify some of the properties of RGNT tumor cells and may help elucidate the histogenesis of RGNT.
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Xiong J, Ding L, Chen H, Chen H, Wang Y. Mixed glioneuronal tumor: a dysembryoplastic neuroepithelial tumor with rosette-forming glioneuronal tumor component. Neuropathology 2012; 33:431-5. [PMID: 23163721 DOI: 10.1111/neup.12000] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2012] [Accepted: 10/22/2012] [Indexed: 12/27/2022]
Abstract
Neuronal and mixed neuronal-glial tumors of the CNS show a wide spectrum of components. Here, we report an unusual case of brain tumor with combined histological features of dysembryoplastic neuroepithelial tumor (DNT) and rosette-forming glioneuronal tumor (RGNT) in a 23-year-old man. It arose in the left anterior cingulate cortex with a pseudo-polycystic appearance on neuroimaging. Histological features contained the "specific glioneuronal element" mimicking DNT and the components of distinct neurocytic rosettes with a center of neuropil islands and pilocytic astrocytoma resembling RGNT. Although the mechanisms of mixed glioneuronal tumor are far from being well-known, their co-existence might suggest a possible etiologic relationship between DNT and RGNT.
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Affiliation(s)
- Ji Xiong
- Department of Neuropathology, Institute of Neurology, Huashan Hospital of Fudan University, Shanghai, China
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Matsumura N, Yokoo H, Mao Y, Yin W, Nakazato Y. Olig2-positive cells in glioneuronal tumors show both glial and neuronal characters: The implication of a common progenitor cell? Neuropathology 2012; 33:246-55. [DOI: 10.1111/j.1440-1789.2012.01355.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2012] [Revised: 09/02/2012] [Accepted: 09/03/2012] [Indexed: 12/24/2022]
Affiliation(s)
- Nozomi Matsumura
- Department of Human Pathology; Gunma University Graduate School of Medicine; Maebashi; Gunma; Japan
| | - Hideaki Yokoo
- Department of Human Pathology; Gunma University Graduate School of Medicine; Maebashi; Gunma; Japan
| | - Ying Mao
- Department of Neurosurgery; Huashan Hospital; Fudan University; Shanghai; China
| | - Wang Yin
- Department of Neuropathology; Huashan Hospital; Fudan University; Shanghai; China
| | - Yoichi Nakazato
- Department of Human Pathology; Gunma University Graduate School of Medicine; Maebashi; Gunma; Japan
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Chakraborti S, Mahadevan A, Govindan A, Bhateja A, Dwarakanath S, Aravinda HR, Phalguni AA, Santosh V, Yasha TC, Rout P, Sampath S, Shankar SK. Rosette-forming glioneuronal tumor -- evidence of stem cell origin with biphenotypic differentiation. Virchows Arch 2012; 461:581-8. [PMID: 22971894 DOI: 10.1007/s00428-012-1313-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2012] [Revised: 08/07/2012] [Accepted: 09/03/2012] [Indexed: 10/27/2022]
Abstract
Rosette-forming glioneuronal tumor (RGNT) of the fourth ventricle is a new addition to the WHO classification of central nervous system tumors. To date, 72 cases have been described in literature. In the present study, we report the clinical and imaging features, with detailed histopathological and immunohistochemical profile, of eight cases. Confocal microscopic evidence of stem cell origin with biphenotypic, glial and neurocytic differentiation is presented with a comprehensive review of literature.
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Affiliation(s)
- S Chakraborti
- Department of Pathology, Kasturba Medical College, Mangalore, Karnataka, India
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Kemp S, Achan A, Ng T, Dexter M. Rosette-forming glioneuronal tumour of the lateral ventricle in a patient with neurofibromatosis 1. J Clin Neurosci 2012; 19:1180-1. [DOI: 10.1016/j.jocn.2011.12.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2011] [Revised: 11/28/2011] [Accepted: 12/03/2011] [Indexed: 10/28/2022]
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Hsu C, Kwan G, Lau Q, Bhuta S. Rosette-forming glioneuronal tumour: Imaging features, histopathological correlation and a comprehensive review of literature. Br J Neurosurg 2012; 26:668-73. [DOI: 10.3109/02688697.2012.655808] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Yano H, Nakayama N, Hirose Y, Ohe N, Shinoda J, Yoshimura SI, Iwama T. Intraventricular glioneuronal tumor with disseminated lesions at diagnosis--a case report. Diagn Pathol 2011; 6:119. [PMID: 22145948 PMCID: PMC3251541 DOI: 10.1186/1746-1596-6-119] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2011] [Accepted: 12/06/2011] [Indexed: 01/05/2023] Open
Abstract
A 55-year-old man presented with a large tumor in his lateral ventricles. Magnetic resonance imaging revealed disseminated lesions in the third and fourth ventricles at the time of diagnosis. The patient underwent a partial removal of the tumor in the lateral ventricles. Histologically, the surgical specimens showed glioneuronal differentiation with ganglion or ganglioid cells, Rosenthal fibers, oligodendroglia-like honeycomb appearances, a spongy pattern, perivascular pseudorosettes, and many hyalinized blood vessels. Papillary structure was not observed. The neuronal component showed a moderately high labeling index of Ki-67/MIB-1. We diagnosed this tumor as atypical intraventricular glioneuronal tumor. The disseminated lesions disappeared after chemoradiation therapy with temozolomide, and the residual tumors in the lateral ventricles remained stable for 3 years after the surgery. We discuss the pathological diagnosis, therapy and clinical course with review of the literatures.
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Affiliation(s)
- Hirohito Yano
- Department of Neurosurgery, Gifu University Graduate School of Medicine, Gifu, Japan.
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Xiong J, Liu Y, Chu SG, Chen H, Chen HX, Mao Y, Wang Y. Rosette-forming glioneuronal tumor of the septum pellucidum with extension to the supratentorial ventricles: Rare case with genetic analysis. Neuropathology 2011; 32:301-5. [DOI: 10.1111/j.1440-1789.2011.01261.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Rosette-forming glioneuronal tumor of the fourth ventricle with bilateral olivary degeneration. Jpn J Radiol 2011; 29:445-8. [DOI: 10.1007/s11604-011-0566-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2010] [Accepted: 01/18/2011] [Indexed: 12/22/2022]
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Matyja E, Grajkowska W, Nauman P, Ozieblo A, Bonicki W. Rosette-forming glioneuronal tumor of the fourth ventricle with advanced microvascular proliferation - a case report. Neuropathology 2010; 31:427-32. [DOI: 10.1111/j.1440-1789.2010.01168.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Solis OE, Mehta RI, Lai A, Mehta RI, Farchoukh LO, Green RM, Cheng JC, Natarajan S, Vinters HV, Cloughesy T, Yong WH. Rosette-forming glioneuronal tumor: a pineal region case with IDH1 and IDH2 mutation analyses and literature review of 43 cases. J Neurooncol 2010; 102:477-84. [PMID: 20872044 PMCID: PMC3089723 DOI: 10.1007/s11060-010-0335-1] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2010] [Accepted: 07/26/2010] [Indexed: 12/22/2022]
Abstract
Rosette-forming glioneuronal tumor (RGNT) of the fourth ventricle is a mixed glio-neuronal neoplasm recently codified by the World Health Organization WHO Classification of Central Nervous System (CNS) Tumors (2007). To date, 43 cases have been described in the literature; most occurring in the fourth ventricle region. We report the fourth case involving the pineal region in a 16-year-old female with signs of increased intracranial pressure (ICP). A stereotactic biopsy of the mass was followed by a debulking procedure. Both specimens revealed classic RGNT histology. The patient had stable scans 7 months post-resection. The clinical, radiological and histopathologic features of the previously described 43 cases are reviewed along with our illustrative case. Mean age of patients was 30 ± 12.8 years with 1.9:1 female to male ratio. The most common presenting signs related to increased ICP and posterior fossa involvement, including: headache (62.8%), ataxia (39.5%) and vomiting and vertigo (both 16.3%). This tumor usually presents with cystic changes (54.5%) with focal enhancement (60.9%) and hydrocephalus (43.2%). Microcalcifications and satellite lesions were common radiographic observations. All reported cases had the classic biphasic pattern. Rosenthal fibers and eosinophilic granular bodies are each present in approximately two thirds of cases. Ki-67 labeling index is consistently low (mean (%): 1.8 ± 0.75 SD). The isocitrate dehydrogenase 1 or 2 mutation found in low grade diffuse gliomas is not identified in this RGNT case. Reported outcome is nearly uniformly excellent after complete or subtotal resection. A solitary report of recurrence after 10 years and the limited experience with this entity suggest that long term follow up is advisable.
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Affiliation(s)
- Orestes E Solis
- Department of Pathology and Laboratory Medicine, Section of Neuropathology, University of California, Los Angeles, Los Angeles, CA, USA.
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