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Li T, Aihemaitiniyazi A, Zhang H, Wei D, Hu Y, Guan Y, Zhou J, Qi X, Wang M, Wu B, Zhu M, Zhang L, Luan G, Liu C. Clinical characteristics and detection of MYB-QKI fusions in patients with angiocentric glioma. Neurol Sci 2024:10.1007/s10072-024-07721-3. [PMID: 39098857 DOI: 10.1007/s10072-024-07721-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2024] [Accepted: 07/29/2024] [Indexed: 08/06/2024]
Abstract
PURPOSE Angiocentric glioma (AG), a benign tumor identified within the last two decades, was officially included in the 2007 WHO Classification of Tumors of the Central Nervous System, WHO grade I. The tumor is relatively rare, with only approximately 100 cases reported. We aim to complement the characteristics and long-term prognosis of AG, as well as to detect MYB-QKI fusions. METHODS The characteristics of all cases collected between 1 March 2009 and 1 March 2023 at the Beijing Sanbo Brain Hospital, Capital Medical University, were summarized and analyzed. Additionally, all fourteen patients were tested for MYB-QKI fusions. RESULTS AG more predominantly occurs in adolescents (median age 16.5-year-old), and commonly presents with drug-resistant epilepsy. AG is frequently localized in the supratentorial regions and only one patient is in the brainstem. Brain parenchyma atrophy, and stalk-like signs can observe in imaging. Pathologically, tumor cells are perivascular pseudorosettes, presenting immunoreactivity for GFAP, S-100, Vimentin, "dot-like" staining for EMA, and low proliferative activity. Focal cortex dysplasia was observed in four patients. Twelve of fourteen (85.7%) patients were found with MYB-QKI fusions. Completely surgical resection typically has a satisfactory prognosis with long-term follow-up. CONCLUSION AG is a rare benign tumor with a favorable prognosis after complete resection, characterized by refractory epilepsy, frequently occurring in adolescents. MYB-QKI fusions were detected in most AG patients, as a good defining genetic alteration pathologically. The potential presence of focal cortical dysplasia (FCD) may affect the prognosis of epilepsy.
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Affiliation(s)
- Tiemin Li
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, No. 50, Yikesong, Xiangshan, Haidian District, Beijing, 100093, China
- Department of Neurosurgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China
| | - Adilijiang Aihemaitiniyazi
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, No. 50, Yikesong, Xiangshan, Haidian District, Beijing, 100093, China
| | - Huawei Zhang
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, No. 50, Yikesong, Xiangshan, Haidian District, Beijing, 100093, China
| | - Da Wei
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, No. 50, Yikesong, Xiangshan, Haidian District, Beijing, 100093, China
- Department of Neurosurgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China
| | - Yue Hu
- Department of Neurosurgery, Aviation General Hospital, China Medical University, Beijing, 100012, China
| | - Yuguang Guan
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, No. 50, Yikesong, Xiangshan, Haidian District, Beijing, 100093, China
| | - Jian Zhou
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, No. 50, Yikesong, Xiangshan, Haidian District, Beijing, 100093, China
| | - Xueling Qi
- Department of Pathology, Sanbo Brain Hospital, Capital Medical University, Beijing, 100093, China
| | - Mengyang Wang
- Department of Neurology, Sanbo Brain Hospital, Capital Medical University, Beijing, 100093, China
| | - Bin Wu
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, No. 50, Yikesong, Xiangshan, Haidian District, Beijing, 100093, China
| | - Mingwang Zhu
- Department of Radiology, Sanbo Brain Hospital, Capital Medical University, Beijing, 100093, China
| | - Linpeng Zhang
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, No. 50, Yikesong, Xiangshan, Haidian District, Beijing, 100093, China
| | - Guoming Luan
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, No. 50, Yikesong, Xiangshan, Haidian District, Beijing, 100093, China.
| | - Changqing Liu
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, No. 50, Yikesong, Xiangshan, Haidian District, Beijing, 100093, China.
- Department of Neurosurgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China.
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Baticulon RE, Wittayanakorn N, Maixner W. Low-grade glioma of the temporal lobe and tumor-related epilepsy in children. Childs Nerv Syst 2024:10.1007/s00381-024-06468-8. [PMID: 38789690 DOI: 10.1007/s00381-024-06468-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2024] [Accepted: 05/15/2024] [Indexed: 05/26/2024]
Abstract
PURPOSE Low-grade glioma is the most common brain tumor among children and adolescents. When these tumors arise in the temporal lobe, patients frequently present with seizures that are poorly controlled with antiepileptic drugs. Here we summarize the clinical features, pathophysiology, preoperative evaluation, surgical treatment, and outcomes of pediatric patients with low-grade gliomas in the temporal lobe. METHODS We reviewed the literature on pediatric low-grade gliomas in the temporal lobe, focusing on cohort studies and systematic reviews that described surgical treatment strategies and reported both oncologic and epilepsy outcomes. RESULTS The differential diagnoses of pediatric low-grade gliomas in the temporal lobe include ganglioglioma, dysembryoplastic neuroepithelial tumor, desmoplastic infantile ganglioglioma, papillary glioneuronal tumor, pilocytic astrocytoma, pleomorphic xanthoastrocytoma, angiocentric glioma, and polymorphous low-grade neuroepithelial tumor of the young. There is no consensus on the optimal surgical approach for these tumors: lesionectomy alone, or extended lesionectomy with anterior temporal lobectomy, with or without removal of mesial temporal structures. Gross total resection and shorter preoperative duration of epilepsy are strongly associated with favorable seizure outcomes, defined as Engel Class I or Class II, approaching 90% in most series. The risk of surgical complications ranges from 4 to 17%, outweighing the lifetime risks of medically refractory epilepsy. CONCLUSION Pediatric patients with temporal low-grade glioma and tumor-related epilepsy are best managed by a multidisciplinary epilepsy surgery team. Early and appropriate surgery leads to prolonged survival and a greater likelihood of seizure freedom, improving their overall quality of life.
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Affiliation(s)
- Ronnie E Baticulon
- Division of Neurosurgery, Department of Neurosciences, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines.
- Department of Anatomy, College of Medicine, University of the Philippines Manila, Manila, Philippines.
| | - Nunthasiri Wittayanakorn
- Division of Neurosurgery, Department of Surgery, Queen Sirikit National Institute of Child Health, Bangkok, Thailand
| | - Wirginia Maixner
- Department of Neurosurgery, The Royal Children's Hospital, Melbourne, Australia
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3
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d’Amati A, Bargiacchi L, Rossi S, Carai A, Bertero L, Barresi V, Errico ME, Buccoliero AM, Asioli S, Marucci G, Del Baldo G, Mastronuzzi A, Miele E, D’Antonio F, Schiavello E, Biassoni V, Massimino M, Gessi M, Antonelli M, Gianno F. Pediatric CNS tumors and 2021 WHO classification: what do oncologists need from pathologists? Front Mol Neurosci 2024; 17:1268038. [PMID: 38544524 PMCID: PMC10966132 DOI: 10.3389/fnmol.2024.1268038] [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: 07/27/2023] [Accepted: 02/23/2024] [Indexed: 05/14/2024] Open
Abstract
The fifth edition of the WHO Classification of Tumors of the Central Nervous System (CNS), published in 2021, established new approaches to both CNS tumor nomenclature and grading, emphasizing the importance of integrated diagnoses and layered reports. This edition increased the role of molecular diagnostics in CNS tumor classification while still relying on other established approaches such as histology and immunohistochemistry. Moreover, it introduced new tumor types and subtypes based on novel diagnostic technologies such as DNA methylome profiling. Over the past decade, molecular techniques identified numerous key genetic alterations in CSN tumors, with important implications regarding the understanding of pathogenesis but also for prognosis and the development and application of effective molecularly targeted therapies. This review summarizes the major changes in the 2021 fifth edition classification of pediatric CNS tumors, highlighting for each entity the molecular alterations and other information that are relevant for diagnostic, prognostic, or therapeutic purposes and that patients' and oncologists' need from a pathology report.
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Affiliation(s)
- Antonio d’Amati
- Unit of Anatomical Pathology, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari “Aldo Moro”, Bari, Italy
- Unit of Human Anatomy and Histology, Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari “Aldo Moro”, Bari, Italy
- Unit of Anatomical Pathology, Department of Radiology, Oncology and Anatomical Pathology, University La Sapienza, Rome, Italy
- Neuropathology Unit, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica S. Cuore, Roma, Italy
| | - Lavinia Bargiacchi
- Unit of Anatomical Pathology, Department of Radiology, Oncology and Anatomical Pathology, University La Sapienza, Rome, Italy
| | - Sabrina Rossi
- Pathology Unit, Department of Laboratories, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Andrea Carai
- Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Luca Bertero
- Pathology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Valeria Barresi
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Maria Elena Errico
- Department of Pathology, AORN Santobono Pausilipon, Pediatric Hospital, Naples, Italy
| | | | - Sofia Asioli
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Gianluca Marucci
- Neuropathology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Giada Del Baldo
- Department of Paediatric Haematology/Oncology, IRCCS Bambino Gesù Children's Hospital, Rome, Italy
| | - Angela Mastronuzzi
- Department of Paediatric Haematology/Oncology, IRCCS Bambino Gesù Children's Hospital, Rome, Italy
| | - Evelina Miele
- Department of Paediatric Haematology/Oncology, IRCCS Bambino Gesù Children's Hospital, Rome, Italy
| | - Federica D’Antonio
- Department of Paediatric Haematology/Oncology, IRCCS Bambino Gesù Children's Hospital, Rome, Italy
| | - Elisabetta Schiavello
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Veronica Biassoni
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Maura Massimino
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Marco Gessi
- Neuropathology Unit, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica S. Cuore, Roma, Italy
| | - Manila Antonelli
- Unit of Anatomical Pathology, Department of Radiology, Oncology and Anatomical Pathology, University La Sapienza, Rome, Italy
- IRCCS Neuromed, Pozzilli, Isernia, Italy
| | - Francesca Gianno
- Unit of Anatomical Pathology, Department of Radiology, Oncology and Anatomical Pathology, University La Sapienza, Rome, Italy
- IRCCS Neuromed, Pozzilli, Isernia, Italy
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Toader C, Eva L, Costea D, Corlatescu AD, Covache-Busuioc RA, Bratu BG, Glavan LA, Costin HP, Popa AA, Ciurea AV. Low-Grade Gliomas: Histological Subtypes, Molecular Mechanisms, and Treatment Strategies. Brain Sci 2023; 13:1700. [PMID: 38137148 PMCID: PMC10741942 DOI: 10.3390/brainsci13121700] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/05/2023] [Accepted: 12/07/2023] [Indexed: 12/24/2023] Open
Abstract
Low-Grade Gliomas (LGGs) represent a diverse group of brain tumors originating from glial cells, characterized by their unique histopathological and molecular features. This article offers a comprehensive exploration of LGGs, shedding light on their subtypes, histological and molecular aspects. By delving into the World Health Organization's grading system, 5th edition, various specificities were added due to an in-depth understanding of emerging laboratory techniques, especially genomic analysis. Moreover, treatment modalities are extensively discussed. The degree of surgical resection should always be considered according to postoperative quality of life and cognitive status. Adjuvant therapies focused on chemotherapy and radiotherapy depend on tumor grading and invasiveness. In the current literature, emerging targeted molecular therapies are well discussed due to their succinctly therapeutic effect; in our article, those therapies are summarized based on posttreatment results and possible adverse effects. This review serves as a valuable resource for clinicians, researchers, and medical professionals aiming to deepen their knowledge on LGGs and enhance patient care.
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Affiliation(s)
- Corneliu Toader
- Department of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.T.); (A.D.C.); (R.-A.C.-B.); (B.-G.B.); (L.A.G.); (H.P.C.); (A.A.P.); (A.V.C.)
- Department of Vascular Neurosurgery, National Institute of Neurology and Neurovascular Diseases, 077160 Bucharest, Romania
| | - Lucian Eva
- Department of Neurosurgery, Dunarea de Jos University, 800010 Galati, Romania
- Department of Neurosurgery, Clinical Emergency Hospital “Prof. Dr. Nicolae Oblu”, 700309 Iasi, Romania
| | - Daniel Costea
- Department of Neurosurgery, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Antonio Daniel Corlatescu
- Department of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.T.); (A.D.C.); (R.-A.C.-B.); (B.-G.B.); (L.A.G.); (H.P.C.); (A.A.P.); (A.V.C.)
| | - Razvan-Adrian Covache-Busuioc
- Department of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.T.); (A.D.C.); (R.-A.C.-B.); (B.-G.B.); (L.A.G.); (H.P.C.); (A.A.P.); (A.V.C.)
| | - Bogdan-Gabriel Bratu
- Department of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.T.); (A.D.C.); (R.-A.C.-B.); (B.-G.B.); (L.A.G.); (H.P.C.); (A.A.P.); (A.V.C.)
| | - Luca Andrei Glavan
- Department of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.T.); (A.D.C.); (R.-A.C.-B.); (B.-G.B.); (L.A.G.); (H.P.C.); (A.A.P.); (A.V.C.)
| | - Horia Petre Costin
- Department of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.T.); (A.D.C.); (R.-A.C.-B.); (B.-G.B.); (L.A.G.); (H.P.C.); (A.A.P.); (A.V.C.)
| | - Andrei Adrian Popa
- Department of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.T.); (A.D.C.); (R.-A.C.-B.); (B.-G.B.); (L.A.G.); (H.P.C.); (A.A.P.); (A.V.C.)
| | - Alexandru Vlad Ciurea
- Department of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.T.); (A.D.C.); (R.-A.C.-B.); (B.-G.B.); (L.A.G.); (H.P.C.); (A.A.P.); (A.V.C.)
- Neurosurgery Department, Sanador Clinical Hospital, 010991 Bucharest, Romania
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5
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Reisz Z, Radics BL, Nemes P, Laxton R, Kaizer L, Gabor KM, Novak T, Barzo P, Al-Sarraj S, Bodi I. Case Report: Brainstem angiocentric glioma presenting in a toddler child-diagnostic and therapeutic challenges. Pathol Oncol Res 2023; 29:1611231. [PMID: 37362245 PMCID: PMC10287963 DOI: 10.3389/pore.2023.1611231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 05/26/2023] [Indexed: 06/28/2023]
Abstract
Introduction: Angiocentric gliomas (AG) in brainstem location are exceedingly rare and might cause differential diagnostic problems and uncertainty regarding the best therapeutic approach. Hereby, we describe the clinicopathological findings in a brainstem AG presenting in a toddler child and review the literature. Case report: A 2-year-old boy presented with 5 weeks history of gait disturbances, frequent falls, left-sided torticollis and swallowing problems. MRI head showed a T2-hyperintense, partly exophytic mass lesion centred in the pontomedullary region, raising the possibility of diffuse midline glioma. The exophytic component was partially resected by suboccipital craniotomy, leaving intact the infiltrative component. Ventriculoperitoneal shunt was implanted due to postoperative hydrocephalus. Histological examination revealed a moderately cellular tumour consisted of bland glial cells infiltrating the brain parenchyma and radially arranged around the blood vessels. By immunohistochemistry, the tumour strongly expressed S100 and GFAP in addition to intense nestin positivity, while OLIG2 was negative in the perivascular tumour cells. DNA methylation array profiled the tumour as "methylation class diffuse astrocytoma, MYB or MYBL1-altered subtype B (infratentorial)" and an in-frame MYB::QKI fusion was identified by RNA sequencing, confirming the diagnosis of angiocentric glioma. The patient has been initially treated with angiogenesis inhibitor and mTOR inhibitor, and now he is receiving palliative vinblastine. He is clinically stable on 9 months follow-up. Conclusion: Brainstem AG may cause a diagnostic problem, and the surgical and oncological management is challenging due to unresectability and lack of response to conventional chemo-radiation. In the future, genetically-tailored therapies might improve the prognosis.
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Affiliation(s)
- Zita Reisz
- Department of Clinical Neuropathology, King’s College Hospital, London, United Kingdom
| | | | - Peter Nemes
- Department of Neurosurgery, University of Szeged, Szeged, Hungary
| | - Ross Laxton
- Department of Clinical Neuropathology, King’s College Hospital, London, United Kingdom
| | - Laszlo Kaizer
- Department of Pathology, University of Szeged, Szeged, Hungary
| | - Krisztina Mita Gabor
- Department of Pediatrics and Pediatric Healthcare Center, University of Szeged, Szeged, Hungary
| | - Timea Novak
- Department of Radiology, University of Szeged, Szeged, Hungary
| | - Pal Barzo
- Department of Neurosurgery, University of Szeged, Szeged, Hungary
| | - Safa Al-Sarraj
- Department of Clinical Neuropathology, King’s College Hospital, London, United Kingdom
| | - Istvan Bodi
- Department of Clinical Neuropathology, King’s College Hospital, London, United Kingdom
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6
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Metodiev D, Minkin K, Ruseva M, Ganeva R, Parvanov D, Nachev S. Pathomorphological Diagnostic Criteria for Focal Cortical Dysplasias and Other Common Epileptogenic Lesions—Review of the Literature. Diagnostics (Basel) 2023; 13:diagnostics13071311. [PMID: 37046529 PMCID: PMC10092959 DOI: 10.3390/diagnostics13071311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 03/20/2023] [Accepted: 03/28/2023] [Indexed: 04/03/2023] Open
Abstract
Focal cortical dysplasia (FCD) represents a heterogeneous group of morphological changes in the brain tissue that can predispose the development of pharmacoresistant epilepsy (recurring, unprovoked seizures which cannot be managed with medications). This group of neurological disorders affects not only the cerebral cortex but also the subjacent white matter. This work reviews the literature describing the morphological substrate of pharmacoresistant epilepsy. All illustrations presented in this study are obtained from brain biopsies from refractory epilepsy patients investigated by the authors. Regarding classification, there are three main FCD types, all of which involve cortical dyslamination. The 2022 revision of the International League Against Epilepsy (ILAE) FCD classification includes new histologically defined pathological entities: mild malformation of cortical development (mMCD), mild malformation of cortical development with oligodendroglial hyperplasia in frontal lobe epilepsy (MOGHE), and “no FCD on histopathology”. Although the pathomorphological characteristics of the various forms of focal cortical dysplasias are well known, their aetiologic and pathogenetic features remain elusive. The identification of genetic variants in FCD opens an avenue for novel treatment strategies, which are of particular utility in cases where total resection of the epileptogenic area is impossible.
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7
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Wu PB, Filley AC, Miller ML, Bruce JN. Benign Glioma. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1405:31-71. [PMID: 37452934 DOI: 10.1007/978-3-031-23705-8_2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
Benign glioma broadly refers to a heterogeneous group of slow-growing glial tumors with low proliferative rates and a more indolent clinical course. These tumors may also be described as "low-grade" glioma (LGG) and are classified as WHO grade I or II lesions according to the Classification of Tumors of the Central Nervous System (CNS) (Louis et al. in Acta Neuropathol 114:97-109, 2007). Advances in molecular genetics have improved understanding of glioma tumorigenesis, leading to the identification of common mutation profiles with significant treatment and prognostic implications. The most recent WHO 2016 classification system has introduced several notable changes in the way that gliomas are diagnosed, with a new emphasis on molecular features as key factors in differentiation (Wesseling and Capper in Neuropathol Appl Neurobiol 44:139-150, 2018). Benign gliomas have a predilection for younger patients and are among the most frequently diagnosed tumors in children and young adults (Ostrom et al. in Neuro Oncol 22:iv1-iv96, 2020). These tumors can be separated into two clinically distinct subgroups. The first group is of focal, well-circumscribed lesions that notably are not associated with an increased risk of malignant transformation. Primarily diagnosed in pediatric patients, these WHO grade I tumors may be cured with surgical resection alone (Sturm et al. in J Clin Oncol 35:2370-2377, 2017). Recurrence rates are low, and the prognosis for these patients is excellent (Ostrom et al. in Neuro Oncol 22:iv1-iv96, 2020). Diffuse gliomas are WHO grade II lesions with a more infiltrative pattern of growth and high propensity for recurrence. These tumors are primarily diagnosed in young adult patients, and classically present with seizures (Pallud et al. Brain 137:449-462, 2014). The term "benign" is a misnomer in many cases, as the natural history of these tumors is with malignant transformation and recurrence as grade III or grade IV tumors (Jooma et al. in J Neurosurg 14:356-363, 2019). For all LGG, surgery with maximal safe resection is the treatment of choice for both primary and recurrent tumors. The goal of surgery should be for gross total resection (GTR), as complete tumor removal is associated with higher rates of tumor control and seizure freedom. Chemotherapy and radiation therapy (RT), while not typically a component of first-line treatment in most cases, may be employed as adjunctive therapy in high-risk or recurrent tumors and in some select cases. The prognosis of benign gliomas varies widely; non-infiltrative tumor subtypes generally have an excellent prognosis, while diffusely infiltrative tumors, although slow-growing, are eventually fatal (Sturm et al. in J Clin Oncol 35:2370-2377, 2017). This chapter reviews the shared and unique individual features of the benign glioma including diffuse glioma, pilocytic astrocytoma and pilomyxoid astrocytoma (PMA), subependymal giant cell astrocytoma (SEGA), pleomorphic xanthoastrocytoma (PXA), subependymoma (SE), angiocentric glioma (AG), and chordoid glioma (CG). Also discussed is ganglioglioma (GG), a mixed neuronal-glial tumor that represents a notable diagnosis in the differential for other LGG (Wesseling and Capper 2018). Ependymomas of the brain and spinal cord, including major histologic subtypes, are discussed in other chapters.
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Affiliation(s)
- Peter B Wu
- Department of Neurosurgery, David Geffen School of Medicine at UCLA, UCLA, Los Angeles, USA
| | - Anna C Filley
- Department of Neurosurgery, Columbia University Medical Center, New York, USA
| | - Michael L Miller
- Department of Pathology and Cell Biology, Columbia University Medical Center, New York, USA
| | - Jeffrey N Bruce
- Department of Neurosurgery, Columbia University Medical Center, New York, USA.
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Fabbri VP, Caporalini C, Asioli S, Buccoliero A. Paediatric-type diffuse low-grade gliomas: a clinically and biologically distinct group of tumours with a favourable outcome. Pathologica 2022; 114:410-421. [PMID: 36534420 PMCID: PMC9763978 DOI: 10.32074/1591-951x-828] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 11/12/2022] [Indexed: 12/23/2022] Open
Abstract
The WHO 2021 classification of central nervous system cancers distinguishes diffuse gliomas that arise in adults (referred to as the "adult type") and those that arise in children (defined as "paediatric") based on clinical and molecular characteristics."). However, paediatric-type gliomas may occasionally be present in younger adults and occasionally adult-type gliomas may occur in children. Diffuse low-grade paediatric glioma includes diffuse astrocytoma altered by MYB or MYBL1, low-grade polymorphic juvenile neuroepithelial tumour, angiocentric glioma, and diffuse low-grade glioma with an altered MAPK pathway. Here, we examine these newly recognised entities according to WHO diagnostic criteria and propose an integrated diagnostic approach that can be used to separate these clinically and biologically distinct tumor groups.
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Affiliation(s)
- Viscardo Paolo Fabbri
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum University of Bologna, Bologna, Italy,Azienda Ospedaliero Universitaria Policlinico Modena, Modena, Italy,Correspondence Viscardo Paolo Fabbri PhD Student of Department of Biomedical and Neuromotor Sciences (School of Oncology, Haemathology and Pathology Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Italy) Bellaria Hospital, via Altura 3, Bologna, Italy E-mail:
| | | | - Sofia Asioli
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum University of Bologna, Bologna, Italy, Programma Neurochirurgia Ipofisi- Pituitary Unit, Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
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9
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2021 WHO classification of tumours of the central nervous system: a review for the neuroradiologist. Neuroradiology 2022; 64:1919-1950. [DOI: 10.1007/s00234-022-03008-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 07/01/2022] [Indexed: 10/17/2022]
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10
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Abstract
Neuropathological examination of the temporal lobe provides a better understanding and management of a wide spectrum of diseases. We focused on inflammatory diseases, epilepsy, and neurodegenerative diseases, and highlighted how the temporal lobe is particularly involved in those conditions. Although all these diseases are not specific or restricted to the temporal lobe, the temporal lobe is a key structure to understand their pathophysiology. The main histological lesions, immunohistochemical markers, and molecular alterations relevant for the neuropathological diagnostic reasoning are presented in relation to epidemiology, clinical presentation, and radiological findings. The inflammatory diseases section addressed infectious encephalitides and auto-immune encephalitides. The epilepsy section addressed (i) susceptibility of the temporal lobe to epileptogenesis, (ii) epilepsy-associated hippocampal sclerosis, (iii) malformations of cortical development, (iv) changes secondary to epilepsy, (v) long-term epilepsy-associated tumors, (vi) vascular malformations, and (vii) the absence of histological lesion in some epilepsy surgery samples. The neurodegenerative diseases section addressed (i) Alzheimer's disease, (ii) the spectrum of frontotemporal lobar degeneration, (iii) limbic-predominant age-related TDP-43 encephalopathy, and (iv) α-synucleinopathies. Finally, inflammatory diseases, epilepsy, and neurodegenerative diseases are considered as interdependent as some pathophysiological processes cross the boundaries of this classification.
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Affiliation(s)
- Susana Boluda
- Sorbonne Université, INSERM, CNRS, UMR S 1127, Paris Brain Institute, ICM, Paris, France; Neuropathology Department, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, AP-HP, Paris, France
| | - Danielle Seilhean
- Sorbonne Université, INSERM, CNRS, UMR S 1127, Paris Brain Institute, ICM, Paris, France; Neuropathology Department, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, AP-HP, Paris, France
| | - Franck Bielle
- Sorbonne Université, INSERM, CNRS, UMR S 1127, Paris Brain Institute, ICM, Paris, France; Neuropathology Department, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, AP-HP, Paris, France.
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11
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Wang H, Zhu J, Zhu P, Luo C. Angiocentric glioma: A case report and review of the literature. J Clin Neurosci 2021; 94:179-185. [PMID: 34863434 DOI: 10.1016/j.jocn.2021.10.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 09/02/2021] [Accepted: 10/13/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Angiocentric glioma (AG) is a rare, low-grade glioma with slow growth. In 2007, AG was first classified as a solid tumor according to the WHO classification of the central nervous system (WHO class I). The outcome and prognosis of most of the cases are very good, but a few cases with tumor metastasis and disease progression, even death, have been reported. We report a case and systematically analyze previous literature to increase our understanding of the disease and determine the factors that may affect disease progression to make prognostic judgments. CASE PRESENTATION A young male patient complained of a 3-year history of epilepsy. Anti-epileptic drug treatment was ineffective. An imaging examination revealed a lesion in the left parietal cortex area. Thus, the lesion was completely resected. The pathological diagnosis was angiocentric glioma. During a follow-up of two years, the patient had epilepsy relief controlled by sodium valproate and a disease-free period. CONCLUSION AG is an epilepsy-related low-grade glioma that heals after complete resection in most reported cases. However, few reported cases have had disease progression and death. This result may be due to the pathological complexity of the diseased tissue. In addition, AG is usually found to have an MYB-QKI rearrangement on genetic analysis. Due to the small number of reported cases and studies, our understanding and knowledge of this disease are still lacking. The potential malignant changes and prognostic factors need to be verified in more than clinical cases and basic research in the future.
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Affiliation(s)
- Haoheng Wang
- Department of Neurosurgery, Tongji Hospital, School of Medicine, Tongji University, Shanghai 200092, China.
| | - Junle Zhu
- Department of Neurosurgery, Tongji Hospital, School of Medicine, Tongji University, Shanghai 200092, China.
| | - Peipei Zhu
- Department of Pathology, Tongji Hospital, School of Medicine, Tongji University, Shanghai 200092, China.
| | - Chun Luo
- Department of Neurosurgery, Tongji Hospital, School of Medicine, Tongji University, Shanghai 200092, China.
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12
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Zhang R, Xu X, Zhou H, Yao D, Wei R, Muhammad S. Pediatric angiocentric glioma with acute intracerebral hemorrhage: A case report with 36 months follow-up. Surg Neurol Int 2021; 12:499. [PMID: 34754549 PMCID: PMC8571264 DOI: 10.25259/sni_791_2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 09/16/2021] [Indexed: 12/21/2022] Open
Abstract
Background: Angiocentric glioma (AG) is an extremely rare intracranial tumor that was first described in 2005 and identified as a special type of intracranial tumor in 2007 by the WHO, which mainly affects children and young adolescents. Epilepsy is the main presentation; therefore, it was recognized as a seizure-related tumor in the past. Here, we report a case of AG with acute intracerebral hemorrhage (ICH) as the first symptom who never had a seizure onset. Case Description: A 3-year-old girl with the right limb weakness was admitted to our hospital 4 h after onset in 2018. Computed tomography showed a hematoma of about 20 ml accompanied by a hyper/iso-dense spheroid lesion located in the sub-cortex of the left parietal lobe. Magnetic resonance image (MRI) showed signs of hypointense signal in T1, T2, and fluid-attenuated inversion recovery sequence, distinct enhancement of this tumefactive lesion in the contrast-enhanced sequence. Thus, the admission diagnosis was neoplasm with acute ICH. A gross total resection of the tumor was achieved by parietal craniotomy. The histopathological diagnosis was AG. No signs showed tumor recurrence after 36 months of follow-up. Conclusion: This is the sole case of AGs with acute intracranial hemorrhage as the first symptom without any kind of epilepsy by far. This case had unique MRI signs that were different from the previous description. This case enriches the clinical and radiological manifestations of AG and reveals that further investigations are needed to further understand AG.
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Affiliation(s)
- Rui Zhang
- Department of Neurosurgery, Xingtai People's Hospital Hebei Medical University, Xingtai, China.,Department of Neurosurgery, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
| | - Xin Xu
- Department of Pathology, Xingtai People's Hospital Hebei Medical University
| | - Huakang Zhou
- Department of Neurosurgery, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
| | - Dongying Yao
- Department of Pathology, Xingtai People's Hospital Hebei Medical University
| | - Ru Wei
- Department of Microbiology and Immunology, Xingtai Medical College, Xingtai, China
| | - Sajjad Muhammad
- Department of Neurosurgery, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany.,Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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13
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Wang Q, Xiong Y, Chen J, Shao Q. Cystic angiocentric glioma: a case report and literature review. Childs Nerv Syst 2021; 37:2701-2705. [PMID: 32979070 DOI: 10.1007/s00381-020-04882-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 09/06/2020] [Indexed: 12/14/2022]
Abstract
Angiocentric glioma (AG) is a rare form of brain tumor characterized by cortical epileptogenic lesions that show angiocentric patterns upon histopathological examination. Cystoid degeneration is a rare radiological manifestation of this condition. We report a case involving the left eloquent cortical areas and review the clinical features of angiocentric glioma. A 10-year-old girl presented with a history of refractory drug-resistant epilepsy. Imaging revealed a cystic-solid neoplasm within the left frontal lobe. Surgical procedures were performed, and it was observed that the pathological manifestations were consistent with those of AG. Angiocentric glioma should be considered for diagnosis when the supratentorial cortical neoplasm contains a cystic component. The diagnosis of AG can be confirmed by histopathological examination. Gross total resection is the recommended strategy for controlling seizures elicited by this condition.
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Affiliation(s)
- Qiqi Wang
- Department of Neurosurgery, Wuhan Brain Hospital, No. 5 Huiji Road, Wuhan, 430014, China
| | - Yubo Xiong
- Department of Neurosurgery, Wuhan Brain Hospital, No. 5 Huiji Road, Wuhan, 430014, China
| | - Jun Chen
- Department of Neurosurgery, Wuhan Brain Hospital, No. 5 Huiji Road, Wuhan, 430014, China
| | - Qiang Shao
- Department of Neurosurgery, Wuhan Brain Hospital, No. 5 Huiji Road, Wuhan, 430014, China.
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14
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Abstract
Angiocentric glioma is a rare brain tumor commonly found in frontal or temporal lobes. It has a benign course, and surgical resection can be curative. Brainstem location is extremely rare, with only six cases reported so far in the literature. In the present study, the seventh case of brainstem angiocentric glioma has been reported, and its course in comparison with supratentorial location and the role of molecular diagnosis has been discussed.
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Affiliation(s)
- Abdulaziz O Almubarak
- Neuroscience Department, King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia. E-mail:
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15
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Abstract
Pediatric gliomas are biologically distinct from adult gliomas. Although recent literature uncovered new genetic alterations, the prognostic implications of these discoveries are still unclear. This article provides an update on the histologic and molecular features with prognostic and/or therapeutic implications in pediatric gliomas.
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Affiliation(s)
- Jared Ahrendsen
- Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston, MA 02115, USA
| | - Sanda Alexandrescu
- Department of Pathology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Bader 104, Boston, MA 02115, USA.
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16
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Angiocentric glioma-associated seizures: The possible role of EATT2, pyruvate carboxylase and glutamine synthetase. Seizure 2021; 86:152-154. [PMID: 33621827 DOI: 10.1016/j.seizure.2021.02.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 02/09/2021] [Accepted: 02/11/2021] [Indexed: 12/17/2022] Open
Abstract
PURPOSE Our purpose was to better understand the pathogenesis of seizures associated with angiocentric glioma. Angiocentric glioma is an indolent and rare low-grade glioma. Its typical clinical presentation is with epileptic seizures. The pathogenesis of tumor-associated seizures is poorly understood. Among the possible pathomechanisms, the increased neurotoxic concentrations of the glutamate has been proposed. Glutamate transporters, pyruvate carboxylase and glutamine synthetase are involved in maintaining the physiological concentration of glutamate in the inter synaptic spaces. METHODS We evaluated the immunohistochemical expression of EAAT2 (the most important glutamate transporter), pyruvate carboxylase and glutamine synthetase in 17 angiocentric gliomas. RESULTS EAAT2 was never expressed (0%) in the neoplastic cells in none of the cases studied. Pyruvate carboxylase was expressed in the cytoplasm of the neoplastic cells in 16/17 cases (94 %). Glutamine synthetase was expressed in the cytoplasm of the neoplastic cells in 15/17 cases (88 %). CONCLUSION The net result of this enzymatic expression, in particular considering the loss of EAAT2, could be an increased glutamate concentration in the synaptic clef, which might increase local network excitability initially involving intratumoral neurons. The observation that the angiocentric glioma-associated epilepsy might be at least in part related to EAAT2 deficiency opens up interesting therapeutic perspectives.
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17
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Tran S, Mathon B, Morcos-Sauvain E, Lerond J, Navarro V, Bielle F. [Neuropathology of epilepsy]. Ann Pathol 2020; 40:447-460. [PMID: 33092907 DOI: 10.1016/j.annpat.2020.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 08/02/2020] [Accepted: 08/17/2020] [Indexed: 10/23/2022]
Abstract
The neuropathology of epilepsy aims at diagnosing the cerebral lesions underlying epilepsy that are obtained from epilepsy surgery, or rarely from biopsy or autopsy. The main histopathological and immunohistochemical characteristics of several entities are described: epilepsy-associated hippocampal sclerosis, long-term epilepsy-associated tumours, cortical malformations, vascular malformations, glial scars, encephalitides, and focal neuronal lipofuscinosis. The diagnostic approach, the differential diagnosis and the histochemical and immunohistochemical tools are detailed in order to provide the pathologist with a summarized toolkit to handle the broad range of epileptogenic lesions.
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Affiliation(s)
- Suzanne Tran
- Département de neuropathologie, laboratoire Escourolle, hôpital de la Pitié-Salpêtrière, AP-HP, 46-83, boulevard de l'Hôpital, 75013 Paris, France
| | - Bertrand Mathon
- Inserm, CNRS, Paris brain institute, ICM, Sorbonne université, AP-HP, Paris, France; Service de neurochirurgie, hôpital de la Pitié-Salpêtrière, AP-HP, Paris, France
| | - Elise Morcos-Sauvain
- Département de neuropathologie, laboratoire Escourolle, hôpital de la Pitié-Salpêtrière, AP-HP, 46-83, boulevard de l'Hôpital, 75013 Paris, France
| | - Julie Lerond
- Inserm, CNRS, Paris brain institute, ICM, Sorbonne université, AP-HP, Paris, France; SiRIC curamus (cancer united research associating medicine, university & society), site de recherche intégrée sur le cancer IUC, Sorbonne université, AP-HP, Paris, France
| | - Vincent Navarro
- Inserm, CNRS, Paris brain institute, ICM, Sorbonne université, AP-HP, Paris, France; Service de neurologie, hôpital de la Pitié-Salpêtrière, AP-HP, Paris, France; Centre de référence des épilepsies rares, Paris, France
| | - Franck Bielle
- Département de neuropathologie, laboratoire Escourolle, hôpital de la Pitié-Salpêtrière, AP-HP, 46-83, boulevard de l'Hôpital, 75013 Paris, France; Inserm, CNRS, Paris brain institute, ICM, Sorbonne université, AP-HP, Paris, France; SiRIC curamus (cancer united research associating medicine, university & society), site de recherche intégrée sur le cancer IUC, Sorbonne université, AP-HP, Paris, France.
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18
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Han G, Zhang J, Ma Y, Gui Q, Yin S. Clinical characteristics, treatment and prognosis of angiocentric glioma. Oncol Lett 2020; 20:1641-1648. [PMID: 32724405 PMCID: PMC7377082 DOI: 10.3892/ol.2020.11723] [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] [Received: 08/30/2019] [Accepted: 05/18/2020] [Indexed: 01/21/2023] Open
Abstract
Angiocentric glioma (AG) is a rare subtype of neuroepithelial tumor in children and young adults that commonly presents with seizures. To study the clinical characteristics, treatment and prognosis of patients with AG, the features of two cases of AG were described and 108 cases reported in the literature were assessed. The cases of the present study were two males aged 8 and 16 years, who mainly presented with seizures. MRI revealed superficial, non-enhanced lesions in the left temporal and right frontal lobe, respectively. The two patients underwent gross total resection (GTR) and remained seizure-free without neurological deficits after 3.5 and 2.5 years, respectively. Histopathological examination revealed that the tumors consisted of monomorphous cells that surrounded the blood vessels and neurons in the cerebral cortex, and formed concentric sleeves or pseudorosettes. Furthermore, immunostaining indicated that the diffuse infiltrative neoplastic cells were positive for glial fibrillary acidic protein and a dot-like pattern of epithelial membrane antigen was observed. AG mostly appeared similar to low-grade gliomas on MRI. GTR of the lesions was curative and radiation or chemotherapy were not required. AG typically has a favorable prognosis, with low mortality and incidence of disability.
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Affiliation(s)
- Guoqing Han
- Department of Neurosurgery, Tianjin Huanhu Hospital, Tianjin 300350, P.R. China
| | - Junsi Zhang
- Department of Neurology, Tianjin Children's Hospital, Tianjin 300074, P.R. China
| | - Yue Ma
- Department of Neurosurgery, Tianjin Huanhu Hospital, Tianjin 300350, P.R. China
| | - Qiuping Gui
- Department of Pathology, Chinese PLA General Hospital, Beijing 100853, P.R. China
| | - Shi Yin
- Department of Neurosurgery, Chinese PLA General Hospital, Beijing 100853, P.R. China
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19
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Slegers RJ, Blumcke I. Low-grade developmental and epilepsy associated brain tumors: a critical update 2020. Acta Neuropathol Commun 2020; 8:27. [PMID: 32151273 PMCID: PMC7063704 DOI: 10.1186/s40478-020-00904-x] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 02/29/2020] [Indexed: 12/14/2022] Open
Abstract
Brain tumors represent the second most frequent etiology in patients with focal seizure onset before 18 years of age and submitted to epilepsy surgery. Hence, this category of brain tumors, herein defined as low-grade, developmental, epilepsy-associated brain tumors (LEAT) is different from those frequently encountered in adults as (A): 77% of LEAT occur in the temporal lobe; (B): the vast majority of LEAT are of low malignancy and classified as WHO I°; (C): LEAT are often composed of mixed glial and neuronal cell components and present with variable growth patterns including small cysts or nodules; (D): LEAT do not share common gene driving mutations, such as IDH1 or 1p/19q co-deletions. Characteristic entities comprise the ganglioglioma (GG), the dysembryoplastic neuroepithelial tumor (DNT), the angiocentric glioma (AG), the isomorphic diffuse glioma (IDG) and the papillary glio-neuronal tumor (PGNT), representing 73.2% of 1680 tumors collected in a large German series of 6747 patients submitted to epilepsy surgery. In the realm of exciting discoveries of genetic drivers of brain tumors new genes have been also reported for LEAT. BRAF V600E mutations were linked to GG with CD34 expression, FGFR1 mutations to DNT, MYB alterations to AG and also IDG and PRKCA fusions to PGNT, suggesting the possibility to also develop a genetically driven tumor classification scheme for LEAT. Rare availability of LEAT in a single center is a challenging obstacle, however, to systematically unravel the neurobiological nature and clinical behavior of LEAT. Other challenges in need of clarification include malignant tumor progression of LEAT entities, seizure relapse in patients following bulk tumor resection and the controversial issue of associated focal cortical dysplasia as additional pathomechanism. In order to advance our understanding and promote reliable diagnostic work-up of LEAT, we recommend, therefore, international collaboration to achieve our goals.
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20
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Gupta S, Rangari KV, Mehrotra A, Pal L, Jaisawal AK, Kumar R. Temporal lobe angiocentric glioma with oligodendroglioma-like areas: a rare association of an uncommon tumor. A case report with review of literature. Childs Nerv Syst 2020; 36:641-646. [PMID: 31897632 DOI: 10.1007/s00381-019-04445-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 11/19/2019] [Indexed: 01/03/2023]
Abstract
BACKGROUND Angiocentric glioma (AG) is a relatively uncommon clinico-pathological entity that presents in childhood. Angiocentric glioma displays various histopathological features which resemble cortical ependymoma, astroblastoma, and pilomyxoid astrocytoma and schwannoma. The astrocytes in angiocentric glioma appear peculiarly elongated, bipolar in shape, and characteristically arranged around blood vessels. They resemble radial glia and tanycytes morphologically. Unlike ependymomas, AG is a diffusely infiltrating lesion and perivascular processes are often much thicker than those in classic ependymomas. CASE PRESENTATION AG usually present clinically as seizures, often as medically intractable epilepsy. In the indexed case, apart from unusual presentation with features of raised intra-cranial tension, an unusual histological picture of a more cellular oligodendroglioma like component was also seen. CONCLUSION The appropriate diagnosis is critical as AG is usually slowly growing and treatable by surgical excision alone.
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Affiliation(s)
- Shruti Gupta
- Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, 226014, India
| | - Kamlesh Vasant Rangari
- Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, 226014, India
| | - Anant Mehrotra
- Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, 226014, India.
| | - Lily Pal
- Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, 226014, India
| | - Awadhesh Kumar Jaisawal
- Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, 226014, India
| | - Raj Kumar
- Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, 226014, India
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21
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O'Halloran PJ, Amoo M, Dablouk MO, Beausang A, MacNally S. Angiocentric glioma: Drop Metastases to the Spinal Cord. World Neurosurg 2020; 136:110-116. [PMID: 31953098 DOI: 10.1016/j.wneu.2020.01.037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 01/04/2020] [Accepted: 01/06/2020] [Indexed: 10/25/2022]
Abstract
BACKGROUND Angiocentric glioma (AG) is an epileptogenic low grade (World Health Organization grade I) glial tumor with astrocytic and ependymal differentiation, most commonly affecting the pediatric and adolescent population. Despite its infiltrating histological growth kinetics, it is widely accepted that AG has a low potential for aggressive behavior. CASE DESCRIPTION We present the case of a 42-year-old man who represents the first documented case of not only extracranial manifestation of AG, but also spinal metastatic dissemination. Our patient initially presented with a generalized tonic clonic seizure; following a biopsy, he was diagnosed with a low-grade supratentorial astrocytoma and subsequently received fractionated radiotherapy. He presented 10 months later with worsening dorsal column symptoms and was found to have a contrast-enhancing intradural extramedullary lesion that was surgically resected and histologically confirmed as an AG. CONCLUSION Further research is required to examine the microenvironment and potential for malignant change in this tumor.
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Affiliation(s)
- Philip J O'Halloran
- Department of Neurosurgery, National Neurosurgical Centre, Beaumont Hospital, Dublin, Ireland; Department of Physiology and Medical Physics, Royal College of Surgeons in Ireland, Dublin, Ireland.
| | - Michael Amoo
- Department of Neurosurgery, National Neurosurgical Centre, Beaumont Hospital, Dublin, Ireland
| | - Mohamed O Dablouk
- Department of Neurosurgery, National Neurosurgical Centre, Beaumont Hospital, Dublin, Ireland
| | - Alan Beausang
- Department of Neuropathology, Beaumont Hospital, Dublin, Ireland
| | - Stephen MacNally
- Department of Neurosurgery, National Neurosurgical Centre, Beaumont Hospital, Dublin, Ireland
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22
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Cavalheiro S, da Costa MDS, Schaurich CG, Cappellano AM, Saba-Silva N, de Seixas Alves MT, Stavale JN. An 8-Year-Old Girl with Blepharospasm and Left Thalamic Tumor. Brain Pathol 2020; 29:457-458. [PMID: 31016833 DOI: 10.1111/bpa.12725] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Affiliation(s)
- Sergio Cavalheiro
- Department of Neurosurgery, Federal University of Sao Paulo, Sao Paulo, Brazil
| | | | | | - Andrea Maria Cappellano
- Department of Pediatrics, Pediatric Oncology Institute/GRAACC, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Nasjla Saba-Silva
- Department of Pediatrics, Pediatric Oncology Institute/GRAACC, Federal University of Sao Paulo, Sao Paulo, Brazil
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23
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da Silva JFC, de Souza Machado GH, Pedro MKF, Vosgerau R, Hunhevicz SC, Ramina R. Angiocentric glioma: Literature review and first case in Brazil. INTERDISCIPLINARY NEUROSURGERY 2019. [DOI: 10.1016/j.inat.2019.100508] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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24
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Freiburg Neuropathology Case Conference : Hypersalivatory Seizures in a 6-year-old Child. Clin Neuroradiol 2019; 29:581-586. [PMID: 31388687 DOI: 10.1007/s00062-019-00820-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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25
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Harmsen H, Mobley BC, Davis LT. Angiocentric glioma mimicking encephalomalacia. Radiol Case Rep 2019; 14:700-703. [PMID: 30976372 PMCID: PMC6441711 DOI: 10.1016/j.radcr.2019.03.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 03/10/2019] [Accepted: 03/13/2019] [Indexed: 11/29/2022] Open
Abstract
Angiocentric glioma is a rare low-grade neoplasm of the central nervous system which typically presents with medication-refractory seizures in children and young adults. On magnetic resonance imaging, angiocentric glioma is classically T1 hypointense and T2/FLAIR hyperintense. We present the case of a 40-year-old male who had been followed by our institution for 17 years for management of epilepsy. Initial and repeat brain imaging showed an apparent region of cystic encephalomalacia in the right frontal lobe. In an attempt to control his seizures, the lesion was resected. Grossly, the cut surface of the specimen was characterized by multiple small cystic spaces. Microscopically, the lesion was composed of an infiltrative population of glial cells variably arranged in perivascular “pseudorosettes,” nodules, and subpial “palisades.” The final diagnosis was angiocentric glioma. This is the second reported case of an angiocentric glioma mistaken for encephalomalacia.
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Affiliation(s)
- Hannah Harmsen
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, 1211 Medical Center Dr, Nashville, TN 37232, USA
| | - Bret C Mobley
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, 1211 Medical Center Dr, Nashville, TN 37232, USA
| | - Larry T Davis
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, 1211 Medical Center Dr, Nashville, TN 37232, USA
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26
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Blümcke I, Coras R, Wefers AK, Capper D, Aronica E, Becker A, Honavar M, Stone TJ, Jacques TS, Miyata H, Mühlebner A, Pimentel J, Söylemezoğlu F, Thom M. Review: Challenges in the histopathological classification of ganglioglioma and DNT: microscopic agreement studies and a preliminary genotype-phenotype analysis. Neuropathol Appl Neurobiol 2018; 45:95-107. [PMID: 30326153 DOI: 10.1111/nan.12522] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 10/03/2018] [Indexed: 12/28/2022]
Abstract
Low-grade epilepsy-associated brain tumours (LEAT) are the second most common cause for drug-resistant, focal epilepsy, that is ganglioglioma (GG) and dysembryoplastic neuroepithelial tumours (DNT). However, molecular pathogenesis, risk factors for malignant progression and their frequent association with drug-resistant focal seizures remain poorly understood. This contrasts recent progress in understanding the molecular-genetic basis and targeted treatment options in diffuse gliomas. The Neuropathology Task Force of the International League Against Epilepsy examined available literature to identify common obstacles in diagnosis and research of LEAT. Analysis of 10 published tumour series from epilepsy surgery pointed to poor inter-rater agreement for the histopathology diagnosis. The Task Force tested this hypothesis using a web-based microscopy agreement study. In a series of 30 LEAT, 25 raters from 18 countries agreed in only 40% of cases. Highest discordance in microscopic diagnosis occurred between GG and DNT variants, when oligodendroglial-like cell patterns prevail, or ganglion cells were difficult to discriminate from pre-existing neurons. Suggesting new terminology or major histopathological criteria did not satisfactorily increase the yield of histopathology agreement in four consecutive trials. To this end, the Task Force applied the WHO 2016 strategy of integrating phenotype analysis with molecular-genetic data obtained from panel sequencing and 450k methylation arrays. This strategy was helpful to distinguish DNT from GG variants in all cases. The Task Force recommends, therefore, to further develop diagnostic panels for the integration of phenotype-genotype analysis in order to reliably classify the spectrum of LEAT, carefully characterize clinically meaningful entities and make better use of published literature.
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Affiliation(s)
- I Blümcke
- Department of Neuropathology, University Hospital, Erlangen, Germany.,Epilepsy Center, Cleveland Clinic, Cleveland, OH, USA
| | - R Coras
- Department of Neuropathology, University Hospital, Erlangen, Germany
| | - A K Wefers
- Department of Neuropathology, Institute of Pathology, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | - D Capper
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.,Institute of Neuropathology, Berlin Institute of Health, Berlin, Germany.,German Cancer Consortium (DKTK), Partner Site Berlin, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - E Aronica
- Department of (Neuro)Pathology, Academic Medisch Centrum (AMC), Amsterdam, The Netherlands.,Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, The Netherlands
| | - A Becker
- Department of Neuropathology, University of Bonn Medical Centre, Bonn, Germany
| | - M Honavar
- Department of Anatomic Pathology, Hospital Pedro Hispano, Matosinhos, Portugal
| | - T J Stone
- Developmental Biology and Cancer Section, UCL Great Ormond Street Institute of Child Health, London, UK.,Department of Histopathology, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - T S Jacques
- Developmental Biology and Cancer Section, UCL Great Ormond Street Institute of Child Health, London, UK.,Department of Histopathology, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - H Miyata
- Department of Neuropathology, Research Institute for Brain and Blood Vessels -AKITA, Akita, Japan
| | - A Mühlebner
- Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, The Netherlands.,Department of Pediatrics, Medical University Vienna, Vienna, Austria
| | - J Pimentel
- Laboratory of Neuropathology, Department of Neurology, Hospital de Santa Maria (CHLN), Lisbon, Portugal
| | - F Söylemezoğlu
- Department of Pathology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - M Thom
- Department of Clinical and Experimental Epilepsy UCL Queens Square, Institute of Neurology, London
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27
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Chaudhari JP, Kothari KS, Pandya TP, Goel NA. Angiocentric Glioma: Report of a Rare Case Presenting with Psychosis. Asian J Neurosurg 2018; 13:1186-1192. [PMID: 30459891 PMCID: PMC6208224 DOI: 10.4103/ajns.ajns_371_16] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Angiocentric glioma (AG), first described in 2005, was included as a distinct entity in the 2007 World Health Organization Classification of Tumors of the Central Nervous System. It is a very rare cerebrocortical tumor mainly affecting children and young adults with a history of intractable partial seizures. The histopathological features of this entity are perivascular arrangement of monomorphic, bipolar spindled cells with subpial aggregation of tumor cells and variable neuroparenchymal colonization. Of uncertain histogenesis, this is a stable/slowly growing tumor. Prognosis following total surgical resection is favorable. We describe an AG in a 16-year-old, intellectually disabled, male patient, with psychosis. This is a rare presentation with only one such case in literature. Patient's symptoms ameliorated following surgery.
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Affiliation(s)
| | - Kanchan Snehal Kothari
- Department of Pathology, Seth G.S. Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - Tejal Pratin Pandya
- Department of Pathology, Seth G.S. Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - Naina Atul Goel
- Department of Pathology, Seth G.S. Medical College and KEM Hospital, Mumbai, Maharashtra, India
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28
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A malignant astrocytoma with uncommon angiocentric features and dot-like EMA expression. Contemp Oncol (Pozn) 2018; 22:205-208. [PMID: 30455594 PMCID: PMC6238096 DOI: 10.5114/wo.2018.78944] [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: 06/18/2018] [Accepted: 08/15/2018] [Indexed: 11/17/2022] Open
Abstract
Angiocentric features are uncommon in high-grade World Health Organisation (WHO) brain tumours, whilst they are typical for WHO grade I tumours, e.g. angiocentric gliomas. We present an unusual glial tumour that occurred in a 59-year-old man. The tumour had equivocal radiologic and histopathologic features, especially a characteristic angiocentric pattern, low-to-moderate Ki67, and dot-like epithelial membrane antigen expression. The tumour did not show features characteristic for glioblastoma; however, it recurred as glioblastoma four months later. Based on this case, we show that high-grade WHO brain tumours may show an angiocentric pattern typical for low-grade WHO brain tumours, such as angiocentric gliomas.
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29
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Weaver KJ, Crawford LM, Bennett JA, Rivera-Zengotita ML, Pincus DW. Brainstem angiocentric glioma: report of 2 cases. J Neurosurg Pediatr 2017; 20:347-351. [PMID: 28753090 DOI: 10.3171/2017.5.peds16402] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Angiocentric glioma is a rare tumor that was recognized by the WHO Classification of Tumours of the Central Nervous System as a distinct clinicopathological entity in 2007. Since this initial description, the vast majority of cases of angiocentric glioma reported in the literature have involved tumors of the cerebral hemispheres. To date, only 1 case of angiocentric glioma arising from the posterior midbrain has been reported. The authors present the cases of 2 pediatric patients who were found to have brainstem angiocentric gliomas. The clinical course, radiological and pathological features, treatment, and follow-up are described. The first case is one of a 5-year-old girl who presented with double vision, headache, and nausea and was found to have a midbrain lesion with pathological features consistent with angiocentric glioma. She was treated with resection and endoscopic third ventriculostomy (ETV), followed by close observation and serial neuroimaging. The second case is one of a 6-year-old boy who presented with progressive mouth drooping and problems with balance. He was found to have a pontine lesion with pathological features consistent with angiocentric glioma. This patient was treated with ETV, followed by close observation and serial neuroimaging. This report includes 6 and 1.5 years of follow-up of the patients, respectively. While there are limited data regarding the prognosis or long-term management of patients with brainstem angiocentric gliomas, the cases described in this report suggest an indolent course for this tumor, similar to the course of angiocentric gliomas located in the cerebral hemispheres.
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30
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Chan E, Bollen AW, Sirohi D, Van Ziffle J, Grenert JP, Kline CN, Tihan T, Perry A, Gupta N, Solomon DA. Angiocentric glioma with MYB-QKI fusion located in the brainstem, rather than cerebral cortex. Acta Neuropathol 2017; 134:671-673. [PMID: 28776091 PMCID: PMC5693679 DOI: 10.1007/s00401-017-1759-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 07/27/2017] [Accepted: 07/28/2017] [Indexed: 10/19/2022]
Affiliation(s)
- Emily Chan
- Department of Pathology, University of California, San Francisco, 513 Parnassus Ave, Health Sciences West 451, San Francisco, CA, 94143, USA
| | - Andrew W Bollen
- Department of Pathology, University of California, San Francisco, 513 Parnassus Ave, Health Sciences West 451, San Francisco, CA, 94143, USA
| | - Deepika Sirohi
- Department of Pathology, University of California, San Francisco, 513 Parnassus Ave, Health Sciences West 451, San Francisco, CA, 94143, USA
- Clinical Cancer Genomics Laboratory, University of California, San Francisco, CA, USA
| | - Jessica Van Ziffle
- Department of Pathology, University of California, San Francisco, 513 Parnassus Ave, Health Sciences West 451, San Francisco, CA, 94143, USA
- Clinical Cancer Genomics Laboratory, University of California, San Francisco, CA, USA
| | - James P Grenert
- Department of Pathology, University of California, San Francisco, 513 Parnassus Ave, Health Sciences West 451, San Francisco, CA, 94143, USA
- Clinical Cancer Genomics Laboratory, University of California, San Francisco, CA, USA
| | - Cassie N Kline
- Division of Hematology/Oncology, Department of Pediatrics, University of California, San Francisco, CA, USA
| | - Tarik Tihan
- Department of Pathology, University of California, San Francisco, 513 Parnassus Ave, Health Sciences West 451, San Francisco, CA, 94143, USA
| | - Arie Perry
- Department of Pathology, University of California, San Francisco, 513 Parnassus Ave, Health Sciences West 451, San Francisco, CA, 94143, USA
- Department of Neurological Surgery, University of California, San Francisco, CA, USA
| | - Nalin Gupta
- Department of Neurological Surgery, University of California, San Francisco, CA, USA
| | - David A Solomon
- Department of Pathology, University of California, San Francisco, 513 Parnassus Ave, Health Sciences West 451, San Francisco, CA, 94143, USA.
- Clinical Cancer Genomics Laboratory, University of California, San Francisco, CA, USA.
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31
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Komori T. The 2016 WHO Classification of Tumours of the Central Nervous System: The Major Points of Revision. Neurol Med Chir (Tokyo) 2017; 57:301-311. [PMID: 28592714 PMCID: PMC5566703 DOI: 10.2176/nmc.ra.2017-0010] [Citation(s) in RCA: 160] [Impact Index Per Article: 22.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
The updated 2016 edition of the World Health Organization (WHO) Classification of Tumours of the Central Nervous System (CNS) uses molecular parameters and the histology to define the main tumor categories for the first time. This represents a shift from the traditional principle of using neuropathological diagnoses, which are primarily based on the microscopic features, to using molecularly-oriented diagnoses. Major restructuring was made with regard to diffuse gliomas, medulloblastomas and other embryonal tumors. New entities that are defined by both the histological and molecular features include glioblastoma, isocitrate dehydrogenase (IDH)-wildtype and glioblastoma, IDH-mutant; diffuse midline glioma, H3 K27M-mutant; RELA fusion-positive ependymoma; medulloblastoma, wingless (WNT)-activated and medulloblastoma, sonic hedgehog (SHH)-activated; and embryonal tumor with multilayered rosettes, C19MC-altered. In addition, some entities that are no longer diagnostically relevant—such as CNS-primitive neuroectodermal tumor—have been deleted from this updated edition. The WHO2016 certainly facilitates clinical and basic research to improve the diagnosis of brain tumors and patient care.
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Affiliation(s)
- Takashi Komori
- Department of Laboratory Medicine and Pathology (Neuropathology), Tokyo Metropolitan Neurological Hospital
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32
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Myers KA, Mandelstam SA, Ramantani G, Rushing EJ, de Vries BB, Koolen DA, Scheffer IE. The epileptology of Koolen-de Vries syndrome: Electro-clinico-radiologic findings in 31 patients. Epilepsia 2017; 58:1085-1094. [DOI: 10.1111/epi.13746] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2017] [Indexed: 02/01/2023]
Affiliation(s)
- Kenneth A. Myers
- Department of Medicine; Epilepsy Research Centre; The University of Melbourne, Austin Health; Heidelberg Victoria Australia
- Section of Neurology; Department of Pediatrics; Alberta Children's Hospital; Cumming School of Medicine; University of Calgary; Calgary Alberta Canada
| | - Simone A. Mandelstam
- Department of Paediatrics; The University of Melbourne; Parkville Victoria Australia
- Department of Radiology; The University of Melbourne; Parkville Victoria Australia
- The Florey Institute of Neuroscience and Mental Health; Heidelberg Victoria Australia
| | - Georgia Ramantani
- Division of Child Neurology; University Children's Hospital; Zurich Switzerland
- Swiss Epilepsy Center; Zurich Switzerland
| | | | - Bert B. de Vries
- Department of Human Genetics; Donders Institute for Brain, Cognition and Behavior; Radboud University Medical Center; Nijmegen The Netherlands
| | - David A. Koolen
- Department of Human Genetics; Donders Institute for Brain, Cognition and Behavior; Radboud University Medical Center; Nijmegen The Netherlands
| | - Ingrid E. Scheffer
- Department of Medicine; Epilepsy Research Centre; The University of Melbourne, Austin Health; Heidelberg Victoria Australia
- Department of Paediatrics; The University of Melbourne; Parkville Victoria Australia
- The Florey Institute of Neuroscience and Mental Health; Heidelberg Victoria Australia
- Department of Neurology; Royal Children's Hospital; Parkville Victoria Australia
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33
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Gonzalez-Quarante LH, Fernández Carballal C, Agarwal V, Vargas Lopez AJ, Gil de Sagredo del Corral OL, Sola Vendrell E. Angiocentric Glioma in an Elderly Patient: Case Report and Review of the Literature. World Neurosurg 2017; 97:755.e5-755.e10. [DOI: 10.1016/j.wneu.2016.10.034] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 10/03/2016] [Accepted: 10/05/2016] [Indexed: 10/20/2022]
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34
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Abstract
Rapid developments in molecular genetic technology and research have swiftly advanced our understanding of neuro-oncology. As a consequence, the WHO invited their expert panels to revise the current classification system of brain tumours and to introduce, for the first time, a molecular genetic approach for selected tumour entities, thus setting a new gold standard in histopathology. The revised 5th edition of the 'blue book' was released in May 2016 and will have a major impact in stratifying diagnosis and treatment. However, low-grade neuroepithelial tumours that present with early-onset focal epilepsy and are mostly seen in children and young adults (previously designated as long-term epilepsy-associated neuroepithelial tumours, LEAT) lack such innovative clinicopathological and molecular genetic tools. The Neuropathology Task Force of the International League against Epilepsy will critically discuss this issue, and will offer perspectives on how to decipher and validate clinically meaningful LEAT entities using the current WHO approach that integrates clinicopathological and genetic classification systems.
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35
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McCracken JA, Gonzales MF, Phal PM, Drummond KJ. Angiocentric glioma transformed into anaplastic ependymoma: Review of the evidence for malignant potential. J Clin Neurosci 2016; 34:47-52. [PMID: 27742374 DOI: 10.1016/j.jocn.2016.08.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 08/01/2016] [Accepted: 08/10/2016] [Indexed: 01/30/2023]
Abstract
Angiocentric glioma (AG) is a low grade glioma, that was first described in 2002. Since this description, 83 patients with AG have been described, including ours. AG typically presents in childhood with medically refractory seizures that are cured with gross surgical resection. Whilst the natural history is that of a benign tumour, there have been reports of recurrence, transformation, and malignant features that suggest that AG is potentially malignant. We add to the literature a case of a 16-year-old girl who presented in May 2011 with a 3-month history of complex partial seizures, with MRI showing a T2-weighted hyperintense lesion in the left insula and inferior frontal lobe. This was confirmed on biopsy as AG and was followed with surveillance imaging. In April 2012, she presented with disease progression and underwent a left temporal lobectomy, with histology showing both AG and grade II astrocytoma. Adjuvant radiotherapy of 50 Gray in 28 fractions was administered. A small area of contrast enhancement appeared in the left parietal lobe in December 2012, which progressed over subsequent months. In June 2013, she underwent a near total excision, with histology showing anaplastic ependymoma. She received six cycles of adjuvant temozolamide. Despite this, the tumour continued to progress, with her seizure control deteriorating, and the development of a right hemiparesis. The patient died in January 2014, aged 19years.
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Affiliation(s)
- James A McCracken
- Department of Neurosurgery, Royal Melbourne Hospital, 300 Grattan Street, Parkville, VIC 3050, Australia.
| | - Michael F Gonzales
- Department of Pathology, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Pramit M Phal
- Department of Radiology, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Katharine J Drummond
- Department of Neurosurgery, Royal Melbourne Hospital, 300 Grattan Street, Parkville, VIC 3050, Australia
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36
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Lehman NL, Hattab EM, Mobley BC, Usubalieva A, Schniederjan MJ, McLendon RE, Paulus W, Rushing EJ, Georgescu MM, Couce M, Dulai MS, Cohen ML, Pierson CR, Raisanen JM, Martin SE, Lehman TD, Lipp ES, Bonnin JM, Al-Abbadi MA, Kenworthy K, Zhao K, Mohamed N, Zhang G, Zhao W. Morphological and molecular features of astroblastoma, including BRAFV600E mutations, suggest an ontological relationship to other cortical-based gliomas of children and young adults. Neuro Oncol 2016; 19:31-42. [PMID: 27416954 DOI: 10.1093/neuonc/now118] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Astroblastomas (ABs) are rare glial tumors showing overlapping features with astrocytomas, ependymomas, and sometimes other glial neoplasms, and may be challenging to diagnose. METHODS We examined clinical, histopathological, and molecular features in 28 archival formalin-fixed, paraffin-embedded AB cases and performed survival analyses using Cox proportional hazards and Kaplan-Meier methods. RESULTS Unlike ependymomas and angiocentric gliomas, ABs demonstrate abundant distinctive astroblastic pseudorosettes and are usually Olig2 immunopositive. They also frequently exhibit rhabdoid cells, multinucleated cells, and eosinophilic granular material. They retain immunoreactivity to alpha thalassemia/mental retardation syndrome X-linked, are immunonegative to isocitrate dehydrogenase-1 R132H mutation, and only occasionally show MGMT promoter hypermethylation differentiating them from many diffuse gliomas. Like pleomorphic xanthoastrocytoma, ganglioglioma, supratentorial pilocytic astrocytoma, and other predominantly cortical-based glial tumors, ABs often harbor the BRAFV600E mutation, present in 38% of cases tested (n = 21), further distinguishing those tumors from ependymomas and angiocentric gliomas. Factors correlating with longer patient survival included age less than 30 years, female gender, absent BRAFV600E , and mitotic index less than 5 mitoses/10 high-power fields; however, only the latter was significant by Cox and Kaplan-Meier analyses (n = 24; P = .024 and .012, respectively). This mitotic cutoff is therefore currently the best criterion to stratify tumors into low-grade ABs and higher-grade anaplastic ABs. CONCLUSIONS In addition to their own characteristic histological features, ABs share some molecular and histological findings with other, possibly ontologically related, cortical-based gliomas of mostly children and young adults. Importantly, the presence of BRAFV600E mutations in a subset of ABs suggests potential clinical utility of targeted anti-BRAF therapy.
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Affiliation(s)
- Norman L Lehman
- Department of Pathology, The Ohio State University, Columbus, Ohio (N.L.L., A.U., C.R.P., K.K., K.Z., N.M., G.Z., W.Z.); Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, Indiana (E.M.H., J.M.B.); Department of Pathology, Vanderbilt University, Nashville, Tennessee (B.C.M.); Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia (M.J.S.); Department of Pathology, Duke University, Durham, North Carolina (R.E.M., E.S.L.); Institute of Neuropathology, University Hospital Münster, Germany (W.P.); Institute for Neuropathology, University Hospital of Zurich, Switzerland (E.J.R.); Department of Pathology, The University of Texas Southwestern, Dallas, Texas (M.-M.G., J.M.R.); Department of Pathology, Case Western Reserve University, Cleveland, Ohio (M.C., M.L.C.); Department of Anatomic Pathology, Beaumont Hospital, Royal Oak, Michigan (M.S.D.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio (C.R.P.); Department of Pathology, University of Illinois, Peoria, Illinois (S.E.M.); Department of Pathology, Sheikh Khalifa Medical City, Abu Dhabi, UAE (M.A.A.-A.); Department of Family and Community Medicine, Contra Costa Regional Medical Center, Martinez, California (T.D.L.)
| | - Eyas M Hattab
- Department of Pathology, The Ohio State University, Columbus, Ohio (N.L.L., A.U., C.R.P., K.K., K.Z., N.M., G.Z., W.Z.); Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, Indiana (E.M.H., J.M.B.); Department of Pathology, Vanderbilt University, Nashville, Tennessee (B.C.M.); Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia (M.J.S.); Department of Pathology, Duke University, Durham, North Carolina (R.E.M., E.S.L.); Institute of Neuropathology, University Hospital Münster, Germany (W.P.); Institute for Neuropathology, University Hospital of Zurich, Switzerland (E.J.R.); Department of Pathology, The University of Texas Southwestern, Dallas, Texas (M.-M.G., J.M.R.); Department of Pathology, Case Western Reserve University, Cleveland, Ohio (M.C., M.L.C.); Department of Anatomic Pathology, Beaumont Hospital, Royal Oak, Michigan (M.S.D.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio (C.R.P.); Department of Pathology, University of Illinois, Peoria, Illinois (S.E.M.); Department of Pathology, Sheikh Khalifa Medical City, Abu Dhabi, UAE (M.A.A.-A.); Department of Family and Community Medicine, Contra Costa Regional Medical Center, Martinez, California (T.D.L.)
| | - Bret C Mobley
- Department of Pathology, The Ohio State University, Columbus, Ohio (N.L.L., A.U., C.R.P., K.K., K.Z., N.M., G.Z., W.Z.); Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, Indiana (E.M.H., J.M.B.); Department of Pathology, Vanderbilt University, Nashville, Tennessee (B.C.M.); Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia (M.J.S.); Department of Pathology, Duke University, Durham, North Carolina (R.E.M., E.S.L.); Institute of Neuropathology, University Hospital Münster, Germany (W.P.); Institute for Neuropathology, University Hospital of Zurich, Switzerland (E.J.R.); Department of Pathology, The University of Texas Southwestern, Dallas, Texas (M.-M.G., J.M.R.); Department of Pathology, Case Western Reserve University, Cleveland, Ohio (M.C., M.L.C.); Department of Anatomic Pathology, Beaumont Hospital, Royal Oak, Michigan (M.S.D.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio (C.R.P.); Department of Pathology, University of Illinois, Peoria, Illinois (S.E.M.); Department of Pathology, Sheikh Khalifa Medical City, Abu Dhabi, UAE (M.A.A.-A.); Department of Family and Community Medicine, Contra Costa Regional Medical Center, Martinez, California (T.D.L.)
| | - Aisulu Usubalieva
- Department of Pathology, The Ohio State University, Columbus, Ohio (N.L.L., A.U., C.R.P., K.K., K.Z., N.M., G.Z., W.Z.); Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, Indiana (E.M.H., J.M.B.); Department of Pathology, Vanderbilt University, Nashville, Tennessee (B.C.M.); Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia (M.J.S.); Department of Pathology, Duke University, Durham, North Carolina (R.E.M., E.S.L.); Institute of Neuropathology, University Hospital Münster, Germany (W.P.); Institute for Neuropathology, University Hospital of Zurich, Switzerland (E.J.R.); Department of Pathology, The University of Texas Southwestern, Dallas, Texas (M.-M.G., J.M.R.); Department of Pathology, Case Western Reserve University, Cleveland, Ohio (M.C., M.L.C.); Department of Anatomic Pathology, Beaumont Hospital, Royal Oak, Michigan (M.S.D.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio (C.R.P.); Department of Pathology, University of Illinois, Peoria, Illinois (S.E.M.); Department of Pathology, Sheikh Khalifa Medical City, Abu Dhabi, UAE (M.A.A.-A.); Department of Family and Community Medicine, Contra Costa Regional Medical Center, Martinez, California (T.D.L.)
| | - Matthew J Schniederjan
- Department of Pathology, The Ohio State University, Columbus, Ohio (N.L.L., A.U., C.R.P., K.K., K.Z., N.M., G.Z., W.Z.); Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, Indiana (E.M.H., J.M.B.); Department of Pathology, Vanderbilt University, Nashville, Tennessee (B.C.M.); Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia (M.J.S.); Department of Pathology, Duke University, Durham, North Carolina (R.E.M., E.S.L.); Institute of Neuropathology, University Hospital Münster, Germany (W.P.); Institute for Neuropathology, University Hospital of Zurich, Switzerland (E.J.R.); Department of Pathology, The University of Texas Southwestern, Dallas, Texas (M.-M.G., J.M.R.); Department of Pathology, Case Western Reserve University, Cleveland, Ohio (M.C., M.L.C.); Department of Anatomic Pathology, Beaumont Hospital, Royal Oak, Michigan (M.S.D.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio (C.R.P.); Department of Pathology, University of Illinois, Peoria, Illinois (S.E.M.); Department of Pathology, Sheikh Khalifa Medical City, Abu Dhabi, UAE (M.A.A.-A.); Department of Family and Community Medicine, Contra Costa Regional Medical Center, Martinez, California (T.D.L.)
| | - Roger E McLendon
- Department of Pathology, The Ohio State University, Columbus, Ohio (N.L.L., A.U., C.R.P., K.K., K.Z., N.M., G.Z., W.Z.); Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, Indiana (E.M.H., J.M.B.); Department of Pathology, Vanderbilt University, Nashville, Tennessee (B.C.M.); Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia (M.J.S.); Department of Pathology, Duke University, Durham, North Carolina (R.E.M., E.S.L.); Institute of Neuropathology, University Hospital Münster, Germany (W.P.); Institute for Neuropathology, University Hospital of Zurich, Switzerland (E.J.R.); Department of Pathology, The University of Texas Southwestern, Dallas, Texas (M.-M.G., J.M.R.); Department of Pathology, Case Western Reserve University, Cleveland, Ohio (M.C., M.L.C.); Department of Anatomic Pathology, Beaumont Hospital, Royal Oak, Michigan (M.S.D.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio (C.R.P.); Department of Pathology, University of Illinois, Peoria, Illinois (S.E.M.); Department of Pathology, Sheikh Khalifa Medical City, Abu Dhabi, UAE (M.A.A.-A.); Department of Family and Community Medicine, Contra Costa Regional Medical Center, Martinez, California (T.D.L.)
| | - Werner Paulus
- Department of Pathology, The Ohio State University, Columbus, Ohio (N.L.L., A.U., C.R.P., K.K., K.Z., N.M., G.Z., W.Z.); Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, Indiana (E.M.H., J.M.B.); Department of Pathology, Vanderbilt University, Nashville, Tennessee (B.C.M.); Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia (M.J.S.); Department of Pathology, Duke University, Durham, North Carolina (R.E.M., E.S.L.); Institute of Neuropathology, University Hospital Münster, Germany (W.P.); Institute for Neuropathology, University Hospital of Zurich, Switzerland (E.J.R.); Department of Pathology, The University of Texas Southwestern, Dallas, Texas (M.-M.G., J.M.R.); Department of Pathology, Case Western Reserve University, Cleveland, Ohio (M.C., M.L.C.); Department of Anatomic Pathology, Beaumont Hospital, Royal Oak, Michigan (M.S.D.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio (C.R.P.); Department of Pathology, University of Illinois, Peoria, Illinois (S.E.M.); Department of Pathology, Sheikh Khalifa Medical City, Abu Dhabi, UAE (M.A.A.-A.); Department of Family and Community Medicine, Contra Costa Regional Medical Center, Martinez, California (T.D.L.)
| | - Elisabeth J Rushing
- Department of Pathology, The Ohio State University, Columbus, Ohio (N.L.L., A.U., C.R.P., K.K., K.Z., N.M., G.Z., W.Z.); Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, Indiana (E.M.H., J.M.B.); Department of Pathology, Vanderbilt University, Nashville, Tennessee (B.C.M.); Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia (M.J.S.); Department of Pathology, Duke University, Durham, North Carolina (R.E.M., E.S.L.); Institute of Neuropathology, University Hospital Münster, Germany (W.P.); Institute for Neuropathology, University Hospital of Zurich, Switzerland (E.J.R.); Department of Pathology, The University of Texas Southwestern, Dallas, Texas (M.-M.G., J.M.R.); Department of Pathology, Case Western Reserve University, Cleveland, Ohio (M.C., M.L.C.); Department of Anatomic Pathology, Beaumont Hospital, Royal Oak, Michigan (M.S.D.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio (C.R.P.); Department of Pathology, University of Illinois, Peoria, Illinois (S.E.M.); Department of Pathology, Sheikh Khalifa Medical City, Abu Dhabi, UAE (M.A.A.-A.); Department of Family and Community Medicine, Contra Costa Regional Medical Center, Martinez, California (T.D.L.)
| | - Maria-Magdalena Georgescu
- Department of Pathology, The Ohio State University, Columbus, Ohio (N.L.L., A.U., C.R.P., K.K., K.Z., N.M., G.Z., W.Z.); Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, Indiana (E.M.H., J.M.B.); Department of Pathology, Vanderbilt University, Nashville, Tennessee (B.C.M.); Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia (M.J.S.); Department of Pathology, Duke University, Durham, North Carolina (R.E.M., E.S.L.); Institute of Neuropathology, University Hospital Münster, Germany (W.P.); Institute for Neuropathology, University Hospital of Zurich, Switzerland (E.J.R.); Department of Pathology, The University of Texas Southwestern, Dallas, Texas (M.-M.G., J.M.R.); Department of Pathology, Case Western Reserve University, Cleveland, Ohio (M.C., M.L.C.); Department of Anatomic Pathology, Beaumont Hospital, Royal Oak, Michigan (M.S.D.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio (C.R.P.); Department of Pathology, University of Illinois, Peoria, Illinois (S.E.M.); Department of Pathology, Sheikh Khalifa Medical City, Abu Dhabi, UAE (M.A.A.-A.); Department of Family and Community Medicine, Contra Costa Regional Medical Center, Martinez, California (T.D.L.)
| | - Marta Couce
- Department of Pathology, The Ohio State University, Columbus, Ohio (N.L.L., A.U., C.R.P., K.K., K.Z., N.M., G.Z., W.Z.); Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, Indiana (E.M.H., J.M.B.); Department of Pathology, Vanderbilt University, Nashville, Tennessee (B.C.M.); Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia (M.J.S.); Department of Pathology, Duke University, Durham, North Carolina (R.E.M., E.S.L.); Institute of Neuropathology, University Hospital Münster, Germany (W.P.); Institute for Neuropathology, University Hospital of Zurich, Switzerland (E.J.R.); Department of Pathology, The University of Texas Southwestern, Dallas, Texas (M.-M.G., J.M.R.); Department of Pathology, Case Western Reserve University, Cleveland, Ohio (M.C., M.L.C.); Department of Anatomic Pathology, Beaumont Hospital, Royal Oak, Michigan (M.S.D.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio (C.R.P.); Department of Pathology, University of Illinois, Peoria, Illinois (S.E.M.); Department of Pathology, Sheikh Khalifa Medical City, Abu Dhabi, UAE (M.A.A.-A.); Department of Family and Community Medicine, Contra Costa Regional Medical Center, Martinez, California (T.D.L.)
| | - Mohanpal S Dulai
- Department of Pathology, The Ohio State University, Columbus, Ohio (N.L.L., A.U., C.R.P., K.K., K.Z., N.M., G.Z., W.Z.); Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, Indiana (E.M.H., J.M.B.); Department of Pathology, Vanderbilt University, Nashville, Tennessee (B.C.M.); Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia (M.J.S.); Department of Pathology, Duke University, Durham, North Carolina (R.E.M., E.S.L.); Institute of Neuropathology, University Hospital Münster, Germany (W.P.); Institute for Neuropathology, University Hospital of Zurich, Switzerland (E.J.R.); Department of Pathology, The University of Texas Southwestern, Dallas, Texas (M.-M.G., J.M.R.); Department of Pathology, Case Western Reserve University, Cleveland, Ohio (M.C., M.L.C.); Department of Anatomic Pathology, Beaumont Hospital, Royal Oak, Michigan (M.S.D.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio (C.R.P.); Department of Pathology, University of Illinois, Peoria, Illinois (S.E.M.); Department of Pathology, Sheikh Khalifa Medical City, Abu Dhabi, UAE (M.A.A.-A.); Department of Family and Community Medicine, Contra Costa Regional Medical Center, Martinez, California (T.D.L.)
| | - Mark L Cohen
- Department of Pathology, The Ohio State University, Columbus, Ohio (N.L.L., A.U., C.R.P., K.K., K.Z., N.M., G.Z., W.Z.); Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, Indiana (E.M.H., J.M.B.); Department of Pathology, Vanderbilt University, Nashville, Tennessee (B.C.M.); Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia (M.J.S.); Department of Pathology, Duke University, Durham, North Carolina (R.E.M., E.S.L.); Institute of Neuropathology, University Hospital Münster, Germany (W.P.); Institute for Neuropathology, University Hospital of Zurich, Switzerland (E.J.R.); Department of Pathology, The University of Texas Southwestern, Dallas, Texas (M.-M.G., J.M.R.); Department of Pathology, Case Western Reserve University, Cleveland, Ohio (M.C., M.L.C.); Department of Anatomic Pathology, Beaumont Hospital, Royal Oak, Michigan (M.S.D.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio (C.R.P.); Department of Pathology, University of Illinois, Peoria, Illinois (S.E.M.); Department of Pathology, Sheikh Khalifa Medical City, Abu Dhabi, UAE (M.A.A.-A.); Department of Family and Community Medicine, Contra Costa Regional Medical Center, Martinez, California (T.D.L.)
| | - Christopher R Pierson
- Department of Pathology, The Ohio State University, Columbus, Ohio (N.L.L., A.U., C.R.P., K.K., K.Z., N.M., G.Z., W.Z.); Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, Indiana (E.M.H., J.M.B.); Department of Pathology, Vanderbilt University, Nashville, Tennessee (B.C.M.); Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia (M.J.S.); Department of Pathology, Duke University, Durham, North Carolina (R.E.M., E.S.L.); Institute of Neuropathology, University Hospital Münster, Germany (W.P.); Institute for Neuropathology, University Hospital of Zurich, Switzerland (E.J.R.); Department of Pathology, The University of Texas Southwestern, Dallas, Texas (M.-M.G., J.M.R.); Department of Pathology, Case Western Reserve University, Cleveland, Ohio (M.C., M.L.C.); Department of Anatomic Pathology, Beaumont Hospital, Royal Oak, Michigan (M.S.D.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio (C.R.P.); Department of Pathology, University of Illinois, Peoria, Illinois (S.E.M.); Department of Pathology, Sheikh Khalifa Medical City, Abu Dhabi, UAE (M.A.A.-A.); Department of Family and Community Medicine, Contra Costa Regional Medical Center, Martinez, California (T.D.L.)
| | - Jack M Raisanen
- Department of Pathology, The Ohio State University, Columbus, Ohio (N.L.L., A.U., C.R.P., K.K., K.Z., N.M., G.Z., W.Z.); Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, Indiana (E.M.H., J.M.B.); Department of Pathology, Vanderbilt University, Nashville, Tennessee (B.C.M.); Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia (M.J.S.); Department of Pathology, Duke University, Durham, North Carolina (R.E.M., E.S.L.); Institute of Neuropathology, University Hospital Münster, Germany (W.P.); Institute for Neuropathology, University Hospital of Zurich, Switzerland (E.J.R.); Department of Pathology, The University of Texas Southwestern, Dallas, Texas (M.-M.G., J.M.R.); Department of Pathology, Case Western Reserve University, Cleveland, Ohio (M.C., M.L.C.); Department of Anatomic Pathology, Beaumont Hospital, Royal Oak, Michigan (M.S.D.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio (C.R.P.); Department of Pathology, University of Illinois, Peoria, Illinois (S.E.M.); Department of Pathology, Sheikh Khalifa Medical City, Abu Dhabi, UAE (M.A.A.-A.); Department of Family and Community Medicine, Contra Costa Regional Medical Center, Martinez, California (T.D.L.)
| | - Sarah E Martin
- Department of Pathology, The Ohio State University, Columbus, Ohio (N.L.L., A.U., C.R.P., K.K., K.Z., N.M., G.Z., W.Z.); Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, Indiana (E.M.H., J.M.B.); Department of Pathology, Vanderbilt University, Nashville, Tennessee (B.C.M.); Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia (M.J.S.); Department of Pathology, Duke University, Durham, North Carolina (R.E.M., E.S.L.); Institute of Neuropathology, University Hospital Münster, Germany (W.P.); Institute for Neuropathology, University Hospital of Zurich, Switzerland (E.J.R.); Department of Pathology, The University of Texas Southwestern, Dallas, Texas (M.-M.G., J.M.R.); Department of Pathology, Case Western Reserve University, Cleveland, Ohio (M.C., M.L.C.); Department of Anatomic Pathology, Beaumont Hospital, Royal Oak, Michigan (M.S.D.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio (C.R.P.); Department of Pathology, University of Illinois, Peoria, Illinois (S.E.M.); Department of Pathology, Sheikh Khalifa Medical City, Abu Dhabi, UAE (M.A.A.-A.); Department of Family and Community Medicine, Contra Costa Regional Medical Center, Martinez, California (T.D.L.)
| | - Trang D Lehman
- Department of Pathology, The Ohio State University, Columbus, Ohio (N.L.L., A.U., C.R.P., K.K., K.Z., N.M., G.Z., W.Z.); Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, Indiana (E.M.H., J.M.B.); Department of Pathology, Vanderbilt University, Nashville, Tennessee (B.C.M.); Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia (M.J.S.); Department of Pathology, Duke University, Durham, North Carolina (R.E.M., E.S.L.); Institute of Neuropathology, University Hospital Münster, Germany (W.P.); Institute for Neuropathology, University Hospital of Zurich, Switzerland (E.J.R.); Department of Pathology, The University of Texas Southwestern, Dallas, Texas (M.-M.G., J.M.R.); Department of Pathology, Case Western Reserve University, Cleveland, Ohio (M.C., M.L.C.); Department of Anatomic Pathology, Beaumont Hospital, Royal Oak, Michigan (M.S.D.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio (C.R.P.); Department of Pathology, University of Illinois, Peoria, Illinois (S.E.M.); Department of Pathology, Sheikh Khalifa Medical City, Abu Dhabi, UAE (M.A.A.-A.); Department of Family and Community Medicine, Contra Costa Regional Medical Center, Martinez, California (T.D.L.)
| | - Eric S Lipp
- Department of Pathology, The Ohio State University, Columbus, Ohio (N.L.L., A.U., C.R.P., K.K., K.Z., N.M., G.Z., W.Z.); Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, Indiana (E.M.H., J.M.B.); Department of Pathology, Vanderbilt University, Nashville, Tennessee (B.C.M.); Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia (M.J.S.); Department of Pathology, Duke University, Durham, North Carolina (R.E.M., E.S.L.); Institute of Neuropathology, University Hospital Münster, Germany (W.P.); Institute for Neuropathology, University Hospital of Zurich, Switzerland (E.J.R.); Department of Pathology, The University of Texas Southwestern, Dallas, Texas (M.-M.G., J.M.R.); Department of Pathology, Case Western Reserve University, Cleveland, Ohio (M.C., M.L.C.); Department of Anatomic Pathology, Beaumont Hospital, Royal Oak, Michigan (M.S.D.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio (C.R.P.); Department of Pathology, University of Illinois, Peoria, Illinois (S.E.M.); Department of Pathology, Sheikh Khalifa Medical City, Abu Dhabi, UAE (M.A.A.-A.); Department of Family and Community Medicine, Contra Costa Regional Medical Center, Martinez, California (T.D.L.)
| | - Jose M Bonnin
- Department of Pathology, The Ohio State University, Columbus, Ohio (N.L.L., A.U., C.R.P., K.K., K.Z., N.M., G.Z., W.Z.); Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, Indiana (E.M.H., J.M.B.); Department of Pathology, Vanderbilt University, Nashville, Tennessee (B.C.M.); Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia (M.J.S.); Department of Pathology, Duke University, Durham, North Carolina (R.E.M., E.S.L.); Institute of Neuropathology, University Hospital Münster, Germany (W.P.); Institute for Neuropathology, University Hospital of Zurich, Switzerland (E.J.R.); Department of Pathology, The University of Texas Southwestern, Dallas, Texas (M.-M.G., J.M.R.); Department of Pathology, Case Western Reserve University, Cleveland, Ohio (M.C., M.L.C.); Department of Anatomic Pathology, Beaumont Hospital, Royal Oak, Michigan (M.S.D.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio (C.R.P.); Department of Pathology, University of Illinois, Peoria, Illinois (S.E.M.); Department of Pathology, Sheikh Khalifa Medical City, Abu Dhabi, UAE (M.A.A.-A.); Department of Family and Community Medicine, Contra Costa Regional Medical Center, Martinez, California (T.D.L.)
| | - Mousa A Al-Abbadi
- Department of Pathology, The Ohio State University, Columbus, Ohio (N.L.L., A.U., C.R.P., K.K., K.Z., N.M., G.Z., W.Z.); Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, Indiana (E.M.H., J.M.B.); Department of Pathology, Vanderbilt University, Nashville, Tennessee (B.C.M.); Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia (M.J.S.); Department of Pathology, Duke University, Durham, North Carolina (R.E.M., E.S.L.); Institute of Neuropathology, University Hospital Münster, Germany (W.P.); Institute for Neuropathology, University Hospital of Zurich, Switzerland (E.J.R.); Department of Pathology, The University of Texas Southwestern, Dallas, Texas (M.-M.G., J.M.R.); Department of Pathology, Case Western Reserve University, Cleveland, Ohio (M.C., M.L.C.); Department of Anatomic Pathology, Beaumont Hospital, Royal Oak, Michigan (M.S.D.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio (C.R.P.); Department of Pathology, University of Illinois, Peoria, Illinois (S.E.M.); Department of Pathology, Sheikh Khalifa Medical City, Abu Dhabi, UAE (M.A.A.-A.); Department of Family and Community Medicine, Contra Costa Regional Medical Center, Martinez, California (T.D.L.)
| | - Kara Kenworthy
- Department of Pathology, The Ohio State University, Columbus, Ohio (N.L.L., A.U., C.R.P., K.K., K.Z., N.M., G.Z., W.Z.); Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, Indiana (E.M.H., J.M.B.); Department of Pathology, Vanderbilt University, Nashville, Tennessee (B.C.M.); Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia (M.J.S.); Department of Pathology, Duke University, Durham, North Carolina (R.E.M., E.S.L.); Institute of Neuropathology, University Hospital Münster, Germany (W.P.); Institute for Neuropathology, University Hospital of Zurich, Switzerland (E.J.R.); Department of Pathology, The University of Texas Southwestern, Dallas, Texas (M.-M.G., J.M.R.); Department of Pathology, Case Western Reserve University, Cleveland, Ohio (M.C., M.L.C.); Department of Anatomic Pathology, Beaumont Hospital, Royal Oak, Michigan (M.S.D.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio (C.R.P.); Department of Pathology, University of Illinois, Peoria, Illinois (S.E.M.); Department of Pathology, Sheikh Khalifa Medical City, Abu Dhabi, UAE (M.A.A.-A.); Department of Family and Community Medicine, Contra Costa Regional Medical Center, Martinez, California (T.D.L.)
| | - Kevin Zhao
- Department of Pathology, The Ohio State University, Columbus, Ohio (N.L.L., A.U., C.R.P., K.K., K.Z., N.M., G.Z., W.Z.); Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, Indiana (E.M.H., J.M.B.); Department of Pathology, Vanderbilt University, Nashville, Tennessee (B.C.M.); Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia (M.J.S.); Department of Pathology, Duke University, Durham, North Carolina (R.E.M., E.S.L.); Institute of Neuropathology, University Hospital Münster, Germany (W.P.); Institute for Neuropathology, University Hospital of Zurich, Switzerland (E.J.R.); Department of Pathology, The University of Texas Southwestern, Dallas, Texas (M.-M.G., J.M.R.); Department of Pathology, Case Western Reserve University, Cleveland, Ohio (M.C., M.L.C.); Department of Anatomic Pathology, Beaumont Hospital, Royal Oak, Michigan (M.S.D.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio (C.R.P.); Department of Pathology, University of Illinois, Peoria, Illinois (S.E.M.); Department of Pathology, Sheikh Khalifa Medical City, Abu Dhabi, UAE (M.A.A.-A.); Department of Family and Community Medicine, Contra Costa Regional Medical Center, Martinez, California (T.D.L.)
| | - Nehad Mohamed
- Department of Pathology, The Ohio State University, Columbus, Ohio (N.L.L., A.U., C.R.P., K.K., K.Z., N.M., G.Z., W.Z.); Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, Indiana (E.M.H., J.M.B.); Department of Pathology, Vanderbilt University, Nashville, Tennessee (B.C.M.); Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia (M.J.S.); Department of Pathology, Duke University, Durham, North Carolina (R.E.M., E.S.L.); Institute of Neuropathology, University Hospital Münster, Germany (W.P.); Institute for Neuropathology, University Hospital of Zurich, Switzerland (E.J.R.); Department of Pathology, The University of Texas Southwestern, Dallas, Texas (M.-M.G., J.M.R.); Department of Pathology, Case Western Reserve University, Cleveland, Ohio (M.C., M.L.C.); Department of Anatomic Pathology, Beaumont Hospital, Royal Oak, Michigan (M.S.D.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio (C.R.P.); Department of Pathology, University of Illinois, Peoria, Illinois (S.E.M.); Department of Pathology, Sheikh Khalifa Medical City, Abu Dhabi, UAE (M.A.A.-A.); Department of Family and Community Medicine, Contra Costa Regional Medical Center, Martinez, California (T.D.L.)
| | - Guojuan Zhang
- Department of Pathology, The Ohio State University, Columbus, Ohio (N.L.L., A.U., C.R.P., K.K., K.Z., N.M., G.Z., W.Z.); Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, Indiana (E.M.H., J.M.B.); Department of Pathology, Vanderbilt University, Nashville, Tennessee (B.C.M.); Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia (M.J.S.); Department of Pathology, Duke University, Durham, North Carolina (R.E.M., E.S.L.); Institute of Neuropathology, University Hospital Münster, Germany (W.P.); Institute for Neuropathology, University Hospital of Zurich, Switzerland (E.J.R.); Department of Pathology, The University of Texas Southwestern, Dallas, Texas (M.-M.G., J.M.R.); Department of Pathology, Case Western Reserve University, Cleveland, Ohio (M.C., M.L.C.); Department of Anatomic Pathology, Beaumont Hospital, Royal Oak, Michigan (M.S.D.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio (C.R.P.); Department of Pathology, University of Illinois, Peoria, Illinois (S.E.M.); Department of Pathology, Sheikh Khalifa Medical City, Abu Dhabi, UAE (M.A.A.-A.); Department of Family and Community Medicine, Contra Costa Regional Medical Center, Martinez, California (T.D.L.)
| | - Weiqiang Zhao
- Department of Pathology, The Ohio State University, Columbus, Ohio (N.L.L., A.U., C.R.P., K.K., K.Z., N.M., G.Z., W.Z.); Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, Indiana (E.M.H., J.M.B.); Department of Pathology, Vanderbilt University, Nashville, Tennessee (B.C.M.); Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia (M.J.S.); Department of Pathology, Duke University, Durham, North Carolina (R.E.M., E.S.L.); Institute of Neuropathology, University Hospital Münster, Germany (W.P.); Institute for Neuropathology, University Hospital of Zurich, Switzerland (E.J.R.); Department of Pathology, The University of Texas Southwestern, Dallas, Texas (M.-M.G., J.M.R.); Department of Pathology, Case Western Reserve University, Cleveland, Ohio (M.C., M.L.C.); Department of Anatomic Pathology, Beaumont Hospital, Royal Oak, Michigan (M.S.D.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio (C.R.P.); Department of Pathology, University of Illinois, Peoria, Illinois (S.E.M.); Department of Pathology, Sheikh Khalifa Medical City, Abu Dhabi, UAE (M.A.A.-A.); Department of Family and Community Medicine, Contra Costa Regional Medical Center, Martinez, California (T.D.L.)
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Highlights from the Literature. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Garcia MA, Solomon DA, Haas-Kogan DA. Exploiting molecular biology for diagnosis and targeted management of pediatric low-grade gliomas. Future Oncol 2016; 12:1493-506. [PMID: 27072750 PMCID: PMC4915741 DOI: 10.2217/fon-2016-0039] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 03/29/2016] [Indexed: 12/14/2022] Open
Abstract
The majority of brain tumors arising in children are low-grade gliomas. Although historically categorized together as pediatric low-grade gliomas (PLGGs), there is significant histologic and genetic diversity within this group. In general, prognosis for PLGGs is excellent, and limitation of sequelae from tumor and treatment is paramount. Advances in high-throughput genetic sequencing and gene expression profiling are fundamentally changing the way PLGGs are classified and managed. Here, we review the histologic subtypes and highlight how recent advances in elucidating the molecular pathogenesis of these tumors have refined diagnosis and prognostication. Additionally, we discuss how characterizing specific genetic alterations has paved the way for the rational use of targeted therapies that are currently in various phase clinical trials.
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Affiliation(s)
- Michael A Garcia
- Department of Radiation Oncology, University of California, San Francisco, CA, USA
| | - David A Solomon
- Division of Neuropathology, Department of Pathology, University of California, San Francisco, CA, USA
| | - Daphne A Haas-Kogan
- Department of Radiation Oncology, Harvard Medical School, Dana-Farber Cancer Institute, Brigham & Women's Hospital, Boston Children's Hospital, MA, USA
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Qaddoumi I, Orisme W, Wen J, Santiago T, Gupta K, Dalton JD, Tang B, Haupfear K, Punchihewa C, Easton J, Mulder H, Boggs K, Shao Y, Rusch M, Becksfort J, Gupta P, Wang S, Lee RP, Brat D, Peter Collins V, Dahiya S, George D, Konomos W, Kurian KM, McFadden K, Serafini LN, Nickols H, Perry A, Shurtleff S, Gajjar A, Boop FA, Klimo PD, Mardis ER, Wilson RK, Baker SJ, Zhang J, Wu G, Downing JR, Tatevossian RG, Ellison DW. Genetic alterations in uncommon low-grade neuroepithelial tumors: BRAF, FGFR1, and MYB mutations occur at high frequency and align with morphology. Acta Neuropathol 2016; 131:833-45. [PMID: 26810070 DOI: 10.1007/s00401-016-1539-z] [Citation(s) in RCA: 262] [Impact Index Per Article: 32.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2015] [Revised: 01/16/2016] [Accepted: 01/17/2016] [Indexed: 12/24/2022]
Abstract
Low-grade neuroepithelial tumors (LGNTs) are diverse CNS tumors presenting in children and young adults, often with a history of epilepsy. While the genetic profiles of common LGNTs, such as the pilocytic astrocytoma and 'adult-type' diffuse gliomas, are largely established, those of uncommon LGNTs remain to be defined. In this study, we have used massively parallel sequencing and various targeted molecular genetic approaches to study alterations in 91 LGNTs, mostly from children but including young adult patients. These tumors comprise dysembryoplastic neuroepithelial tumors (DNETs; n = 22), diffuse oligodendroglial tumors (d-OTs; n = 20), diffuse astrocytomas (DAs; n = 17), angiocentric gliomas (n = 15), and gangliogliomas (n = 17). Most LGNTs (84 %) analyzed by whole-genome sequencing (WGS) were characterized by a single driver genetic alteration. Alterations of FGFR1 occurred frequently in LGNTs composed of oligodendrocyte-like cells, being present in 82 % of DNETs and 40 % of d-OTs. In contrast, a MYB-QKI fusion characterized almost all angiocentric gliomas (87 %), and MYB fusion genes were the most common genetic alteration in DAs (41 %). A BRAF:p.V600E mutation was present in 35 % of gangliogliomas and 18 % of DAs. Pathogenic alterations in FGFR1/2/3, BRAF, or MYB/MYBL1 occurred in 78 % of the series. Adult-type d-OTs with an IDH1/2 mutation occurred in four adolescents, the youngest aged 15 years at biopsy. Despite a detailed analysis, novel genetic alterations were limited to two fusion genes, EWSR1-PATZ1 and SLMAP-NTRK2, both in gangliogliomas. Alterations in BRAF, FGFR1, or MYB account for most pathogenic alterations in LGNTs, including pilocytic astrocytomas, and alignment of these genetic alterations and cytologic features across LGNTs has diagnostic implications. Additionally, therapeutic options based upon targeting the effects of these alterations are already in clinical trials.
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Soylemezoglu F, Himmetoglu C, Oguz KK, Saygi S, Akalan N. A 41-Year-Old Man wıth Drug-Resıstant Complex Partıal Seızures. Brain Pathol 2016; 25:511-2. [PMID: 26095595 DOI: 10.1111/bpa.12271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Figen Soylemezoglu
- Hacettepe University, Faculty of Medicine, Department of Pathology, Neurology, Radiology, Neurosurgery
| | - Cigdem Himmetoglu
- Hacettepe University, Faculty of Medicine, Department of Pathology, Neurology, Radiology, Neurosurgery
| | - Kader K Oguz
- Hacettepe University, Faculty of Medicine, Department of Pathology, Neurology, Radiology, Neurosurgery
| | - Serap Saygi
- Hacettepe University, Faculty of Medicine, Department of Pathology, Neurology, Radiology, Neurosurgery
| | - Nejat Akalan
- Hacettepe University, Faculty of Medicine, Department of Pathology, Neurology, Radiology, Neurosurgery
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Bandopadhayay P, Ramkissoon LA, Jain P, Bergthold G, Wala J, Zeid R, Schumacher SE, Urbanski L, O'Rourke R, Gibson WJ, Pelton K, Ramkissoon SH, Han HJ, Zhu Y, Choudhari N, Silva A, Boucher K, Henn RE, Kang YJ, Knoff D, Paolella BR, Gladden-Young A, Varlet P, Pages M, Horowitz PM, Federation A, Malkin H, Tracy AA, Seepo S, Ducar M, Van Hummelen P, Santi M, Buccoliero AM, Scagnet M, Bowers DC, Giannini C, Puget S, Hawkins C, Tabori U, Klekner A, Bognar L, Burger PC, Eberhart C, Rodriguez FJ, Hill DA, Mueller S, Haas-Kogan DA, Phillips JJ, Santagata S, Stiles CD, Bradner JE, Jabado N, Goren A, Grill J, Ligon AH, Goumnerova L, Waanders AJ, Storm PB, Kieran MW, Ligon KL, Beroukhim R, Resnick AC. MYB-QKI rearrangements in angiocentric glioma drive tumorigenicity through a tripartite mechanism. Nat Genet 2016; 48:273-82. [PMID: 26829751 PMCID: PMC4767685 DOI: 10.1038/ng.3500] [Citation(s) in RCA: 189] [Impact Index Per Article: 23.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Accepted: 01/06/2016] [Indexed: 12/15/2022]
Abstract
Angiocentric gliomas are pediatric low-grade gliomas (PLGGs) without known recurrent genetic drivers. We performed genomic analysis of new and published data from 249 PLGGs including 19 Angiocentric Gliomas. We identified MYB-QKI fusions as a specific and single candidate driver event in Angiocentric Gliomas. In vitro and in vivo functional studies show MYB-QKI rearrangements promote tumorigenesis through three mechanisms: MYB activation by truncation, enhancer translocation driving aberrant MYB-QKI expression, and hemizygous loss of the tumor suppressor QKI. This represents the first example of a single driver rearrangement simultaneously transforming cells via three genetic and epigenetic mechanisms in a tumor.
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Affiliation(s)
- Pratiti Bandopadhayay
- Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts, USA.,Broad Institute, Cambridge, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Lori A Ramkissoon
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Payal Jain
- Division of Neurosurgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Cell and Molecular Biology Graduate Group, Gene Therapy and Vaccines Program, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Guillaume Bergthold
- Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Department de Cancerologie de l'Enfant et de l'Adolescent et Unité Mixte de Recherche du Centre National de la Recherche Scientifique 8203 'Vectorologie et Nouvelles Therapeutiques du Cancer', Gustave Roussy, Université Paris XI Sud, Villejuif, France
| | - Jeremiah Wala
- Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Broad Institute, Cambridge, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Rhamy Zeid
- Harvard Medical School, Boston, Massachusetts, USA.,Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Steven E Schumacher
- Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Broad Institute, Cambridge, Massachusetts, USA
| | - Laura Urbanski
- Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Ryan O'Rourke
- Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Broad Institute, Cambridge, Massachusetts, USA
| | - William J Gibson
- Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Broad Institute, Cambridge, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Kristine Pelton
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Shakti H Ramkissoon
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Department of Pathology, Boston Children's Hospital, Boston, Massachusetts, USA.,Department of Pathology, Harvard Medical School, Boston, Massachusetts, USA
| | - Harry J Han
- Division of Neurosurgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Yuankun Zhu
- Division of Neurosurgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Namrata Choudhari
- Division of Neurosurgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Amanda Silva
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Division of Neurosurgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Katie Boucher
- Division of Neurosurgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Rosemary E Henn
- Division of Neurosurgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Yun Jee Kang
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - David Knoff
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Brenton R Paolella
- Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Broad Institute, Cambridge, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | | | - Pascale Varlet
- Laboratoire de Neuropathologie, Hopital Sainte-Anne, Université Paris V Descartes, Paris, France
| | - Melanie Pages
- Laboratoire de Neuropathologie, Hopital Sainte-Anne, Université Paris V Descartes, Paris, France
| | - Peleg M Horowitz
- Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Department of Neurosurgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Alexander Federation
- Harvard Medical School, Boston, Massachusetts, USA.,Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Hayley Malkin
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts, USA
| | | | - Sara Seepo
- Broad Institute, Cambridge, Massachusetts, USA
| | - Matthew Ducar
- Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Center for Cancer Genome Discovery, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Paul Van Hummelen
- Center for Cancer Genome Discovery, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Mariarita Santi
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | - Mirko Scagnet
- Neurosurgery Unit, Anna Meyer Children's Hospital, University of Florence, Florence, Italy
| | - Daniel C Bowers
- Division of Pediatric Hematology-Oncology, University of Texas Southwestern Medical School, Dallas, Texas, USA
| | - Caterina Giannini
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Stephanie Puget
- Departement de Neurochirurgie, Hopital Necker-Enfants Malades, Université Paris V Descartes, Paris, France
| | - Cynthia Hawkins
- Division of Pathology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Uri Tabori
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Almos Klekner
- Department of Neurosurgery, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary
| | - Laszlo Bognar
- Department of Neurosurgery, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary
| | - Peter C Burger
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Charles Eberhart
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Fausto J Rodriguez
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - D Ashley Hill
- Brain Tumor Institute, Children's National Medical Center, Washington, DC, USA.,Center for Neuroscience and Behavioral Medicine, Brain Tumor Institute, Children's National Medical Center, Washington, DC, USA.,Department of Pathology, Children's National Medical Center, Washington, DC, USA
| | - Sabine Mueller
- Department of Neurology, University of California San Francisco School of Medicine, San Francisco, California, USA.,Department of Neurological Surgery, University of California San Francisco School of Medicine, San Francisco, California, USA.,Department of Pediatrics, University of California San Francisco School of Medicine, San Francisco, California, USA
| | - Daphne A Haas-Kogan
- Department of Neurological Surgery, University of California San Francisco School of Medicine, San Francisco, California, USA.,Department of Radiation Oncology, Helen Diller Family Comprehensive Cancer Center, University of California San Francisco School of Medicine, San Francisco, California, USA.,Department of Radiation Oncology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Joanna J Phillips
- Department of Neurological Surgery, University of California San Francisco School of Medicine, San Francisco, California, USA.,Department of Pathology, University of California San Francisco, San Francisco, California, USA
| | - Sandro Santagata
- Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Department of Pathology, Boston Children's Hospital, Boston, Massachusetts, USA.,Department of Pathology, Harvard Medical School, Boston, Massachusetts, USA
| | - Charles D Stiles
- Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - James E Bradner
- Broad Institute, Cambridge, Massachusetts, USA.,Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Nada Jabado
- Division of Experimental Medicine, Montreal Children's Hospital, McGill University and McGill University Health Centre, Montreal, Quebec, Canada.,Department of Human Genetics, McGill University, Montreal, Quebec, Canada.,Department of Pediatrics, McGill University, Montreal, Quebec, Canada
| | - Alon Goren
- Broad Technology Laboratories, Broad Institute, Cambridge, Massachusetts, USA
| | - Jacques Grill
- Department de Cancerologie de l'Enfant et de l'Adolescent et Unité Mixte de Recherche du Centre National de la Recherche Scientifique 8203 'Vectorologie et Nouvelles Therapeutiques du Cancer', Gustave Roussy, Université Paris XI Sud, Villejuif, France
| | - Azra H Ligon
- Brigham and Women's Hospital Department of Pathology, Center for Advanced Molecular Diagnostics, Division of Cytogenetics, Boston, Massachusetts, USA
| | - Liliana Goumnerova
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts, USA.,Department of Neurosurgery, Boston Children's Hospital, Boston, Massachusetts, USA.,Department of Neurosurgery, Harvard Medical School, Boston, Massachusetts, USA
| | - Angela J Waanders
- Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Center for Childhood Cancer Research, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Center for Data-Driven Discovery in Biomedicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Phillip B Storm
- Division of Neurosurgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Center for Childhood Cancer Research, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Center for Data-Driven Discovery in Biomedicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Mark W Kieran
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Keith L Ligon
- Broad Institute, Cambridge, Massachusetts, USA.,Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Department of Pathology, Boston Children's Hospital, Boston, Massachusetts, USA.,Department of Pathology, Harvard Medical School, Boston, Massachusetts, USA
| | - Rameen Beroukhim
- Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Broad Institute, Cambridge, Massachusetts, USA.,Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA.,Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Adam C Resnick
- Division of Neurosurgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Center for Childhood Cancer Research, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Center for Data-Driven Discovery in Biomedicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
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42
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Ampie L, Choy W, DiDomenico JD, Lamano JB, Williams CK, Kesavabhotla K, Mao Q, Bloch O. Clinical attributes and surgical outcomes of angiocentric gliomas. J Clin Neurosci 2016; 28:117-22. [PMID: 26778052 DOI: 10.1016/j.jocn.2015.11.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 11/27/2015] [Indexed: 11/29/2022]
Abstract
Angiocentric gliomas (AG) are exceedingly rare low-grade neoplasms which often present in the form of intractable epilepsy within younger patients. The current study extensively reviews all reported cases which were pathologically verified as AG in the literature to analyze clinical attributes and surgical outcomes of this neoplasm. There were 88 patients with AG reported in the literature consisting mostly of pediatric cases. The sex distribution consisted of 45 males and 36 females with the remaining seven cases not documenting sex. The average age of initial diagnosis was 16years with almost half of all diagnosed patients being within the first decade of life. In cases where extent of resection was reported, gross total resection (GTR) was achieved in 54 patients, subtotal resection (STR) in 16, and biopsy only in three. Post-operative complications were transient and only occurred in three patients with no reports of death following surgery. Only five cases reported tumor recurrence on follow-up. Eight patients had seizure recurrence post-operatively and GTR offered improved rates of seizure control when compared to STR (p=0.0005). Nearly half of the cases of AG are diagnosed within the first decade of life and they usually manifest with intractable seizures. GTR appears to offer better seizure control in the post-operative period. Surgical resection is the mainstay therapy for AG as post-operative complications and tumor recurrence remain uncommon. Since the number of reported cases is limited, future studies with longer follow-up periods will help elaborate more long-term outcomes.
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Affiliation(s)
- Leonel Ampie
- Department of Neurological Surgery, Northwestern University, Feinberg School of Medicine, 676 N. St Clair Street, Suite 2210, Chicago, IL 60611-2911, USA
| | - Winward Choy
- Department of Neurological Surgery, Northwestern University, Feinberg School of Medicine, 676 N. St Clair Street, Suite 2210, Chicago, IL 60611-2911, USA
| | - Joseph D DiDomenico
- Department of Neurological Surgery, Northwestern University, Feinberg School of Medicine, 676 N. St Clair Street, Suite 2210, Chicago, IL 60611-2911, USA
| | - Jonathan B Lamano
- Department of Neurological Surgery, Northwestern University, Feinberg School of Medicine, 676 N. St Clair Street, Suite 2210, Chicago, IL 60611-2911, USA
| | - Christopher Kazu Williams
- Department of Neurological Surgery, Northwestern University, Feinberg School of Medicine, 676 N. St Clair Street, Suite 2210, Chicago, IL 60611-2911, USA
| | - Kartik Kesavabhotla
- Department of Neurological Surgery, Northwestern University, Feinberg School of Medicine, 676 N. St Clair Street, Suite 2210, Chicago, IL 60611-2911, USA
| | - Qinwen Mao
- Department of Pathology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Orin Bloch
- Department of Neurological Surgery, Northwestern University, Feinberg School of Medicine, 676 N. St Clair Street, Suite 2210, Chicago, IL 60611-2911, USA.
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43
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Abstract
This chapter describes the epidemiology, pathology, molecular characteristics, clinical and neuroimaging features, treatment, outcome, and prognostic factors of the rare glial tumors. This category includes subependymal giant cell astrocytoma, pleomorphic xanthoastrocytoma, astroblastoma, chordoid glioma of the third ventricle, angiocentric glioma, ganglioglioma, desmoplastic infantile astrocytoma and ganglioma, dysembryoplastic neuroepithelial tumor, papillary glioneuronal tumor, and rosette-forming glioneuronal tumor of the fourth ventricle. Many of these tumors, in particular glioneuronal tumors, prevail in children and young adults, are characterized by pharmacoresistant seizures, and have an indolent course, and long survival following surgical resection. Radiotherapy and chemotherapy are reserved for recurrent and/or aggressive forms. New molecular alterations are increasingly recognized.
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Affiliation(s)
- Riccardo Soffietti
- Department of Neuro-Oncology, University and City of Health and Science Hospital, Turin, Italy.
| | - Roberta Rudà
- Department of Neuro-Oncology, University and City of Health and Science Hospital, Turin, Italy
| | - David Reardon
- Center for Neuro-Oncology, Harvard Medical School and Dana-Farber Cancer Institute, Boston, USA
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44
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Abstract
Angiocentric glioma (AG) is a distinct group of tumors, grade I according to the 2007 WHO classification of tumors of the central nervous system. It is a rare group predominantly seen in children and young adults, with good prognosis following gross total resection. A young child presented with progressively worsening seizure activity; MRI revealed a lesion involving the left posterior frontal lobe. The lesion was surgically resected, and the child is now free of seizure medications, with good neurological function.
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45
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Cheng S, Lü Y, Xu S, Liu Q, Lee P. Cystoid angiocentric glioma: A case report and literature review. J Radiol Case Rep 2015; 9:1-9. [PMID: 26629293 DOI: 10.3941/jrcr.v9i7.2413] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Angiocentric glioma is a rare subtype of neuroepithelial tumor that is associated with a history of epilepsy. We report a case of cystoid angiocentric glioma associated with an area of calcification. This 25 year old male patient presented with tonic clonic spasm. He underwent craniotomy with complete resection of the lesion. Pathologic specimen showed monomorphous bipolar cells with angiocentric growth pattern.
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Affiliation(s)
- Sainan Cheng
- Shandong Medical Imaging Research Institute, Shandong University, Jinan, China
| | - Yubo Lü
- Shandong Medical Imaging Research Institute, Shandong University, Jinan, China
| | - Shangchen Xu
- Department of Neurosurgery, Provincial Hospital, Shandong University, Jinan, China
| | - Qiang Liu
- Shandong Medical Imaging Research Institute, Shandong University, Jinan, China
| | - Pearlene Lee
- Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, USA
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46
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Yamasaki K, Yokogami K, Yamashita S, Takeshima H. Rapidly Enlarging Pediatric Cortical Ependymoma. J Korean Neurosurg Soc 2015; 57:487-90. [PMID: 26180622 PMCID: PMC4502251 DOI: 10.3340/jkns.2015.57.6.487] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Revised: 04/07/2014] [Accepted: 05/13/2014] [Indexed: 11/27/2022] Open
Abstract
We report a 10-year-old boy with supratentorial cortical ependymoma that rapidly grew in the course of 3 years. He suffered generalized seizures when he was 5 years old; MRI showed a small cortical lesion in the right postcentral gyrus. MRI performed 2 years later revealed no changes. For the next 3 years he was free of seizures. However, at the age of 10 he again suffered generalized seizures and MRI disclosed a large parietal tumor. It was resected totally and he remains free of neurological deficits. The histopathological diagnosis was ependymoma. Pediatric supratentorial cortical ependymomas are extremely rare. We recommend including cortical ependymoma as a differential diagnosis in pediatric patients with cortical mass lesions presenting with seizures and careful follow-up even in the absence of symptoms because these tumors may progress.
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Affiliation(s)
- Kouji Yamasaki
- Department of Neurosurgery, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Kiyotaka Yokogami
- Department of Neurosurgery, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Shinji Yamashita
- Department of Neurosurgery, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Hideo Takeshima
- Department of Neurosurgery, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
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47
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Sajjad J, Kaliaperumal C, Bermingham N, Marks C, Keohane C. "Unusual brain stone": heavily calcified primary neoplasm with some features suggestive of angiocentric glioma. J Neurosurg 2015; 123:1256-60. [PMID: 26024003 DOI: 10.3171/2014.11.jns131158] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This 40-year-old man presented with a 5-month history of progressive right-sided headache associated with visual blurring. He also had a history of epilepsy but had been seizure free with medication for the past 10 years. An initial CT scan of his brain performed 16 years previously had revealed a small area of calcification in the right parietal region. In the current presentation, he had a left-sided homonymous hemianopia but no other neurological deficits. A CT scan of his brain showed a much larger calcified, partly cystic lesion in the right parietal region. Because he was symptomatic, the lesion was excised and the cyst was drained. Histological examination of the excised tissue showed an unusual primary tumor that was difficult to classify but had some features of angiocentric glioma. The heavy calcification, mixed-density cell population, and regions with features of angiocentric glioma were most unusual. The patient remained asymptomatic 5 years after surgery, and follow-up scans did not show recurrence.
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48
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Mohaghegh MR, Chitsaz A, Okhovat AA, Pour EB. Supratentorial cortical ependymoma: An unusual presentation of a rare tumor. Adv Biomed Res 2015; 4:72. [PMID: 25878997 PMCID: PMC4386199 DOI: 10.4103/2277-9175.153896] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Accepted: 06/08/2014] [Indexed: 11/04/2022] Open
Abstract
Ependymomas are glial tumors derived from ependymal cells lining the ventricles and the central canal of the spinal cord. Two thirds of ependymomas arise in the infratentorial or intraventricles, whereas one-third are located in supratentorial space. But supratentorial "cortical" ependymomas are very rare. We report a case of a cortical ependymoma in a 17-year-old boy. The patient presented with transient recurrent right weakness and diplopia. This tumor was located in the left parieto-occipital region and he had gross total excision. Microscopy and immunohistochemistry showed grade III differentiation ependymoma.
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Affiliation(s)
- Mohammad Reza Mohaghegh
- Department of Neurology and Pathology, Isfahan Neurosciences Research Center, Alzahra Hospital, Isfahan, Iran
| | - Ahmad Chitsaz
- Department of Neurology, Isfahan Neurosciences Research Center, Alzahra Hospital, Isfahan, Iran
| | - Ali Asghar Okhovat
- Department of Neurology, Kashani Hospital, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Elnaz Babaei Pour
- Resident of Pathology, Isfahan University of Medical Sciences, Isfahan, Iran
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49
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Lacruz CR, Catalina-Fernández I, Bardales RH, Pimentel J, López-Presa D, Sáenz-Santamaría J. Intraoperative consultation on pediatric central nervous system tumors by squash cytology. Cancer Cytopathol 2015; 123:331-46. [DOI: 10.1002/cncy.21537] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Revised: 02/10/2015] [Accepted: 02/11/2015] [Indexed: 01/09/2023]
Affiliation(s)
- César R. Lacruz
- Department of Pathology; Gregorio Marañon University General Hospital; Madrid Spain
| | | | | | - José Pimentel
- Neuropathology Laboratory; Santa Maria University Hospital; Lisbon Portugal
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50
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Ni HC, Chen SY, Chen L, Lu DH, Fu YJ, Piao YS. Angiocentric glioma: a report of nine new cases, including four with atypical histological features. Neuropathol Appl Neurobiol 2015; 41:333-46. [PMID: 24861831 DOI: 10.1111/nan.12158] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Accepted: 05/21/2014] [Indexed: 11/26/2022]
Affiliation(s)
- Hai-Chun Ni
- Department of Neuropathology; Xuanwu Hospital; Capital Medical University; Beijing China
- Department of Pathology; Central Hospital of Wuhan; Wuhan China
| | - Shi-Yun Chen
- Department of Neuropathology; Xuanwu Hospital; Capital Medical University; Beijing China
| | - Li Chen
- Department of Neuropathology; Xuanwu Hospital; Capital Medical University; Beijing China
| | - De-Hong Lu
- Department of Neuropathology; Xuanwu Hospital; Capital Medical University; Beijing China
| | - Yong-Juan Fu
- 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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