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Kurdi N, Mokánszki A, Balogh I, Ujfalusi A, Szabó S, Méhes G, Bedekovics J. Extracranial metastatic oligodendroglioma with molecular progression, case presentation. Diagn Pathol 2024; 19:103. [PMID: 39061087 PMCID: PMC11282783 DOI: 10.1186/s13000-024-01529-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Accepted: 07/21/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND Extraneural metastasis of central nervous system tumors is generally rare and most often reported in glioblastomas and medulloblastomas, whereas oligodendrogliomas seem to have the lowest risk of extracranial metastasis. Given its infrequent occurrence, both the diagnosis and therapy of metastatic oligodendroglioma is often challenging. CASE PRESENTATION This case study presents an oligodendroglioma, the isocitrate dehydrogenase 1 (IDH1) mutant, 1p/19q-codeleted tumor with bone marrow metastasis. The significance of this case lies in the comprehensive molecular analysis conducted for both the primary tumor and the metastasis. Chromosome 7 trisomy and chromosome 10 monosomy (+ 7/-10) were detected in the metastasis indicating molecular progression, which, to the best of our knowledge, has not been previously documented in metastatic oligodendroglioma. CONCLUSIONS This case study serves additional information for better understanding of the metastatic capabilities of CNS tumors.
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Affiliation(s)
- Nour Kurdi
- Department of Pathology, Faculty of Medicine, University of Debrecen, Nagyerdei krt 98, Debrecen, H-4032, Hungary
| | - Attila Mokánszki
- Department of Pathology, Faculty of Medicine, University of Debrecen, Nagyerdei krt 98, Debrecen, H-4032, Hungary
| | - Ingrid Balogh
- Department of Oncology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Anikó Ujfalusi
- Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Sándor Szabó
- Department of Neurosurgery, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Gábor Méhes
- Department of Pathology, Faculty of Medicine, University of Debrecen, Nagyerdei krt 98, Debrecen, H-4032, Hungary
| | - Judit Bedekovics
- Department of Pathology, Faculty of Medicine, University of Debrecen, Nagyerdei krt 98, Debrecen, H-4032, Hungary.
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TAKAHASHI T, SHIOZAWA H, ISHIZAKI T, OKADA K, KONDO H. Anaplastic oligodendroglioma with nasal invasion and systemic metastasis in a dog. J Vet Med Sci 2023; 85:1052-1056. [PMID: 37558495 PMCID: PMC10600530 DOI: 10.1292/jvms.23-0136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 07/26/2023] [Indexed: 08/11/2023] Open
Abstract
An 11-year-old spayed female French bulldog was referred on suspicion of nasal tumor. Anaplastic oligodendroglioma in the olfactory bulb that was suspected to have invaded the nasal cavity was diagnosed from imaging and histopathology. Metastasis to cervical lymph nodes was suspected, with no other metastases identified. The brain-to-nasal lesion and lymph nodes were treated with hypo-fractionated radiation therapy. Nasal congestion soon resolved. About 3 months later, follow-up computed tomography revealed multiple hepatic and splenic masses, which were cytologically suspected as metastatic oligodendroglioma. Nimustine, followed by toceranib phosphate, seemed to have no effect, and the dog died on day 167. Postmortem examination revealed the primary tumor disappearance and systemic metastases. Canine oligodendroglioma can grow outside the cranial vault, and systemically metastasize.
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Affiliation(s)
- Tomoko TAKAHASHI
- Department of Veterinary Medicine, College of Bioresource
Sciences, Nihon University, Kanagawa, Japan
| | - Hitoshi SHIOZAWA
- Department of Veterinary Medicine, College of Bioresource
Sciences, Nihon University, Kanagawa, Japan
| | | | | | - Hirotaka KONDO
- Department of Veterinary Medicine, College of Bioresource
Sciences, Nihon University, Kanagawa, Japan
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3
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Chiba K, Aihara Y, Oda Y, Masui K, Komori T, Yokoo H, Kawamata T. Systemic Metastasis of Pediatric Diffuse High-grade Astrocytoma: A Case Report. NMC Case Rep J 2023; 10:265-271. [PMID: 37953909 PMCID: PMC10635901 DOI: 10.2176/jns-nmc.2023-0018] [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: 02/06/2023] [Accepted: 06/14/2023] [Indexed: 11/14/2023] Open
Abstract
Extracranial brain tumor metastases are extremely rare. The etiology, pathophysiology, and clinical progression of systemic metastatic brain cancer remain to be elucidated. We encountered a case of pediatric diffuse high-grade astrocytoma in a four-year-old girl with subcutaneous and lymph node metastases. Numerous metastatic lesions emerged, progressed rapidly, and were difficult to manage despite temozolomide (TMZ) administration. The patient underwent repeated surgical resection for these lesions. Conversely, the primary intracranial lesions responded well to TMZ for some time. However, the patient died 15 months after the initial diagnosis. Extracranial metastasis and highly varying effects of chemotherapy were the characteristic clinical features in this case. Our analysis did not reveal definitive histopathological and molecular factors contributing to this presentation. The lack of notable molecular pathological features illustrates the unpredictability of glioma metastasis, and the treatment for extracranial metastasis remains unknown. A gene panel analysis revealed several genetic aberrations, including PDGFRA, PIK3CA, and NBN mutations. As it is impossible to resect all frequently and rapidly progressing lesions, we stress that the prognosis of metastatic brain tumors is undoubtedly poor if these tumors are refractory to existing treatments, including chemotherapy.
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Affiliation(s)
- Kentaro Chiba
- Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan
| | - Yasuo Aihara
- Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan
| | - Yuichi Oda
- Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan
| | - Kenta Masui
- Department of Pathology I, Tokyo Women's Medical University, Tokyo, Japan
| | - Takashi Komori
- Department of Laboratory Medicine and Pathology (Neuropathology), Tokyo Metropolitan Neurological Hospital, Tokyo, Japan
| | - Hideaki Yokoo
- Department of Pathology, Gunma University, Maebashi, Gunma, Japan
| | - Takakazu Kawamata
- Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan
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Kazemi MA, Amini F, Kargar B, Lotfi M, Aghazadeh K, Sharifian H, Moradi B, Azadbakht J. The Value of Ultrasound-guided Core Needle Biopsy in Differentiating Benign from Malignant Salivary Gland Lesions. Indian J Otolaryngol Head Neck Surg 2023; 75:266-270. [PMID: 37275055 PMCID: PMC10235295 DOI: 10.1007/s12070-022-03148-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 08/19/2022] [Indexed: 06/07/2023] Open
Abstract
Purpose In recent years, core needle biopsy (CNB) technique has received much attention, being used as alternative method of tissue sampling for surgical biopsy of salivary gland tumors (SGTs). The present study aimed to evaluate the value of CNB in differentiating benign from malignant SGTs. Materials and methods Patients with suspected benign or malignant SGTs in imaging were enrolled in this study. All core needle biopsies were performed under ultrasound guidance, i.e. ultrasound-guided Core Needle Biopsy (USCNB). Histological examination of the specimen after surgical excision was regarded as gold standard test and set as reference standard to assess USCNB accuracy for discriminating between ultrasound-visible benign and malignant SGTs. Results Based on USCNB results, from 36 participants (14 women and 22 men) with SGTs, 44.4% of detected tumors were benign and 55.5% were malignant. Twenty-two patients underwent surgery and postoperative specimen histological examination showed that 59% of excised lesions were benign and 41% were malignant. USCNB and surgical biopsy (SB) findings were completely compatible for 21 patients. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of USCNB were 100% in differentiating malignant from benign lesions. Conclusion USCNB is a valuable and accurate method of diagnosis with high sensitivity and specificity in distinguishing benign from malignant ultrasound-visible SGTs.
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Affiliation(s)
- Mohammad Ali Kazemi
- Department of Radiology, Amiralam Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Department of radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Medical Imaging Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzaneh Amini
- Department of Radiology, Amiralam Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Bita Kargar
- Faculty of medicine, Islamic Azad University Tehran Medical Sciences, Tehran, Iran
| | - Maryam Lotfi
- Department of Pathology, Amiralam Hospital Complexes, Tehran University of Medical Sciences, Tehran, Iran
| | - Keyvan Aghazadeh
- Otorhinolaryngology research center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hashem Sharifian
- Department of Radiology, Amiralam Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Department of radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Medical Imaging Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Behnaz Moradi
- Department of radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Medical Imaging Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
- Department of Radiology, Women’ Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Javid Azadbakht
- Department of Radiology, Faculty of Medicine, Kashan University of Medical Sciences, Shahid Beheshti Hospital, Qotb Ravandi Blvd, 8715981151 Kashan, Iran
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Karaman AK, Korkmazer B, Urganci N, Baş G, Arslan S, Comunoglu N, Hanci MM, Kızılkılıç O. Case report: Spinal drop metastasis of IDH-mutant, 1p/19q-codeleted oligodendroglioma. Front Neurol 2022; 13:1086591. [PMID: 36588881 PMCID: PMC9800869 DOI: 10.3389/fneur.2022.1086591] [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: 11/01/2022] [Accepted: 12/01/2022] [Indexed: 12/23/2022] Open
Abstract
Background Symptomatic spinal metastases of oligodendroglioma are rare. Moreover, none of the previously published cases demonstrated the typical IDH mutation and 1p/19q-codeletion for this glial tumor. This case presents an IDH mutant, 1p/19q-codeleted oligodendroglioma with multiple spinal drop metastases. Case description We report a case of a 55-year-old woman with left frontal grade 3 oligodendroglioma diagnosed 3 years ago. No tumor recurrence was observed in post-operative follow-up MRI examinations. However, she was admitted to our institution again with severe low back pain. Gadolinium enhanced MRI of the spine revealed an intradural, extramedullary metastatic lesion between T11-L1 levels and multiple enhancing metastatic tumor deposits around cauda equine roots between L4-S1. T11-T12 midline laminectomy was performed and gross total resection of metastatic lesions was achieved. Final histological diagnosis of the spinal lesions was WHO Grade 3 Oligodendroglioma, IDH-mutant, 1p/19q-codeleted. Conclusion This case is the first molecularly-defined spinal metastatic oligodendroglioma. The possibility of drop metastasis should be kept in mind in oligodendroglioma patients with spinal cord-related symptoms. There is no standard approach for the diagnosis and treatment of spinal metastases of this type of glial tumor.
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Affiliation(s)
- Ahmet Kursat Karaman
- Department of Radiology, Sureyyapasa Chest Diseases and Thoracic Surgery Training Hospital, Istanbul, Turkey,*Correspondence: Ahmet Kursat Karaman ✉
| | - Bora Korkmazer
- Division of Neuroradiology, Department of Radiology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Nil Urganci
- Department of Pathology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Gülçin Baş
- Department of Neurosurgery, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Serdar Arslan
- Division of Neuroradiology, Department of Radiology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Nil Comunoglu
- Department of Pathology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Mehmet Murat Hanci
- Department of Neurosurgery, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Osman Kızılkılıç
- Division of Neuroradiology, Department of Radiology, Istanbul University-Cerrahpasa, Istanbul, Turkey
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6
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Coca-Pelaz A, Bishop JA, Zidar N, Agaimy A, Gebrim EMMS, Mondin V, Cohen O, Strojan P, Rinaldo A, Shaha AR, de Bree R, Hamoir M, Mäkitie AA, Kowalski LP, Saba NF, Ferlito A. Cervical Lymph Node Metastases from Central Nervous System Tumors: A Systematic Review. Cancer Manag Res 2022; 14:1099-1111. [PMID: 35300060 PMCID: PMC8921675 DOI: 10.2147/cmar.s348102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 02/17/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction Lymph node metastasis (LNM) from primary tumors of the central nervous system (CNS) is an infrequent condition, and classically it was thought that CNS tumors could not spread via the lymphatic route. Recent discoveries about this route of dissemination make its knowledge necessary for surgeons and pathologists to avoid delays in diagnosis and unnecessary treatments. The aim of this paper is to review the literature and to discuss the relevant pathogenetic mechanism and the cytologic features along with recommendations for surgical treatment of these cervical LNM. Materials and Methods Using PRISMA guidelines, we conducted a systematic review of the literature published from 1944 to 2021, updating the comprehensive review published in 2010 by our group. Results Our review includes data of 143 articles obtaining 174 patients with LNM from a primary CNS tumor. The mean age of the patients was 31.9 years (range, 0.1–87) and there were 61 females (35.1%) and 103 males (59.2%), and in 10 cases (5.7%) the gender was not specified. The more frequent sites of distant metastasis were bones (23%), lungs (11.5%) and non-cervical lymph nodes (11%). Conclusion Cervical LNM from CNS tumors is infrequent. Pathologic diagnosis can be obtained by fine-needle aspiration cytology in most cases, giving surgeons the option to plan the appropriate surgical treatment. Given the poor prognosis of these cases, the most conservative possible cervical dissection is usually the treatment of choice.
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Affiliation(s)
- Andrés Coca-Pelaz
- Department of Otolaryngology, Hospital Universitario Central de Asturias-University of Oviedo, Instituto de Investigación Sanitaria del Principado de Asturias, IUOPA, CIBERONC, Oviedo (Asturias), Spain
- Correspondence: Andrés Coca-Pelaz, Department of Otolaryngology, Hospital Universitario Central de Asturias-University of Oviedo, Instituto de Investigación Sanitaria del Principado de Asturias, IUOPA, CIBERONC, Avenida de Roma s/n, Oviedo (Asturias), 33011, Spain, Email
| | - Justin A Bishop
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Nina Zidar
- Institute of Pathology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Abbas Agaimy
- Institute of Pathology, Friedrich Alexander University Erlangen-Nürnberg, University Hospital, Erlangen, Germany
| | - Eloisa Maria Mello Santiago Gebrim
- Otorhinolaryngology Department, National Institute of Rehabilitation, Mexico City, Mexico
- Radiology Department, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil
| | - Vanni Mondin
- ENT Clinic, Policlinico Città di Udine, Udine, Italy
| | - Oded Cohen
- ARM - Center for Otolaryngology - Head and Neck Surgery and Oncology, Assuta Medical Center, Tel Aviv, Affiliated with Ben Gurion University, Beer Sheva, Israel
| | - Primož Strojan
- Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia
| | | | - Ashok R Shaha
- Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Remco de Bree
- Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht, The NetherlAnds
| | - Marc Hamoir
- Department of Head and Neck Surgery, UC Louvain, St Luc University Hospital and King Albert II Cancer Institute, Brussels, Belgium
| | - Antti A Mäkitie
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Luiz P Kowalski
- Head and Neck Surgery and Otorhinolaryngology Department, A C Camargo Cancer Center and Department of Head and Neck Surgery, University of São Paulo Medical School, São Paulo, Brazil
| | - Nabil F Saba
- Department of Hematology and Medical Oncology, The Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - Alfio Ferlito
- International Head and Neck Scientific Group, Padua, Italy
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7
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Luan XZ, Wang HR, Xiang W, Li SJ, He H, Chen LG, Wang JM, Zhou J. Extracranial multiorgan metastasis from primary glioblastoma: A case report. World J Clin Cases 2021; 9:10300-10307. [PMID: 34904103 PMCID: PMC8638031 DOI: 10.12998/wjcc.v9.i33.10300] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 08/31/2021] [Accepted: 09/16/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Glioblastoma has a high degree of malignancy and poor prognosis. It is common to have in situ recurrence and intracranial metastasis, while extracranial metastasis is rare, and extracranial multiorgan metastasis is extremely rare. We report a case of glioblastoma with extracranial multiorgan metastasis, which will strengthen clinicians’ attention to the extracranial metastasis of glioblastoma and its treatment.
CASE SUMMARY A male patient visited our hospital for treatment of dizziness and headache. Magnetic resonance imaging of the brain revealed a space-occupying lesion in the right temporoparietal occipital region. Chest computed tomography and abdominal ultrasound were normal, and no space-occupying lesions were observed in other organs of the body. The patient underwent surgery and diagnosed with glioblastoma. Postoperative concurrent radiotherapy and chemotherapy were completed. During the follow-up, the tumor was found to have metastasized to the scalp and neck, and a second tumor resection was performed. Postoperative follow-up revealed extracranial metastases to multiple extracranial organs including skull, scalp, ribs, spine, liver and lung. His family members refused further treatment, and requested only symptomatic treatment such as pain relief, and the patient died of systemic multiple organ failure. Survival time from diagnosis to death was 13 mo and from extracranial metastasis to death was 6 mo.
CONCLUSION Glioblastoma extracranial metastasis is extremely rare, clinicians should always pay attention to its existence. The mechanism of glioblastoma extracranial metastasis is still unclear, and genetic and molecular studies are required.
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Affiliation(s)
- Xing-Zhao Luan
- Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
- Sichuan Clinical Research Center for Neurosurgery, Southwest Medical University, Luzhou 646000, Sichuan Province, China
| | - Hao-Run Wang
- Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
- Sichuan Clinical Research Center for Neurosurgery, Southwest Medical University, Luzhou 646000, Sichuan Province, China
- Academician (Expert) Workstation of Sichuan Province, Southwest Medical University, Luzhou 646000, Sichuan Province, China
| | - Wei Xiang
- Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
- Sichuan Clinical Research Center for Neurosurgery, Southwest Medical University, Luzhou 646000, Sichuan Province, China
- Academician (Expert) Workstation of Sichuan Province, Southwest Medical University, Luzhou 646000, Sichuan Province, China
| | - Shen-Jie Li
- Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
- Sichuan Clinical Research Center for Neurosurgery, Southwest Medical University, Luzhou 646000, Sichuan Province, China
- Academician (Expert) Workstation of Sichuan Province, Southwest Medical University, Luzhou 646000, Sichuan Province, China
| | - Haiping He
- Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
- Sichuan Clinical Research Center for Neurosurgery, Southwest Medical University, Luzhou 646000, Sichuan Province, China
- Academician (Expert) Workstation of Sichuan Province, Southwest Medical University, Luzhou 646000, Sichuan Province, China
| | - Li-Gang Chen
- Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
- Sichuan Clinical Research Center for Neurosurgery, Southwest Medical University, Luzhou 646000, Sichuan Province, China
- Academician (Expert) Workstation of Sichuan Province, Southwest Medical University, Luzhou 646000, Sichuan Province, China
| | - Jian-Mei Wang
- Department of Pathology, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
| | - Jie Zhou
- Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
- Sichuan Clinical Research Center for Neurosurgery, Southwest Medical University, Luzhou 646000, Sichuan Province, China
- Academician (Expert) Workstation of Sichuan Province, Southwest Medical University, Luzhou 646000, Sichuan Province, China
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Li ZG, Zheng MY, Zhao Q, Liu K, Du JX, Zhang SW. Solitary vertebral metastatic glioblastoma in the absence of primary brain tumor relapse: a case report and literature review. BMC Med Imaging 2020; 20:89. [PMID: 32736607 PMCID: PMC7395336 DOI: 10.1186/s12880-020-00488-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Accepted: 07/22/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Metastatic glioblastoma presenting as a solitary osteolytic cervical vertebral mass without primary brain tumor relapse is extremely rare with only 1 reported case in the literature. Because of its rarity, it can be easily overlooked and misdiagnosed, posing a diagnostic dilemma. CASE PRESENTATION A 51-year-old man with right temporal glioblastoma was initially treated by tumor resection, radiotherapy and chemotherapy. Eighteen months after surgery, he was readmitted with complaints of neck pain for 2 weeks. Follow-up magnetic resonance imaging (MRI) and fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) revealed a solitary FDG-avid osteolytic lesion in the 4th cervical vertebral body without other abnormal FDG-uptake in the body and in the absence of local recurrence at the resection cavity. Because of the sudden worsening situation and intractable neck pain, the patient underwent tumor resection. Postoperatively, the pain was obviously reduced and the situation was improved. Interestingly, the immunohistochemical findings of glial fibrillary acidic protein (GFAP) indicated the characteristic of metastatic glioblastoma, despite that the histopathological findings of Hematoxylin & Eosin (H&E) staining was suspicious of osteoclastoma. According to the clinical history, imaging findings, pathological and immunohistochemical results, a final diagnosis of solitary vertebral metastasis from glioblastoma without central nervous system (CNS) relapse was confirmed. Then, the patient received radiotherapy on spine and adjuvant chemotherapy with temozolomide. However, he died suddenly 2 months after the tumor resection, nearly 21 months after the initial diagnosis. CONCLUSION We emphasize that metastatic glioblastoma should be considered in the differential diagnosis of a solitary FDG-avid osteolytic vertebral mass on PET/CT. And the diagnosis of extracranial metastasis (ECM) from glioblastoma can be achieved through clinical history, imaging findings, pathological examination, and immunohistochemical staining with GFAP.
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Affiliation(s)
- Zu-Gui Li
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China.,Department of Pathology, Tianjin Union Medical Center, Tianjin, 300121, China
| | - Min-Ying Zheng
- Department of Pathology, Tianjin Union Medical Center, Tianjin, 300121, China
| | - Qi Zhao
- Department of Pathology, Tianjin Union Medical Center, Tianjin, 300121, China
| | - Kai Liu
- Department of Pathology, Tianjin Union Medical Center, Tianjin, 300121, China
| | - Jia-Xing Du
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China.,Department of Pathology, Tianjin Union Medical Center, Tianjin, 300121, China
| | - Shi-Wu Zhang
- Department of Pathology, Tianjin Union Medical Center, Tianjin, 300121, China. .,Nankai University School of Medicine, Nankai University, Tianjin, 300070, China.
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Evzikov GY, Konovalov NA, Argylova VN, Vasiliev SA, Timonin SY. [Spinal cord metastasis of anaplastic oligodendroglioma of the brain without recurrence of primary tumor. Ccase report and literature review]. ZHURNAL VOPROSY NEIROKHIRURGII IMENI N. N. BURDENKO 2020; 84:54-60. [PMID: 32759927 DOI: 10.17116/neiro20208404154] [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: 06/11/2023]
Abstract
Spinal cord metastases of brain gliomas are rare. However, incidence of these tumors has been increasing recently. The vast majority of neurosurgeons and oncologists recognize spinal cord metastasis of malignant brain glioma followed by symptoms of transverse spinal cord lesion as non-curable terminal stage of malignant process. In this paper, we report a rare clinical case of metastatic spinal cord lesion in a patient after previous surgery for anaplastic oligodendroglioma of the right frontal lobe. There were no signs of local recurrence of the primary tumor. Active surgical strategy followed by radio- and chemotherapy significantly improved the patient's quality of life. Postoperative follow-up is 6 months by the moment of writing the manuscript, no clinical signs of progression are observed.
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Affiliation(s)
- G Yu Evzikov
- Sechenov First Moscow State Medical University, Moscow, Russia
| | | | - V N Argylova
- Sechenov First Moscow State Medical University, Moscow, Russia
| | - S A Vasiliev
- Petrovsky National Research Center of Surgery, Moscow, Russia
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10
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Shimizu H, Motomura K, Ohka F, Aoki K, Tanahashi K, Hirano M, Chalise L, Nishikawa T, Yamaguchi J, Wakabayashi T, Natsume A. Multiple metastases to the bone and bone marrow from a 1p/19q-codeleted and IDH2-mutant anaplastic oligodendroglioma: a case report and literature review. Neurooncol Adv 2020; 2:vdaa101. [PMID: 33005899 PMCID: PMC7513887 DOI: 10.1093/noajnl/vdaa101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Hiroyuki Shimizu
- Department of Neurosurgery, Nagoya University School of Medicine, Nagoya, Japan
| | - Kazuya Motomura
- Department of Neurosurgery, Nagoya University School of Medicine, Nagoya, Japan
| | - Fumiharu Ohka
- Department of Neurosurgery, Nagoya University School of Medicine, Nagoya, Japan
| | - Kosuke Aoki
- Department of Neurosurgery, Nagoya University School of Medicine, Nagoya, Japan
| | - Kuniaki Tanahashi
- Department of Neurosurgery, Nagoya University School of Medicine, Nagoya, Japan
| | - Masaki Hirano
- Department of Neurosurgery, Nagoya University School of Medicine, Nagoya, Japan
| | - Lushun Chalise
- Department of Neurosurgery, Nagoya University School of Medicine, Nagoya, Japan
| | - Tomohide Nishikawa
- Department of Neurosurgery, Nagoya University School of Medicine, Nagoya, Japan
| | - Junya Yamaguchi
- Department of Neurosurgery, Nagoya University School of Medicine, Nagoya, Japan
| | | | - Atsushi Natsume
- Department of Neurosurgery, Nagoya University School of Medicine, Nagoya, Japan
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11
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Zhang M, Zhao Y, Zhao J, Huang T, Wu Y. Impact of AKAP6 polymorphisms on Glioma susceptibility and prognosis. BMC Neurol 2019; 19:296. [PMID: 31759389 PMCID: PMC6875069 DOI: 10.1186/s12883-019-1504-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 10/20/2019] [Indexed: 12/20/2022] Open
Abstract
PURPOSE Glioma is the most common primary malignant brain tumor with high mortality and poor prognosis. Our aim was to clarify the correlation between Kinase-anchored protein 6 (AKAP6) gene polymorphisms and glioma susceptibility and prognosis in Chinese Han population. METHODS Five single-nucleotide polymorphisms (SNPs) of AKAP6 were genotyped by Agena MassARRAY in 575 glioma patients and 500 healthy controls. Logistic regression model was utilized to calculate odds ratios (OR) and 95% confidence intervals (CI). The associations between polymorphisms and survival were assessed using the log-rank test, Kaplan-Meier analysis and Cox regression model. RESULTS We found that rs2239647 polymorphism was strongly associated with an increased risk of glioma (OR = 1.90, p = 0.007) and a worse prognosis for glioma, especially in high-grade glioma (HR = 1.67, p = 0.034). Stratified analysis showed that rs2239647 increased the risk of glioma in female (OR = 1.62, p = 0.016). Whereas, rs4261436 (HR = 0.70, p = 0.045) and rs17522122 (HR = 0.75, p = 0.016) were associated with better prognosis of astrocytoma. In addition, we also found that surgical methods and chemotherapy are critical factors for the prognosis of glioma patients. CONCLUSIONS This study firstly provided evidence for the impact of AKAP6 polymorphisms on susceptibility and prognosis of glioma, suggesting AKAP6 variants might have potential roles in the etiology of glioma.
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Affiliation(s)
- Ming Zhang
- Department of Neurosurgery, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, China
| | - Yonglin Zhao
- Department of Oncology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, China
| | - Junjie Zhao
- Department of Neurosurgery, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China
| | - Tingqin Huang
- Department of Neurosurgery, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, China
| | - Yuan Wu
- Department of Critical Care Medicine, the Second Affiliated Hospital of Xi'an Jiaotong University, #157 Xiwu Road, Xi'an, 710004, Shaanxi, China.
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12
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Burgy M, Chenard MP, Noël G, Bourahla K, Schott R. Bone metastases from a 1p/19q codeleted and IDH1-mutant anaplastic oligodendroglioma: a case report. J Med Case Rep 2019; 13:202. [PMID: 31248444 PMCID: PMC6598291 DOI: 10.1186/s13256-019-2061-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Accepted: 03/20/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Oligodendroglioma is a rare type of primary brain tumor which, like other malignant gliomas, metastasizes very rarely even when in high-grade form. CASE REPORT A 36-year-old white man diagnosed 29 months previously as having 1p/19q codeleted anaplastic oligodendroglioma presented bilateral cruralgia and lower limb motor deficits. A computed tomography scan showed multiple osteoblastic bone lesions. The presence of oligodendroglial cells was revealed by bone marrow biopsy and confirmed by immunohistochemical analyses. A positon emission tomography-computed tomography scan confirmed the exclusive involvement of bones. CONCLUSION This case joins less than 20 other reported cases of oligodendroglioma bone marrow metastasis, and is one of only a handful of cases of diffuse bone metastases beyond the axial skeleton. To the best of our knowledge, the early relapse of 1p/19q codeleted anaplastic oligodendroglioma with this distribution of metastases has never been described in the literature.
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Affiliation(s)
- Mickaël Burgy
- Medical Oncology Department, Centre Paul Strauss, 3 Rue de la Porte de l'Hôpital, 67000, Strasbourg, France.,Université de Strasbourg, LBP, CNRS UMR 7213, Illkirch, France
| | | | - Georges Noël
- Radiotherapy Department, Centre Paul-Strauss, Strasbourg, France
| | - Khalil Bourahla
- Nuclear Medicine Department, Centre Paul-Strauss, Strasbourg, France
| | - Roland Schott
- Medical Oncology Department, Centre Paul Strauss, 3 Rue de la Porte de l'Hôpital, 67000, Strasbourg, France.
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13
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Romo CG, Palsgrove DN, Sivakumar A, Elledge CR, Kleinberg LR, Chaichana KL, Gocke CD, Rodriguez FJ, Holdhoff M. Widely metastatic IDH1-mutant glioblastoma with oligodendroglial features and atypical molecular findings: a case report and review of current challenges in molecular diagnostics. Diagn Pathol 2019; 14:16. [PMID: 30738431 PMCID: PMC6368694 DOI: 10.1186/s13000-019-0793-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 02/01/2019] [Indexed: 01/06/2023] Open
Abstract
Background Gliomas with 1p/19q-codeletion as well as mutation of isocitrate dehydrogenase (IDH) 1 are typically characterized as oligodendrogliomas with comparatively good response to treatment with radiation and chemotherapy. Case presentation We present the case of a 28-year-old man with an IDH1 and TP53 mutant high grade glioma with abnormalities in chromosomes 1 and 19 suggestive of anaplastic oligodendroglioma that rapidly progressed to widespread metastatic disease. Biopsy of a liver lesion confirmed metastasis of the patient’s known brain primary and chemotherapy with temozolomide was initiated. The patient’s rapidly growing tumor burden with fulminant liver failure and tumor lysis led to multisystem failure of which the patient died. Further molecular testing illustrated features more consistent with glioblastoma: multiple large chromosomal aberrations including loss of whole chromosome 1 and 2q; gain/amplification of MYCN, MET, and CDK4; loss of CDKN2A/B; and an ATRX mutation. Conclusion This case illustrates the importance of higher level molecular diagnostic testing for patients with particularly aggressive disease progression that is not concordant with standard prognoses. Additional data on cases with atypical alterations of 1p and 19q are needed to better understand the distinct biology of these cancers so that appropriate therapies can be developed. Electronic supplementary material The online version of this article (10.1186/s13000-019-0793-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Carlos G Romo
- Brain Cancer Program, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, 1550 Orleans Street, 1M16, Baltimore, MD, 21287, USA
| | - Doreen N Palsgrove
- Department of Pathology, Johns Hopkins University of Medicine, Baltimore, MD, USA
| | - Ananyaa Sivakumar
- Brain Cancer Program, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, 1550 Orleans Street, 1M16, Baltimore, MD, 21287, USA
| | - Christen R Elledge
- Department of Radiation Oncology, Johns Hopkins University of Medicine, Baltimore, MD, USA
| | - Lawrence R Kleinberg
- Department of Radiation Oncology, Johns Hopkins University of Medicine, Baltimore, MD, USA
| | - Kaisorn L Chaichana
- Department of Neurosurgery, Johns Hopkins University of Medicine, Baltimore, MD, USA
| | - Christopher D Gocke
- Department of Pathology, Johns Hopkins University of Medicine, Baltimore, MD, USA
| | - Fausto J Rodriguez
- Department of Pathology, Johns Hopkins University of Medicine, Baltimore, MD, USA
| | - Matthias Holdhoff
- Brain Cancer Program, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, 1550 Orleans Street, 1M16, Baltimore, MD, 21287, USA.
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14
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Singh VK, Singh S, Bhupalam L. Anaplastic oligodendroglioma metastasizing to the bone marrow: a unique case report and literature review. Int J Neurosci 2018; 129:722-728. [PMID: 30526175 DOI: 10.1080/00207454.2018.1557165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Oligodendrogliomas are a rare type of primary brain tumor. They are genetically defined as diffuse gliomas carrying mutation in isocitrate dehydrogenase type 1 (IDH1) or type 2 (IDH2) and codeletion of chromosomes 1p and 19q. The WHO grading system distinguishes two histopathologic grades of ODs: grade II (low-grade) and grade III (anaplastic oligodendroglioma or AO). These tumors rarely metastasize outside of central nervous system with only few cases reported in the literature. Here we present a case of an AO, which metastasized to the bone marrow and other sites within a year of diagnosis despite aggressive treatment measures. Our patient eventually succumbed to his disease, raising many questions about this rare condition, its natural course and optimal management strategy.
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Affiliation(s)
- Vikas K Singh
- a James Graham Brown Cancer Center , University of Louisville , Louisville , KY , USA
| | - Shipra Singh
- b College of Education and Human Development , University of Louisville , Louisville , KY , USA
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15
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Aydemir F, Kardes O, Hasbay B, Sedef AM, Tufan K, Kayaselçuk F. Multiple Extraneural Metastases of Anaplastic Oligodendroglioma. Asian J Neurosurg 2018; 13:830-833. [PMID: 30283558 PMCID: PMC6159050 DOI: 10.4103/1793-5482.238010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Oligodendrogliomas (ODGs) is a diffuse glial tumor that constitutes 4.2% of all brain tumors. Extraneural metastases, sometimes seen in glioblastoma multiforme, are extremely rare in ODG. In this report, we present a 63-year-old male patient who was diagnosed with Grade 3 ODG and had an intracranial mass resected in our clinic 4 years ago. The subject now presented with low back pain and was found to have widespread metastases. The prolongation of patient survival by current treatment regimens has revealed a growing number of ODG patients with metastases. We believe that back pain complaints in patients with ODG should be viewed as an indicator of metastasis.
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Affiliation(s)
- Fatih Aydemir
- Department of Neurosurgery, Medical Park Hospital, Haşim İşcan Caddesi Fomara Meydanı No: 1 Osmangazi, Bursa, Turkey
| | - Ozgur Kardes
- Department of Neurosurgery, Faculty of Medicine, Adana Practice and Research Center, Baskent University, Adana, Turkey
| | - Bermal Hasbay
- Department of Pathology, Faculty of Medicine, Adana Practice and Research Center, Baskent University, Adana, Turkey
| | - Ali Murat Sedef
- Department of Oncology, Faculty of Medicine, Adana Practice and Research Center, Baskent University, Adana, Turkey
| | - Kadir Tufan
- Department of Neurosurgery, Faculty of Medicine, Adana Practice and Research Center, Baskent University, Adana, Turkey
| | - Fazilet Kayaselçuk
- Department of Pathology, Faculty of Medicine, Adana Practice and Research Center, Baskent University, Adana, Turkey
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16
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A Case of Anaplastic Oligodendroglioma With Extensive Extraneural Metastases Imaged With FDG PET. Clin Nucl Med 2018; 42:968-970. [PMID: 29076897 DOI: 10.1097/rlu.0000000000001859] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A 28-year-old man with history of anaplastic oligodendroglimoma in the left frontal lobe presented with worsening right leg weakness 2 months after surgical resection. MRI of the brain and spine demonstrated a new mass in the left parietal lobe, as well as extraneural osseous metastases. FDG PET scan subsequently showed widespread extraneural metastatic disease. Extraneural metastases from primary brain tumors are a rare occurrence, although anaplastic oligodendroglioma has a propensity for spreading in such a manner. FDG PET can effectively stage patients with extraneural metastases from anaplastic oligodendroglioma by detecting metastatic disease in sites such as the skeleton and liver.
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17
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Maiguel Carrizosa CE, Sanchez Paez MG, Martinez Amado A, Gonzalez Gutierrez A, Garcia Ardila ME. Spinal metastases of two different grade oligodendrogliomas: a case report and review of literature. JOURNAL OF SPINE SURGERY 2017; 3:468-474. [PMID: 29057359 DOI: 10.21037/jss.2017.06.14] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Oligodendrogliomas (OGD) are glial tumors, together with mixed oligoastrocytoma constituting 5-20% of all gliomas, which occur predominantly in younger populations and are managed with surgery and chemotherapy with good long-term prognosis after treatment and additionally present with low rates of metastases. We present the case of a 46-year-old patient with intracranial right frontal subcortical OGD [World Health Organisation (WHO) grade II] managed at the Neurosurgery Department in Foscal Clinic, Floridablanca, Colombia. Two years after brain surgery the patient presents with neurological symptomatology suggestive of spinal cord compression and is found to have a neoplastic lesion with extra medullary compressive strength on the conus medullary and wrapping all of the roots with the final report of pathology and immunohistochemistry indicating: OGD (WHO grade III), this lesion was the only one found, the brain studies shows any residual tumor or recurrence in the primary tumor site.
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18
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Sun Q, Xu R, Xu H, Wang G, Shen X, Jiang H. Extracranial metastases of high-grade glioma: the clinical characteristics and mechanism. World J Surg Oncol 2017; 15:181. [PMID: 28985756 PMCID: PMC5639596 DOI: 10.1186/s12957-017-1249-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 09/26/2017] [Indexed: 11/10/2022] Open
Abstract
Background This presentation of two cases and literature review discusses the epidemiology, clinical manifestations, pathogenesis, diagnosis, treatment, and prognosis of high-grade glioma with extracranial metastases. Methods A retrospective analysis of the clinical features of two cases of malignant glioma, including metastatic sites, pathological data, and treatment methods, and a literature review was performed. Results Two patients developed extracranial metastases within 1 year after surgery for primary glioma. One patient developed cervical lymph node and bone metastases while the other developed bone metastases, and both patients died within 2 months after the diagnosis of the extracranial metastasis. Conclusion Extracranial metastases may develop from malignant gliomas. According to the literature, the most common extracranial site is intraspinal (along the neural axis), followed by the vertebrae, lungs, liver, and lymph nodes. The complex metastatic mechanism remains unclear, and the prognosis is very poor, with a survival duration of less than 6 months.
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Affiliation(s)
- Qian Sun
- Department of Radiation Oncology, the First Affiliated Hospital of Bengbu Medical College, Bengbu, 233000, China
| | - Rui Xu
- Department of Surgical Oncology, the First Affiliated Hospital of Bengbu Medical College, Bengbu, 233000, China
| | - Hongbo Xu
- Department of Radiation Oncology, the First Affiliated Hospital of Bengbu Medical College, Bengbu, 233000, China
| | - Gengming Wang
- Department of Radiation Oncology, the First Affiliated Hospital of Bengbu Medical College, Bengbu, 233000, China
| | - Xueming Shen
- Department of Radiation Oncology, the First Affiliated Hospital of Bengbu Medical College, Bengbu, 233000, China
| | - Hao Jiang
- Department of Radiation Oncology, the First Affiliated Hospital of Bengbu Medical College, Bengbu, 233000, China.
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19
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Maloney PR, Yamaki VN, Kumar R, Johnson D, Hunt C, Jentoft ME, Clarke M. Osteosclerosis Secondary to Metastatic Oligodendroglioma. Rare Tumors 2017; 9:6837. [PMID: 28435646 PMCID: PMC5379227 DOI: 10.4081/rt.2017.6837] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 10/20/2016] [Indexed: 11/22/2022] Open
Abstract
This paper reviews a case of metastatic 1p/19q codeleted oligodendrioglioma causing diffuse osteosclerosis and pain. Primary central nervous system (CNS) tumors rarely metastasize outside the CNS, and metastatic oligodendroglioma is rarer still. The patient in this study had relief of pain after being treated with temozolomide. We discuss this rare presentation and potential treatment options, and review the literature in regards to metastatic oligodendrogliomas.
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Affiliation(s)
- Patrick R Maloney
- Departments of Neurosurgery, Mayo Clinic, College of Medicine, Rochester, MN, USA
| | - Vitor Nagai Yamaki
- Departments of Neurosurgery, Mayo Clinic, College of Medicine, Rochester, MN, USA
| | - Ravi Kumar
- Departments of Neurosurgery, Mayo Clinic, College of Medicine, Rochester, MN, USA
| | - Derek Johnson
- Neurology, Mayo Clinic, College of Medicine, Rochester, MN, USA
| | - Christopher Hunt
- Neuroradiology, Mayo Clinic, College of Medicine, Rochester, MN, USA
| | - Mark E Jentoft
- Anatomic Pathology, Mayo Clinic, College of Medicine, Rochester, MN, USA
| | - Michelle Clarke
- Departments of Neurosurgery, Mayo Clinic, College of Medicine, Rochester, MN, USA
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20
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Jian Y, Gao W, Wu Y, Li Y, Zhang Y, Yang G, Chen W. Oligodendroglioma metastasis to the bone marrow mimicking multiple myeloma: A case report. Oncol Lett 2016; 12:351-355. [PMID: 27347150 DOI: 10.3892/ol.2016.4568] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Accepted: 04/08/2016] [Indexed: 11/06/2022] Open
Abstract
The present study reports a case of a 59-year-old male suffering from oligodendroglioma that metastasized to the bone marrow (BM). The metastasis was detected 5 years after craniotomy was performed for the resection of the primary tumor; however, it manifested as multiple myeloma (MM)-like bone lesions, a small M component and myeloma cell-like morphology in the BM. A brain magnetic resonance imaging scan was performed; evidence from the previously performed oligodendroglioma resection was observed on the scan, but there were no significant findings, which made the diagnosis particularly challenging. The patient exhibited no response to the multiple combination therapies administered targeting MM and oligodendroglioma, and subsequently developed epilepsy and pneumonia, prior to succumbing to multiple organ failure. Among the various tumor types involving the central nervous system, oligodendroglioma is the least likely to metastasize; thus, distant metastases from brain oligodendrogliomas are extremely rare. To the best of our knowledge, this is the first case of metastatic oligodendroglioma presenting with typical MM-like symptoms and without any recurrence in the brain.
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Affiliation(s)
- Yuan Jian
- Department of Hematology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, P.R. China
| | - Wen Gao
- Department of Hematology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, P.R. China
| | - Yin Wu
- Department of Hematology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, P.R. China
| | - Yanchen Li
- Department of Hematology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, P.R. China
| | - Yong Zhang
- Department of Hematology, Beijing Luhe Hospital, Capital Medical University, Beijing 101100, P.R. China
| | - Guangzhong Yang
- Department of Hematology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, P.R. China
| | - Wenming Chen
- Department of Hematology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, P.R. China
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21
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Xi Y, Chen Y. Oncogenic and Therapeutic Targeting of PTEN Loss in Bone Malignancies. J Cell Biochem 2015; 116:1837-47. [DOI: 10.1002/jcb.25159] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2015] [Accepted: 03/09/2015] [Indexed: 12/25/2022]
Affiliation(s)
- Yongming Xi
- Department of Orthopaedics; Affiliated Hospital of Qingdao University; China
| | - Yan Chen
- Division in Signaling Biology; Princess Margaret Cancer Center; University Health Network; Toronto Canada
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22
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Antiangiogenic Therapies and Extracranial Metastasis in Glioblastoma: A Case Report and Review of the Literature. Case Rep Oncol Med 2015. [PMID: 26199775 PMCID: PMC4493308 DOI: 10.1155/2015/431819] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
We present a case report of a patient with glioblastoma multiforme (GBM) complicated by extracranial metastasis (ECM) whose survival of nearly four years surpassed the anticipated life expectancy given numerous negative prognostic factors including EGFRvIII-mutation, unmethylated MGMT promoter status, and ECM. Interestingly, while this patient suffered from locally aggressive disease with multiple intracranial recurrences, the proximal cause of death was progressive extracranial disease and complications related to pulmonary metastases. Herein, we review potential mechanisms of ECM with an emphasis upon glioblastoma molecular and genetic profiles and the potential implications of targeted agents such as bevacizumab.
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23
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Oligodendroglioma: pathology, molecular mechanisms and markers. Acta Neuropathol 2015; 129:809-27. [PMID: 25943885 PMCID: PMC4436696 DOI: 10.1007/s00401-015-1424-1] [Citation(s) in RCA: 123] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Revised: 04/08/2015] [Accepted: 04/10/2015] [Indexed: 02/07/2023]
Abstract
For nearly a century, the diagnosis and grading of oligodendrogliomas and oligoastrocytomas has been based on histopathology alone. Roughly 20 years ago, the first glioma-associated molecular signature was found with complete chromosome 1p and 19q codeletion being particularly common in histologically classic oligodendrogliomas. Subsequently, this codeletion appeared to not only carry diagnostic, but also prognostic and predictive information, the latter aspect only recently resolved after carefully constructed clinical trials with very long follow-up times. More recently described biomarkers, including the non-balanced translocation leading to 1p/19q codeletion, promoter hypermethylation of the MGMT gene, mutations of the IDH1 or IDH2 gene, and mutations of FUBP1 (on 1p) or CIC (on 19q), have greatly enhanced our understanding of oligodendroglioma biology, although their diagnostic, prognostic, and predictive roles are less clear. It has therefore been suggested that complete 1p/19q codeletion be required for the diagnosis of 'canonical oligodendroglioma'. This transition to an integrated morphological and molecular diagnosis may result in the disappearance of oligoastrocytoma as an entity, but brings new challenges as well. For instance it needs to be sorted out how (histopathological) criteria for grading of 'canonical oligodendrogliomas' should be adapted, how pediatric oligodendrogliomas (known to lack codeletions) should be defined, which platforms and cut-off levels should ideally be used for demonstration of particular molecular aberrations, and how the diagnosis of oligodendroglioma should be made in centers/countries where molecular diagnostics is not available. Meanwhile, smart integration of morphological and molecular information will lead to recognition of biologically much more uniform groups within the spectrum of diffuse gliomas and thereby facilitate tailored treatments for individual patients.
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24
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Kros JM, Mustafa DM, Dekker LJM, Sillevis Smitt PAE, Luider TM, Zheng PP. Circulating glioma biomarkers. Neuro Oncol 2014; 17:343-60. [PMID: 25253418 DOI: 10.1093/neuonc/nou207] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Accepted: 07/13/2014] [Indexed: 02/06/2023] Open
Abstract
Validated biomarkers for patients suffering from gliomas are urgently needed for standardizing measurements of the effects of treatment in daily clinical practice and trials. Circulating body fluids offer easily accessible sources for such markers. This review highlights various categories of tumor-associated circulating biomarkers identified in blood and cerebrospinal fluid of glioma patients, including circulating tumor cells, exosomes, nucleic acids, proteins, and oncometabolites. The validation and potential clinical utility of these biomarkers is briefly discussed. Although many candidate circulating protein biomarkers were reported, none of these have reached the required validation to be introduced for clinical practice. Recent developments in tracing circulating tumor cells and their derivatives as exosomes and circulating nuclear acids may become more successful in providing useful biomarkers. It is to be expected that current technical developments will contribute to the finding and validation of circulating biomarkers.
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Affiliation(s)
- Johan M Kros
- Department of Pathology, Erasmus Medical Center, Rotterdam, The Netherlands (J.M.K., D.M.M., P.-P.Z.); Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands (L.J.M.D., P.A.E.S.S., T.M.L.); Brain Tumor Center Rotterdam, Erasmus Medical Center, Rotterdam, The Netherlands (J.M.K., D.M.M., L.J.M.D., P.A.E.S.S., T.M.L., P.-P.Z.)
| | - Dana M Mustafa
- Department of Pathology, Erasmus Medical Center, Rotterdam, The Netherlands (J.M.K., D.M.M., P.-P.Z.); Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands (L.J.M.D., P.A.E.S.S., T.M.L.); Brain Tumor Center Rotterdam, Erasmus Medical Center, Rotterdam, The Netherlands (J.M.K., D.M.M., L.J.M.D., P.A.E.S.S., T.M.L., P.-P.Z.)
| | - Lennard J M Dekker
- Department of Pathology, Erasmus Medical Center, Rotterdam, The Netherlands (J.M.K., D.M.M., P.-P.Z.); Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands (L.J.M.D., P.A.E.S.S., T.M.L.); Brain Tumor Center Rotterdam, Erasmus Medical Center, Rotterdam, The Netherlands (J.M.K., D.M.M., L.J.M.D., P.A.E.S.S., T.M.L., P.-P.Z.)
| | - Peter A E Sillevis Smitt
- Department of Pathology, Erasmus Medical Center, Rotterdam, The Netherlands (J.M.K., D.M.M., P.-P.Z.); Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands (L.J.M.D., P.A.E.S.S., T.M.L.); Brain Tumor Center Rotterdam, Erasmus Medical Center, Rotterdam, The Netherlands (J.M.K., D.M.M., L.J.M.D., P.A.E.S.S., T.M.L., P.-P.Z.)
| | - Theo M Luider
- Department of Pathology, Erasmus Medical Center, Rotterdam, The Netherlands (J.M.K., D.M.M., P.-P.Z.); Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands (L.J.M.D., P.A.E.S.S., T.M.L.); Brain Tumor Center Rotterdam, Erasmus Medical Center, Rotterdam, The Netherlands (J.M.K., D.M.M., L.J.M.D., P.A.E.S.S., T.M.L., P.-P.Z.)
| | - Ping-Pin Zheng
- Department of Pathology, Erasmus Medical Center, Rotterdam, The Netherlands (J.M.K., D.M.M., P.-P.Z.); Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands (L.J.M.D., P.A.E.S.S., T.M.L.); Brain Tumor Center Rotterdam, Erasmus Medical Center, Rotterdam, The Netherlands (J.M.K., D.M.M., L.J.M.D., P.A.E.S.S., T.M.L., P.-P.Z.)
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