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Cain SA, Pope B, Mangiola S, Mantamadiotis T, Drummond KJ. Somatic mutation landscape in a cohort of meningiomas that have undergone grade progression. BMC Cancer 2023; 23:216. [PMID: 36882706 PMCID: PMC9990218 DOI: 10.1186/s12885-023-10624-9] [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: 08/13/2022] [Accepted: 02/09/2023] [Indexed: 03/09/2023] Open
Abstract
BACKGROUND A subset of meningiomas progress in histopathological grade but drivers of progression are poorly understood. We aimed to identify somatic mutations and copy number alterations (CNAs) associated with grade progression in a unique matched tumour dataset. METHODS Utilising a prospective database, we identified 10 patients with meningiomas that had undergone grade progression and for whom matched pre- and post-progression tissue (n = 50 samples) was available for targeted next-generation sequencing. RESULTS Mutations in NF2 were identified in 4/10 patients, of these 94% were non-skull base tumours. In one patient, three different NF2 mutations were identified in four tumours. NF2 mutated tumours showed large-scale CNAs, with highly recurrent losses in 1p, 10, 22q, and frequent CNAs on chromosomes 2, 3 and 4. There was a correlation between grade and CNAs in two patients. Two patients with tumours without detected NF2 mutations showed a combination of loss and high gain on chromosome 17q. Mutations in SETD2, TP53, TERT promoter and NF2 were not uniform across recurrent tumours, however did not correspond with the onset of grade progression. CONCLUSION Meningiomas that progress in grade generally have a mutational profile already detectable in the pre-progressed tumour, suggesting an aggressive phenotype. CNA profiling shows frequent alterations in NF2 mutated tumours compared to non NF2 mutated tumours. The pattern of CNAs may be associated with grade progression in a subset of cases.
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Affiliation(s)
- Sarah A Cain
- Department of Neurosurgery, The Royal Melbourne Hospital, 300 Grattan street, Parkville, VIC, Australia.
| | - Bernard Pope
- Melbourne Bioinformatics, The University of Melbourne, Parkville, Australia.,Department of Surgery (Royal Melbourne Hospital), Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia.,Department of Medicine, Central Clinical School, Faculty of Medicine Nursing and Health Sciences, Monash University, Monash, Australia
| | - Stefano Mangiola
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia
| | - Theo Mantamadiotis
- Department of Microbiology & Immunology, The University of Melbourne, Parkville, Australia.,Department of Surgery (Royal Melbourne Hospital), Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Katharine J Drummond
- Department of Neurosurgery, The Royal Melbourne Hospital, 300 Grattan street, Parkville, VIC, Australia.,Department of Surgery (Royal Melbourne Hospital), Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
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Gilani A, Lee JC, Kleinschmidt-DeMasters BK. Innumerable Meningiomas Arising in a Patient With Tuberous Sclerosis Complex Decades After Radiation Therapy. Pediatr Dev Pathol 2021; 24:471-477. [PMID: 33826429 DOI: 10.1177/10935266211006078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Meningioma is the most common radiation-induced brain neoplasm, usually occurring after a latency of 20 - 35 years, with multiplicity in 10% of cases. Radiation-induced meningiomas (RIMs) have not previously been reported in patients with tuberous sclerosis complex (TSC), unlike their well-known occurrence in other familial tumor predisposition syndrome patients. We report a TSC patient who developed numerous intracranial meningiomas twenty five year after radiation therapy for subependymal giant cell astrocytoma (SEGA). Autopsy examination showed innumerable, coalescent, benign, meningothelial meningiomas, WHO grade 1, ranging in size from 0.2 cm to 3.3 cm. Autopsy also showed small residual SEGA, radiation-induced cerebral vasculopathy, and classic TSC features including several small subependymal nodules ("candle gutterings"), white matter radial heterotopia, facial angiofibromas, dental enamel pitting, one ash leaf spot, and multiple hepatic and renal angiomyolipomas. Next-generation sequencing analysis utilizing a 500+ gene cancer panel demonstrated chromosomal loss involving the majority of chromosome 22, including the NF2 gene locus, as well as a truncating nonsense mutation in TSC1 p. R509*. While TSC patients rarely require radiation therapy, this striking case suggests that patients with TSC should be monitored closely if cranial therapeutic radiation is administered.
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Affiliation(s)
- Ahmed Gilani
- Department of Pathology, University of Colorado Anschutz Medical Campus, Aurora, Colorado.,Department of Pathology, Children's Hospital Colorado, Aurora, Colorado
| | - Julieann C Lee
- Department of Pathology, University of California, San Francisco, California
| | - B K Kleinschmidt-DeMasters
- Department of Pathology, University of Colorado Anschutz Medical Campus, Aurora, Colorado.,Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora, Colorado.,Department of Neurosurgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado
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Abstract
BACKGROUND Tuberous sclerosis complex (TSC) is a neurocutaneous disorder with a wide spectrum of manifestations. Recent consensus recommendations stress the importance of multidisciplinary management of children with TSC. The objective of this study was to examine the manifestations of TSC at a large referral centre to determine the care needs of this population. METHODS A retrospective, systematic chart review was performed of children with TSC managed at British Columbia Children's Hospital. Patients were identified through epilepsy and clinical neurophysiology databases. RESULTS The study population comprised 81 patients, born between 1987 and 2014, who were a median of 10 years (range, 0.2-23.2) at most recent follow-up. Epilepsy occurred in 91% of patients, including 32% with a history of infantile spasms. Nineteen patients underwent epilepsy surgery, nine (47%) of whom were seizure-free at most recent follow-up. Overall, 61% of epilepsy patients had been seizure-free for at least 1 year at the time of last follow-up. Neuropsychiatric disorders were diagnosed in 49% of children, with autism (25%), attention deficit hyperactivity order (19%) and anxiety (16%) being the most common. Cardiac rhabdomyomata occurred in 35% of children and renal angiomyolipomas were seen in 43%. A total of 91% had skin manifestations. CONCLUSION This study outlines the multisystem manifestations of TSC, observed through a large pediatric referral center. Epilepsy and neuropsychiatric disorders are the major source of morbidity in this age group and provide many challenges to the treating clinician. Because a subset of the study population is still quite young, the prevalence of neuropsychiatric disorders is likely underestimated.
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Sahuc P, Joubert C, Nguyen AT, Fouet B, Wybrecht D, Faivre A, Alla P, Dagain A. Glioblastoma Secondary to Meningioma: A Case Report and Literature Review. World Neurosurg 2016; 98:881.e9-881.e13. [PMID: 27867119 DOI: 10.1016/j.wneu.2016.11.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 11/06/2016] [Accepted: 11/07/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND The pathophysiologies underlying meningioma and glioma are distinct. The coexistence of those 2 lesions in the same patient is rare, and at the same location, it is even more exceptional. CASE DESCRIPTION We report a case of a 79-year-old man initially presenting with a meningioma that was treated by complete excision of the lesion. The patient had 2 relapses at the same site, in which glioblastoma was confirmed histopathologically. CONCLUSIONS Glial transformation meningiomas remain a contentious issue, with coincidental occurrence being the most prevalent explanation. Nevertheless, impairment of the same molecular signaling pathways in both tumor types suggests a common origin. Another hypothesis is that perilesional parenchymal damage from radiotherapy or surgery may lead to glial transformation in the tissues surrounding the original meningioma lesion. Further research is needed to determine if the original tumor or surgery has an oncogenic effect on the adjacent tissue.
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Affiliation(s)
- Pauline Sahuc
- Department of Neurology, Sainte-Anne French Military Teaching Hospital, Toulon, France.
| | - Christophe Joubert
- Department of Neurosurgery, Sainte-Anne French Military Teaching Hospital, Toulon, France
| | - Anh-Tuan Nguyen
- Department of Anatomopathology, Sainte-Anne French Military Teaching Hospital, Toulon, France
| | - Bernard Fouet
- Department of Anatomopathology, Sainte-Anne French Military Teaching Hospital, Toulon, France
| | - Delphine Wybrecht
- Department of Neurology, Sainte-Anne French Military Teaching Hospital, Toulon, France
| | - Anthony Faivre
- Department of Neurology, Sainte-Anne French Military Teaching Hospital, Toulon, France
| | - Philippe Alla
- Department of Neurology, Sainte-Anne French Military Teaching Hospital, Toulon, France
| | - Arnaud Dagain
- Department of Neurosurgery, Sainte-Anne French Military Teaching Hospital, Toulon, France
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Lee J, Yu HJ, Lee J, Kim JH, Shin HJ, Suh YL, Lee M. Chordoid meningioma in a pediatric patient with tuberous sclerosis complex. KOREAN JOURNAL OF PATHOLOGY 2014; 48:302-6. [PMID: 25214863 PMCID: PMC4160594 DOI: 10.4132/koreanjpathol.2014.48.4.302] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Revised: 09/11/2013] [Accepted: 09/12/2013] [Indexed: 11/23/2022]
Affiliation(s)
- Jiwon Lee
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hee Joon Yu
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jeehun Lee
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji Hye Kim
- Department of Radiology and Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyung Jin Shin
- Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yeon-Lim Suh
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Munhyang Lee
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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