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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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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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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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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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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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Persaud-Sharma D, Burns J, Trangle J, Moulik S. Disparities in Brain Cancer in the United States: A Literature Review of Gliomas. ACTA ACUST UNITED AC 2017; 5:medsci5030016. [PMID: 29099032 PMCID: PMC5635804 DOI: 10.3390/medsci5030016] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Revised: 07/10/2017] [Accepted: 07/10/2017] [Indexed: 11/24/2022]
Abstract
In the human body, the central regulatory system of homeostasis is maintained by the brain. Its complexity is mesmerizing and many of its functions are largely uncharted. Unfortunately, its functionality is often impaired through neoplastic growths, like gliomas, which are devastating to patients and their families. Annually, gliomas are the most common primary brain tumours affecting over 20,000 people in the United States. However, despite their status as the third most common cause of cancer related death for individuals between ages 20 and 39, the aetiology of gliomas remains unknown. This paper aims to review the latest information regarding the 2016 World Health Organization (WHO) 4th edition classifications of gliomas, their malignant effects, and disparities within these classifications, as well as identify areas for further research. These suggestions for future inquiry may contribute to a better understanding of the pathology of these cancers enabling improvement in prevention, screening, and treatment.
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Affiliation(s)
- Dharam Persaud-Sharma
- Florida International University, Herbert Wertheim College of Medicine, Miami, FL 33199, USA.
| | - Joseph Burns
- Florida International University, Herbert Wertheim College of Medicine, Miami, FL 33199, USA.
| | - Jeran Trangle
- Florida International University, Herbert Wertheim College of Medicine, Miami, FL 33199, USA.
| | - Sabyasachi Moulik
- Florida International University, Herbert Wertheim College of Medicine, Department of Cellular Biology and Pharmacology, Miami, FL 33199, USA.
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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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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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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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Wu B, Sha L, Wang Y, Xu W, Yu Y, Feng F, Sun C, Xia L. Diagnostic and prognostic value of a disintegrin and metalloproteinase-17 in patients with gliomas. Oncol Lett 2014; 8:2616-2620. [PMID: 25364437 PMCID: PMC4214486 DOI: 10.3892/ol.2014.2582] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2013] [Accepted: 06/24/2014] [Indexed: 11/08/2022] Open
Abstract
A disintegrin and metalloproteinase-17 (ADAM17) has been shown to regulate numerous proteins involved in the cell cycle, as well as tumor oncogenes. The expression pattern of ADAM17 in glioma patients, however, is unclear. In the present study, the expression pattern and prognostic significance of ADAM17 was investigated in patients with glioma. A total of 60 glioma specimens and eight normal control samples were obtained. Immunohistochemical and western blot analyses were used to examine the expression of ADAM17. In addition, the association of ADAM17 expression with the clinicopathological parameters and the survival rates of the glioma patients was analyzed. The results showed that ADAM17 was upregulated in the high-grade glioma tissues compared with that in the low-grade and normal brain tissues of the glioma patients, and that the level increased with ascending World Health Organization tumor grade (P<0.05). Furthermore, the survival rate of the patients with ADAM17-positive tumors was lower compared with the patients with ADAM17-negative tumors. These results indicated that the overexpression of ADAM17 was correlated with a high tumor grade and a poor prognosis in patients with glioma. ADAM17 may have an important oncogenic function in glioma progression, and is a potential diagnostic and therapeutic target.
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Affiliation(s)
- Bin Wu
- Department of Neurosurgery, Zhejiang Cancer Hospital, Hangzhou, Zhejiang 310022, P.R. China
| | - Longgui Sha
- Department of Neurosurgery, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Pudong, Shanghai 200120, P.R. China
| | - Yong Wang
- Department of Neurosurgery, The Second Affiliated Hospital of Nantong University, Nantong, Jiangsu 226001, P.R. China
| | - Wei Xu
- Department of Neurosurgery, The Second Affiliated Hospital of Nantong University, Nantong, Jiangsu 226001, P.R. China
| | - Yang Yu
- Department of Neurosurgery, Zhejiang Cancer Hospital, Hangzhou, Zhejiang 310022, P.R. China
| | - Fang Feng
- Department of Neurosurgery, Zhejiang Cancer Hospital, Hangzhou, Zhejiang 310022, P.R. China
| | - Caixing Sun
- Department of Neurosurgery, Zhejiang Cancer Hospital, Hangzhou, Zhejiang 310022, P.R. China
| | - Liang Xia
- Department of Neurosurgery, Zhejiang Cancer Hospital, Hangzhou, Zhejiang 310022, P.R. China
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