TY - JOUR
T1 - Combined Diffuse Astrocytoma and Pleomorphic Xanthoastrocytoma Grade III Sharing IDH1 R132H Mutation
AU - Tourne, Morgan
AU - Tauziède-Espariat, Arnault
AU - Dezamis, Edouard
AU - Saffroy, Raphaël
AU - Dhermain, Frédéric
AU - Chrétien, Fabrice
AU - Varlet, Pascale
N1 - Publisher Copyright:
© 2018 Elsevier Inc.
PY - 2018/8/1
Y1 - 2018/8/1
N2 - Background: Collision tumors are often difficult to distinguish from intratumoral heterogeneity in diffuse gliomas. Case Description: We report the case of a 44-year-old woman admitted for intracranial hypertension. Magnetic resonance imaging revealed a right intra-axial frontal mass, composed of a hypervascular nodular portion contrasting with a large nonenhanced infiltrative and muliticystic portion. Histopathologic examination showed the occurrence of two morphologically different gliomas. The largest component corresponded to an anaplastic astrocytoma, IDH1-mutated. The second corresponded to a leptomeningeal nodule, reminiscent of a pleomorphic xanthoastrocytoma. Both tumoral components exhibited anaplastic features, World Health Organization grade III. Immunohistochemical and molecular studies showed that the 2 components were identical, IDH1 R132H mutated but without BRAF V600E mutation. Tumor progression was assessed 2 years after surgery, after radiotherapy and chemotherapy, showing supratentorial leptomeningeal dissemination. Conclusions: Collision tumors and combined neoplasms have been rarely described in the brain and only 4 similar articles report the synchronous occurrence of 2 primary gliomas. A review of the literature is proposed, focusing on criteria that could be used to discriminate them.
AB - Background: Collision tumors are often difficult to distinguish from intratumoral heterogeneity in diffuse gliomas. Case Description: We report the case of a 44-year-old woman admitted for intracranial hypertension. Magnetic resonance imaging revealed a right intra-axial frontal mass, composed of a hypervascular nodular portion contrasting with a large nonenhanced infiltrative and muliticystic portion. Histopathologic examination showed the occurrence of two morphologically different gliomas. The largest component corresponded to an anaplastic astrocytoma, IDH1-mutated. The second corresponded to a leptomeningeal nodule, reminiscent of a pleomorphic xanthoastrocytoma. Both tumoral components exhibited anaplastic features, World Health Organization grade III. Immunohistochemical and molecular studies showed that the 2 components were identical, IDH1 R132H mutated but without BRAF V600E mutation. Tumor progression was assessed 2 years after surgery, after radiotherapy and chemotherapy, showing supratentorial leptomeningeal dissemination. Conclusions: Collision tumors and combined neoplasms have been rarely described in the brain and only 4 similar articles report the synchronous occurrence of 2 primary gliomas. A review of the literature is proposed, focusing on criteria that could be used to discriminate them.
KW - Anaplastic astrocytoma
KW - BRAF V600E
KW - Collision tumour
KW - IDH1 mutation
KW - Pleomorphic xanthoastrocytoma
UR - http://www.scopus.com/inward/record.url?scp=85048773292&partnerID=8YFLogxK
U2 - 10.1016/j.wneu.2018.05.156
DO - 10.1016/j.wneu.2018.05.156
M3 - Article
C2 - 29859360
AN - SCOPUS:85048773292
SN - 1878-8750
VL - 116
SP - 316
EP - 321
JO - World Neurosurgery
JF - World Neurosurgery
ER -