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Mesbahi T, Zaine H, Mahazou Abdou I, Chekrine T, Sahraoui S, Karkouri M, Lakhdar A. Glioblastoma Following Treated Medulloblastoma After 29 Years in the Posterior Fossa: Case Report and Review of Literature. Front Oncol 2022; 12:760011. [PMID: 35494079 PMCID: PMC9043312 DOI: 10.3389/fonc.2022.760011] [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: 08/17/2021] [Accepted: 03/08/2022] [Indexed: 11/13/2022] Open
Abstract
Glioblastoma multiforme (GBM) is a high-grade glioma that may be a rare complication of radiotherapy. We report a case of a patient who was treated for medulloblastoma (MB) of the posterior fossa at the age of 27 years. Twenty-nine years later, at the age of 56 years, he presented with a double-location tumor: supratentorial and in the posterior fossa. Imaging features of the supratentorial location were very suggestive of a meningioma. We operated on the posterior fossa location, which revealed a glioblastoma. Histologically, the tumor cells exhibited characteristics of both GBM and rhabdoid tumor cells. Literature reports of cases of GBM following MB at the same place are very rare, and presenting rhabdoid characteristics is even rarer. This is the first case of MB and GBM at ages 27 and 56 years, respectively. The double-location supratentorial probable meningioma and GBM of the posterior fossa 32 years after MB is the only case reported in the literature. What to do in this case remains a topic of debate, and there are no clear recommendations in the literature.
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Affiliation(s)
- Tarek Mesbahi
- Neurosurgery Department of the IBN ROCHD University Hospital Center, Casablanca, Morocco
| | - Hind Zaine
- Department of Radiotherapy and Oncology of the IBN ROCHD University Hospital Center, Casablanca, Morocco
| | - Ismaël Mahazou Abdou
- Neurosurgery Department of the IBN ROCHD University Hospital Center, Casablanca, Morocco
| | - Tarik Chekrine
- Department of Radiotherapy and Oncology of the IBN ROCHD University Hospital Center, Casablanca, Morocco
| | - Souha Sahraoui
- Department of Radiotherapy and Oncology of the IBN ROCHD University Hospital Center, Casablanca, Morocco
| | - Mehdi Karkouri
- Anatomic Pathology Department of the IBN ROCHD University Hospital Center, Casablanca, Morocco
| | - Abdelhakim Lakhdar
- Neurosurgery Department of the IBN ROCHD University Hospital Center, Casablanca, Morocco
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Wang Y, Song S, Su X, Wu J, Dai Z, Cui D, Reng Y, Fan J, Shen Y, Wu Q, Wang Z. Radiation-induced glioblastoma with rhabdoid characteristics following treatment for medulloblastoma: A case report and review of the literature. Mol Clin Oncol 2018; 9:415-418. [PMID: 30233795 PMCID: PMC6142298 DOI: 10.3892/mco.2018.1703] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 06/11/2018] [Indexed: 11/06/2022] Open
Abstract
Glioblastoma multiforme (GBM) is a high-grade glioma that may develop from several other central nervous system tumors after radiation therapy. We herein report a case of GBM occurring 8 years after radiation therapy for medulloblastoma. The secondary tumor was histologically distinctly different from the primary tumor. Previously reported cases indicate that GBM induced by radiation therapy is associated with a highly aggressive clinical course with a high risk of early recurrence and poor prognosis. In addition, histological examination revealed that the tumor cells exhibited characteristics of both GBM and rhabdoid tumor cells. The diverse pathological characteristics of GBM may reflect the potential effects of radiation therapy on the tumor.
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Affiliation(s)
- Ying Wang
- Department of Radiotherapy, 306th Hospital of PLA, Beijing 100101, P.R. China
| | - Shujun Song
- Center for Special Medicine and Experimental Research, 306th Hospital of PLA, Beijing 100101, P.R. China
| | - Xiaoming Su
- Department of Radiotherapy, 306th Hospital of PLA, Beijing 100101, P.R. China
| | - Jihua Wu
- Department of Pathology, 306th Hospital of PLA, Beijing 100101, P.R. China
| | - Zhuojie Dai
- Department of Radiotherapy, 306th Hospital of PLA, Beijing 100101, P.R. China
| | - Di Cui
- Department of Radiotherapy, 306th Hospital of PLA, Beijing 100101, P.R. China
| | - Ye Reng
- Department of Radiotherapy, 306th Hospital of PLA, Beijing 100101, P.R. China
| | - Jingjing Fan
- Department of Radiotherapy, 306th Hospital of PLA, Beijing 100101, P.R. China
| | - Yulong Shen
- Department of Radiotherapy, 306th Hospital of PLA, Beijing 100101, P.R. China
| | - Qingqin Wu
- Department of Radiotherapy, 306th Hospital of PLA, Beijing 100101, P.R. China
| | - Zongye Wang
- Department of Radiotherapy, 306th Hospital of PLA, Beijing 100101, P.R. China
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Nitta N, Moritani S, Fukami T, Yoshimura Y, Hirai H, Nozaki K. Intraventricular Epithelioid Glioblastoma: A Case Report. World Neurosurg 2018; 112:257-263. [PMID: 29425978 DOI: 10.1016/j.wneu.2018.01.200] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 01/29/2018] [Accepted: 01/30/2018] [Indexed: 11/15/2022]
Abstract
BACKGROUND Epithelioid glioblastoma, a high-grade, diffuse astrocytic tumor variant, comprises closely packed epithelioid cells and rhabdoid cells. This rare tumor usually develops in the cerebral cortex and diencephalon; however, in the case reported here, it was located intraventricularly. CASE DESCRIPTION A 47-year-old woman was referred to our hospital with a right intraventricular mass that had rapidly increased in size. On discovery of the tumor 3 years earlier at the referring hospital, the mass was small, calcified, and attached to the periventricular parenchyma. Over the next 2 years, the mass grew slowly, as observed on periodic magnetic resonance imaging scans. Forty days before the referral, the patient experienced headache and nausea, and marked growth and intratumoral hemorrhage were visible on a computed tomography scan of the head. The tumor was partially removed via a superior parietal lobule corticotomy. Histopathological examination confirmed an isocitrate dehydrogenase-wild-type epithelioid glioblastoma with a BRAF V600E mutation, but the original slow-growing lesion was no longer detected. Consequently, we assume that in this case, a low-grade glioma transformed into an aggressively malignant epithelioid glioblastoma. CONCLUSIONS We present the first case of an intraventricular epithelioid glioblastoma that might have arisen from a low-grade glioma with calcification. We recommend including this tumor variant in the differential diagnosis of lateral ventricle tumors.
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Affiliation(s)
- Naoki Nitta
- Department of Neurosurgery, Shiga University of Medical Science, Otsu, Japan; National Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka, Japan.
| | - Suzuko Moritani
- Division of Diagnostic Pathology, Department of Clinical Laboratory Medicine, Shiga University of Medical Science, Otsu, Japan
| | - Tadateru Fukami
- Department of Neurosurgery, Shiga University of Medical Science, Otsu, Japan
| | - Yayoi Yoshimura
- Department of Neurosurgery, Shiga University of Medical Science, Otsu, Japan
| | - Hisao Hirai
- Department of Neurosurgery, Koto Memorial Hospital, Higashiomi, Japan
| | - Kazuhiko Nozaki
- Department of Neurosurgery, Shiga University of Medical Science, Otsu, Japan
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Nakajima N, Nobusawa S, Nakata S, Nakada M, Yamazaki T, Matsumura N, Harada K, Matsuda H, Funata N, Nagai S, Nakamura H, Sasaki A, Akimoto J, Hirato J, Yokoo H. BRAF V600E, TERT promoter mutations and CDKN2A/B homozygous deletions are frequent in epithelioid glioblastomas: a histological and molecular analysis focusing on intratumoral heterogeneity. Brain Pathol 2017; 28:663-673. [PMID: 29105198 DOI: 10.1111/bpa.12572] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 10/25/2017] [Accepted: 10/28/2017] [Indexed: 12/28/2022] Open
Abstract
Epithelioid glioblastoma (E-GBM) is a rare aggressive variant of IDH-wildtype glioblastoma newly recognized in the 2016 World Health Organization classification, composed predominantly of monotonous, patternless sheets of round cells with laterally positioned nuclei and plump eosinophilic cytoplasm. Approximately 50% of E-GBM harbor BRAF V600E, which is much less frequently found in other types of glioblastomas. Most E-GBM are recognized as primary/de novo lesions; however, several E-GBM with co- or pre-existing lower-grade lesions have been reported. To better understand associations between E-GBM and the lower-grade lesions, we undertook a histological and molecular analysis of 14 E-GBM, 10 of which exhibited lower-grade glioma-like components (8 E-GBM with co-existing diffuse glioma-like components, 1 E-GBM with a co-existing PXA-like component and 1 E-GBM with a pre-existing PXA). Molecular results demonstrated that the prevalence of BRAF V600E, TERT promoter mutations and CDKN2A/B homozygous deletions in E-GBM were 13/14 (93%), 10/14 (71%) and 11/14 (79%), respectively, and concurrent BRAF V600E, TERT promoter mutations and CDKN2A/B homozygous deletions were observed in 7/14 (50%) of E-GBM. These alterations were also frequently seen in the lower-grade lesions irrespective of the histology. Genetic analysis including array comparative genomic hybridization performed for 5 E-GBM with co- and pre-existing lower-grade components revealed that all molecular changes found in the lower-grade components were also observed in the E-GBM components, and additional changes were detected in the E-GBM components. In conclusion, E-GBM frequently exhibit BRAF V600E, TERT promoter mutations and CDKN2A/B homozygous deletions and these alterations tend to coexist in E-GBM. Taken together with the facts that only one PXA preceded E-GBM among these lower-grade lesions, and that co-occurrence of BRAF V600E, TERT promoter mutations and CDKN2A/B homozygous deletions have been reported to be rare in conventional lower-grade diffuse gliomas, the diffuse glioma-like components may be distinct infiltrative components of E-GBM, reflecting intratumoral heterogeneity.
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Affiliation(s)
- Nozomi Nakajima
- Department of Human Pathology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Sumihito Nobusawa
- Department of Human Pathology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Satoshi Nakata
- Department of Human Pathology, Gunma University Graduate School of Medicine, Maebashi, Japan.,Department of Neurosurgery, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Mitsutoshi Nakada
- Department of Neurosurgery, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Tatsuya Yamazaki
- Department of Human Pathology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Nozomi Matsumura
- Department of Human Pathology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Kenichi Harada
- Department of Human Pathology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Hadzki Matsuda
- Department of Neurosurgery, Dokkyo Medical University, Mibu, Japan
| | - Nobuaki Funata
- Department of Pathology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Shoichi Nagai
- Department of Neurosurgery Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Hideo Nakamura
- Department of Neurosurgery, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
| | - Atsushi Sasaki
- Department of Pathology, Saitama Medical University, Moroyama, Japan
| | - Jiro Akimoto
- Department of Neurosurgery, Tokyo Medical University, Tokyo, Japan
| | - Junko Hirato
- Department of Pathology, Gunma University Hospital, Maebashi, Japan
| | - Hideaki Yokoo
- Department of Human Pathology, Gunma University Graduate School of Medicine, Maebashi, Japan
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Yamamoto Y, Yamazaki K, Yamada M, Ishida Y, Iwakami T, Miyamoto S, Hoya K. Rhabdoid Glioblastoma: Touch Imprint Cytology Clearly Demonstrates Globular Cytoplasmic Inclusions. Diagn Cytopathol 2016; 44:556-8. [PMID: 26997571 DOI: 10.1002/dc.23474] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 02/26/2016] [Accepted: 03/01/2016] [Indexed: 11/06/2022]
Affiliation(s)
- Yoshinari Yamamoto
- Department of Pathology, Teikyo University, Chiba Medical Center, Ichihara, Japan
| | - Kazuto Yamazaki
- Department of Pathology, Teikyo University, Chiba Medical Center, Ichihara, Japan
| | - Masatoshi Yamada
- Department of Pathology, Teikyo University, Chiba Medical Center, Ichihara, Japan
| | - Yasuo Ishida
- Department of Pathology, Teikyo University, Chiba Medical Center, Ichihara, Japan
| | - Takayuki Iwakami
- Department of Neurosurgery, Teikyo University, Chiba Medical Center, Ichihara, Japan
| | - Shinya Miyamoto
- Department of Neurosurgery, Teikyo University, Chiba Medical Center, Ichihara, Japan
| | - Katsumi Hoya
- Department of Neurosurgery, Teikyo University, Chiba Medical Center, Ichihara, Japan
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6
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Miyahara M, Nobusawa S, Inoue M, Okamoto K, Mochizuki M, Hara T. Glioblastoma with Rhabdoid Features: Report of Two Young Adult Cases and Review of the Literature. World Neurosurg 2016; 86:515.e1-9. [DOI: 10.1016/j.wneu.2015.10.065] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Revised: 10/12/2015] [Accepted: 10/13/2015] [Indexed: 11/26/2022]
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Murnyák B, Szepesi R, Hortobágyi T. [Molecular genetics of familial tumour syndromes of the central nervous system]. Orv Hetil 2015; 156:171-7. [PMID: 25618858 DOI: 10.1556/oh.2015.30092] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Although most of the central nervous system tumours are sporadic, rarely they are associated with familial tumour syndromes. These disorders usually present with an autosomal dominant inheritance and neoplasia develops at younger age than in sporadic cases. Most of these tumours are bilateral, multiplex or multifocal. The causative mutations occur in genes involved in cell cycle regulation, cell growth, differentiation and DNA repair. Studying these hereditary cancer predisposition syndromes associated with nervous system tumours can facilitate the deeper understanding of the molecular background of sporadic tumours and the development of novel therapeutic agents. This review is an update on hereditary tumour syndromes with nervous system involvement with emphasis on molecular genetic characteristics and their clinical implications.
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Affiliation(s)
- Balázs Murnyák
- Debreceni Egyetem, Általános Orvostudományi Kar Patológiai Intézet, Neuropatológiai Tanszék Debrecen Nagyerdei krt. 98. 4032
| | - Rita Szepesi
- Debreceni Egyetem, Általános Orvostudományi Kar Orvosi Rehabilitáció és Fizikális Medicina Tanszék Debrecen Debreceni Egyetem, Általános Orvostudományi Kar Neurológiai Tanszék Debrecen
| | - Tibor Hortobágyi
- Debreceni Egyetem, Általános Orvostudományi Kar Patológiai Intézet, Neuropatológiai Tanszék Debrecen Nagyerdei krt. 98. 4032
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8
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Gelal MF, Rezanko TA, Sarp AF, Dirilenoğlu F, Güvenç G, Ölmezoğlu A. Magnetic Resonance Imaging Features of Rhabdoid Glioblastomas. Clin Neuroradiol 2014; 26:329-40. [PMID: 25516148 DOI: 10.1007/s00062-014-0366-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2014] [Accepted: 11/21/2014] [Indexed: 11/30/2022]
Abstract
PURPOSE Rhabdoid glioblastoma (rGB) is a recently described, highly aggressive brain tumor, in which glioblastoma (GB) is associated with a rhabdoid component. So far only 21 cases have been reported and its imaging findings have not been studied in detail. In this paper, we present 11 additional cases and aim to depict detailed magnetic resonance imaging (MRI) features of this tumor in comparison with the previous cases of rGBs and our cohort of typical GBs. METHODS Retrospective evaluation of the glass slides of 249 GB patients disclosed 14 cases with rhabdoid morphology. Eleven of these cases with available MRI were included in the study. Immunohistochemistry was also performed. MRI and clinicopathologic findings were compared with those of previous rGBs and typical GBs. RESULTS (1) rGB is usually a large, well-delineated solid tumor with extensive necrosis, heterogeneous contrast enhancement, occasional hemorrhage, and cysts, (2) rGB may present at an older age than previously reported, but still in younger individuals compared with typical GB patients, (3) tumor dissemination in the form of leptomeningeal seeding and more rarely extracranial metastases is a feature of rGBs, although leptomeningeal seeding may not be as high as previously reported, (4) prognosis is poor in rGBs. CONCLUSIONS rGB is a new entity which has not yet appeared in the WHO classification of central nervous system (CNS) tumors. Understanding its clinical and imaging features may help to distinguish it from other tumors of CNS.
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Affiliation(s)
- M F Gelal
- Department of Radiology, İzmir Katip Celebi University Atatürk Training and Research Hospital, İzmir, Turkey.
| | - T A Rezanko
- Department of Pathology, İzmir Katip Celebi University Atatürk Training and Research Hospital, İzmir, Turkey
| | - A F Sarp
- Department of Radiology, İzmir Katip Celebi University Atatürk Training and Research Hospital, İzmir, Turkey
| | - F Dirilenoğlu
- Department of Pathology, İzmir Katip Celebi University Atatürk Training and Research Hospital, İzmir, Turkey
| | - G Güvenç
- Department of Neurosurgery, İzmir Katip Celebi University Atatürk Training and Research Hospital, İzmir, Turkey
| | - A Ölmezoğlu
- Department of Radiation Oncology, İzmir Katip Celebi University Atatürk Training and Research Hospital, İzmir, Turkey
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A case of cerebellar hemangioblastoma with rhabdoid features. Brain Tumor Pathol 2014; 32:145-50. [PMID: 24880233 DOI: 10.1007/s10014-014-0193-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Accepted: 05/18/2014] [Indexed: 10/25/2022]
Abstract
We present an unusual case of cerebellar hemangioblastoma characterized by rhabdoid features. The patient was a 35-year-old Japanese man with occipital neuralgia and exacerbating blurred vision. Magnetic resonance imaging revealed a left posterior cranial fossa tumor, which was isointense on T1-weighted images and hyperintense on T2-weighted images with marked homogeneous enhancement. Histology of the surgically resected tumor showed cellular-type hemangioblastoma with extensive proliferation of rhabdoid cells Immunohistochemistry analysis showed tumor cells positive for inhibin A, CD56, vimentin, INI-1, and vascular endothelial growth factor; negative for PAX8, CD10, epithelial membrane antigen, cytokeratin, (AE1/3), alpha-smooth muscle actin and D2-40; and had focal positivity for glial fibrillary acidic protein and S100. The Ki-67 labeling index was <1 %. Ultrastructural analysis revealed large lipid droplets and abundant intracellular accumulation of intermediate filaments. Based on these findings, the diagnosis was hemangioblastoma with focal rhabdoid features. After a 14-month follow-up, there was no evidence of recurrence. This is the first report of hemangioblastoma with rhabdoid features in the central nervous system. In addition, we discuss the possible pathogenesis.
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Byeon SJ, Cho HJ, Baek HW, Park CK, Choi SH, Kim SH, Kim HK, Park SH. Rhabdoid glioblastoma is distinguishable from classical glioblastoma by cytogenetics and molecular genetics. Hum Pathol 2014; 45:611-20. [DOI: 10.1016/j.humpath.2013.08.024] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Revised: 07/31/2013] [Accepted: 08/02/2013] [Indexed: 02/09/2023]
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Rhabdoid glioblastoma: a recently recognized subtype of glioblastoma. Acta Neurochir (Wien) 2013; 155:1443-8; discussion 1448. [PMID: 23812963 DOI: 10.1007/s00701-013-1793-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2013] [Accepted: 06/04/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Rhabdoid glioblastoma is a rare type of recently described malignant brain tumor. It is characterized by a glioblastoma associated with rhabdoid components. METHODS Here we report two cases of rhabdoid glioblastoma and a brief literature review. The first patient was a 19-year-old boy who initially presented with a foul-smelling odor and progressive right-side weakness. The second case was a 29-year-old male patient who presented only with a severe headache. RESULTS Both of these patients were young, and the disease progression was quick despite optimal treatment. CONCLUSION The diagnosis of rhabdoid glioblastoma was confirmed after microscopic and immunohistochemical findings.
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Babu R, Hatef J, McLendon RE, Cummings TJ, Sampson JH, Friedman AH, Adamson C. Clinicopathological characteristics and treatment of rhabdoid glioblastoma. J Neurosurg 2013; 119:412-9. [DOI: 10.3171/2013.3.jns121773] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Object
Rhabdoid glioblastoma (GB) is an exceedingly rare tumor in which some of the tumor cells possess rhabdoid features such as eccentric nuclei, abundant eosinophilic cytoplasm, and pseudopapillary formations. These tumors are exceptionally aggressive, and leptomeningeal dissemination is common. In the 9 previously reported cases, the longest survival was only 9 months, with a median survival of 17.8 weeks. The authors report the clinicopathological characteristics of 4 cases of rhabdoid GB and demonstrate the utility of intensive temozolomide and adjuvant therapy in these tumors. The authors also review the literature to provide the most comprehensive understanding of these rare tumors to date.
Methods
A retrospective review was performed of patients treated for GB at the Duke University Medical Center between 2004 and 2012. One of two experienced neuropathologists identified 4 cases as being rhabdoid GBs. Immunohistochemistry and fluorescence in situ hybridization analyses were performed in all cases. Kaplan-Meier analysis was used to assess overall survival, with the log-rank test being used to evaluate differences between survival curves. An extensive review of the literature was also performed.
Results
The median age of patients with rhabdoid GB was 30 years. Clinical presentation varied with location, with headache being a presenting symptom in 90% of patients. All lesions were supratentorial, and 45.5% of the cases involved the temporal lobe. Leptomeningeal dissemination occurred in 63.6% of patients, with 1 patient having extracranial metastasis to the scalp and lungs. Fluorescence in situ hybridization revealed epidermal growth factor receptor gain or amplification in all study cases. The median survival in the authors' cohort was significantly higher than that of all previously reported cases (27.5 vs 4.5 months, p = 0.003). Postoperative treatment in the authors' cohort included radiotherapy with concurrent temozolomide, bevacizumab, interleukin 13, CCNU, and/or etoposide.
Conclusions
Enhanced survival in the authors' 4 patients suggests that the current standard of care for the treatment of GB may be beneficial in rhabdoid GB cases, with postoperative radiotherapy and concomitant temozolomide treatment followed by adjuvant therapy. Due to the rapid tumor dissemination associated with these lesions, aggressive and timely therapy is warranted, with frequent surveillance and/or continued therapy despite stable disease. Additionally, patients should undergo full craniospinal imaging to monitor the development of distant metastatic disease.
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Affiliation(s)
- Ranjith Babu
- 1Departments of Surgery (Division of Neurosurgery),
| | | | | | | | | | | | - Cory Adamson
- 1Departments of Surgery (Division of Neurosurgery),
- 3Neurobiology, Duke University Medical Center; and
- 4Neurosurgery Section, Durham VA Medical Center, Durham, North Carolina
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Endo S, Terasaka S, Yamaguchi S, Ikeda H, Kato T, Kobayashi H, Tanaka S, Houkin K. Primary rhabdoid tumor with low grade glioma component of the central nervous system in a young adult. Neuropathology 2012; 33:185-91. [PMID: 22765644 DOI: 10.1111/j.1440-1789.2012.01336.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
In the CNS, primary tumors with rhabdoid components are classified as atypical teratoid/rhabdoid tumor, rhabdoid meningioma or rhabdoid glioblastoma. The authors present a young adult patient with supratentorial rhabdoid tumor incidentally found after head trauma as a small pre-existing lesion in the parahippocampal gyrus. MRI demonstrated an area of hypointensity on T1-weighted images and hyperintensity on T2-weighted and fluid attenuated inversion recovery images. A serial MR scan revealed no change 3 months after the initial examination but drastic changes at 6 months. As the tumor and accompanying intratumoral hemorrhage enlarged rapidly, resection of the tumor was performed. Histopathology revealed that the main component of the tumor was typical rhabdoid cells with some necrotic areas. There were also pathological features consistent with oligoastrocytoma. The specimen had neither vascular proliferation usually seen in high-grade glioma nor the meningothelial pattern that suggests meningioma. Immunohistochemical findings revealed that cells were strongly positive for vimentin, epithelial membrane antigen and INI-1 antibody throughout the specimen. Further, monosomy 22 was detected by fluorescence in situ hybridization. The tumor was finally thought to be an unclassifiable primitive rhabdoid tumor with oligoastrocytoma that arose in the CNS. The patient died within 5 months of detection of the tumor, regardless of surgical resection, radiotherapy and chemotherapy.
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Affiliation(s)
- Shogo Endo
- Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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