Combined Diffuse Astrocytoma and Pleomorphic Xanthoastrocytoma Grade III Sharing IDH1 R132H Mutation.

Abstract:

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.

journal_name

World Neurosurg

journal_title

World neurosurgery

authors

Tourne M,Tauziède-Espariat A,Dezamis E,Saffroy R,Dhermain F,Chrétien F,Varlet P

doi

10.1016/j.wneu.2018.05.156

subject

Has Abstract

pub_date

2018-08-01 00:00:00

pages

316-321

eissn

1878-8750

issn

1878-8769

pii

S1878-8750(18)31110-0

journal_volume

116

pub_type

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