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A glioblastoma arising from the attached region where a meningioma had been totally removed
Author(s) -
Ohba Shigeo,
Shimizu Kazuhiko,
Shibao Syunsuke,
Miwa Tomoru,
Nakagawa Toru,
Sasaki Hikaru,
Murakami Hideki
Publication year - 2011
Publication title -
neuropathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.701
H-Index - 61
eISSN - 1440-1789
pISSN - 0919-6544
DOI - 10.1111/j.1440-1789.2011.01198.x
Subject(s) - meningioma , glioma , pathology , astrocytoma , lesion , medicine , glioblastoma , isocitrate dehydrogenase , radiation therapy , biology , cancer research , radiology , biochemistry , enzyme
The co‐occurrence of different histological tumors in the nervous system is rare and is mainly associated with phakomatoses or radiation exposure. A 72‐year‐old man underwent surgery for a frontal convexity meningioma. Four years after the surgery, a new lesion was detected in the attached region where the meningioma had been removed. The second tumor exhibited a high degree of cellularity, atypical mitosis, pseudo‐palisading and microvascular proliferation, and was immunohistologically positive for GFAP and was diagnosed as a glioblastoma. Wild‐type isocitrate dehydrogenase 1 was found in the second specimen. A genetic analysis using comparative genomic hybridization showed a DNA copy number loss on 1p35, 9pter‐21, 10, 11q23, 13q, 14q, 20q, 22q and a gain on 7 in the second specimen. Although the mechanism responsible for the consecutive occurrence of meningioma and glioblastoma has not been elucidated, five hypotheses are feasible: (i) the lesions occurred incidentally; (ii) a low‐grade astrocytoma present at the time of the first operation transformed into a high‐grade glioma during the next 4 years; (iii) radiation received during the endovascular treatment induced glioblastoma; (iv) a brain scar created at the time of the first operation for meningioma led to the occurrence of a glioblastoma; and (v) the previous meningioma affected the surrounding glial cells, causing neoplastic transformation.