Malignant transformation of grade II ganglioglioma to glioblastoma: A case report

2012 ◽  
Vol 3 (2) ◽  
Author(s):  
Hrvoje Čupić ◽  
Tomislav Sajko ◽  
Nikolina Sesar ◽  
Mihovil Ivica ◽  
Leo Pažanin
Keyword(s):  
Malignant Transformation ◽  
Ganglion Cells ◽  
Histopathological Examination ◽  
World Health ◽  
Proliferation Index ◽  
Surgical Removal ◽  
Ki 67 ◽  
Grade Ii ◽  
Health Organization ◽  
P53 Immunoreactivity

AbstractGangliogliomas are well differentiated and slowly growing neuroepithelial tumors composed of neoplastic ganglion cells and neoplastic glial cells corresponding mostly to the World Health Organization grade I tumors. However, some of these tumors disclose histologically more malignant glial component and correspond to grade II or grade III tumors. We report a case of left temporal lobe tumor in a 42-year-old woman fulfilling the diagnostic criteria for atypical (grade II) ganglioglioma with high Ki-67 proliferation index and p53 immunoreactive tumor cells. In spite of gross total removal of the tumor, it recurred eight months after surgery. Histopathological examination of the recurrent tumor revealed that it had undergone malignant transformation into a glioblastoma. This case indicates that gangliogliomas with high Ki-67 proliferating index and p53 immunoreactivity should be carefully monitored for recurrence and malignant progression regardless of their morphological grading and seemingly total surgical removal.

scholarly journals Demographics and outcome of histologically confirmed intracranial meningiomas

2019 ◽  
Vol 3 (2) ◽  
pp. 2514183X1989494
Author(s):  
Maria Kamenova ◽  
Raphael Guzman ◽  
Jehuda Soleman
Keyword(s):  
Demographic Data ◽  
Tumor Location ◽  
Morbidity And Mortality ◽  
World Health ◽  
Proliferation Index ◽  
Who Grade ◽  
Primary Tumors ◽  
Radiological Data ◽  
Grade Ii ◽  
Health Organization

Objective: Meningiomas represent the most common intracranial extraaxial neoplasia in adults, accounting for a third of all diagnosed primary tumors of the brain. Despite decades of research, relatively little data on demographics of meningiomas exist. The aim of our study was to undertake an analysis of demographics and outcome of patients who underwent meningioma surgery over an 8-year time period at our institution. Methods: We reviewed 187 consecutive patients with histologically confirmed meningioma. Demographic data, tumor location and side, surgical resection grade, and histopathological and radiological data were collected and assessed for all patients. Furthermore, recurrence, morbidity, and mortality were evaluated. Results: Of the 187 consecutive patients undergoing meningioma resection over a period of 8 years, 131 (70.1%) were women ( p < 0.001). Meningiomas were classified as World Health Organization (WHO) grade I, grade II, and grade III in 66.8%, 31.0%, and 2.1%, of the cases, respectively ( p < 0.001). MIB-1 proliferation index was <1 in 7.5%, 1–5 in 52.9%, 6–10 in 22.4%, >10 in 11.8% of the lesions ( p < 0.001). In 82.4% of the cases, gross total resection was achieved. Recurrence occurred in 23 patients (12.3%), while overall morbidity and mortality rate was 41.2% and 7.7%, respectively. Conclusion: Based on our results, women are more than twice as likely to be affected, and the peak age is between 60 years and 70 years. Recurrence rate in our cohort was relatively low when compared to the data in the literature. The diagnosis of WHO grade II meningiomas, 31% in our cohort, is increasing since the 2007 WHO criteria have been published.

The Ki-67 labeling index as a prognostic factor in Grade II oligoastrocytomas

2005 ◽  
Vol 102 (6) ◽  
pp. 1033-1039 ◽  
Author(s):  
Mark E. Shaffrey ◽  
Elana Farace ◽  
David Schiff ◽  
James M. Larner ◽  
Melike Mut ◽  
...  
Keyword(s):  
Labeling Index ◽  
World Health ◽  
Ki 67 ◽  
Content Type ◽  
Prognostic Utility ◽  
Grade Ii ◽  
Health Organization ◽  
The University ◽  
Grade Iii ◽  
Fine Print

Object. This study was conducted to determine whether proliferative tumor activity, as assessed using the Ki-67 immunohistochemical labeling index (LI), has prognostic utility for patients with Grade II oligoastrocytomas. Methods. The study period spans the years 1988 to 2000. In a retrospective analysis, the authors selected cases with biopsy-proven diagnoses of Grade II oligoastrocytomas on initial presentation. The authors added new patients to this group and followed all patients prospectively at the University of Virginia Neuro-Oncology Center. Twenty-three adult patients were followed for at least 1 year (median 40.3 months). Eleven patients with Grade II tumors and initial Ki-67 LIs less than 10% had a significantly longer median time to tumor progression (TTP, 51.8 months compared with 9.9 months) and a longer median survival (93.1 months compared with 16.1 months) than 12 patients with initial Ki-67 LIs of 10% or greater. Twelve patients with Grade III oligoastrocytomas had a mean TTP that was similar to the TTP of patients with Grade II tumors and high Ki-67 LIs (mean 4 months compared with 9.9 months) and duration of survival (13.3 months compared with 16.1 months). Conclusions. Patients with a Grade II oligoastrocytoma and a Ki-67 LI of 10% or greater have a much shorter TTP and potentially a poorer disease prognosis than expected—more similar to patients with a Grade III oligoastrocytoma. These results indicate that in the future a measure of proliferative activity should be taken into consideration along with the World Health Organization grading criteria for oligoastrocytomas.

An Unusual Intracranial Collision Tumor of Anaplastic Ependymoma and Atypical Meningioma

2019 ◽  
Vol 152 (Supplement_1) ◽  
pp. S53-S53
Author(s):  
Zainab Harb ◽  
Luis Moral
Keyword(s):  
World Health Organization ◽  
Collision Tumor ◽  
Atypical Meningioma ◽  
World Health ◽  
Proliferation Index ◽  
Anaplastic Ependymoma ◽  
Ki 67 ◽  
Collision Tumors ◽  
Microvascular Proliferation ◽  
Health Organization

Abstract The close geographic association of two or more synchronous primary brain tumors is an unusual occurrence. There are around 50 case reports of these intracranial collision tumors, mostly consisting of malignant astrocytoma (mainly glioblastoma) and meningioma. We present a rare intracranial collision tumor consisting of anaplastic ependymoma and atypical meningioma. To our knowledge, this is the first reported case of intracranial collision tumor with this combination. The patient is a 33-year-old gentleman who presented 2 years ago with new-onset intermittent headaches with increasing severity and associated blurry vision and vomiting. On imaging, he was found to have a 4.2 × 4.1 × 4.1-cm cystic-solid and heterogeneously enhancing extra-axial mass lesion in the left frontal lobe, with an enhancing dural tail. Histologic examination of the surgically excised lesion showed two geographically distinct areas of an extra-axial atypical meningioma (World Health Organization grade II) and an intra-axial anaplastic ependymoma (World Health Organization grade III). The anaplastic ependymoma component showed increased cellularity, pseudorosettes, microvascular proliferation, necrosis, and increased mitoses. It was diffusely positive for GFAP and had a Ki-67 proliferation index of 40%. The atypical meningioma showed 5 mitoses per 10 high-power fields. It had a membranous EMA immunoreaction and a Ki-67 proliferation index of approximately 20%. Recently, the patient had a recurrence of the anaplastic ependymoma component only. So far, no clear explanation has been found in the literature to understand the mechanisms leading to collision tumors. Since our patient does not appear to have any syndrome, it may represent a sporadic phenomenon; however, the sharing of a common oncogenic insult or any underlying molecular/genetic mechanism leading to synchronous tumorigenesis remains to be elucidated in this case.

Meningiomas

2017 ◽  
Author(s):  
Rakesih Jalali ◽  
Patrick Y. Wen ◽  
Takamitsu Fujimaki
Keyword(s):  
Cranial Nerves ◽  
Standard Of Care ◽  
World Health ◽  
Surgical Removal ◽  
Primary Brain Tumour ◽  
Particle Irradiation ◽  
Conventional Radiation ◽  
Grade Ii ◽  
Benign Tumours ◽  
Health Organization

Meningiomas are the most common type of primary brain tumour, comprising approximately one-third of all intracranial neoplasms. It is therefore important for all neuro-oncologists to understand the biology and optimal managements of these tumours. The majority of meningiomas are World Health Organization grade I benign tumours, but grade II (atypical) or grade III (anaplastic) tumours are not uncommon. Total surgical removal is the standard of care but may not be feasible if the tumour involves critical structures such as cranial nerves or important blood vessels. Conventional radiation therapy, stereotactic radiosurgery, or particle irradiation is used for residual or recurrent tumours. To date, medical treatments have had a limited role, except for controlling seizures. However, there are ongoing clinical trials with molecularly targeted drugs and immunotherapies based on improved understanding of the molecular pathogenesis of these tumours. In this chapter, the clinical presentation, biology, and therapy for these tumours are discussed.

scholarly journals Is There a Need for New Classifications to Predict Prognosis in Gastroenteropancreatic Neuroendocrine Carcinomas?

2021 ◽  
Author(s):  
Emel Tekin ◽  
Arzu Avcı ◽  
Neşe Ekinci
Keyword(s):  
Survival Rates ◽  
Case Series ◽  
Threshold Value ◽  
World Health ◽  
Proliferation Index ◽  
Neuroendocrine Neoplasms ◽  
Ki 67 ◽  
Significant Difference ◽  
Who 2010 Classification ◽  
Health Organization

Objective: Neuroendocrine neoplasms (NEN) are frequently located in the lung and gastroenteropancreatic (GEP) system organs. Neuroendocrine carcinoma (NEC) constitutes 5% of GEP NENs and has a very high malignancy potential. In this study, it is aimed to determine a new threshold value in addition to the 20% Ki-67 proliferation index that was specified as a threshold value for predicting survival in patients with grade (G) 3 tumors according to World Health Organization (WHO) 2010 classification. Method: Demographic, clinicopathologic features and survival rates of 34 patients diagnosed with GEP NEC between 2008-2015 in İzmir Katip Celebi University Atatürk Training and Research Hospital Medical Pathology Clinic were evaluated retrospectively. Results: Most of the 34 (76.5%) cases were male and the average age was 63.9 years. Median survival rates were 15, and 7 months in patients with Ki-67 indexes of ≤65% and >65%, respectively (p=0.232). Conclusion: Recent studies have shown heterogeneity of high-grade NENs, identified as NEC and foreseen their subdivision into biological subgroups. The researchers suggest that the NECs should be divided into two categories as patients with Ki-67 indexes of 20-55% and >55%. In our study, the most significant difference in survival rates was observed when 65% was selected as threshold value for Ki-67 index which supports the results of other studies in the literature. Since the number of our cases is limited and it is a single-center study, the findings obtained needs to be further investigated in studies with greater number of case series.

Immunoexpression of Ki-67 Labelling Proliferation Index in Phyllodes Tumour of Breast by Polymer-based Detection Method

2019 ◽  
Vol 31 (3) ◽  
pp. 245-250
Keyword(s):  
Detection Method ◽  
World Health ◽  
Proliferation Index ◽  
Ki 67 ◽  
Clear Cut ◽  
Tumour Margin ◽  
Phyllodes Tumour ◽  
Proliferative Markers ◽  
Health Organization

Phylloides tumours (PTs) are rare breast neoplasms with a variable clinical course depending on the tumour category. The classification of PTs proposed by the World Health Organization (WHO) into benign, borderline and malignant is based on a combination of several histologic features, including Stromal cellularity, nuclear atypia, mitotic activity, stromal overgrowth and tumour margin appearance. However, there are no defined criteria or clear cut-offs for individual histologic parameters. Thus, the diagnosis of PTs based on the integration of morphology remains challenging. Along with the grade, additional study of proliferative markers such as Ki-67 are essential to identify those with potential for aggressive behaviour. This study was undertaken to assess the histopathological characters and correlate Ki-67 expression in different subtypes of PTs. In this study, 30 cases of PTs were studied. Regarding histologic features, routine H&E stains were taken into consideration for diagnosis and classification of tumours. Immunostaining for Ki-67 was also performed by polymer-based detection method. Ki-67 labelling index (LI) was categorized as 0-10, 11-30, 31-50, 51 and above depending on the percentage of positive tumor cells and was correlated with histologic grade and clinical features in each case. Twenty cases (66.7%) of benign phyllodes tumour (BPT), 3 cases (10%) of borderline PT, and 7 cases (23.3%) cases of malignant phylloides tumour (MPT) were examined in this study. Among 20 cases of BPT, 3 cases (15%) were recurrent tumours. Average Ki-67 LI in BPT was 5% (range 1-10%) and borderline PT was 17.5% (range 15-20%). MPT exhibited Ki-67 LI range of 15-35% with average LI of 25%. A significant association was seen between expression of Ki-67 in different grades of PT(p=0.01). So, Ki-67 LI should be performed in routine histopathology reporting of phylloides for sub-categorisation of phylloides.

scholarly journals Extracranial metastases in secondary glioblastoma multiforme: a case report

BMC Neurology ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jessica Rossi ◽  
Lucia Giaccherini ◽  
Francesco Cavallieri ◽  
Manuela Napoli ◽  
Claudio Moratti ◽  
...  
Keyword(s):  
Brain Lesion ◽  
Rare Event ◽  
Subsequent Development ◽  
World Health ◽  
Who Grade ◽  
Systemic Involvement ◽  
Grade Ii ◽  
The Stability ◽  
Health Organization ◽  
Extracranial Metastases

Abstract Background Glioblastoma (GBM) is known for its devastating intracranial infiltration and its unfavorable prognosis, while extracranial involvement is a very rare event, more commonly attributed to IDH wild-type (primary) GBM evolution. Case presentation We present a case of a young woman with a World Health Organization (WHO) grade II Astrocytoma evolved to WHO grade IV IDH mutant glioblastoma, with subsequent development of lymphatic and bone metastases, despite the favorable biomolecular pattern and the stability of the primary brain lesion. Conclusions Our case highlights that grade II Astrocytoma may evolve to a GBM and rarely lead to a secondary metastatic diffusion, which can progress quite rapidly; any symptoms referable to a possible systemic involvement should be carefully investigated.

scholarly journals Recent Updates on Neuroendocrine Tumors From the Gastrointestinal and Pancreatobiliary Tracts

2016 ◽  
Vol 140 (5) ◽  
pp. 437-448 ◽  
Author(s):  
Joo Young Kim ◽  
Seung-Mo Hong
Keyword(s):  
World Health Organization ◽  
Neuroendocrine Tumors ◽  
Classification Scheme ◽  
Neuroendocrine Cells ◽  
Labeling Index ◽  
World Health ◽  
World Health Organization Classification ◽  
Clinicopathologic Characteristics ◽  
Ki 67 ◽  
Health Organization

Context.—Gastrointestinal (GI) and pancreatobiliary tracts contain a variety of neuroendocrine cells that constitute a diffuse endocrine system. Neuroendocrine tumors (NETs) from these organs are heterogeneous tumors with diverse clinical behaviors. Recent improvements in the understanding of NETs from the GI and pancreatobiliary tracts have led to more-refined definitions of the clinicopathologic characteristics of these tumors. Under the 2010 World Health Organization classification scheme, NETs are classified as grade (G) 1 NETs, G2 NETs, neuroendocrine carcinomas, and mixed adenoneuroendocrine carcinomas. Histologic grades are dependent on mitotic counts and the Ki-67 labeling index. Several new issues arose after implementation of the 2010 World Health Organization classification scheme, such as issues with well-differentiated NETs with G3 Ki-67 labeling index and the evaluation of mitotic counts and Ki-67 labeling. Hereditary syndromes, including multiple endocrine neoplasia type 1 syndrome, von Hippel-Lindau syndrome, neurofibromatosis 1, and tuberous sclerosis, are related to NETs of the GI and pancreatobiliary tracts. Several prognostic markers of GI and pancreatobiliary tract NETs have been introduced, but many of them require further validation. Objective.—To understand clinicopathologic characteristics of NETs from the GI and pancreatobiliary tracts. Data Sources.—PubMed (US National Library of Medicine) reports were reviewed. Conclusions.—In this review, we briefly summarize recent developments and issues related to NETs of the GI and pancreatobiliary tracts.

scholarly journals Assessing viability of a minimally invasive autopsy technique in ascertaining the probable cause of death in patients who were SARS CoV19 positive at the time of their demise

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Ajay H. Bhandarwar ◽  
Girish D. Bakhshi ◽  
Eham Arora ◽  
Nikhil Dhimole ◽  
Sanjay R. Bijwe ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Cause Of Death ◽  
Histopathological Examination ◽  
Health Hazard ◽  
World Health ◽  
Invasive Technique ◽  
Tissue Samples ◽  
Conventional Autopsy ◽  
Minimally Invasive Autopsy ◽  
Health Organization

Abstract Background SARS CoV-19 was declared as a pandemic by the World Health Organization (WHO), raising up challenges on various levels ranging from therapeutics to diagnostics. The conventional autopsy technique may pose a health hazard to health care workers. A minimally invasive autopsy technique can diminish this hazard. Materials and methods Between August and November 2020, 51 patients who were suffering from Covid-19 at the time of their demise were included. A novel minimally invasive ultrasound-guided technique for procuring tissue samples of major organs was employed which were thereafter subject to histopathological examination. A detailed review of the course in hospital was noted. An analysis was performed to correlate the cause of death ascertained from our minimally invasive technique with the cause of death ascertained clinically. Results There was adequate tissue sampling in 45 cases, where the minimally invasive autopsy technique confirmed the cause of death in all 45 cases (100%) and made it more specific in 5 cases (11.11%). Conclusion Minimally Invasive Autopsy is an easily reproducible technique which has the potential to strengthen the probable the cause of death with reasonable certainty while ensuring safety and ethics.

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