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Updated: Aug 23, 2026
Primary Orthotopic Glioma Xenografts Recapitulate Infiltrative Growth and Isocitrate Dehydrogenase I Mutation
Published on: January 14, 2014
[A multicentric glioma presenting different pathological appearances: a case report]
Shougo Kaku1, Tohru Terao, Keisuke Taya
1Department of Neurosurgery, Jikei University School of Medicine, Kashiwa Hospital, Chiba, Japan. shougo@jikei.ac.jp
Abstract:
We report a multicentric glioma case which revealed different pathological appearances. A 45-year-old male had been admitted to our hospital complaining of an attack of transient sudden aphasia. On magnetic resonance imaging (MRI), T1-weighted images revealed a low intensity and T2-weighted images demonstrated a homogeneous high intensity abnormal mass in the frontal lobe, which was not enhanced with gadolinium. Removal of the tumor was performed through a right frontal transcortical approach in March, 2002. Histological diagnosis was gemistocytic astrocytoma. The patient's condition was uneventful and postoperative MRI revealed a marked decrease in the volume of the tumor. A total of 54 Gy radiation to the brain in the locality was performed. Four months after the initial surgery, the patient suffered from incomplete right hemiparesis. MRI showed a left parietal abnormal mass which had a ring formation enhancement after gadolinium administration. This Neuro-radiological examination demonstrated complete independence from the initial right frontal tumor. A second surgery which was concerned with cyst aspiration was carried out on August 10, 2002. During the next month, a third operation for partial removal of a left parietal abnormal mass was performed. Histological diagnosis was anaplastic astrocytoma. The right frontal and left parietal tumors revealed neither continuous relation suggesting intracerebral invasion, nor dissemination through the subarachnoid space nor intracerebral metastasis. Our case was diagnosed as multicentric glioma with different pathological appearances, of which only 9 cases have been reported previously.
Insights
This multicentric glioma case presented distinct pathological features in two separate brain locations. The rare condition highlights the varied presentations of glioma, emphasizing the need for thorough investigation.
Area of Science:
- Neuro-oncology
- Neurosurgery
- Neuropathology
Background:
- Multicentric glioma is a rare brain tumor characterized by multiple primary lesions.
- Understanding its varied pathological appearances is crucial for diagnosis and treatment planning.
Observation:
- A 45-year-old male presented with transient aphasia and was diagnosed with a frontal lobe glioma (gemistocytic astrocytoma).
- Four months later, a separate, independent left parietal lobe tumor (anaplastic astrocytoma) developed, presenting with ring enhancement.
Findings:
- The patient underwent multiple surgical interventions and radiation therapy for both lesions.
- Histopathological examination confirmed distinct diagnoses for each tumor, with no apparent connection between them.
- This case represents one of the few reported instances of multicentric glioma with differing pathological characteristics.
Implications:
- This case underscores the importance of considering multicentric glioma in patients with multiple, distinct brain lesions.
- The differing pathological findings emphasize the complex nature of glioma and the need for individualized treatment strategies.
- Further research into the pathogenesis and management of multicentric glioma is warranted.
