Glioblastoma Multiforme: A clinico-pathological analysis
Keywords:
Glioblastoma Multiforme, Glioblastoma Multiforme variants
Abstract
Background: Aim of the study was to classify Glioblastoma Multiforme (GBM) and its variants on histology and analyze their clinico-pathological features. Better understanding of the heterogeneous nature of GBM and its variants may provide improved treatment paradigms, prognostic classification and approaches towards molecular targeted treatments.Materials and Methods:40 cases of GBM were analyzed retrospectively and prospectively, covering a period of 8 years (January 2008- July2015). Cases were analyzed on the basis of clinical presentation, histopathological features and radiological reports. Results: Of the 40 cases of GBM, the Conventional GBM, GBM with oligodendroglial component, Giant Cell GBM accounted for 26, 9 and 3 cases respectively. While there was 1 case each of Gliosarcoma and P-NET variants. Conventional GBM most commonly presented with Headache (69.2%) and paresis (57.7%) whereas GBMO patients presented with convulsions. On radiology, the variants of GBM cannot be distinguished as the findings were similar in all of them. Non-palisading necrosis was predominantly present in Conventional GBM (61.5%) and palisading necrosis in GBMO (66.7%).Conclusion:Histopathology remains the main tool for differentiating the variants as radiological differentiation is not possible due to similar appearing features.DOI: 10.21276/APALM.1658References
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2.Dolecek TA, Propp JM, Stroup NE, Kruchko C. CBTRUS statistical report: primary brain and central nervous system tumors diagnosed in the United States in 2005-2009. Neuro Oncol 2012; 14 Suppl 5: v1-49.
3.Stupp R, Mason WP, van den Bent MJ, Weller M, Fisher B, Taphoorn MJ et al.European Organisation for Research and Treatment of Cancer Brain Tumor and Radiotherapy Groups; National Cancer Institute of Canada Clinical Trials Group.N Engl J Med. 2005 Mar 10;352(10):987-96.
4.Iacob G, Dinca EB. Current data and strategy in glioblastoma multiforme. J Med Life. 2009 Oct-Dec;2:386-93.
5.Ghosh A, Sarkar S, Begum Z, Dutta S, Mukherjee J, Bhattacharjee M, Sarkar P, Banerjee C, Mandal M, Mazumdar A, Bhattacharjee MK, Chaudhuri S, Chaudhuri S. The first cross sectional survey on intracranial malignancy in Kolkata, India: reflection of the state of the art in southern West Bengal. Asian Pac J Cancer Prev. 2004 Jul-Sep;5(3):259-67. PubMed PMID: 15373704.
6.Khanna M, Mendiratta P and Roy S: Clinicopathological study of 115 cases of Glioblastoma multiforme with special reference to Gliosarcoma – An original research article. Int J Pharm Sci Res 2013; 4(6); 2384-2392. doi: 10.13040/IJPSR.0975-8232.4(6).2384-92.
7.Rees JH, Smirniotopoulos JG, Jones RV et-al. Glioblastoma multiforme: radiologic-pathologic correlation. Radiographics. 1996;16 (6): 1413-38.
8.Chandrasoma PT, Smith MM, Apuzzo ML. Stereotactic biopsy in the diagnosis of brain masses: comparison of results of biopsy and resected surgical specimen. Neurosurgery. 1989 Feb;24(2):160-5.
9.Miller CR ,Perry A. Glioblastoma. Arch Pathol Lab Med 2007; 131:397-406.
10.Karsy M, Gelbman M, Shah P, Balumbu O, Moy F, Arslan E. Established and emerging variants of glioblastoma multiforme: review of morphological and molecular features. Folia Neuropathol. 2012;50(4):301-21.
11.Kraus JA, Lamszus K, Glesmann N, et al. Molecular genetic alterations in glioblastomas with oligodendroglial component. Acta Neuropathol. 2001;101:311–320.
12.Salvati M, Formichella AI, D’Elia A, et al. Cerebral glioblastoma with oligodendrogliomal component: analysis of 36 cases. J Neurooncol. 2009;94:129–134.
13.Homma T, Fukushima T, Vaccarella S, et al. Correlation among pathology, genotype, and patient outcomes in glioblastoma. J Neuropathol Exp Neurol. 2006;65:846–854.
14.Wang Y, Li S, Chen L, You G, Bao Z, Yan W, Shi Z, Chen Y, Yao K, Zhang W, Kang C, Jiang T. Glioblastoma with an oligodendroglioma component: distinct clinical behavior, genetic alterations, and outcome. Neuro Oncol. 2012 Apr; 14(4):518-25.
15.Salvati M, Formichella AI, D'Elia A, Brogna C, Frati A, Giangaspero F, Delfini R, Santoro A. Cerebral glioblastoma with oligodendrogliomal component: analysis of 36 cases. J Neurooncol 2009;94: 129-134.
16.Valle-Folgueral JM, Mascarenhas L, Costa JA, Vieira F, Soares-Fernandes J, Beleza P,et al. Giant cell glioblastoma: review of the literature and illustrated case. Neurocirugia (Astur ) 2008;19(4):343-9.
17.Kozak KR, Moody JS. Giant cell glioblastoma: a glioblastoma subtype with distinct epidemiology and superior prognosis. Neurooncology 2009; 11: 833-841.
18.Dohrmann GJ, Farwell JR, Flannery JT. Glioblastoma multiforme in children. J Neurosurg 1976; 44 :442-8.
19.Morantz RA, Feigin I, Ransohoff J. Clinical and pathological study of 24 cases of gliosarcoma. J Neurosurg 1976; 45: 398-408.
20.Kumar N, Kumar P, Angurana SL, Khosla D, Mukherjee KK, Aggarwal R, et al. Evaluation of outcome and prognostic factors in patients of glioblastoma multiforme: A single institution experience. J Neurosci Rural Pract 2013, 4(Suppl 1):s46-55.
21.Varlet P, Soni D, Miquel C, Roux FX, Meder JF, Chneiweiss H, Daumas-Duport C. New variants of malignant glioneuronal tumors: a clinicopathological study of 40 cases. Neurosurgery. 2004 Dec;55(6):1377-91: discussion 1391-2. PubMed PMID: 15574220.
22.Perry A, Miller CR, Gujrati M, Scheithauer BW, Zambrano SC, Jost SC, Raghavan R, Qian J, Cochran EJ, Huse JT, Holland EC, Burger PC, Rosenblum MK. Malignant gliomas with primitive neuroectodermal tumor-like components: a clinicopathologic and genetic study of 53 cases. Brain Pathol. 2009;19:81–90.
Published
22-12-2017
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