A glioma with an arteriovenous malformation: an association or a different entity?

Abstract

A 58-year-old male was admitted with headache to our neurosurgery clinic. His neurological examination revealed slight left hemiparesis. The radiological evaluation with contrast administred magnetic resonance imaging (MRI) scan demonstrated a right temporo-parietal ring enhancing mass lesion surrounded by edema which was resembling a typical glioma (Fig. 1). The patient was operated on via a temporo-parietal craniotomy and an arteriovenous malformation surrounded by abnormal glial tissue was observed during the exposure. A nidus supplied by several branches arising from the middle cerebral artery (MCA) was obvious. The venous drainage of the malformation was to the superficial venous system. The observed arterial feeders and the draining vein were coagulated and the nidus was macroscopically totally excised. The frozen examination from surrounding glial tissue revealed a high grade glioma. The tumor was also macroscopically totally excised. Postoperatively, the cerebral angiogram demonstrated a right temporal arteriovenous malformation with a centrally excised nidus. The remaining major feeders involved the angular gyrus and the posterior temporal arteries. The venous drainage was to the straight and sigmoid sinuses (Fig. 2). The final histopathological examination of the specimen revealed an arteriovenous malformation surrounded by a high grade glioma (Fig. 3). The patient refused a second operation for total removal of the AVM. Postoperatively, he is doing well with improvement of his left hemiparesis.

De novo formation of large arteriovenous shunting and a vascular nidus mimicking an arteriovenous malformation within an anaplastic oligodendroglioma: treatment with embolization and resection

“…9 Only 2 oth er cases have been reported since the advent of MR imaging. 7,22 In none of the others was there documentation of de novo formation of simultaneous glioma and large arteriovenous shunting and nidus mimicking an AVM. Arteriovenous shunting was documented by cerebral angiography in 12 of 14 cases.…”

“…Despite the skepticism, there are reported cases that have documented angiographically confirmed arteriovenous shunts associated with pathologically confirmed neoplasms. [5][6][7][8]10,11,13,14,[21][22][23] A literature review revealed 13 earlier cases of arteriovenous shunts associated with tumors of glial origin, including 3 oligodendrogliomas, 4,5,14 7 astrocytomas, 6-9,13,21,23 1 "high-grade" glioma, 22 1 glioblastoma multiforme, 11 and 1 pleomorphic xanthoastrocytoma (Table 1). 10 Nine of the cases were anatomically indistinct lesions, 4,6-8,10,13,21-23 3 were noncontiguous but involved the same hemisphere, 5,11,14 and 1 occurred in the contralateral hemisphere.…”

“…Their association with brain neoplasms is extremely rare, and data are limited to case reports. [4][5][6][7][8][9][10][11]13,14,[21][22][23] It has been postulated that the hyperangiogenic environment of high-grade tumors induces abnormal arteriovenous connections. 7 It is not known why only a very few brain neoplasms develop large arteriovenous shunts with vascular niduses mimicking true AVMs.…”

Molecular complexity of primary open angle glaucoma: current concepts

“…Immune system plays a beneficial role in the body by removing the extraneous challenges like bacteria and viruses. But aberrant stress induced immune response is harmful to the body (Young and Elliott 1989;van Noort 1996;Ziyal et al 2004). Oxidative stress caused by the reperfusion injuries give rise to various proteins that are damaged by ROS.…”

Surgical strategy in case with co-existence of malignant oligodendroglioma and arteriovenous malformation: A case report

“…Other tumors found in association with AVM include hemangioblastoma [5], hemangiopericytoma [22], ganglioneuroma, [23] subependymal giant astrocytomas [29], and craniopharyngioma [14]. In the remaining 2 cases, histology was simply described as glioma [27,37]. In the present case, the histology was that of an anaplastic oligodendroglioma, which is the type of tumor most frequently associated with AVM.…”