Contribution to the problem of giant cell astrocytomas

Müller, Wilhelm; Slowik, F.; Firsching, Raimund; Afra, D; Sanker, P.

doi:10.1007/bf01782050

Cited by 14 publications

(12 citation statements)

References 35 publications

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“…Giant cell glioblastoma shares with secondary "common" glioblastoma p53 mutations in more than 70% of the cases and younger patient age at presentation; features shared with primary "common" glioblastoma are 30% frequency of PTEN mutations, short clinical history and absence of less malignant precursor lesion 40 . Overall, analyses of survival in large series seem to agree that the prognosis is somewhat better than that of "common" glioblastoma, e.g., 38 cases -27.4 months average postoperative survival 35 24 cases -57 weeks mean survival time 37 .…”

Section: Review Of the Literaturementioning

confidence: 89%

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Giant cell glioblastoma: review of the literature and illustrated case

et al. 2008

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SummaryGiant cell glioblastoma is an infrequent variety of glioblastoma (5% of the cases). It has deserved a separate category in the World Health Organization classification of grade IV tumors. The clinical, imaging, histological and immunohistochemical characteristics, and the genetic alterations are reviewed. Treatment and prognosis are discussed and updated. The case of a patient that survived 19 months and died of spinal leptomeningeal metastases is illustrated.KEYWORDS: Giant cell glioblastoma. Leptomeningeal metastases. Surgery. Temozolomide. Radiotherapy.Glioblastoma de células gigantes: revisión de la literatura e ilustración de un caso Resumen El glioblastoma de células gigantes es una variante rara dentro de los glioblastomas (5% de los casos). En la clasificación de la Organización Mundial de la Salud esta entidad ha merecido una categoría aparte en los tumores de grado IV. Se revisan las características clínicas, radiológicas, histológicas, inmunohistoquímicas y las alteraciones genéticas que caracterizan este tumor. El tratamiento y el pronóstico son discutidos aportando información actualizada. Finalmente se presenta un caso clínico ilustrado, en el cual el paciente sobrevivió durante 19 meses, falleciendo como consecuencia de una diseminación espinal leptomeníngea.PALABRAS CLAVE: Glioblastoma de células gigantes. Metástasis leptomeníngeas. Cirugía. Temozolomida. Radioterapia IntroductionUnlike the "common" glioblastoma, giant cell glioblastoma is not encountered in everyday practice and it probably comes as an unexpected diagnosis most of the times. Despite certain similarities between the two disease processes, there are differences that may be of relevance for the management of the occasional patient harboring this lesion. A case of giant cell glioblastoma managed at the authors' institution is reported and the key features of giant cell glioblastoma are reviewed. Clinical caseA 54 year-old man presented with headache and motor dysphasia of short duration. MR disclosed a voluminous mass in the left temporal lobe (figure 1-A&B). The patient was operated. A frontotemporal approach was employed. The lesion had a good cleavage plane, was moderately hemorrhagic and was totally resected in a piece meal fashion. The postoperative course was uneventful. Histological examination disclosed a highly cellular neoplasm with marked pleomorphism. Prominent giant cells and numerous atypical mitotic figures were found (figure 1-C). Reticulin was abundant in the stroma. Immunohistochemistry showed positivity for GFAP, S100 protein and p53. The picture was consistent with giant cell glioblastoma. Adjuvant radiotherapy (60Gy) and chemotherapy (temozolomide) were given. There was no evidence of relapse at the 14 month follow up MR ( figure 1-D). The patient was symptom free and had no neurological deficits at that time. Three months after, the patient complained of backache, lower limb weakness and deteriorating general condition. MR disclosed spinal leptomeningeal metastases (figure 1-E). Curiously there was no ev...

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Section: Review Of the Literaturementioning

confidence: 89%

“…Giant tumor cells may show lipid accumulation 27,41 , and abundant microcalcifications may be present as well 27 . Infiltration of the tumor by cells pertaining to the immune system can be prominent, namely mononuclear leukocytes 44 and eosinophilic granulocytes 35 . Cellular whorls can also be a feature of the tumor 23 .…”

Section: Review Of the Literaturementioning

confidence: 99%

Giant cell glioblastoma: review of the literature and illustrated case

et al. 2008

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“…Only two types of malignant cerebral tumors containing giant cells have been classified by WHO, and one of them is the giant-cell glioblastoma multiform (Muller et al, 1987). Probably the presence of NFs, together with GFAP, define the pluripotential character of these giant cells.…”

Section: Discussionmentioning

confidence: 99%

Immunophenotyping of childhood astrocytomas with a library of monoclonal antibodies

Bodey

Zeltzer

Saldivar

et al. 1990

Intl Journal of Cancer

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Immunophenotype (IP) analysis of 14 childhood glial tumors was performed with a library of 16 monoclonal antibodies (MAbs) using biotin-streptavidin-alkaline phosphatase immunohistochemical detection technique. Presence of glial or neuronal differentiated cells within the tumors was evaluated with MAbs against cell-lineage-specific markers: high-, medium- and low-molecular-weight neurofilament protein (NFP) and glial fibrillary acidic protein (GFAP). Intense expression of GFAP was demonstrated in 14/14 astrocytomas. The three NFs were detected in 10-50% of the cells in 6/14 cases. The pan-neuro-ectodermal antigen defined by MAb UJ 13/A was present in 7/14 astrocytomas on more than 10% of the cells. Thy-1 was expressed in 14/14 tumors on more than 50% of their cells. The GQ ganglioside antigen detected by MAB A2B5, was found in 12/14 tumors. Shared antigens exist among morphologically benign and malignant glial tumor cells and leukocytes detectable with the following four MAbs: Thy-1, PI 153/3, UJ 308 and anti-HLe, common leukocyte antigen (CLA). CLA-expressing cells were demonstrated in 8/12 astrocytomas, and in 4/12 cases more than 90% of the cells were positive. We have shown that cells within childhood astrocytomas can express neuronal IP. The most common expressed phenotype for glial tumors was: GFAP+, Thy-1+, A2B5+, UJ 167.11+, UJ 223.8+, NF (H,M)+, UJ 13/A+, UJ 127.11-, and NF (L)-.

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“…In another study of 113 supratentorial GBMs diagnosed between 1987 and 1998, 5.3% survived longer than 5 years with 3 of these being gcGBM [156]. GcGBMs often show distinct surgical borders and present in younger patient populations than GBM [105]. These support the impetus to perform more aggressive surgical resections which may help in part to explain the improve survival from this GBM subtype.…”

Section: Giant Cell Glioblastoma Multiformementioning

confidence: 98%

“…GcGBMs have also been poignantly termed monstrocellular sarcomas and can variably stain for S-100, vimentin, class III β-tubulin, p53, EGFR and GFAP [89,115,116]. The presence of multinucleated giant cells and lymphocytic in filtration has been reported in multiple studies as favourable features in gcGBM [18,33,105]. However, there may be multiple reasons for this improved survival in gcGBM.…”

Section: Giant Cell Glioblastoma Multiformementioning

confidence: 99%

Established and emerging variants of glioblastoma multiforme: review of morphological and molecular features

Karsy¹,

Gelbman²,

Shah³

et al. 2012

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A b s t r a c t Since the recent publication of the World Health Organization brain tumour classification guidelines in 2007, a significant expansion in the molecular understanding of glioblastoma multiforme (GBM) and its pathological as well as genomic variants has been evident. The purpose of this review article is to evaluate the histopathological, molecular and clinical features surrounding emerging and currently established GBM variants. The tumours discussed include classic glioblastoma multiforme and its four genomic variants, proneural, neural, mesenchymal, classical, as well as gliosarcoma (GS), and giant cell GBM (gcGBM). Furthermore, the emerging variants include fibrillary/epithelial GBM, small cell astrocytoma (SCA), GBM with oligodendroglial component (GBMO), GBM with primitive neuroectodermal features (GBM-PNET), gemistocytic astrocytoma (GA), granular cell astrocytoma (GCA), and paediatric high-grade glioma (HGG) as well as diffuse intrinsic pontine glioma (DIPG

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Contribution to the problem of giant cell astrocytomas

Cited by 14 publications

References 35 publications

Giant cell glioblastoma: review of the literature and illustrated case

Giant cell glioblastoma: review of the literature and illustrated case

Immunophenotyping of childhood astrocytomas with a library of monoclonal antibodies

Established and emerging variants of glioblastoma multiforme: review of morphological and molecular features

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