Multicentric Glioma: An Ideal Model to Reveal the Mechanism of Glioma

Abstract

As a special type of glioma, multicentric glioma provides an ideal pathological model for glioma research. According to the stem-cell-origin theory, multiple lesions of multicentric glioma share the same neuro-oncological origin, both in gene level and in cell level. Although the number of studies focusing on genetic evolution in gliomas with the model of multicentric gliomas were limited, some mutations, including IDH1 mutations, TERTp mutations and PTEN deletions, are found to be at an early stage in the process of genetic aberrance during glioma evolution based on the results of these studies. This article reviews the clinical reports and genetic studies of multicentric glioma, and intends to explain the various clinical phenomena of multicentric glioma from the perspective of genetic aberrance accumulation and tumor cell evolution. The malignant degree of a glioma is determined by both the tumorigenicity of early mutant genes, and the stemness of early suffered cells.

Unraveling the Complexity of Multicentric Gliomas: Insights Into Chronicity and Genetic Aberrations

“…Attribution of the second lesion to metastasis of the first one hindered the confident diagnosis of an MCG. Genetic testing could provide evidence for the second and third cases and ultimately provide a definitive diagnosis [ 10 ].…”

“…The utilization of FLAIR sequences on MRI discerns the disjointness of lesions as a characteristic of MCGs. Failure to provide evidence of anatomic connections through white matter pathways and CSF or metastasis advocates the diagnosis of MCGs over MFGs [ 10 ]. Currently, the focus is on the genetic basis that allows lesions to be organized into a genetic tree, with each lesion occupying a specific position within it.…”

“…When there is a contradiction between genetic analysis and anatomic correlation, many researchers favor the genetic basis over the anatomic findings. The relatively low incidence of MCGs, reported as low as 2%, would then increase [ 10 , 13 , 14 ]. Of note, the low incidence of MCGs can be attributed to other reasons including the neglect of small lesions on MRI, and loss of follow-up of patients with metachronous MCGs.…”

“…One or more critical genetic mutations cause cell division defects, and MCG formation is determined by multiple directional migrations in which each cell lineage undergoes a series of genetic mutations [ 10 ]. This indicates that genetic mutations shared in MCG centers may be the earliest genetic abnormalities, enabling screening tools in high-risk populations [ 10 , 11 ].…”

Dendritic cell therapy for neurospoagioma: Immunomodulation mediated by tumor vaccine

“…Neurospoagioma, which originates from various glial cell types including astrocytes, oligodendrocytes, and ependymal cells, is the most prevalent type of central nervous system tumor. This tumor is marked by rapid proliferation, limited differentiation, significant invasiveness, postoperative recurrence, and an unfavorable prognosis [ 1 ]. Glioblastoma (GBM), comprising 56.6% of all neurospoagiomas, represents the most aggressive form of this tumor.…”