继发于低级别胶质瘤的继发性胶质肉瘤一例

doi:10.3969/j.issn.1672-6731.2019.12.009

中国现代神经疾病杂志 ›› 2019, Vol. 19 ›› Issue (12): 958-963. doi: 10.3969/j.issn.1672-6731.2019.12.009

2 继发于低级别胶质瘤的继发性胶质肉瘤一例

郭为, 刘竞辉, 冀培刚, 娄淼, 翟玉龙, 高国栋, 屈延, 王樑

710038 西安, 空军军医大学唐都医院神经外科

收稿日期:2019-11-15 出版日期:2019-12-25 发布日期:2020-01-03
通讯作者: 王樑,Email:doctorwangliang@163.com
基金资助:
国家自然科学基金资助项目（项目编号：81772661）；空军军医大学唐都医院院创新课题（项目编号：2018LCYJ011）

Secondary gliosarcoma transformed from lower grade glioma: one case report

GUO Wei, LIU Jing-hui, JI Pei-gang, LOU Miao, ZHAI Yu-long, GAO Guo-dong, QU Yan, WANG Liang

Department of Neurosurgery, Tangdu Hospital, Air Force Military Medical University of Chinese PLA, Xi'an 710038, Shaanxi, China

Received:2019-11-15 Online:2019-12-25 Published:2020-01-03
Contact: WANG Liang (Email:doctorwangliang@163.com)
Supported by:
This study was supported by the National Natural Science Foundation of China (No. 81772661) and Tangdu Hospital, Air Force Military Medical Unviersity of Chinese PLA Innovation Project (No. 2018LCYJ011).

摘要/Abstract

摘要：

目的介绍1例继发于低级别胶质瘤的继发性胶质肉瘤患者的治疗原则，总结胶质肉瘤的组织病理学和分子病理学特征及预后。方法与结果 女性患者，42岁，头部CT显示左侧额叶占位性病变，首次手术切除，术后病理诊断为少突胶质细胞瘤（WHOⅡ级）；术后19个月肿瘤复发，第2次手术切除，术后病理诊断为胶质母细胞瘤（WHOⅣ级），术后辅助替莫唑胺化疗；第2次术后22个月肿瘤再次复发，第3次手术切除，术后病理诊断为胶质肉瘤（WHOⅣ级），术后辅助放射治疗和替莫唑胺同步化疗；第3次术后14个月死亡。结论针对胶质肉瘤的治疗方案与胶质母细胞瘤相似，应最大程度手术安全切除，术后辅助放射治疗和同步药物化疗；IDH1基因突变和MGMT启动子区甲基化对预后具有重要预测意义。

关键词: 神经胶质瘤, 肉瘤, 肿瘤, 继发原发性, 病理学

Abstract:

Objective A case of secondary gliosarcoma transformed from lower grade glioma was analyzed. The clinicopathological features, molecular pathological features and prognosis of secondary gliosarcoma were discussed with relevant literatures. Methods and Results A 42-year-old female patient was admitted to our hospital. CT showed occupying lesion in left frontal lobe. The first surgery was performed and the initial pathological diagnosis was oligodendroglioma (WHO Ⅱ grade). Nineteen months after the first surgery, the tumor recurred, and the second surgery and chemotherapy were performed. The post-operative pathological diagnosis was glioblastoma (WHOⅣ grade). Twenty-two months after the second surgery, the tumor recurred again. Then the third surgery was performed and the pathological diagnosis was gliosarcoma (WHOⅣ grade). Radiotherapy and chemotherapy were given after operation. The patient died 14 months after the third surgery. Conclusions According to the 2016 WHO classification, gliosarcoma, classified as a subtype of glioblastoma, was a WHO grade Ⅳ tumor. As of now, the treatment paradigms for gliosarcoma were similar to that of gliosarcoma, including maximal safe resection, post-operative radiotherapy and concurrent and adjuvant chemotherapy. IDH1 mutation and MGMT promoter methylation had certain predictive value for the prognosis.

Key words: Glioma, Sarcoma, Neoplasms, second primary, Pathology

郭为, 刘竞辉, 冀培刚, 娄淼, 翟玉龙, 高国栋, 屈延, 王樑. 继发于低级别胶质瘤的继发性胶质肉瘤一例[J]. 中国现代神经疾病杂志, 2019, 19(12): 958-963.

GUO Wei, LIU Jing-hui, JI Pei-gang, LOU Miao, ZHAI Yu-long, GAO Guo-dong, QU Yan, WANG Liang. Secondary gliosarcoma transformed from lower grade glioma: one case report[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2019, 19(12): 958-963.

http://journal11.magtechjournal.com/cjcnn/CN/Y2019/V19/I12/958

参考文献

[1] Morantz RA, Feigin I, Ransohoff J 3rd. Clinical and pathological study of 24 cases of gliosarcoma[J]. J Neurosurg, 1976, 45:398-408.
[2] Han SJ, Yang I, Otero JJ, Ahn BJ, Tihan T, McDermott MW, Berger MS, Chang SM, Parsa AT. Secondary gliosarcoma after diagnosis of glioblastoma:clinical experience with 30 consecutive patients[J]. J Neurosurg, 2010, 112:990-996.
[3] Han SJ, Yang I, Tihan T, Prados MD, Parsa AT. Primary gliosarcoma:key clinical and pathologic distinctions from glioblastoma with implications as a unique oncologic entity[J]. J Neurooncol, 2010, 96:313-320.
[4] Damodaran O, van Heerden J, Nowak AK, Bynevelt M, McDonald K, Marsh J, Lee G. Clinical management and survival outcomes of gliosarcomas in the era of multimodality therapy[J]. J Clin Neurosci, 2014, 21:478-481.
[5] Frandsen J, Orton A, Jensen R, Colman H, Cohen AL, Tward J, Shrieve DC, Suneja G. Patterns of care and outcomes in gliosarcoma:an analysis of the National Cancer Database[J]. J Neurosurg, 2018, 128:1133-1138.
[6] Louis DN, Perry A, Reifenberger G, von Deimling A, Figarella-Branger D, Cavenee WK, Ohgaki H, Wiestler OD, Kleihues P, Ellison DW. The 2016 World Health Organization classification of tumors of the central nervous system:a summary[J]. Acta Neuropathol, 2016, 131:803-820.
[7] Paulus W, Bayas A, Ott G, Roggendorf W. Interphase cytogenetics of glioblastoma and gliosarcoma[J]. Acta Neuropathol, 1994, 88:420-425.
[8] Biernat W, Aguzzi A, Sure U, Grant JW, Kleihues P, Hegi ME. Identical mutations of the p53 tumor suppressor gene in the gliomatous and the sarcomatous components of gliosarcomas suggest a common origin from glial cells[J]. J Neuropathol Exp Neurol, 1995, 54:651-656.
[9] Reis RM, Könü-Lebleblicioglu D, Lopes JM, Kleihues P, Ohgaki H. Genetic profile of gliosarcomas[J]. Am J Pathol, 2000, 156:425-432.
[10] Walker C, Joyce KA, Thompson-Hehir J, Davies MP, Gibbs FE, Halliwell N, Lloyd BH, Machell Y, Roebuck MM, Salisbury J, Sibson DR, Du Plessis D, Broome J, Rossi ML. Characterisation of molecular alterations in microdissected archival gliomas[J]. Acta Neuropathol, 2001, 101:321-333.
[11] Actor B, Cobbers JM, Büschges R, Wolter M, Knobbe CB, Lichter P, Reifenberger G, Weber RG. Comprehensive analysis of genomic alterations in gliosarcoma and its two tissue components[J]. Genes Chromosomes Cancer, 2002, 34:416-427.
[12] Cachia D, Kamiya-Matsuoka C, Mandel JJ, Olar A, Cykowski MD, Armstrong TS, Fuller GN, Gilbert MR, De Groot JF. Primary and secondary gliosarcomas:clinical, molecular and survival characteristics[J]. J Neurooncol, 2015, 125:401-410.
[13] Meis JM, Martz KL, Nelson JS. Mixed glioblastoma multiforme and sarcoma:a clinicopathologic study of 26 radiation therapy oncology group cases[J]. Cancer, 1991, 67:2342-2349.
[14] Lutterbach J, Guttenberger R, Pagenstecher A. Gliosarcoma:a clinical study[J]. Radiother Oncol, 2001, 61:57-64.
[15] Galanis E, Buckner JC, Dinapoli RP, Scheithauer BW, Jenkins RB, Wang CH, O'Fallon JR, Farr G Jr. Clinical outcome of gliosarcoma compared with glioblastoma multiforme:North Central Cancer Treatment Group results[J]. J Neurosurg, 1998, 89:425-430.
[16] Perry JR, Ang LC, Bilbao JM, Muller PJ. Clinicopathologic features of primary and postirradiation cerebral gliosarcoma[J]. Cancer, 1995, 75:2910-2918.
[17] Kozak KR, Mahadevan A, Moody JS. Adult gliosarcoma:epidemiology, natural history, and factors associated with outcome[J]. Neuro Oncol, 2009, 11:183-191.
[18] Hegi ME, Diserens AC, Gorlia T, Hamou MF, de Tribolet N, Weller M, Kros JM, Hainfellner JA, Mason W, Mariani L, Bromberg JE, Hau P, Mirimanoff RO, Cairncross JG, Janzer RC, Stupp R. MGMT gene silencing and benefit from temozolomide in glioblastoma[J]. N Engl J Med, 2005, 352:997-1003.
[19] Kang SH, Park KJ, Kim CY, Yu MO, Park CK, Park SH, Chung YG. O⁶-methylguanine DNA methyltransferase status determined by promoter methylation and immunohistochemistry in gliosarcoma and their clinical implications[J]. J Neurooncol, 2011, 101:477-486.
[20] Zhang G, Huang S, Zhang J, Wu Z, Lin S, Wang Y. Clinical outcome of gliosarcoma compared with glioblastoma multiforme:a clinical study in Chinese patients[J]. J Neurooncol, 2016, 127:355-362.

选择文件类型/文献管理软件名称

选择包含的内容

2 继发于低级别胶质瘤的继发性胶质肉瘤一例

Secondary gliosarcoma transformed from lower grade glioma: one case report

RichHTML

PDF

可视化

被引次数

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价

[1]	马晓丽, 童家杰, 张秀智, 杜倩, 隋爱霞, 赵焕芬. 表现为垂体腺瘤卒中的黄色瘤性垂体炎[J]. 中国现代神经疾病杂志, 2023, 23(7): 599-603.
[2]	邹鹏, 罗鹏, 张昊阜子, 刘剑, 程光, 蒋晓帆. 脑胶质瘤清醒麻醉术中癫痫发作对术后情绪及肌力的影响[J]. 中国现代神经疾病杂志, 2023, 23(5): 454-459.
[3]	李建瑞, 刘宵雪, 许强, 骆仲强, 卢光明, 张志强. 扩散峰度成像直方图联合EphA2分级在胶质瘤分级诊断中的价值[J]. 中国现代神经疾病杂志, 2023, 23(3): 254-263.
[4]	李字林, 胡文瀚, 张凯. 癫痫外科常见病理类型体细胞突变研究进展[J]. 中国现代神经疾病杂志, 2023, 23(2): 115-123.
[5]	王圆圆, 王鲁宁, 朱明伟. 病理性TDP-43蛋白在常见神经系统变性疾病患者杏仁核中的表达变化[J]. 中国现代神经疾病杂志, 2022, 22(9): 787-794.
[6]	姚盈盈, 王雷明, 滕梁红. 脑胶质瘤DNA甲基化临床意义及研究进展[J]. 中国现代神经疾病杂志, 2022, 22(9): 823-828.
[7]	菅凤增, 王兴文. 分子病理诊断时代脊柱脊髓肿瘤的诊断与治疗[J]. 中国现代神经疾病杂志, 2022, 22(8): 651-654.
[8]	姚庆宇, 马龙冰, 菅凤增. 脊髓空洞症大鼠模型长期稳定性评价[J]. 中国现代神经疾病杂志, 2022, 22(8): 662-668.
[9]	王军成, 赵岳阳, 马东明. 我国脑肿瘤专病人脑组织资源库建设意义及进展[J]. 中国现代神经疾病杂志, 2022, 22(7): 635-640.
[10]	刘子悦, 朱以诚. 脑小静脉与脑结构变化相关研究进展[J]. 中国现代神经疾病杂志, 2022, 22(6): 450-454.
[11]	张梓枫, 周政旭, 唐文天, 洪汛宁, 王协锋, 程刚, 刘宁, 鲁艾林, 张军霞, 尤永平. IDH突变型岛叶胶质瘤MRI特征预测因素分析[J]. 中国现代神经疾病杂志, 2022, 22(5): 404-413.
[12]	闫可, 赵海峰, 吴杰, 王为华, 朱文昱, 黄强. 胶质瘤发生发展及其与人巨细胞病毒感染相关研究进展[J]. 中国现代神经疾病杂志, 2022, 22(5): 429-433.
[13]	王孟泽, 杨雷, 赵迁浩. 儿童黏液样胶质神经元肿瘤一例[J]. 中国现代神经疾病杂志, 2022, 22(5): 439-443.
[14]	梁恭博, 王卓才, 何文源, 赖续文, 王蔚. 罕见松果体区骨外黏液样软骨肉瘤[J]. 中国现代神经疾病杂志, 2022, 22(12): 1059-1067.
[15]	李智. 应关注颅内SMARCB1/INI-1缺陷型肿瘤的病理诊断与鉴别诊断：《罕见松果体区骨外黏液样软骨肉瘤》有感[J]. 中国现代神经疾病杂志, 2022, 22(12): 1068-1069.

模态框（Modal）标题

选择文件类型/文献管理软件名称

选择包含的内容

2 继发于低级别胶质瘤的继发性胶质肉瘤一例

Secondary gliosarcoma transformed from lower grade glioma: one case report

RichHTML

PDF

可视化

被引次数

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价