Multicentric malignant glioma with striking morphologic heterogeneity and early and extensive metastatic spread to the bone.

Multicentric malignant glioma with striking morphologic heterogeneity and early and extensive metastatic spread to the bone. Clin Neuropathol. 2019 Oct 29;: Authors: Peter N, Roetzer T, Furtner J, Kiesel B, Herac M, Susani M, Capper D, Zimprich F, Hainfellner JA, Marosi C, Woehrer A Abstract We document the case of a young adult female patient who presented with multiple intracerebral and extracerebral bone lesions, the latter most prominently along the vertebral column. The spatially distinct intracerebral lesions included a superficial frontal tumor nodule as well as diffuse enlargement of the pons. Differential diagnoses ranged from neoplastic to inflammatory conditions. Repeated bone biopsies yielded uncharacteristic reactive changes whereas cerebrospinal fluid cytology pointed towards a neoplastic disease. Resection of the superficial frontal tumor nodule prompted the diagnosis of an unusual "gliofibroma" with anaplastic features, WHO grade III. TMZ chemotherapy was initiated and led to intracranial disease stabilization, whereas the bone lesions were progressive. At 16 months after diagnosis, new brain lesions occurred, and further progression of the brain stem lesion led to clinical deterioration and patient death. Postmortem examination confirmed extensively disseminated intracranial disease with unusually striking morphologic heterogeneity across the various lesions ranging from diffuse spindle-celled areas to perivascular r...
Source: Clinical Neuropathology - Category: Pathology Authors: Tags: Clin Neuropathol Source Type: research