Angiocentric glioma transformed into anaplastic ependymoma: Review of the evidence for malignant potential |
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| Affiliation: | 1. Department of Neurosurgery, Royal Melbourne Hospital, 300 Grattan Street, Parkville, VIC 3050, Australia;2. Department of Pathology, Royal Melbourne Hospital, Parkville, VIC, Australia;3. Department of Radiology, Royal Melbourne Hospital, Parkville, VIC, Australia;1. Department of Neurosurgery, The Keck School of Medicine of the University of Southern California, 1200 N State Street, Suite 3300, Los Angeles, CA 90033, USA;2. Neurorestoration Center, University of Southern California, Los Angeles, CA, USA;1. Division of Spine, Department of Orthopaedics, University of British Columbia and Vancouver Coastal Health, 6th Floor Blusson Spinal Cord Centre, Vancouver, British Columbia V5Z 1M9, Canada;2. Department of Neurosurgery, John Hopkins University, Baltimore, MD, USA;3. Department of Radiation Oncology, Sunnybrook Odette Cancer Centre, Toronto, ON, Canada;4. Department of Neurosurgery, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY, USA;5. Department of Orthopaedics, McGill University, Montreal, QC, Canada;6. Department of Neurosurgery, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA;7. Neural Repair and Regeneration, Toronto Western Hospital, Toronto, ON, Canada;8. Division of Orthopaedic Surgery, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada;9. Department of Neurological Surgery, UCSF, San Francisco, CA, USA;10. Department of Neurological Surgery, Mayo Clinic, Rochester, MN, USA;1. Northeast Ohio Medial University, Rootstown, OH, USA;2. Department of Neurosurgery, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA;3. Department of Pathology, Pathology and Laboratory Medicine Institute, L25, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA;1. Department of Neurological Surgery, Nihon University School of Medicine, Itabashi 173-8610, Tokyo, Japan;2. Division of Human Pathology, Department of Pathology and Microbiology, Nihon University School of Medicine, Itabashi 173-8610, Tokyo, Japan;3. Department of Radiology, Nihon University School of Medicine, Itabashi 173-8610, Tokyo, Japan;1. Department of Neurosurgery, LSU Health-Shreveport, 1501 Kings Highway, Shreveport, LA 71103-33932, USA;2. Department of Pathology, LSU Health-Shreveport, 1501 Kings Highway, Shreveport, LA 71103-33932, USA |
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| Abstract: | Angiocentric glioma (AG) is a low grade glioma, that was first described in 2002. Since this description, 83 patients with AG have been described, including ours. AG typically presents in childhood with medically refractory seizures that are cured with gross surgical resection. Whilst the natural history is that of a benign tumour, there have been reports of recurrence, transformation, and malignant features that suggest that AG is potentially malignant. We add to the literature a case of a 16-year-old girl who presented in May 2011 with a 3-month history of complex partial seizures, with MRI showing a T2-weighted hyperintense lesion in the left insula and inferior frontal lobe. This was confirmed on biopsy as AG and was followed with surveillance imaging. In April 2012, she presented with disease progression and underwent a left temporal lobectomy, with histology showing both AG and grade II astrocytoma. Adjuvant radiotherapy of 50 Gray in 28 fractions was administered. A small area of contrast enhancement appeared in the left parietal lobe in December 2012, which progressed over subsequent months. In June 2013, she underwent a near total excision, with histology showing anaplastic ependymoma. She received six cycles of adjuvant temozolamide. Despite this, the tumour continued to progress, with her seizure control deteriorating, and the development of a right hemiparesis. The patient died in January 2014, aged 19 years. |
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| Keywords: | Anaplastic astrocytoma Anaplastic ependymoma Angiocentric glioma Low grade glioma Paediatric tumours |
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