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Early atypical malignant transformation of diffuse low-grade astrocytoma: The importance of genotyping

Institution:	1. Department of Neurosurgery, Centro Hospitalar Universitário São João, Oporto, Portugal;2. Faculty of Medicine, Oporto University, Portugal;3. Department of Anatomical Pathology, Centro Hospitalar Universitário São João, Oporto, Portugal;4. Neurosciences Centre, Hospital CUF, Oporto, Portugal;1. Department of Neurosurgery, Neurosurgery Teaching Hospital, Baghdad, Iraq;2. Department of Neurosurgery, Division of Neurosurgery, Faculty of Health Sciences, University of Bamenda, Bamenda, Cameroon;1. Neurosurgery Department, Centro Hospitalar Universitário São João, Porto, Portugal;2. Faculty of Medicine, University of Porto, Porto, Portugal;3. Neurology Department, Centro Hospitalar Universitário São João, Porto, Portugal;4. Neurosciences Centre, Hospital CUF Porto, Portugal;1. Servicio de Medicina Intensiva, Hospital Universitario La Paz, Madrid, España;2. Grupo BMP, Instituto de Investigación-IdiPaz, Madrid, España;3. Universidad de la Rioja , Logroño, España;4. Unidad Docente Multiprofesional de Atención Familiar y Comunitaria Sureste, Madrid, España;1. Department of Neurosurgery, University Hospital Complex of Vigo, Pontevedra, Spain;2. Neuroscience Research Group, Galicia Sur Health Research Institute, Vigo, Pontevedra, Spain;3. Department of Neurosurgery, Hospital Universitari Arnau de Vilanova, Lleida, Spain;1. Sección de Dermatología, Hospital Dr. José Molina Orosa, Lanzarote, Provincia de Las Palmas, España;2. Servicio de Neurocirugía, Hospital Universitario de Gran Canaria Doctor Negrín, Provincia de Las Palmas, España;3. Servicio de Patología, Hospital Universitario de Gran Canaria Doctor Negrín, Provincia de Las Palmas, España;4. Servicio de Medicina Interna, Hospital Dr. José Molina Orosa, Lanzarote, Provincia de Las Palmas, España;1. Servicio de Neurocirugía, Hospital Universitario La Paz, Madrid, España;2. Servicio de Cirugía General, Hospital Universitario La Paz, Madrid, España;3. Neurofisiología Clínica, Servicio de Neurología, Hospital Universitario La Paz, Madrid, España

Abstract:	Diffuse astrocytoma (WHO grade II) has classically been considered a slow growing tumour, typically affecting young adults, with tendency for late malignant conversion. We describe a case of early atypical malignant transformation of diffuse astrocytoma seventeen months after complete surgical removal, as an intraventricular high-grade glioma (HGG). Retrospective laboratory findings for the presence of IDH 1/2 (isocitrate dehydrogenase) mutations were negative. There is growing evidence that IDH-wildtype (wt) astrocytomas behave more aggressively, therefore identifying IDH-mutation status should be mandatory in order to determine disease prognosis and guide treatment course.

Keywords:	Diffuse astrocytoma IDH 1/2 mutation IDH-wildtype Lower-grade gliomas Tumour genotype Astrocitoma difuso Mutación IDH 1/2 IDH-wildtype Glioma de bajo grado Genotipificar
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