Rapid malignant transformation of low-grade astrocytomas

Report of 2 cases and review of the literature

James L. Frazier, Michael W. Johnson, Peter C. Burger, Jon D. Weingart, Alfredo Quinones-Hinojosa

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Background: Low-grade gliomas have been documented to undergo transformation into high-grade astrocytomas, and the time interval of this transformation has been reported to generally occur within 5 years in about 50% of patients harboring these low-grade lesions. Several studies have investigated the evolution of low-grade gliomas into malignant gliomas by CT and MRI characteristics, but many have not documented the timing of these transformation processes. Case Description: The authors discuss the cases of 2 patients with histopathologically confirmed grade II astrocytomas after craniotomies that underwent rapid evolution into malignant gliomas within 13 weeks. Interestingly, both low-grade astrocytomas were positive with immunostaining for the epidermal growth factor receptor, in which its amplification has been implicated as a molecular marker of malignant gliomas. In addition, the grade II astrocytomas were negative for p53 in both patients but were found to be positive upon transformation into malignant gliomas. Conclusions: To our knowledge, this is the first report of rapid malignant transformation of lowgrade gliomas, which were proven by histology, within 13 weeks. There may be patients with a subtype of low-grade astrocytomas that may warrant molecular characterization to determine if aggressive adjuvant therapy would be of benefit.

Original languageEnglish (US)
Pages (from-to)53-62
Number of pages10
JournalWorld Neurosurgery
Volume73
Issue number1
DOIs
StatePublished - Jan 2010
Externally publishedYes

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Astrocytoma
Glioma
Craniotomy
Epidermal Growth Factor Receptor
Histology

Keywords

  • Glioblastoma
  • Grade II astrocytoma
  • High-grade glioma
  • Histopathology
  • Low-grade glioma
  • Malignant transformation

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Rapid malignant transformation of low-grade astrocytomas : Report of 2 cases and review of the literature. / Frazier, James L.; Johnson, Michael W.; Burger, Peter C.; Weingart, Jon D.; Quinones-Hinojosa, Alfredo.

In: World Neurosurgery, Vol. 73, No. 1, 01.2010, p. 53-62.

Research output: Contribution to journalArticle

Frazier, James L. ; Johnson, Michael W. ; Burger, Peter C. ; Weingart, Jon D. ; Quinones-Hinojosa, Alfredo. / Rapid malignant transformation of low-grade astrocytomas : Report of 2 cases and review of the literature. In: World Neurosurgery. 2010 ; Vol. 73, No. 1. pp. 53-62.
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