open access

Vol 50, No 4 (2016)
Case reports
Submitted: 2015-12-13
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The molecular pattern of histopathological progression to anaplastic meningioma – A case report

Waldemar Och, Kamil Kulbacki, Błażej Szostak, Beata Sikorska, Magdalena Zakrzewska, Tomasz Szmuda, Paweł P. Liberski, Tomasz Budzisz
DOI: 10.1016/j.pjnns.2016.03.008
·
Neurol Neurochir Pol 2016;50(4):288-293.

open access

Vol 50, No 4 (2016)
Case reports
Submitted: 2015-12-13

Abstract

Meningiomas (MGs) are the most frequent primary tumours of the central nervous system (CNS) and exhibit a large spectrum of histological types and clinical phenotypes. The WHO classification of CNS tumours established strict diagnostic criteria of the benign (Grade 1), atypical (Grade 2) and anaplastic (Grade 3) subtypes. Combined with the resection rate, WHO grading has the most crucial role as the prognostic factor. Additionally, such biomarkers as Ki-67/MIB-1, progesterone receptors and phosphor-histone H3 were correlated with MG progression. Recently, it was suggested that the aggressive behaviour of some MGs is attributed to molecular alterations, regardless of their histopathology. The analysis of loss of heterozygosity (LOH) at chromosomes 1, 9, 10, 14 and 22 was performed. The presented case of WHO Grade 2 MG initially exhibited LOH at chromosomes 10, 14 and 22. In the first recurrence, the tumour genetic profiling revealed additional LOH at chromosome 1p and atypical histopathology. During the second recurrence, an aggressive phenotype was observed and tumour progressed to an anaplastic form. Considering the appearance of the tumour relapses, the set of molecular changes overtook the histopathological progression. The genetic and histopathological imbalance in the tumour progression in secondary anaplastic MGs has not been previously described. The evolution of genetic and histopathological changes was presented in the same patient. In the future, the individualised therapy of potentially more aggressive forms of MGs could be based on certain chromosome aberrations.

Abstract

Meningiomas (MGs) are the most frequent primary tumours of the central nervous system (CNS) and exhibit a large spectrum of histological types and clinical phenotypes. The WHO classification of CNS tumours established strict diagnostic criteria of the benign (Grade 1), atypical (Grade 2) and anaplastic (Grade 3) subtypes. Combined with the resection rate, WHO grading has the most crucial role as the prognostic factor. Additionally, such biomarkers as Ki-67/MIB-1, progesterone receptors and phosphor-histone H3 were correlated with MG progression. Recently, it was suggested that the aggressive behaviour of some MGs is attributed to molecular alterations, regardless of their histopathology. The analysis of loss of heterozygosity (LOH) at chromosomes 1, 9, 10, 14 and 22 was performed. The presented case of WHO Grade 2 MG initially exhibited LOH at chromosomes 10, 14 and 22. In the first recurrence, the tumour genetic profiling revealed additional LOH at chromosome 1p and atypical histopathology. During the second recurrence, an aggressive phenotype was observed and tumour progressed to an anaplastic form. Considering the appearance of the tumour relapses, the set of molecular changes overtook the histopathological progression. The genetic and histopathological imbalance in the tumour progression in secondary anaplastic MGs has not been previously described. The evolution of genetic and histopathological changes was presented in the same patient. In the future, the individualised therapy of potentially more aggressive forms of MGs could be based on certain chromosome aberrations.

Get Citation

Keywords

Meningioma, Anaplastic meningioma, Molecular biology, Loss of heterozygosity, Tumour progression

About this article
Title

The molecular pattern of histopathological progression to anaplastic meningioma – A case report

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 50, No 4 (2016)

Pages

288-293

DOI

10.1016/j.pjnns.2016.03.008

Bibliographic record

Neurol Neurochir Pol 2016;50(4):288-293.

Keywords

Meningioma
Anaplastic meningioma
Molecular biology
Loss of heterozygosity
Tumour progression

Authors

Waldemar Och
Kamil Kulbacki
Błażej Szostak
Beata Sikorska
Magdalena Zakrzewska
Tomasz Szmuda
Paweł P. Liberski
Tomasz Budzisz

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