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Oligodendroglioma and juvenile
pilocytic astrocytoma presenting as synchronous primary brain tumors. Case
report with histological and molecular differentiation of the tumors and review
of the literature
Kan P, Gottfried O, Blumenthal DT, Townsend JJ, Drozd-Borysiuk E, Brothman
AR, Jensen RL
Department of Neurosurgery, University of Utah, Salt Lake City, Utah 84132-2303,
USA.
Multiple metastatic brain tumors and multifocal primary brain tumors of a single
histological type are well described in the literature.
The concurrent presence of multiple primary brain tumors with different
histological characteristics, however, is very rare.
The authors describe the first known case in which an oligodendroglioma and a
juvenile pilocytic astrocytoma (JPA) presented as synchronous primary brain
tumors in the same patient.
This 43-year-old man presented with a 2-month history of progressive headaches,
nausea, and vomiting.
Magnetic resonance imaging demonstrated an enhancing heterogeneous right medial
cerebellar lesion and a larger calcified, nonenhancing, heterogeneous right
frontal lesion with surrounding edema and a mass effect.
The results of a metastatic workup were unremarkable.
The patient underwent an initial right frontotemporal craniotomy and a
subsequent suboccipital craniectomy 2 years later for resection of the posterior
fossa lesion.
Histological examination revealed the frontal and cerebellar lesions to be an
oligodendroglioma and JPA, respectively.
A molecular analysis detected a deletion of chromosome 1p36 in the
oligodendroglioma, but not in the JPA.
After the initial operation, the patient received follow-up care for his
oligodendroglioma, but eventually required temozolomide for tumor
progression.
His condition remains stable both neurologically and according to imaging
studies.
The authors describe the first known case in which a low-grade oligodendroglioma
and a JPA presented as synchronous primary brain tumors.
They review the literature on multiple primary brain tumors with different
histological characteristics and discuss potential mechanisms for the
development of these lesions.
PMID: 15070126 [PubMed - indexed for MEDLINE]
Source: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15070126
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