Low-grade multicentric glioma: a rare entity
Abstract
Multiple gliomas (multifocal and multicentric) are rare in low-grade gliomas. In multicentric gliomas, their etiology is poorly understood, and their management is controversial. A 27-year-old female patient, with two lesions compatible with low-grade glioma, confirmed by pathological study, for which; she received chemotherapy and radiotherapy, maintaining stable disease after one year of follow-up; she could not undergo surgery because the lesions were located in eloquent areas. For this type of patient, the standard of care is surgery whenever feasible based on eloquence and vascular involvement, followed by chemotherapy and radiotherapy like treatment given in single gliomas. Low-grade multicentric gliomas are a rare pathology that must be managed by a multidisciplinary team where surgery is the standard of care whenever feasible, followed by chemotherapy and radiotherapy.
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References
Grosu F, Ungureanu A, Bianchi E, Moscu B, Coldea L, Stupariu AL, et al. Multifocal and multicentric low-grade oligoastrocytoma in a young patient. Rom J Morphol Embryol. 2017;58(1):207-210.
Patil CG, Eboli P, Hu J. Management of Multifocal and Multicentric Gliomas. Neurosurg Clin N Am. 2012;23(2):343-350. doi: 10.1016/j. nec.2012.01.012.
Batzdorf U, Malamud N. The Problem of Multicentric Gliomas. J Neurosurg. 1963;20(2):122-136. doi: 10.3171/jns.1963.20.2.0122.
Solomon A, Perret GE, McCormick WF. Multicentric Gliomas of the Cerebral and Cerebellar Hemispheres: Case Report. J Neurosurg. 1969;31(1):87-93. doi: 10.3171/jns.1969.31.1.0087.
Ampil F, Burton GV, Gonzalez-Toledo E, Nanda A. Do we need whole brain irradiation in multifocal or multicentric high-grade cerebral gliomas? Review of cases and the literature. J Neurooncol. 2007;85(3):353-355. doi: 10.1007/s11060-007-9413-4.
Terakawa Y, Yordanova YN, Tate MC, Duffau H. Surgical management of multicentric diffuse low-grade gliomas: functional and oncological outcomes: Clinical article. J Neurosurg. 2013;118(6):1169-1175. doi: 10.3171/2013.2.JNS121747.
Gkekas N, Vyziotis A, Dimitriadi A, Koutsonikas G, Georgakoulias N. Multifocal low-grade gliomas: Adapting the optimal therapeutic management. Br J Neurosurg. 2015;29(1):94-96. doi: 10.3109/02688697.2014.957156.
Salvati M, Caroli E, Orlando ER, Frati A, Artizzu S, Ferrante L. Multicentric glioma: our experience in 25 patients and critical review of the literature. Neurosurg Rev. 2003;26(4):275-279. doi: 10.1007/s10143-003-0276-7.
Kato T, Aida T, Abe H, Ogata A, Nakamura N, Nagashima K, et al. Clinicopathological study of multiple gliomas--report of three cases. Neurol Med Chir (Tokyo). 1990;30(8):604-9. doi: 10.2176/ nmc.30.604.
McLendon R, Rosenblum M, Bigner D. Russell & Rubinstein’s Pathology of Tumors of the Nervous System 7Ed. 7th Edition. London: CRC Press; 2006. doi: 10.1201/b13439..
ClaesA,IdemaAJ,WesselingP.Diffusegliomagrowth:aguerilla war. Acta Neuropathol (Berl). 2007;114(5):443-458. doi: 10.1007/ s00401-007-0293-7.
ZamponiN,RychlickiF,DucatiA,RegnicoloL,SalvoliniU,Ricciuti RA. Multicentric glioma with unusual clinical presentation: Childs Nerv Syst. 2001;17(1-2):101-105. doi: 10.1007/PL00013723.
Barnard RO, Geddes JF. The incidence of multifocal cerebral gliomas. A histologic study of large hemisphere sections. Cancer. 1987;60(7):1519-1531. doi: 10.1002/1097-0142(19871001)60:7<1519:AID- CNCR2820600719>3.0.CO;2-1.
Mishra HB, Haran RP, Singh JP, Joseph T. Multicentric gliomas: two case reports and a review of the literature. Br J Neurosurg. 1990;4(6):535-539. doi: 10.3109/02688699008993805.
ChamberlainMC.Radiographicpatternsofrelapseinglioblastoma.J Neurooncol. 2011;101(2):319-323. doi: 10.1007/s11060-010-0251- 4.
NakhlF,ChangEM,ShiauJS,AlastraA,WrzolekM,OdaimiM,etal. A patient with multiple synchronous gliomas of distinctly different grades and correlative radiographic findings. Surg Neurol Int. 2010;1(1):1-48. doi: 10.4103/2152-7806.69375.
Rees JH, Smirniotopoulos JG, Jones RV, Wong K. Glioblastoma multiforme: radiologic-pathologic correlation. Radiographics. 1996;16(6):1413-1438. doi: 10.1148/radiographics.16.6.8946545.
GanHK,RosenthalMA,DowlingA,KalninsR,AlgarE,WongN,et al. A phase II trial of primary temozolomide in patients with grade III oligodendroglial brain tumors. Neuro Oncol. 2010;12(5):500-7. doi: 10.1093/neuonc/nop065.
Showalter TN, Andrel J, Andrews DW, Curran WJ, Daskalakis C, Werner-Wasik M. Multifocal Glioblastoma Multiforme: Prognostic Factors and Patterns of Progression. Int J Radiat Oncol. 2007;69(3):820-824. doi: 10.1016/j.ijrobp.2007.03.045.
HassaneenW,LevineNB,SukiD,SalaskarAL,deMouraLimaA, McCutcheon IE, et al. Multiple craniotomies in the management of multifocal and multicentric glioblastoma: Clinical article. J Neurosurg. 2011;114(3):576-84. doi: 10.3171/2010.6.JNS091326.
WellerM,VanDenBentM,PreusserM,LeRhunE,TonnJC,Minniti G,etal.EANOguidelinesonthediagnosisandtreatmentofdiffuse gliomas of adulthood. Nat Rev Clin Oncol. 2021;18(3):170-186. doi: 10.1038/s41571-020-00447-z.
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