Epithelioid Glioblastoma in A 15-Year-Old Boy: A Rare Case Report
Life Sciences -Pathology
DOI:
https://doi.org/10.22376/ijlpr.2023.13.5.L316-L321Keywords:
Epithelioid Glioblastoma, Histopathology, Immunohistochemistry, Prognosis, BRAFV600E mutation.Abstract
Epithelioid glioblastoma (E-GBM), one of the rarest intrusive forms of Glioblastoma multiforme (GBM), was consigned in the World Health Organization (WHO) categorization of the Central nervous system (CNS) in the year 2016. The current article reports a rare epithelioid glioblastoma described for its histomorphological character and clinical finding for its medical rarity. The present case deals with a 15-year-old boy complaining of headaches and multiple episodes of vomiting. The investigatory procedures revealed hypo-intense multiple lesions in the left medial frontal lobe extending to a Sylvian fissure. The case is being discussed to distinguish the development of secondary glioblastomas, which usually occur due to pre-existing lesions, which were not present in our discussed case. The patient had come from a rural background with no previous investigations, ophthalmological examination revealed the presence of bilateral papilledema, and the hematological reports were within normal range. The patient was managed with magnetic resonance imaging (MRI) and computed tomography (CT), which depicted a multifocal tumor. Further left fronto temporal craniotomy and ablation of the lesion were done. The surgical procedure upshot divulged that the patient was conscious with improved right side weakness but a remnant motor aphasia, but within a short span, he could walk with support. The incidence of E-GBM that too in adolescent children is minuscule, and due to its poor prognosis, it's very crucial to acknowledge the attributable features of epithelioid glioblastoma, inclusive of functional outset, neuro-imaging, and the hazards of surgical measures.
References
Hanif F, Muzaffar K, Perveen K, Malhi SM, SimjeeShU. Glioblastoma Multiforme: A Review of its Epidemiology and Pathogenesis through Clinical Presentation and Treatment. Asian Pac J Cancer Prev. 2017 Jan 1; 18(1):3-9. doi: 10.22034/APJCP.2017.18.1.3
Tamimi AF, Juweid M. Epidemiology and Outcome of Glioblastoma. In: De Vleeschouwer S, editor. Glioblastoma [Internet]. Brisbane (AU): Codon Publications; 2017 Sep 27. Chapter 8. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470003/ doi: 10.15586/codon.glioblastoma.
Louis DN, Perry A, Reifenberger G, von Deimling A, Figarella-Branger D, Cavenee WK, et al. The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary. ActaNeuropathol. 2016 Jun; 131(6):803-20. doi 10.1007/s00401-016-1545-1.
D'Alessio A, Proietti G, Sica G, Scicchitano BM. Pathological and Molecular Features of Glioblastoma and Its Peritumoral Tissue. Cancers (Basel). 2019 Apr 3; 11(4):469. doi 10.3390/cancers11040469.
Kleinschmidt-DeMasters BK, Aisner DL, Birks DK, Foreman NK. Epithelioid GBMs show a high percentage of BRAF V600E mutation. Am J SurgPathol. 2013 May; 37(5):685-98. doi: 10.1097/PAS.0b013e31827f9c5e
Nayar G, Ejikeme T, Chongsathidkiet P, Elsamadicy AA, Blackwell KL, Clarke JM, et al. Leptomeningeal disease: current diagnostic and therapeutic strategies. Oncotarget. 2017 Aug 16; 8(42):73312-73328. doi: 10.18632/oncotarget.20272.
Shakur SF, Bit-Ivan E, Watkin WG, Merrell RT, Farhat HI. Multifocal and multicentric glioblastoma with leptomeningeal gliomatosis: a case report and review of the literature. Case Rep Med. 2013; 2013:132679. doi: 10.1155/2013/132679.
Kohno D, Inoue A, Fukushima M, Aki T, Matsumoto S, Suehiro S, et al. Epithelioid glioblastoma presenting as multicentric glioma: A case report and review of the literature. SurgNeurol Int. 2020 Jan 17; 11:8. Doi - 10.25259/SNI_544_2019.
Liebelt BD, Boghani Z, Takei H, Fung SH, Britz GW. Epithelioid glioblastoma presenting as massive intracerebral hemorrhage: Case report and review of the literature. SurgNeurol Int. 2015 Mar 19; 6 (Suppl 2):S97–100. Doi - 10.4103/2152-7806.153643
Zeng Y, Zhu X, Wang Y, Liu B, Yang X, Wang Q, et al. Clinicopathological, Immunohistochemical and Molecular Genetic Study on Epithelioid Glioblastoma: A Series of Fifteen Cases with Literature Review. OncoTargetsTher. 2020 May 8; 13:3943–52. Doi - 10.2147/OTT.S249317
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):535–9. Doi - 10.3109/02688699008993805.
Woo PYM, Lam TC, Pu JKS, Li LF, Leung RCY, Ho JMK, et al. Regression of BRAF V600E mutant adult glioblastoma after primary combined BRAF-MEK inhibitor targeted therapy: a report of two cases. Oncotarget. 2019 Jun 4; 10(38):3818–26. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6557198/
Akimoto J, Namatame H, Haraoka J, Kudo M. Epithelioid glioblastoma: a case report. Brain Tumor Pathol. 2005; 22(1):21–7. doi: 10.1007/s10014-005-0173-6.
Nakajima N, Nobusawa S, Nakata S, Nakada M, Yamazaki T, Matsumura N, et al. BRAF V600E, TERT promoter mutations and CDKN2A/B homozygous deletions are frequent in epithelioid glioblastomas: a histological and molecular analysis focusing on intratumoral heterogeneity. Brain Pathol. 2017 Dec 5; 28(5):663–73. doi:10.1111/bpa.12572
Louis DN, Perry A, Reifenberger G, von Deimling A, Figarella-Branger D, Cavenee WK, et al. The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary. ActaNeuropathol (Berl). 2016 Jun; 131(6):803–20. doi: 10.1007/s00401-016-1545-1.
Nitta N, Moritani S, Fukami T, Yoshimura Y, Hirai H, Nozaki K. Intraventricular Epithelioid Glioblastoma: A Case Report. World Neurosurg. 2018 Apr; 112: 257–63. doi: 10.1016/j.wneu.2018.01.200.
Broniscer A, Tatevossian RG, Sabin ND, Klimo P, Dalton J, Lee R, et al. Clinical, radiological, histological and molecular characteristics of pediatric epithelioid glioblastoma. NeuropatholApplNeurobiol. 2014 Apr; 40(3):327–36. doi: 10.1111/nan.12093.
Khanna G, Pathak P, Suri V, Sharma MC, Chaturvedi S, Ahuja A, et al. Immunohistochemical and molecular genetic study on epithelioid glioblastoma: Series of seven cases with review of literature. Pathol Res Pract. 2018 May; 214(5):679–85. doi: 10.1016/j.prp.2018.03.019.
Korshunov A, Chavez L, Sharma T, Ryzhova M, Schrimpf D, Stichel D, et al. Epithelioid glioblastomas stratify into established diagnostic subsets upon integrated molecular analysis. Brain Pathol Zurich Switz. 2018 Sep; 28(5):656–62. doi: 10.1111/bpa.12566. Epub 2017 Oct 30.
Wang S, He Q, Zhang Q, Guan B, Zhou X. Clinicopathologic features and prognosis of epithelioid glioblastoma. Int J ClinExpPathol. 2020; 13(7):1529–39. https://pubmed.ncbi.nlm.nih.gov/32782671/
Lu VM, George ND, Brown DA, Akinduro OO, Raghunathan A, Jentoft M, et al. Confirming Diagnosis and Effective Treatment for Rare Epithelioid Glioblastoma Variant: An Integrated Survival Analysis of the Literature. World Neurosurgery. 2019 Nov 1; 131: 243-251.e2. doi. -10.1016/j.wneu.2019.08.007.
Sugimoto K, Ideguchi M, Kimura T, Kajiwara K, Imoto H, Sadahiro H, et al. Epithelioid/rhabdoid glioblastoma: a highly aggressive subtype of glioblastoma. Brain Tumor Pathol. 2016 Apr; 33(2):137–46. doi: 10.1007/s10014-015-0243-3.
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