A glioblastoma arising from the attached region where a meningioma had been totally removed
Article first published online: 1 FEB 2011
© 2011 Japanese Society of Neuropathology
Volume 31, Issue 6, pages 606–611, December 2011
How to Cite
Ohba, S., Shimizu, K., Shibao, S., Miwa, T., Nakagawa, T., Sasaki, H. and Murakami, H. (2011), A glioblastoma arising from the attached region where a meningioma had been totally removed. Neuropathology, 31: 606–611. doi: 10.1111/j.1440-1789.2011.01198.x
- Issue published online: 21 NOV 2011
- Article first published online: 1 FEB 2011
- Received 1 September 2010; revised and accepted 19 December 2010.
The co-occurrence of different histological tumors in the nervous system is rare and is mainly associated with phakomatoses or radiation exposure. A 72-year-old man underwent surgery for a frontal convexity meningioma. Four years after the surgery, a new lesion was detected in the attached region where the meningioma had been removed. The second tumor exhibited a high degree of cellularity, atypical mitosis, pseudo-palisading and microvascular proliferation, and was immunohistologically positive for GFAP and was diagnosed as a glioblastoma. Wild-type isocitrate dehydrogenase 1 was found in the second specimen. A genetic analysis using comparative genomic hybridization showed a DNA copy number loss on 1p35, 9pter-21, 10, 11q23, 13q, 14q, 20q, 22q and a gain on 7 in the second specimen. Although the mechanism responsible for the consecutive occurrence of meningioma and glioblastoma has not been elucidated, five hypotheses are feasible: (i) the lesions occurred incidentally; (ii) a low-grade astrocytoma present at the time of the first operation transformed into a high-grade glioma during the next 4 years; (iii) radiation received during the endovascular treatment induced glioblastoma; (iv) a brain scar created at the time of the first operation for meningioma led to the occurrence of a glioblastoma; and (v) the previous meningioma affected the surrounding glial cells, causing neoplastic transformation.