Clonal evolution and supratentorial dissemination of a spinal cord glioma
- PDF / 1,334,622 Bytes
- 5 Pages / 595.276 x 790.866 pts Page_size
- 13 Downloads / 181 Views
LETTER TO THE EDITOR
Clonal evolution and supratentorial dissemination of a spinal cord glioma Ziren Kong 1 & Wenlin Chen 1 & Dachun Zhao 2 & Yu Wang 1
&
Wenbin Ma 1
Received: 30 May 2020 / Accepted: 19 November 2020 # Fondazione Società Italiana di Neurologia 2020
Dear Editor: Spinal cord gliomas are relatively uncommon central nervous system tumors that harbor significantly different molecular features from those of supratentorial gliomas [1]. Dissemination to the supratentorial region and rapid progression after dissemination are extremely rare for spinal cord gliomas, and the mechanisms driving these processes remain to be investigated. Here, we present the molecular characteristics of a glioma patient whose tumor originated from the spinal cord and disseminated to the pons, right cavernous sinus, and right temporal lobe, with rapid progression during recurrence. A 34-year-old female presented with numbness and pain in the right side of her face 2 months after pregnancy, and cranial magnetic resonance imaging (MRI) suggested the possibility of pontine glioma (supplementary material 1). Abortion and sonodynamic therapy were applied 2 and 4 months after initial presentation (Fig. 1a), and surgery was not carried out due to the dread of potential risks. Repeated MRI displayed contrast enhancement in the pons and right medial temporal lobe 5 months after initial presentation, and focal irradiation of 36 Gy was delivered, reaching stable disease and partial response at 1 month and 6 months after radiotherapy (Fig. 1b). A lesion in the cervical spinal cord (C3) was discovered during the designation of the radiation area (Fig. 1c), but no treatment was provided. Significant clinical worsening and radiological progression occurred 21 months after initial presentation (Fig. 1c), and spinal MRI also revealed the C3 lesion * Yu Wang [email protected] 1
Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, China
2
Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
(Fig. 1b). Salvage craniotomy and tumor biopsy were performed, and the patient passed away due to glioma infiltration into the brain stem 10 days after surgery. In compliance with the patient’s last wishes, a cranial autopsy was performed 4 h after the patient died. Glioma infiltration with necrosis of the temporal lobe, midbrain, brain stem, and part of the medulla oblongata was visible under microscopy, and tumor infiltration at the C3 level was also noted. Histopathology suggested the spinal cord, pons, cavernous sinus, and temporal lobe tumors to be the World Health Organization (WHO) grade II, III, IV, and IV, respectively (Fig. 1d). Tumor tissues were acquired for further analysis, and the methodologies are detailed in supplementary material 2. Whole-exome sequencing (WES) and whole-genome sequencing (WGS) were perfor
Data Loading...
