A clinicopathologic study of 30 cases of oligoastrocytoma including p53 immunohistochemistry.
Mixed gliomas have been difficult to define and subsequently diagnose due to the paucity of literature specifically examining this group of tumors. Thirty mixed gliomas in which the minor glial component comprised at least 20% of the total tumor were studied: 20 oligoastrocytomas (OA) and ten malignant oligoastrocytomas (MOA). Nineteen patients were male (mean age 36 years) and 19 patients (63%) presented with seizures. The tumor was located in the frontal lobe in 17 patients (57%) and the temporal lobe in nine patients (30%). The duration of preoperative symptoms in 25 patients ranged from five days to 14 years (mean 2.6 years). A mean follow-up of four years was available in 29 patients. Fourteen patients, seven with OA and seven with MOA, had recurrent tumor. One patient with MOA and four patients with OA (three with tumor progression and one with extensive leptomeningeal spread) died as a result of their tumor one to five years after diagnosis. Eighteen patients received chemotherapy and/or radiation therapy. Twenty-five tumors were immunostained with antibody to p53 protein. p53 nuclear staining was seen in 5/16 OA (31%) and 3/9 MOA (33%). Positive staining was observed only in astrocytic appearing cells. One of the four patients who died with OA was p53 positive. Three recurrent MOAs were p53 positive. Our study indicates that: 1. mixed gliomas most frequently occur in the frontal lobe and the majority of patients present with seizures; 2. there is no obvious association of p53 detection in mixed gliomas with tumor grade or behavior; and 3. similar to pure fibrillary astrocytomas, a subset of OA and MOA may be associated with p53 alterations.
Beckmann
M J
MJ
Department of Anatomic Pathology, Cleveland Clinic Foundation, Ohio, USA.
Prayson
R A
RA
D000293:Adolescent; D000328:Adult; D000368:Aged; D001254:Astrocytoma / Q000378:metabolism* / Q000473:pathology*; D001932:Brain Neoplasms / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007223:Infant; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism*
D016159:Tumor Suppressor Protein p53