title: Consecutive histological changes in an astroblastoma that disseminated to the spinal cord after repeated intracranial recurrences: a case report.
abstract: A 17-year-old male patient underwent surgery five times (four consecutive intracranial tumor removal surgeries and a final spinal tumor removal surgery). After the third surgery, this case was reported as a low-grade astroblastoma that is characterized by perivascular pseudorosettes consisting of elongated tumor cells arranged around the blood vessels. However, the fourth and fifth surgical specimens demonstrated very interesting histological changes in the astroblastoma. Through the course of relapses, the constituent cells of the astroblastic perivascular rosettes became smaller and rounder, and a multilayered cell arrangement was observed. The nucleus-to-cytoplasm ratio increased, and the compact intervascular cells ultimately lost glial fibrillary acidic protein (GFAP) expression. These undifferentiated cells showed high MIB-1 indices and an increased olig2 index. On the other hand, the cells in all the surgical specimens were positive for certain neuronal markers such as NSE, TUJ1, and nestin. Some astroblastomas may be more immature than the usual astrocytes; however, it is necessary to study more cases to confirm this.
authors.affiliation: Department of Neurosurgery, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan. hirahira@m2.kufm.kagoshima-u.ac.jp
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Hirano
authors.forename: Shunji
authors.initials: S
authors.lastname: Yunoue
authors.forename: Masatomo
authors.initials: M
authors.lastname: Kaji
authors.forename: Masahiro
authors.initials: M
authors.lastname: Tsuchiya
authors.forename: Kazunori
authors.initials: K
authors.lastname: Arita
mesh_terms: D000293:Adolescent; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000628:therapy; D005904:Glial Fibrillary Acidic Protein / Q000096:biosynthesis; D006801:Humans; D007150:Immunohistochemistry; D020287:In Situ Nick-End Labeling; D008279:Magnetic Resonance Imaging; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000378:metabolism / Q000473:pathology / Q000628:therapy; D018302:Neoplasms, Neuroepithelial / Q000378:metabolism / Q000556:secondary* / Q000628:therapy; D019635:Neurosurgical Procedures; D010751:Phosphopyruvate Hydratase / Q000096:biosynthesis; D016634:Radiosurgery; D013120:Spinal Cord Neoplasms / Q000378:metabolism / Q000556:secondary* / Q000628:therapy
chemical_list: D000970:Antineoplastic Agents; D005904:Glial Fibrillary Acidic Protein; D010751:Phosphopyruvate Hydratase