title: A glioblastoma arising from the attached region where a meningioma had been totally removed.
abstract: 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.
authors.affiliation: Department of Neurosurgery, Ashikaga Red Cross Hospital, Ashikaga, Tochigi, Japan. shigeo.ohba@gmail.com
authors.forename: Shigeo
authors.initials: S
authors.lastname: Ohba
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Shimizu
authors.forename: Syunsuke
authors.initials: S
authors.lastname: Shibao
authors.forename: Tomoru
authors.initials: T
authors.lastname: Miwa
authors.forename: Toru
authors.initials: T
authors.lastname: Nakagawa
authors.forename: Hikaru
authors.initials: H
authors.lastname: Sasaki
authors.forename: Hideki
authors.initials: H
authors.lastname: Murakami
mesh_terms: D000368:Aged; D001932:Brain Neoplasms / Q000235:genetics / Q000378:metabolism / Q000473:pathology*; D055028:Comparative Genomic Hybridization; D005909:Glioblastoma / Q000235:genetics / Q000378:metabolism / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008577:Meningeal Neoplasms / Q000378:metabolism / Q000473:pathology*; D008579:Meningioma / Q000378:metabolism / Q000473:pathology*; D016609:Neoplasms, Second Primary / Q000235:genetics / Q000378:metabolism / Q000473:pathology*