Genetically Heterogeneous Glioblastoma Recurring with Disappearance of 1p/19q Losses

摘要: OBJECTIVE: Intratumor heterogeneity is of great importance in many clinical aspects glioma biology, including tumor grading, therapeutic response, and recurrence. Modifications the genetic features a specific primary recurring after chemo- radiotherapy are poorly understood. We report recurrent glioblastoma case exhibiting loss heterozygosity (LOH) on chromosome 10q, while exhibited LOH status 1p, 19q, 10q. To determine relationship between such modifications heterogeneous chemosensitivity, cultured cells heterogeneously showing 1p/19q/10q losses were established from surgical specimen oligoastrocytoma treated with chemotherapeutic agents. CLINICAL PRESENTATION: A 46-year-old woman 1-month history headache visual disturbances presented to our institution. INTERVENTION: right temporoparietal craniotomy gross total resection performed. The pathological diagnosis was multiforme oligodendroglial components. Whereas 10q identified at all sites, only components 1p 19q. recurred 6 months postoperative chemotherapy using interferon-β ranimustine, as well course fractionated external-beam radio; therapy (total dose, 60 Gy). Gene analysis revealed no 1p/19q allelic but LOH. CONCLUSION: might be explained by presence more than one subclone tumor. Here, 1 p/19q high chemosensitivity have been killed adjuvant those chemoresistance recurred. This study preliminary laboratory findings suggest an approach brain physiology, diagnosis, therapy.