A case history of glioma progression

摘要: Low-grade diffuse astrocytomas have an intrinsic tendency for malignant progression but the factors determining kinetics of this process are still poorly understood. We report here case a male patient who developed fibrillary astrocytoma at age 33 years and underwent six surgical interventions over period 17 without radiotherapy or chemotherapy. The first three biopsies spanned 11 led to diagnosis low-grade, (WHO grade II), with growth fraction (MIB-1 labeling index) 2.3–3.7%. fourth sixth showed histological features anaplastic III), fractions between 5.0 10.5%. gemistocytic neoplastic astrocytes also increased, from 0.3% in biopsy 17.5% last preceded increase proliferative activity transition astrocytoma. tumor cells immunoreactive BCL-2 increased 8.2%. A p53 mutation codon 273 (CGT→TGT, Arg→Cys) was identified persisted throughout course disease. However, protein accumulation significantly during progression, 3.2% 13.7% last. absence additional genetic alterations (PTEN mutations, loss chromosome 10 19q) may be responsible slow lack glioblastoma even after 17-year disease duration.