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Revisiting gliomatosis cerebri in adult-type diffuse gliomas: a comprehensive imaging, genomic and clinical analysis

Authors
 Ilah Shin  ;  Yae Won Park  ;  Yongsik Sim  ;  Seo Hee Choi  ;  Sung Soo Ahn  ;  Jong Hee Chang  ;  Se Hoon Kim  ;  Seung-Koo Lee  ;  Rajan Jain 
Citation
 ACTA NEUROPATHOLOGICA COMMUNICATIONS, Vol.12(1) : 128, 2024-08 
Journal Title
ACTA NEUROPATHOLOGICA COMMUNICATIONS
Issue Date
2024-08
MeSH
Adult ; Aged ; Brain Neoplasms* / diagnostic imaging ; Brain Neoplasms* / genetics ; Brain Neoplasms* / pathology ; Female ; Genomics ; Glioma* / diagnostic imaging ; Glioma* / genetics ; Glioma* / pathology ; Humans ; Isocitrate Dehydrogenase* / genetics ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Mutation ; Neoplasms, Neuroepithelial* / diagnostic imaging ; Neoplasms, Neuroepithelial* / genetics ; Neoplasms, Neuroepithelial* / pathology ; Retrospective Studies ; Young Adult
Keywords
Glioblastoma ; Glioma ; Gliomatosis cerebri ; Magnetic resonance imaging ; World Health Organization
Abstract
Although gliomatosis cerebri (GC) has been removed as an independent tumor type from the WHO classification, its extensive infiltrative pattern may harbor a unique biological behavior. However, the clinical implication of GC in the context of the 2021 WHO classification is yet to be unveiled. This study investigated the incidence, clinicopathologic and imaging correlations, and prognostic implications of GC in adult-type diffuse glioma patients. Retrospective chart and imaging review of 1,211 adult-type diffuse glioma patients from a single institution between 2005 and 2021 was performed. Among 1,211 adult-type diffuse glioma patients, there were 99 (8.2%) patients with GC. The proportion of molecular types significantly differed between patients with and without GC (P = 0.017); IDH-wildtype glioblastoma was more common (77.8% vs. 66.5%), while IDH-mutant astrocytoma (16.2% vs. 16.9%) and oligodendroglioma (6.1% vs. 16.5%) were less common in patients with GC than in those without GC. The presence of contrast enhancement, necrosis, cystic change, hemorrhage, and GC type 2 were independent risk factors for predicting IDH mutation status in GC patients. GC remained as an independent prognostic factor (HR = 1.25, P = 0.031) in IDH-wildtype glioblastoma patients on multivariable analysis, along with clinical, molecular, and surgical factors. Overall, our data suggests that although no longer included as a distinct pathological entity in the WHO classification, recognition of GC may be crucial considering its clinical significance. There is a relatively high incidence of GC in adult-type diffuse gliomas, with different proportion according to molecular types between patients with and without GC. Imaging may preoperatively predict the molecular type in GC patients and may assist clinical decision-making. The prognostic role of GC promotes its recognition in clinical settings.
Files in This Item:
T202405839.pdf Download
DOI
10.1186/s40478-024-01832-w
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Se Hoon(김세훈) ORCID logo https://orcid.org/0000-0001-7516-7372
Park, Yae Won(박예원) ORCID logo https://orcid.org/0000-0001-8907-5401
Shin, Ilah(신일아)
Sim, Yongsik(심용식) ORCID logo https://orcid.org/0000-0003-2711-2793
Ahn, Sung Soo(안성수) ORCID logo https://orcid.org/0000-0002-0503-5558
Lee, Seung Koo(이승구) ORCID logo https://orcid.org/0000-0001-5646-4072
Chang, Jong Hee(장종희) ORCID logo https://orcid.org/0000-0003-1509-9800
Choi, Seo Hee(최서희) ORCID logo https://orcid.org/0000-0002-4083-6414
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/200733
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