Brain Tumor Res Treat.  2013 Apr;1(1):36-41. 10.14791/btrt.2013.1.1.36.

Solitary Primary Leptomeningeal Glioma: Case Report

• Kim YG
• Kim EH
• Kim SH
• Chang JH

• KMID: 2165221
• DOI: http://doi.org/10.14791/btrt.2013.1.1.36

Abstract

We report a case of solitary primary leptomeningeal glioma. The mass was totally removed under awake surgery. Intraoperatively, no parenchymal involvement was noted. Histopathological study revealed a predominant anaplastic oligodendroglioma component and a focal anaplastic astrocytoma component, which was consistent with an anaplastic oligoastrocytoma. Adjuvant tomotherapy was followed and the tumor has not recurred until 12 months after surgery. A focal type of primary leptomeningeal glioma is extremely rare. We report a rare case of solitary primary leptomeningeal anaplastic oligoastrocytoma.

Keyword

Glioma; Leptomeningeal; Oligoastrocytoma; Solitary

MeSH Terms

Astrocytoma
Glioma*
Oligodendroglioma

Figure

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  Fig. 1 Preoperative computed tomography shows a suspicious tumor mass on the right medial frontal lobe (A). Magnetic resonance imaging (MRI) revealed heterogeneous subtle enhancement on T1-weighted images (B and C). T2-weighted MRI showed well-circumscribed tumor mass with superficial siderosis (arrowheads) (D).

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  Fig. 2 The tumor is grayish and distinguished from normal brain by gross appearance (A). There was no continuation between tumor mass and surrounding normal brain. The tumor was totally removed (B), which was confirmed on immediate postoperative magnetic resonance imaging (C).

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  Fig. 3 Low power view shows relatively well-circumscribed tumor mass (A). High power view demonstrates glial tumor cells with increased cellularity (B). The majority of tumor cells are small round cells with a perinuclear halo, which is consistent with anaplastic oligodendroglioma (C). However, astrocytic tumor component was also observed in a small part of the tumor (D). A: H&E 12×. B: H&E 100×. C and D: H&E 400×.

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  Fig. 4 By immunohistochemistry (IHC) stains, the tumor cells were strong positive for glial fibrillary acidic protein (GFAP) and Olig-2 (A, B). IHC also revealed that isocitrate dehydrogenase 1 (IDH1) was mutated (C) and epidermal growth factor receptor (EGFR) was amplified (D). Ki-67 proliferative index was about 10-15% (E). A: GFAP-IHC 200×. B: Olig-2-IHC 200×. C: IDH1-IHC 200×. D: EGFR-IHC 200×. E: Ki-67-IHC 200×.

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