Intramedullary gangliogliomas: histopathologic and molecular features of 25 cases

Hum Pathol. 2016 Mar:49:107-13. doi: 10.1016/j.humpath.2015.09.041. Epub 2015 Oct 31.

Abstract

Gangliogliomas are uncommon glioneuronal tumors, which usually arise in the cerebral hemispheres and occasionally in the brain stem. Gangliogliomas occurring in the spinal cord are extremely rare. In this study, we analyzed the clinical, histopathologic, and molecular features of 25 spinal gangliogliomas. The cases included in our series affected mostly children and young adults (15 males and 10 females; mean age, 20 years; median age, 14 years; age range, 1-72 years) and were predominantly localized in the cervical and thoracic spine. From the clinical point of view (detailed follow-up available for 9 pediatric cases; mean follow-up: 2 years 10 months; range, 3 months to 5 years 10 months), most patients showed stable disease after subtotal resection. Radiotherapy was rarely used as adjuvant treatment. Histologically, gangliogliomas (WHO grade I) (21 cases) showed features largely similar to their supratentorial counterparts. Anaplastic gangliogliomas (World Health Organization grade III) (4 cases) showed features of anaplasia (including high cellularity and increased mitotic and proliferation activity). From a molecular point of view, only 2 tumors (2/19, 11%) harbored a BRAF(V600E) mutation. In conclusion, although spinal gangliogliomas display histologic and clinical features similar to their supratentorial counterparts, they show a relatively low frequency of BRAF(V600E) mutations, alteration otherwise common in hemispheric and brain stem gangliogliomas.

Keywords: Anaplastic ganglioglioma; BRAF; BRAF(V600E); Ganglioglioma; Immunohistochemistry; Spinal cord.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Biomarkers, Tumor* / analysis
  • Biomarkers, Tumor* / genetics
  • Biopsy
  • Child
  • Child, Preschool
  • DNA Mutational Analysis
  • Female
  • Ganglioglioma / chemistry
  • Ganglioglioma / diagnosis*
  • Ganglioglioma / genetics
  • Ganglioglioma / mortality
  • Ganglioglioma / pathology
  • Ganglioglioma / surgery
  • Gene Fusion
  • Genetic Predisposition to Disease
  • Humans
  • Immunohistochemistry
  • Infant
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Mutation
  • Phenotype
  • Proto-Oncogene Proteins B-raf / genetics
  • Radiotherapy, Adjuvant
  • Spinal Neoplasms / chemistry
  • Spinal Neoplasms / diagnosis*
  • Spinal Neoplasms / genetics
  • Spinal Neoplasms / mortality
  • Spinal Neoplasms / pathology
  • Spinal Neoplasms / surgery
  • Time Factors
  • Treatment Outcome
  • Young Adult

Substances

  • Biomarkers, Tumor
  • BRAF protein, human
  • Proto-Oncogene Proteins B-raf