IDH-wildtype infiltrative low-grade glial tumor with nodule-like enhancement pattern

• Main Authors: Sho Hanai, Eiichi Ishikawa, Noriaki Sakamoto, Shunichiro Miki, Koichi Ichimura, Makoto Shibuya, Junzo Nakao, Masahide Matsuda, Hiroyoshi Akutsu, Shingo Takano, Akira Matsumura
• Format: Article
• Language: English
• Published: Elsevier 2018-12-01
• Series: Interdisciplinary Neurosurgery
• Online Access: http://www.sciencedirect.com/science/article/pii/S2214751918300094

The authors describe a usual case of infiltrative low-grade glial neoplasm with a marked enhanced area which is difficult to diagnose. A 42-year-old man had the diffuse mass lesion partially with apparent enhancement in the right temporal lobe, the insular, and the basal ganglia regions. Final pathological diagnosis from the removed specimens was IDH-wildtype diffuse astrocytoma according to 2016 WHO classification, although it had unusual findings including gliomesenchymal reaction. The nodule-like enhancement was thought to be owing to the mesenchymal component. Several molecular analysis including pyrosequence analysis, Ion Torrent™ next-generation sequencing and multiplex ligation-dependent probe amplification analysis detected no genomic abnormality. IDH-wildtype diffuse astrocytoma is a heterogeneous category and has a minor subset with a silent genomic landscape like the present case.