WHO Grade IV Gliofibroma: A Grading Label Denoting Malignancy for an Otherwise Commonly Misinterpreted Neoplasm

• Main Authors: Paola A. Escalante Abril, Miguel Fdo. Salazar, Nubia L. López García, Mónica N. Madrazo Moya, Yadir U. Zamora Guerra, Yadira Gandhi Mata Mendoza, Erick Gómez Apo, Laura G. Chávez Macías
• Format: Article
• Language: English
• Published: Korean Society of Pathologists & the Korean Society for Cytopathology 2015-07-01
• Series: Journal of Pathology and Translational Medicine
• Subjects: Gliofibroma; Bimorphic neoplasm; Desmoplastic glioma; Adult population; Tumour suppressor protein 53
• Online Access: http://www.jpatholtm.org/upload/pdf/jptm-49-4-325.pdf
• ISSN: 2383-7837; 2383-7845

We report a 50-year-old woman with no relevant clinical history who presented with headache and loss of memory. Magnetic resonance imaging showed a left parieto-temporal mass with annular enhancement after contrast media administration, rendering a radiological diagnosis of high-grade astrocytic neoplasm. Tumour sampling was performed but the patient ultimately died as a result of disease. Microscopically, the lesion had areas of glioblastoma mixed with a benign mesenchymal constituent; the former showed hypercellularity, endothelial proliferation, high mitotic activity and necrosis, while the latter showed fascicles of long spindle cells surrounded by collagen and reticulin fibers. With approximately 40 previously reported cases, gliofibroma is a rare neoplasm defined as either glio-desmoplastic or glial/benign mesenchymal. As shown in our case, its prognosis is apparently determined by the degree of anaplasia of the glial component.