Management and Molecular Characterization of Intraventricular Glioblastoma: A Single-Institution Case Series
While the central nervous system (CNS) tumor classification has increasingly incorporated molecular parameters, there is a paucity of literature reporting molecular alterations found in intraventricular glioblastoma (IVGBM), which are rare. We present a case series of nine IVGBMs, including molecula...
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MDPI AG
2023-08-01
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| Series: | International Journal of Molecular Sciences |
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| Online Access: | https://www.mdpi.com/1422-0067/24/17/13285 |
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| author | Megan Parker Anita Kalluri Joshua Materi Sachin K. Gujar Karisa Schreck Debraj Mukherjee Jon Weingart Henry Brem Kristin J. Redmond Calixto-Hope G. Lucas Chetan Bettegowda Jordina Rincon-Torroella |
| author_facet | Megan Parker Anita Kalluri Joshua Materi Sachin K. Gujar Karisa Schreck Debraj Mukherjee Jon Weingart Henry Brem Kristin J. Redmond Calixto-Hope G. Lucas Chetan Bettegowda Jordina Rincon-Torroella |
| author_sort | Megan Parker |
| collection | DOAJ |
| description | While the central nervous system (CNS) tumor classification has increasingly incorporated molecular parameters, there is a paucity of literature reporting molecular alterations found in intraventricular glioblastoma (IVGBM), which are rare. We present a case series of nine IVGBMs, including molecular alterations found in standardized next-generation sequencing (NGS). We queried the clinical charts, operative notes, pathology reports, and radiographic images of nine patients with histologically confirmed IVGBM treated at our institution (1995–2021). Routine NGS was performed on resected tumor tissue of two patients. In this retrospective case series of nine patients (22% female, median (range) age: 64.3 (36–85) years), the most common tumor locations were the atrium of the right lateral ventricle (33%) and the septum pellucidum (33%). Five patients had preoperative hydrocephalus, which was managed with intraoperative external ventricular drains in three patients and ventriculoperitoneal shunts in one patient. Hydrocephalus was managed with subtotal resection of a fourth ventricular IVGBM in one patient. The most common surgical approach was transcortical intraventricular (56%). Gross total resection was achieved in two patients, subtotal resection was achieved in six patients, and one patient received a biopsy only. Immunohistochemistry for IDH1 R132H mutant protein was performed in four cases and was negative in all four. Genetic alterations common in glioblastoma, IDH-wildtype, were seen in two cases with available NGS data, including EGFR gene amplification, TERT promoter mutation, PTEN mutation, trisomy of chromosome 7, and monosomy of chromosome 10. Following surgical resection, four patients received adjuvant chemoradiation. Median survival among our cohort was 4.7 months (IQR: 0.9–5.8 months). Management of IVGBM is particularly challenging due to their anatomical location, presentation with obstructive hydrocephalus, and fast growth, necessitating prompt intervention. Additional studies are needed to better understand the genetic landscape of IVGBM compared to parenchymal glioblastoma and may further elucidate the unique pathophysiology of these rare tumors. |
| first_indexed | 2024-03-10T23:21:23Z |
| format | Article |
| id | doaj.art-5b8ab20694a64b8187fc588be19f5927 |
| institution | Directory Open Access Journal |
| issn | 1661-6596 1422-0067 |
| language | English |
| last_indexed | 2024-03-10T23:21:23Z |
| publishDate | 2023-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | International Journal of Molecular Sciences |
| spelling | doaj.art-5b8ab20694a64b8187fc588be19f59272023-11-19T08:15:06ZengMDPI AGInternational Journal of Molecular Sciences1661-65961422-00672023-08-0124171328510.3390/ijms241713285Management and Molecular Characterization of Intraventricular Glioblastoma: A Single-Institution Case SeriesMegan Parker0Anita Kalluri1Joshua Materi2Sachin K. Gujar3Karisa Schreck4Debraj Mukherjee5Jon Weingart6Henry Brem7Kristin J. Redmond8Calixto-Hope G. Lucas9Chetan Bettegowda10Jordina Rincon-Torroella11Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USADepartment of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USADepartment of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USADivision of Neuroradiology, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USADepartment of Neurology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USADepartment of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USADepartment of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USADepartment of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USADepartment of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USADepartment of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USADepartment of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USADepartment of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USAWhile the central nervous system (CNS) tumor classification has increasingly incorporated molecular parameters, there is a paucity of literature reporting molecular alterations found in intraventricular glioblastoma (IVGBM), which are rare. We present a case series of nine IVGBMs, including molecular alterations found in standardized next-generation sequencing (NGS). We queried the clinical charts, operative notes, pathology reports, and radiographic images of nine patients with histologically confirmed IVGBM treated at our institution (1995–2021). Routine NGS was performed on resected tumor tissue of two patients. In this retrospective case series of nine patients (22% female, median (range) age: 64.3 (36–85) years), the most common tumor locations were the atrium of the right lateral ventricle (33%) and the septum pellucidum (33%). Five patients had preoperative hydrocephalus, which was managed with intraoperative external ventricular drains in three patients and ventriculoperitoneal shunts in one patient. Hydrocephalus was managed with subtotal resection of a fourth ventricular IVGBM in one patient. The most common surgical approach was transcortical intraventricular (56%). Gross total resection was achieved in two patients, subtotal resection was achieved in six patients, and one patient received a biopsy only. Immunohistochemistry for IDH1 R132H mutant protein was performed in four cases and was negative in all four. Genetic alterations common in glioblastoma, IDH-wildtype, were seen in two cases with available NGS data, including EGFR gene amplification, TERT promoter mutation, PTEN mutation, trisomy of chromosome 7, and monosomy of chromosome 10. Following surgical resection, four patients received adjuvant chemoradiation. Median survival among our cohort was 4.7 months (IQR: 0.9–5.8 months). Management of IVGBM is particularly challenging due to their anatomical location, presentation with obstructive hydrocephalus, and fast growth, necessitating prompt intervention. Additional studies are needed to better understand the genetic landscape of IVGBM compared to parenchymal glioblastoma and may further elucidate the unique pathophysiology of these rare tumors.https://www.mdpi.com/1422-0067/24/17/13285glioblastomaintraventricularnext-generation sequencingIDH-wildtype |
| spellingShingle | Megan Parker Anita Kalluri Joshua Materi Sachin K. Gujar Karisa Schreck Debraj Mukherjee Jon Weingart Henry Brem Kristin J. Redmond Calixto-Hope G. Lucas Chetan Bettegowda Jordina Rincon-Torroella Management and Molecular Characterization of Intraventricular Glioblastoma: A Single-Institution Case Series International Journal of Molecular Sciences glioblastoma intraventricular next-generation sequencing IDH-wildtype |
| title | Management and Molecular Characterization of Intraventricular Glioblastoma: A Single-Institution Case Series |
| title_full | Management and Molecular Characterization of Intraventricular Glioblastoma: A Single-Institution Case Series |
| title_fullStr | Management and Molecular Characterization of Intraventricular Glioblastoma: A Single-Institution Case Series |
| title_full_unstemmed | Management and Molecular Characterization of Intraventricular Glioblastoma: A Single-Institution Case Series |
| title_short | Management and Molecular Characterization of Intraventricular Glioblastoma: A Single-Institution Case Series |
| title_sort | management and molecular characterization of intraventricular glioblastoma a single institution case series |
| topic | glioblastoma intraventricular next-generation sequencing IDH-wildtype |
| url | https://www.mdpi.com/1422-0067/24/17/13285 |
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