Malignant degeneration in oligodendroglioma after surgical resection

Case contributed by Dr Hani Salam

Presentation

30 year old male patient presented with headache and vomiting

Patient Data

Age: 30
Gender: Male

Case Discussion

Path proven oligodendroglioma, WHO grade II.

The patient was on regular MR brain follow up after surgical resection and radiotherapy. Subsequent follow up reveals development of small enhancing nodule in the surgical bed (not shown), so recurrence was suspected. PET brain confirm the presence of high metabolic rate lesion correlate to the MRI finding.

However, the patient refuse to undergo another surgical resection. 

In 3 months duration, the patient presented with progressively increasing  headache. MRI performed which revealed an aggressive lesion. Path proven glioblastoma.

Pathology report:

Immunohistochemistry
GFAP+, P53+strongly, KI-67 high (over 25%)

Diagnosis
Glioblastoma with oligodendroglial component, WHO grade IV.

This is a high grade mixed oligoastrocytoma that shows necrosis; which should be classified as glioblastoma with oligodendroglial component, although it might have a better prognosis than standard glioblastoma.
The previous material  was reviewed and it shows low grade oligodendroglioma.

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Case Information

rID: 10699
Case created: 7th Sep 2010
Last edited: 30th Nov 2016
Inclusion in quiz mode: Included

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