Glioneuronal tumor with neuropil-like islands

• Published in: Human pathology 2000-11, Vol.31 (11), p.1435-1438
• Main Authors: Prayson, Richard A., Abramovich, Caroline M.
• Format: Article
• Language: English
• Subjects: Adult; Antigens, Nuclear; Biological and medical sciences; Brain Neoplasms - chemistry; Brain Neoplasms - pathology; Brain Neoplasms - surgery; Brain Neoplasms - therapy; Cell Nucleus - chemistry; Cell Nucleus - pathology; Female; Ganglioglioma - chemistry; Ganglioglioma - pathology; Ganglioglioma - surgery; Ganglioglioma - therapy; glial tumors; glioneuronal tumor; Humans; Immunoenzyme Techniques; Ki-67 Antigen; Medical sciences; mixed neoplasms; Neovascularization, Pathologic - pathology; Neurology; neuronal tumors; Neuropil - chemistry; Neuropil - pathology; Nuclear Proteins - analysis; Reoperation; Synaptophysin - analysis; Treatment Outcome; Tumor Suppressor Protein p53 - analysis; Tumors of the nervous system. Phacomatoses
• ISSN: 0046-8177; 1532-8392
• DOI: 10.1016/S0046-8177(00)80018-0

Mixed glioneuronal neoplasms are relatively uncommon tumors in the central nervous system. Recently, an unusual glioneuronal tumor arising in adults marked histologically by neuropil-like islands was described. We present a similar case arising in a 23-year-old woman who presented with headaches and seizures and on imaging studies was noted to have a frontal-temporal lobe mass. The patient underwent partial resection of the tumor, which histologically resembled anaplastic astrocytoma, and received a course of radiation therapy and chemotherapy. Increasing seizure frequency and expanding size on neuroimaging prompted a re-excision of the tumor. The second resection was marked by islands of tissue resembling gray matter with slightly atypical neuronal and glial cells situated in the white matter. These islands stained positively with synaptophysin and did not stain with glial fibrillary acid protein. Mild vascular proliferation and moderate nuclear pleomorphism also characterized the tumor. Areas of necrosis were not noted. A M1B-1 labeling index of 18.1% was noted. P53 inununoreactivity was observed in approximately 40% of tumor cell nuclei. This lesion is felt to represent a clinically aggressive glioneuronal neoplasm with an unusual and distinctive histologic phenotype.