Yanjun Zhang*#, Canliang Yuan*, Dequan Yu
1Department of radiotherapy, Tangdu Hospital, Affliated Hospital of Air Force Medical university, Xinsi road 169, Baqiao, Xi'an, 710038, Shann’xi, China
The authors contributed equally to this work.
Corresponding author: Yanjun Zhang, Department of radiotherapy, Tangdu Hospital, Affliated Hospital of Air Force Medical university, Xinsi road 169, Baqiao, Xi'an, 710038, Shann’xi, China; Tel.: +86-2984777613; Fax: +86-2984777613; E-mail: [email protected]
Background: It is generally accepted that gliomas rarely metastasize outside the central nervous system (CNS). However, the issue that anaplastic oligodendrogliomas is prone to spread outside CNS is being disputed again.
Methods: We described in detail the clinical case of one patient with recurrent anaplastic oligodendroglioma, which metastasized to right pelvis bones 5 years after second neurosurgical procedures. Genetic analyses included detection of 1p and 19q loss of heterozygosity (LOH) and IDH-1 mutations. A review of literature was conducted on metastatic anaplastic oligodendrogliomas.
Results: A puncture biopsy of the right ischium bone in this patient revealed that high grade glioma cells had infiltrated the right ischium marrow. Moreover, the diagnosis of multiple-bone metastases of glioma was confirmed by the whole-body [18F] fluorodeoxyglucose positron emission tomography computed tomography (PET/CT) scan. Immunohistochemisty stain analyses showed that the right ischium metastasis glioma cells originated from right parietal lobe anaplastic oligodendrogliomas. The 1p and 19q LOH and the R132H site mutation of IDH-1 were detected in the samples of the recurrence brain tumor in 2009.
Conclusions: The incidence of extracranial metastases in anaplastic oligodendrogliomas is very low but they do occur; bone metastasis may be the most common site. The molecular markers such as the 1p/19q LOH and IDH-1 mutations not only help prove the pathologic diagnosis of oligodendrogliomas, but also help elucidate a subtype of anaplastic oligodendrogliomas which has a good prognosis even with extracranial metastases.
Keywords: gliomas, anaplastic oligodendrogliomas, extracranial metastasis, 1p/19q LOH, IDH-1 mutation.